Testing It Up

Over 100 San Diego physicians registered last week to California’s Controlled Substance Utilization Review and Evaluation System (CURES) to prevent prescription drug abuse.

CURES contains more than 100 million entries of controlled substance drugs that were dispensed in California. It was designed to help doctors and pharmacies make better prescribing decisions and reduce incidents of prescription drug abuse and overdoses in the state.

The 2012 Prescription Drug Abuse Report Card found that deaths due to prescription drug overdoses in San Diego exceed the number of people dying from highway accidents, homicides, and suicides. Last year, prescription drugs were involved in the deaths of 267 San Diegans — a 27 percent increase from 2007. Overdoses were either as a result of abuse or accidental. The prescription medications killing the most people were Methadone, Oxycodone, Valium, Hydrocodone, Morphine, and Xanax.

With CURES, however, registered health care providers would be able to care and help patients who may be abusing controlled substances.

“When a physician sees there’s an abusive pattern or addictive pattern, they will be able to refer those patients into some type of a treatment program for one of the issues they have, which is addiction. They may have an underlying health issue, that needs to be looked at also,” Tom Lenox, supervisory special agent of the Drug Enforcement Administration, told KPBS.

The National Institutes of Health estimated that there are more than 1 million people in the United States who are addicted to prescription pain relievers. But ironically, only a few Americans consider chronic pain as a major health concern.

According to a new national public opinion poll commissioned by Research!America, 63 percent of Americans reported knowing someone who uses prescription medicines to treat chronic pain conditions but only 18 percent believed chronic pain is a major health problem. Instead, the majority of the polled participants are more concerned about the misuse of pain relievers.

Of the 1,016 people surveyed last month,  82 percent believed taking prescription painkillers for long-term, chronic pain could lead to addiction, which almost 50 percent described as a major health problem. Moreover, 85 percent were very concerned or somewhat concerned that prescription pain medication can be abused or misused.

“We need to better understand addiction,” Research!America President and CEO Mary Woolley, said in a news release. “We shouldn’t shy away from research on new pain treatments based on fears of abuse. The suffering is simply too great. More robust investment in research and the engagement and support of policy makers and health care providers are essential to developing effective strategies to reduce the prevalence of addiction.”

The poll also found more than 65 percent of the respondents were not aware that tamper- and abuse-resistant formulations for some prescription pain medications are now available. And while 52 percent reported that physicians tend to dismiss chronic pain, 54 percent of the surveyed Americans said doctors were not discussing the possibility of developing dependence or addiction to pain medication enough with their patients.

Based on their experience or what they have heard, 64 percent said they would use physical therapy to relieve chronic pain; 55 percent would resort to OTC drugs; 54 percent would rather resort to diet or lifestyle change; 49 percent would seek the help of a chiropractor; and 47 percent would go for prescription pain medication.

The recent arrest of a Salt Lake City court judge has shed light on the severity of Utah’s prescription drug abuse problem.

According to Deseret News, Judge Virginia Bauskett Ward was apprehended on Monday for receiving a package of 338 oxycodone pills mailed via the UPS from Las Vegas. The Drug Enforcement Agency said the 45-year-old court judge was to deliver the pills to someone else, but it did not say whether she was abusing the medication, as well as distributing it.

Utah has one of the worse prescription drug abuse problems in the nation, and state police and doctors treating substance abuse patients are aware of the growing dilemma. The 2012 Utah Division of Substance Abuse and Mental Health report showed an average of 12 Utahns die each month from prescription opioid abuse. Since 2000, the number of deaths due to overdose of pain medication has risen to more than 400 percent, the report found.

“It’s a big problem here in the state of Utah. I’d say we are up near the top in the country, and that’s unusual for substance abuse,” said Dr. Glen Hanson, director of the Utah Addiction Center at the University of Utah. “For almost every other drug of abuse, whether it’s tobacco, or alcohol, or cocaine, or heroin, we’re usually way down near the lowest in the country.”

Michael Crookston, medical director of the Dayspring treatment programs for chemical dependence at LDS Hospital, said the prevalence of prescription drug abuse in the state has led to more overdose deaths. In fact, more than the number of deaths caused by highway accidents.

Crookston added that even though OxyContin abuse had decreased in recent years, oxycodone abuse has risen.

“(Oxycodone) is a very addicting drug. Its widely prescribed for pain, and some people become addicted,” Crookston said. “It’s a good pain medication for the right person. But some people do become addicted to it and lose control.”

A few years ago drug manufacturers altered the formulation of OxyContin to prevent addicts from crushing and abusing it but that move prompted drug addicts to shift their attention to other substances, such as oxycodone and heroin. From 2011 to 2012, the number of people admitted for substance abuse in public treatment facilities in Utah climbed to more than 700, the report noted.

Law enforcement officials have said the trade and abuse of prescription drugs among Grand Forks-area youth is getting way out of hand.

