Tag: opioid

Presidential candidate Rep. Tim Ryan (D-OH) said it is reckless for President Donald Trump to tout a controversial new depression drug that works similarly to an opioid.

A state coroner has recommended a complete reframing of drug policy in New South Wales and says the government should consider decriminalising drug use. On Friday the deputy state coroner, Harriet Grahame, released findings from an inquest held into opioid-related deaths. The special inquest examined the deaths of six people from opioids in May 2016. Grahame recommended the government hold a drug summit, bringing together health, addiction, drug law reform and law enforcement experts focused on “minimising harm to users, their families and the community”. Most significantly, she said the summit should give “full and genuine consideration” to ways of reducing drug overdoses in NSW, including “decriminalising personal use of drugs, as a mechanism to reduce the harm caused by drug use”. Amid a suite of recommendations she also said the NSW health department should conduct “further research” into the use of medical cannabis for chronic non-cancer-related pain “as an overdose prevention strategy”. Grahame said the health department should consider introducing “additional venues” for the medically supervised injection of opioids. Currently there is only one injection room in NSW, in Sydney’s King’s Cross. “If the death rate continues upwards, as it has in the United States, the annual death toll could reach many thousands over the next five years.” Prohibition policies are rarely successful and are highly likely to cause harm to many in the community Harriet Grahame But it is Grahame’s comments about the wider decriminalisation of drugs that will cause most debate. “There is extensive research to support the view that prohibition policies are rarely successful and are highly likely to cause harm to many in the community,” Grahame wrote.

The online tribute to a young woman who lost her battle with opioid addiction has captured attention nationwide. The Vermont police chief who penned a response pushing for an end to this epidemic joins Stephanie Ruhle to discuss his call…

More than 70,000 people died of opioid overdoses in the U.S. last year. Now, President Trump is urging the Justice Department to sue opioid manufacturers. Ali Velshi and “Dopesick” author Beth Macy discuss whether this move would make a difference.…

Science journalist John Tierney explored “The Real War on Science” in an excellent essay in City Journal in 2016. He bemoans the “groupthink” that allows confirmation bias to infiltrate the peer review process. One of us, Rafael Fonseca, recently encountered a peer reviewed publication that asserted, and concluded by conjecture, that opioid manufacturers, by providing meals to physicians at educational presentations, were skewing prescription patterns and increasing the number of opioids being prescribed. The editors of the journal did not consider confounding covariates, which as we have shown, would make the analysis questionable. An example of how researchers “spin” their findings to comport with the prevailing narrative and increase the likelihood of publication occurred on January 17, 2018 when Jeffrey Singer encountered a story in the Los Angeles Times touting a recently published study in the peer-reviewed medical journal BMJ, in which the principal finding was that refilling opioid prescriptions given to patients for acute pain dramatically increased their risk of addiction. It began the conclusion to its abstract with: “Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naïve patients…” But what the Times reporter neglected to mention, and what the study’s authors only mentioned in passing, was the initial finding: the “total misuse rate,” i.e., rate of all opioid misuse diagnostic codes (defined separately as dependence, abuse, and overdose—a broad category within which addiction is only one component) among the 568,000 patients prescribed the opioids, was 0.6 percent. Instead of emphasizing this encouraging finding, the bulk of the study investigates the effect the duration of time a patient is on opioids—expressed principally by numbers of refills—has on the misuse rate. Rather than point out that the incidence of misuse is extremely low in patients given opioids for acute postsurgical pain, even after multiple refills, the authors chose to pass over the low overall incidence of misuse and instead focus on the “large increase in opioid misuse” seen with each refill and week of opioid use. They both fed into the prevailing narrative animating policy toward opioid use, abuse, and overdose. Both provide good examples of how researchers as well as peer reviewers fall easy prey to confirmation bias.

