Opioid Epidemic Leaving grandparents to Raise Grandchildren

A million children now live with their grandparents primarily due to their parents’ addictions, increasingly because of opioids.

The growing opioid crisis has been declared a public health emergency. It’s sparked a parallel crisis you rarely hear about: the impact on children neglected by addicted parents. More than one million American children now live with grandparents, primarily because of their parent’s addiction to opioids and other drugs: heroin, crack, meth and alcohol. Grandparents are putting off retirement and plowing through savings to rescue their grandchildren from dangerous situations.

To see how widespread this is, we went to one of the healthiest states in the country, Utah. Tonight, we’ll introduce you to a few families around Salt Lake City, and meet children, raised in the wreckage of the opioid crisis, getting a chance at a normal life.

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The Controlled Substances Bill is Florida’s response to opioid abuse.

This website provides basic information pertaining to CS/CS/HB 21, the Controlled Substances Bill, and the upcoming changes for prescribers and dispensers. Signed by the Governor on March 19, 2018 with an effective date of July 1, 2018, the law addresses opioid abuse by establishing prescribing limits, requiring continuing education on controlled substance prescribing, expanding required use of Florida’s Prescription Drug Monitoring Program, EFORCSE, and more.

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Woman lost 2 sons in one night to opioids; fighting the crisis is now her life’s work

Everything just kind of seemed like a blur that day,” Becky Savage said. “Your mind is not really meant to process something that extreme.” The day Savage is describing is June 14, 2015.

The Indiana mom’s two oldest sons, Nick and Jack, were celebrating at high school graduation parties the night before. The boys came home about 12:30 a.m. and checked in with their mom, who had been waiting up.

The next morning, as Savage was picking up laundry in Jack’s room, she noticed that he wasn’t stirring as she tried to wake him.
“He was unresponsive. I called 911, and I remember hollering for Nick, for him to come up, and how he never came.”

Nick, her eldest son, was downstairs sleeping in the basement with friends.

The first responders arrived and tried to resuscitate Jack, and then Savage noticed one of them going downstairs to the basement.

“I had no idea at that point what they were doing in our basement. And then I remember one of them coming up and asking for a coroner. That’s the last thing that I remember that day.”

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Worried about your alcohol consumption? Sober moms share their advice

If you think alcohol may be affecting your life or serving as a crutch, it’s time to get curious about your behavior. That’s one of several tips from three women who decided to stop drinking. “I want the women who are watching to know that we are never alone. There needs to be no shame attached to this,” mother and psychotherapist Kelley Kitley told Megyn Kelly.

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Substance Abuse in Older Adults – Topic Overview

Many people think alcohol and drug abuse happen only to teens and younger adults. But all ages can have problems with drugs and alcohol, including older adults.

Older adults may use illegal drugs, use prescription or over-the-counter medicines in harmful ways, drink too much alcohol, or mix alcohol and medicines. Doing any of these can cause serious health problems and problems with money and the law. It also can harm relationships with family and friends.

Substance abuse in older adults may be overlooked, because:

Older adults are more likely to drink or use drugs at home rather than in public.
Older adults may not have duties that are affected by substance abuse, such as going to school or work.
Signs of abuse are similar to those found in health problems that many older adults have, such as depression and dementia.
Caregivers of older adults may be aware of the problem but may not want to talk about it.

Alcohol

Alcohol abuse is dangerous for all people, and it can be very dangerous for older adults. Older adults:1

  • Usually need less alcohol to become drunk (intoxicated) than someone younger.
  • Stay drunk longer, because their bodies process alcohol more slowly.
  • May have vision and hearing problems and slower reaction times. Alcohol can make these problems worse, which means alcohol-related falls, car crashes, and other kinds of accidents are more likely.
  • May be more likely to mix alcohol and medicine because they are taking so many medicines. Mixing alcohol with many over-the-counter and prescription medicines can be dangerous or even fatal.

In older adults, alcohol can trigger some health problems or make them worse. These health problems include high blood pressure, ulcers, liver disease, anxiety, sleep problems, and depression.1

Experts suggest that adults 65 and older have:1

  • No more than 1 standard drink camera.gif a day.
  • No more than 2 drinks on any drinking occasion, such as New Year’s Eve or weddings.

Some older adults should not drink alcohol. Women who are small may want to ask their doctors what amount of alcohol is safe for them.