Detective Travis Jacobson, of the Grand Forks Police Department, noted that they receive a report of prescription drug abuse “at least once or twice every couple of weeks.” He told INFORUM that this past fall, the number of arrests or reports related to prescription drugs was the highest that he’s seen in his 12 years with the department.

Kids trade pills for marijuana, favors, gas money or other pills. Some students with attention deficit hyperactivity disorder (ADHD) sell or trade Adderall they get from their pharmacists to other kids in order to fit in. There are prescription drugs, like hydrocodone, that have become so common that students describe them as free, the article notes.

“I’m guessing that for everyone who’s actually caught with an illicit drug like marijuana or meth, there are probably 10 cases that have to do with prescription pills,” Jacobson said.

Although prescription drug abuse tends to be more prevalent among high school students, some college students were found to use mind-enhancing drugs to keep up with the demands of school.

Jacobson and Jane Croeker, University of North Dakota’s health and wellness promotion director, are aware that some female students at UND do use Adderall to help them stay up longer to study or suppress their appetite, though many of these students know that abusing prescription medications isn’t a good idea.

In addition to prescription drugs abuse, law enforcement officials are also seeing an increase in heroin use. People who are having difficulty obtaining pills are turning to heroin because it’s cheaper.

Following a long battle against rampant methamphetamine abuse, officials from the western part of the country have a new enemy to fight in the form of painkiller abuse.

The Wall Street Journal reports that the epidemic of painkiller abuse which is gripping the Southern and Eastern U.S. has made a move on the western states and officials are unprepared for the invasion.

According to the 2010-11 survey released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in January, Oregon, Colorado, Washington and Idaho were among the western states that have the highest rates of prescription drug abuse in the nation.

The SAMHSA report said 6.5 percent of Oregon residents aged 12 and older abuse opioid painkillers, compared with the 4.5 percent of residents who abused similar drugs in Kentucky.

Elisha Figueroa, Idaho’s drug policy administrator, said she started noticing that prescription drug abuse was becoming pervasive in the state about two years ago. At this point, they are “just in the beginning stages of grasping the full magnitude of this issue.”

In Colorado, hospital admissions due to opioids rose to 7 percent of all visits in 2012, compared to 2.5 percent in 2004. But the state’s task force still has its eyes on tackling meth abuse. Colorado’s Attorney General  John W. Suthers said lawmakers will begin exploring freeing up resources this year to address painkiller abuse.

Arizona, which ranked 6th in the SAMSHSA survey, has yet to establish a unified strategy that would combat the problem, though officials had launched pilot programs last year aimed at educating physicians in three counties about safely prescribing painkillers.

In Oregon, data shows painkiller overdose increased from 218 in 2004 to 378 in 2011. Over a year ago, the state introduced a program to monitor and track painkiller prescriptions.

The Legislative Building at Carson City, Nevada was packed with people on March 6 to hear the testimony on a bill that would allow patients addicted to prescription drugs to sue the physician who prescribed the medication and the drug’s maker.

SB75, sponsored by Sen. Tick Segerblom (D-Las Vegas), seeks to create liability for anyone licensed to prescribe drugs, such as physicians and dentists, as well as the drug’s manufacturer if a patient becomes addicted or experiences injury resulting from an addiction to the drug. State-run medical marijuana dispensaries could likewise be held liable if a user gets addicted to pot. If a patient wins the lawsuit, the defendant would have to shoulder the patient’s rehabilitation treatment, as well as pay possible punitive damages and attorney’s fees, The Associated Press reports.

“They know the person can get addicted to the drug so they should pay for the process of them getting off it,” said Sen. Segerblom, who was present at the legislative hearing.

However, the senator’s proposal was strongly opposed, particularly by health care professionals. Las Vegas physician David Johnson said the legislation “ties the hands of physicians and takes away the rights of patients to choose which risk to assume while seeking treatment for their diseases.”

James Marx, a pain management specialist in Las Vegas, shared an anecdote about one of his patients who suffers from severe disfigurement and has been on painkillers for 15 years. “Without Methadone, her life would be a living hell,” Marx argued. “I can’t imagine anyone with expertise in chronic pain management was consulted in the drafting of this bill.”

Although Segerblom expressed skepticism over claims that prescription drugs are the only solution in managing chronic pains, he said the state has to “create a better way to control and regulate” medicines if they are truly the only way to treat certain diseases.

The committee has not yet reached any decision on the measure. It wasn’t clear when the next discussion for the bill will be held.

Kentucky officials continue to tinker with their campaign against prescription drug abuse, which they started last year. Officials now want a few changes in their existing prescription drug law that would benefit those who are not prescription drug abusers.