Good morning, As prescription opioids are blamed for fuelling a crisis that has killed thousands of Canadians, five pharmaceutical companies including Purdue Pharma have heeded a call from the federal government to stop marketing those painkillers. Purdue’s introduction of OxyContin in 1996 is seen as the root of the current crisis, as the company promoted the drug as safer and less addictive than other opioids. In February, Purdue’s parent company stopped promoting prescription painkillers in the United States, where it has previously acknowledged misleading marketing and paid more than US$600-million to settle criminal and civil charges. Ontario’s newly elected premier, Doug Ford, has already set work dismantling some of the previous government’s policies. Mr. Ford’s campaign promise to cancel cap and trade is prompting the federal government to say it’s reconsidering $400-million in funding. Francisco Valencia, the activist, has been a major voice for improving the South American country’s health-care system, which has collapsed. The Globe and Mail Editorial Board on gun crime in Toronto: “The mayor’s belief that “answers are easy” if the city just throws enough police at the problem is indicative of a failed mindset that has prevailed in Toronto for too long.” Kent Roach (The Globe and Mail) on self-defence: “We need to examine whether the 2012 changes to our self-defence laws have made it too easy for people to use guns to defend property, self and others. The CBSA says detention is used as a last resort, in situations where, for example, officers need to complete an examination, or have security concerns, or have grounds to believe the individual will not appear for an immigration proceeding. It is well past time to accept that the Supreme Court is a political institution and deal with it accordingly.” Help The Globe monitor political ads on Facebook: During an election campaign, you can expect to see a lot of political ads. The Globe and Mail wants to report on how these ads are used, but we need to see the same ads Facebook users are seeing.

The so-called institutions for mental disease, or IMD, exclusion, which since the 1970s has largely banned Medicaid funds from paying for stays IMDs, with more than 16 beds. But Congress' attempt to change it has drawn sharp criticism from some who say lifting it for treating opioid addicts could skew states toward focusing on expensive residential treatment over the continuum of care approach. Ryan also said that residential treatment needs to be looked at in terms of continuum. The IMD exclusion is a hold-over of the days when people with mental illness were kept in institutions. In the divided mental health advocacy community, some continue to worry that paring back the exclusion is a slippery slope back to institutionalizing the mentally ill. Congress has tried and failed to open up the exclusion in the past, and the Obama administration took a regulatory step in 2016 to let Medicaid to pay for stays of up to 15 days, provided they were coordinated through a managed care plan. The Trump administration has picked up where the Obama administration left off, expediting state's Medicaid 1115 waivers to fund IMD stays for opioid and substance abuse patients for 15 days each month. "If you have a psychiatric illness and have hospital care, you won't get residential SUD treatment." Then they might head to an IMD, which will focus on substance abuse treatment rather than treatment of mental illness offered by psychiatric hospitals. The focus on opioid addicts makes sense politically, Berger said, because the opioid epidemic has the country awake to addicts' need for treatment. Apart from California, states didn't have data on how many IMDs they have, where they are located, or what they cost.

Author Eric Bolling lost his 19-year-old son due to an accidental drug overdose that included opioids. He joins Morning Joe with Dr. Dave Campbell to discuss the White House opioid summit and the WH response to the crisis. » Subscribe…

President Donald Trump’s opioid commission will call Wednesday for big boosts in substance abuse treatment programs but stop short of asking for new funding that federal and state officials say is critical to pay for such programs. Chris Christie, will recommend the Trump administration increase access to addiction treatment and recovery programs, expand the availability of medication-assisted therapies and expand first responders' ability to administer the life-saving overdose reversal drug, naloxone, according to a draft of the commission’s final report obtained by POLITICO. The report also says federal funding is needed to help states share data from their prescription drug monitoring programs and recommends funding for a national media campaign that would address the stigma surrounding addiction and the danger of opioids. Advocates and policy experts say without new resources, most of the panel’s recommendations will be difficult to fully implement. “It’s great to have good ideas but you need money to implement them,” said Chuck Ingoglia, vice president of public policy at the National Council for Behavioral Health. Some advocates say it’s not the opioid commission’s responsibility, but rather Congress’s job, to sort out the funding issues. But last week, administration officials seemed to imply the White House was looking to the commission to help it come up with an appropriate request. It calls on Congress and the White House to block grant money to the states to streamline the complicated application process states currently must follow for different programs. To track funding, the commission recommended the Office of National Drug Control Policy establish a system to monitor all federally funded efforts, using HHS and SAMHSA's regional directors. But advocates say such proposals are meaningless without detailing where the funding will come from.

One painful aspect of the public debates over the opioid-addiction crisis is how much they mirror the arguments that arise from personal addiction crises. "Tough love" -- i.e., cutting off all support for my brother so he could hit rock bottom and then start over, had the best chance of success. But you know what else would happen if we legalized heroin and opioids? More people would use heroin and opioids. And the more people who use such addictive drugs, the more addicts you get. Doctors prescribed more opioids, and government subsidies made them more affordable. When you increase supply, lower costs and reduce stigma, you increase use. The overdose crisis is largely driven by the fact that once addicted to legal opioids, people seek out illegal ones -- heroin, for example -- to fend off the agony of withdrawal once they can't get, or afford, any more pills. Last year, 64,000 Americans died from overdoses. But what people forget is that drug addiction makes people irrational.