Florida governor signs major bill to combat opioid epidemic

Florida Governor Rick Scott talks to the media at the end of the legislative session at the Florida State Capitol in Tallahassee, Fla., Sunday March 11, 2018. The ending of the legislative session in Florida is called Sine Die and is signaled with the ceremonial dropping of the handkerchief from the Florida House and Senate. Mark Wallheiser AP Photo

Gov. Rick Scott on Monday signed Florida’s opioid legislation into law, a move seen by many as a good first step in combating a crisis that has claimed at least 16 lives a day in the Sunshine State.

“What it does take is a pretty comprehensive approach to addressing the epidemic,” said Mark Fontaine, Executive Director for the Florida Alcohol and Drug Abuse Association. “It has education programs and helps control the measures for availability.”

The legislation includes tougher limits on most painkiller prescriptions, more money for treatment programs and requirements for physicians to check the state’s prescription database. The Republican governor and the state Legislature had made passing opioid legislation a priority of the recently concluded session.

Opioid-related deaths across Florida have jumped 35 percent from 2015 to 2016, according to the Florida Department of Law Enforcement. Opioids were identified as either the cause of death or were present in the deceased person’s body in 5,725 cases in 2016. The 2017 figures are still being compiled.

“I don’t think anyone wakes up in the morning with the goal of becoming an addict. This will make a big difference in reducing the number of addicts,” said Scott, who signed the bill at the Manatee County Sheriff’s Office in Bradenton.

Manatee County suffered the highest ratio of deaths in Florida in 2016 from fentanyl analogs — synthetic versions of fentanyl that can be 5,000 times more lethal than heroin.

House speaker Richard Corcoran, who attended the signing, said the measure is one of the first in Florida that attempts to combat the opioids crisis at the front end by limiting supplies and by doctors’ checks on the prescription database.

The new laws, which take effect July 1, also contains some of the nation’s toughest mandates on initial prescriptions for Schedule II painkillers such as Oxycontin and Fentanyl. The initial limit would be three days, but doctors could prescribe up to seven days for acute pain exceptions. It does not place medication limits for trauma cases, chronic pain, cancer and terminal illnesses.

Florida is the 25th state since 2016 that has passed legislation that imposes some limits or guidelines on opioid prescriptions. Only two others — Kentucky and Minnesota — have statutory limits of three or four days.

Fraser Cobbe, who represents the Florida Orthopedic Society, said doctors would have liked to see the limit extended to 10 days for surgeries not related to traumatic injuries, like hip and other joint replacements.

“The concern is major surgery was not addressed or focused on the human element,” Cobbe said.

Cobbe said his organization is putting most of its focus on informing members about the new regulations with checking the state’s prescription database as well as the requirements for doctors to complete a 2-hour continuing education course on responsibly prescribing opioids.

The state’s Prescription Drug Monitoring Program will receive a software upgrade that should make it easier to integrate into a patient’s medical file as well as making it easier to track medication history nationwide — a move designed to prevent someone near state lines from trying to doctor shop for multiple prescriptions.

There are some critics though who think the $65 million in the state budget signed by Scott last Friday does not go far enough in properly funding law enforcement and treatment programs.

Democratic gubernatorial candidate Gwen Graham said in a statement that Scott and the Legislature must join other five other states in suing drug manufacturers and hold them more accountable.

Scott’s signing came hours before President Donald Trump spoke Monday in New Hampshire about federal steps to combat opioid addiction. Florida Attorney General Pam Bondi was a member of the president’s opioid commission.

Second high intensity drug bust results in 49 arrests in Martin County

The second high intensity drug bust in Martin County yields in 49 arrests over a two day period.

According to the Martin County Sheriff’s Office, deputies focused on a busy stretch of roadway located near Highway 710 in Indiantown the first week in March.

Deputies say out of the 49 arrests, 36 resulted in felonies, and 27 were misdemeanor charges.

The interdiction effort resulted in the seizure of unique varieties of drugs moving through the area.

These drugs included:

  • 1 gram of LSD
  • Alprazolam 34 pills
  • Adderall 1 pill
  • MDMA 26 pills
  • Oxycodone 2 pills
  • LSD 1g (70-doses)
  • Cocaine 6.8g
  • Psilocybin Mushrooms 20.8g
  • Cannabis 243g

The MCSO utilized federal and regional law enforcement including the MC Special Investigations Division, narcotics detectives, K-9 and aviation units, criminal interdiction team, marine unit, warrants, criminal investigations division, uniform road patrol, corrections department, and dispatch.