Gov. Steve Beshear and some leaders of the House and Senate have joined forces in pushing for legislation that would exempt patients in hospitals, nursing homes, and hospice centers from rules intended to make it more difficult for addicts to get painkillers, The Associated Press reports.

Under the state’s current law, medical professionals are required to check their patients’ drug histories using the state’s electronic drug tracking system — Kentucky All Schedule Prescription Electronic Reporting (KASPER) — before writing a prescription. But a little leniency for certain patients may soon apply if HB 217 clears the senate.

According to the Courier-Journal, the legislation is proposing patients in hospitals and long-term care facilities to be exempted from some prescription regulations. Physical and mental examinations would only be required “as appropriate to the patient’s medical complaints,” rather than in each case when a controlled substance is prescribed. Additionally, surgery patients would have a 14-day exemption period to receive pain medication related to the procedure. The changes are aimed at accommodating patients who are clearly not drug abusers or traffickers.

“This issue is about Kentucky and the health of Kentucky and the safety of Kentucky and the very lives of Kentuckians,” Beshear said.

Green Day lead vocalist Billie Joe Armstrong opens up about his years of alcohol and prescription drug abuse in the latest issue of Rolling Stone magazine.

The 41-year-old rock musician said: “I couldn’t predict where I was going to end up at the end of the night. I’d wake up in a strange house on a couch. I wouldn’t remember how. It was a complete blackout.”

Armstrong realized it was time for him to seek professional help following a September 2012 incident at the iHeartRadio festival in Las Vegas where he angrily smashed his guitar after the band was told to wrap up their set.

“I remember tiny things,” Armstrong said. “The next morning, I woke up. I asked [my wife] Adrienne, ‘How bad was it?’ She said, ‘It’s bad.’ I called my manager. He said, ‘You’re getting on a plane, going back to Oakland and going into rehab immediately.’”

In October, the group canceled the rest of their 2012 tour dates for their album trilogy ¡Uno!, ¡Dos!, ¡Tre!. But by late December they announced that they were ready to hit the road again, with a fully-packed schedule beginning in March. Armstrong has issued a statement through his Instagram account thanking fans for their support in the previous tumultuous months and promising them that the show must go on.

The full Rolling Stone interview will be available when the issue hits news stands on Friday.

Ritalin and Adderall can be effective treatment for attention deficit/hyperactivity disorder (ADHD) when used as directed. But when misused, these ADHD stimulant medications can cause adverse symptoms, such as nervousness, insomnia, dizziness, and cardiovascular or psychiatric problems.

According to The Drug Abuse Warning Network (DAWN) released by the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of emergency room visits involving attention deficit/hyperactivity disorder (ADHD) stimulant medications between 2005 and 2010 increased from 13,379 to 31,244. In 2010, non-medical use of ADHD medications accounted for half of all emergency department visits involving ADHD medications.

From 5,212 in 2005, emergency room visits related to non-medical use of ADHD medications nearly tripled at 15,585 in 2010. The rate of increase occurred among those aged 18 and older.

The report also showed the differences in the rates of emergency room visits related to the non-medical use of ADHD medications between males and females. In 2005, 3,770 of these emergency department visits involved males compared to 1,439 involving females. By 2011, 8,650 of these visits involved men while 6,932 involved females.

“ADHD medications, when properly prescribed and used, can be of enormous benefit to those suffering from ADHD, but like any other medication they can pose serious risks – particularly when they are misused,” SAMHSA Administrator Pamela S. Hyde said in a news release. “This study indicates that a better job has to be done alerting all segments of society – not just the young – that misuse of these medications is extremely dangerous.”

Mayor Michael R. Bloomberg announced on Jan. 10 at Elmhurst Hospital in Queens the new opioid emergency department prescription guidelines for the City’s public hospitals.

The guidelines state that emergency departments will not prescribe long-acting opioid painkillers, such as extended-release oxycodone, fentanyl patches or methadone; can only prescribe up to a three-day supply of opioids; and will not refill lost, stolen or destroyed prescriptions.

According to City officials, the new policy is designed to reduce prescription abuse and overdose by encouraging judicious prescribing, patient education, referral to primary care and treatment for substance abuse when needed.

“Prescription painkillers can provide life-changing relief for people in dire health situations, but they can be extremely dangerous if used or prescribed improperly,” Mayor Bloomberg said in a news release. “Working with health care providers and public health criminal justice experts our task force is providing the tools to fight a burgeoning epidemic while protecting legitimate health care needs.”

A report from the Mayor’s office highlights the rising cases of emergency room visits and overdose deaths in New York City due to prescription drug misuse. Between 2008-2009, more than 260,000 New Yorkers aged 12 and older reported misuse of opioid medications. In 2010, prescription painkillers were involved in 173 unintentional overdose deaths in New York City, a 30 percent increase from 2005.

City health officials, however, were quick to point that the new guidelines would not apply to patients who need prescriptions for cancer pain or palliative care.