Long-awaited study finds monthly Vivitrol as effective as daily pill for opioid addiction

The largest head-to-head study to date between two leading drugs to treat opioid addiction has found them roughly equivalent — an outcome that could dramatically change prescribing habits and boost the fortunes of the newer drug, Vivitrol.

The study, sponsored by the National Institute on Drug Abuse, found that a monthly shot of naltrexone (sold as Vivitrol) is as effective as its main competitor, the daily pill of buprenorphine and naloxone (sold as Suboxone). Researchers found that about half of people with opioid addiction who took either drug remained free from relapse six months later.

Previously, there’s been a “widespread belief” that patients “don’t do as well on naltrexone as they do on buprenorphine,” said Dr. Nora Volkow, director of NIDA. “We’re hopeful this changes the prejudice.”

The finding, however, comes with a major caveat. A large number of people were unable to even start treatment with Vivitrol. That’s because participants had to thoroughly wean themselves off opioids for a period of three days before they could start taking Vivitrol, to avoid sudden symptoms of opioid withdrawal. Because of that hurdle, patients failed to start on Vivitrol at four times the rate that they did Suboxone.

Vivitrol, which received Food and Drug Administration approval in 2010 for opioid treatment, is seen as attractive option because patients only have to take it once a month, and it doesn’t contain opioids. Suboxone, by contrast, has been treated with skepticism by some physicians and officials — including former Health and Human Services Secretary Tom Price — because it’s “substituting” one opioid for another. But Vivitrol, which costs about $1,000 a shot, is also much more expensive than Suboxone, and up until now has had limited evidence showing how well it works.

Addiction experts say this study, which confirms the results of a smaller head-to-head trial recently published, offer more clarity at a time where misconceptions have clouded the public’s judgment about treatments for opioid addiction.

Costs and benefits

The research was conducted between 2014 and 2017 at eight community-based inpatient treatment facilities across the U.S. A group of 570 opioid-dependent adults — the majority of whom were white men between the ages of 25 and 45 — received one of the two medication-assisted treatments.

Over the subsequent six months, researchers both solicited self-reports of opioid use as well as weekly urine samples. Participants also reported side effects and their level of opioid craving. At the end of six months, 52 percent of those who had received Vivitrol had relapsed, compared with 56 percent of those receiving Suboxone. However, 28 percent of participants assigned to Vivitrol couldn’t make it through the detox period, as compared to 6 percent of people who quit the study before initiating Suboxone dosage. Taking into account all the participants, Suboxone had a lower rate of relapse than Vivitrol.

Dr. Joshua Lee, an associate professor with New York University’s School of Medicine and a leading author of the study, which published in the Lancet on Tuesday, said the findings indicate that each drug can help certain patients, rather than one simply being better than the other.

“Both medications worked quite similarly and, therefore, both should be discussed as treatment options,” Lee told STAT. “The problem is not enough people are getting into treatment anyway, and when they do go into treatment, they don’t get any of these treatment options. Enough of the circular firing squad among the addiction treatment providers, and the war amongst all these different medications.”

But other addiction doctors said that the gap in rates of people who successfully started each treatment was an alarming sign.

“The take-home from this study is that buprenorphine [Suboxone] is more effective” than Vivitrol, said Dr. Sarah Wakeman, the medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital. She said the study confirmed what she sees at her clinical practice — that it is easier to initiate Suboxone treatment with patients, and patients stay with the treatment longer.

She also pointed out that many of the overdoses in the study occurred after detox — a phase that isn’t required if patients are given Suboxone.

Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, agreed. “Buprenorphine outperformed naltrexone, period,” he said.

The need for evidence

One charge the study does settle is that there is a lack of evidence supporting Vivitrol’s touted effects. Alkermes, which manufactures the drug, was dinged by a number of investigative reports earlier this year highlighting the company’s expansive claims about the drug’s potential to investors and its aggressive lobbying of federal lawmakers.

Alkermes did not donate drugs to this trial. But two of study’s senior authors — Lee and Dr. John Rotrosen, a psychiatry professor at NYU’s School of Medicine — had received free drugs from Alkermes for an unrelated trial. Two other researchers involved in the study disclosed receiving either research support or consulting fees from Alkermes in the past. In a statement, Alkermes CEO Richard Pops said the “data from the study reinforce the value of [medication-assisted treatment] and the distinct differences between two important options” for opioid-use disorder.

Indivior, the company that makes Suboxone, donated drugs to this trial and “had access to periodic safety data only, with no input or review of this manuscript,” according to the study.

Volkow, for her part, believes physicians should be prescribing medication out of a series of choices. For instance, Vivitrol might be a better treatment for someone in a rural area because he or she wouldn’t have to drive as frequently to a faraway clinic; chronic pain patients might respond better to Suboxone, as it blocks pain receptors.

Ultimately, Volkow feels more long-term research and development of opioid addiction treatments — including extended-release buprenorphine — is needed now to truly know what works best for patients.

“They’re not perfect — in this trial 50 percent of the patients relapsed after six months,” Volkow said. “So it behooves us to research more and develop more medications.”

OxyContin maker stops promoting opioids, cuts sales staff

OxyContin maker Purdue Pharma LP said on Saturday that it has cut its sales force in half and will stop promoting opioids to physicians, following widespread criticism of the ways that drugmakers market addictive painkillers.

The drugmaker said it will inform doctors on Monday that its sales representatives will no longer visit physician offices to discuss its opioid products. It will now have about 200 sales representatives, Purdue said.

  • The drugmaker said it will inform doctors on Monday that its sales representatives will no longer visit physician offices to discuss its opioid products.
  • Doctors with opioid-related questions will be directed to its medical affairs department.
  • Opioids were involved in more than 42,000 overdose deaths in 2016, according to the U.S. Centers for Disease Control and Prevention.

“We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” the Stamford, Connecticut-based company said in a statement.

Doctors with opioid-related questions will be directed to its medical affairs department. Its sales representatives will now focus on Symproic, a drug for treating opioid-induced constipation, and other potential non-opioid products, Purdue said.

Opioids were involved in more than 42,000 overdose deaths in 2016, according to the U.S. Centers for Disease Control and Prevention.

Among other opioid producers, Endo International Plc agreed in July to pull its Opana ER painkiller after the Food and Drug Administration called for its withdrawal.

Purdue and other drugmakers have been fighting lawsuits by states, counties and cities that have accused them of pushing addictive painkillers through deceptive marketing.

The lawsuits have generally accused Purdue of downplaying OxyContin’s addiction risk and of misleading marketing that overstated the benefits of opioids for treating chronic, rather than short-term, pain.

At least 14 states have sued privately held Purdue. Alabama Attorney General Steve Marshall filed a lawsuit on Tuesday accusing Purdue of deceptively marketing prescription opioids.

Purdue is also facing a federal investigation by the U.S. Attorney’s Office in Connecticut.

Purdue has denied the allegations in the various lawsuits. It has said its drugs are approved by the U.S. Food and Drug Administration and account for only 2 percent of all opioid prescriptions.

Purdue and three executives pleaded guilty in 2007 to federal charges related to the misbranding of OxyContin and agreed to pay $634.5 million to resolve a U.S. Justice Department probe.

That year, Purdue also reached a $19.5-million settlement with 26 states and the District of Columbia. It agreed in 2015 to pay $24 million to resolve a lawsuit by Kentucky.

U.S. President Donald Trump has drawn criticism for his response to the opioid crisis. He has yet to declare it a national emergency as he pledged to do in August following a recommendation by a presidential commission.

Major heroin, fentanyl dealers arrested in St. Lucie County, sheriff’s office says

FORT PIERCE, Fla. – The St. Lucie County Sheriff’s Office and multiple federal agencies held a news conference Friday morning to announced the results of a seven-month drug investigation,

Officials said they investigated heroin and fentanyl dealers, which resulted in more than 40 arrests.

St. Lucie County Sheriff Ken Mascara singled out four people as primary dealers: Cybil Green, her boyfriend Johnny Lewis, his son Rodney Stevens and his girlfriend Latoya Felder.

The sheriff said Green utilized her juvenile children to package drugs for sale.

They called the investigation “Operation Big Mi-steak” because the sheriff said Green was selling drugs from a Steak ‘n Shake where she worked off Okeechobee Road near the Florida Turnpike.

The sheriff’s office said the following drugs were confiscated: 50 grams of fentanyl, 4 grams of heroin, 220 grams or almost half a pound of powder cocaine, 9 grams of crack cocaine, 1 gram of Molly, 11.5 grams of crystal meth, 80 pounds of marijuana, 23 marijuana plants, 16 liquid ounces of THC oil, 1,000 milligrams of cannabis oil, 71 caplets of carfentanyl, 2 vials of testosterone, 10 Xanax pills, and various drug paraphernalia.

In addition, investigators said they seized 25 firearms.

Following the arrests of the suspected dealers, officials said they noticed a drop in overdoses in the community.