Opioids Play Larger Role in Midterm Campaign Ads

So far in 2018, ads containing opioid messaging have aired more than 50,000 times across 25 states. At this point in 2014, there had been only one political TV ad touching on the topic that aired 70 times—in Kentucky’s Senate race.

The opioid crisis has grown from an afterthought in political campaigns to an important issue in some of this fall’s biggest midterm races, according to television advertising data from Kantar Media/CMAG. A Wall Street Journal analysis found that, so far in 2018, ads containing opioid messaging have aired more than 50,000 times across 25 states. At this point in 2014, there had been only one political TV ad touching on the topic that aired 70 times—in Kentucky’s Senate race. Opioids aren’t so widely discussed in this year’s ads as some issues—ads discussing the drugs make up only 3 percent of total TV advertisements, lagging behind immigration and gun control. Still, the analysis shows how ads have begun to mimic the spread of the crisis.

The ads’ messages include promising more funds for treatment and stopping the inflow of opioids from elsewhere. The jump in ads lifts the opioid issue from near obscurity to a potent, nationwide political topic. The map of ad purchases shows a role for the issue in states with closely contested U.S. Senate and gubernatorial races such as Florida, Missouri, Wisconsin and West Virginia. In Ohio and Pennsylvania, House candidates have aired thousands of ads. Florida is running a lot of ads but has a lower rate of overdose deaths than many other states. States including Wisconsin, Missouri and Pennsylvania are also heavy on opioid ads but aren’t among the states hardest hit by the epidemic. Each of those states has seen a rise of more than 50 percent in opioid overdoses between 2012 and 2016. While both parties have taken up the issue, Republican ads have been more likely to mention it. That’s been particularly true in Ohio and Pennsylvania, two states that have seen the biggest jumps in overdoses.

from https://thecrimereport.org

‘Drug Llama’ Charged With Shipping 50,000 Fentanyl Pills

Melissa Scanlan, a San Diego woman known to her dark web customers as “The Drug Llama,” has been arrested on accusations of shipping more than 50,000 fentanyl pills throughout the U.S.

A San Diego woman known to her dark web customers as “The Drug Llama” has been arrested on accusations of shipping more than 50,000 fentanyl pills throughout the U.S., the San Diego Union-Tribune reports. While the charges against Melissa Scanlan, 31, stem from a federal grand jury indictment in Illinois, she also is being investigated in connection with two overdose deaths closer to home. Scanlan is suspected of selling fentanyl that killed a 10-month-old boy and a woman in San Diego County, in separate instances last September. In one case, Scanlan is suspected of selling fentanyl to a father, who then allegedly left the drugs within reach of his infant. The baby was found unresponsive in bed with his parents. The second overdose victim was a 41-year-old woman.

Fentanyl is a synthetic heroin that has invaded the nation’s drug supply because it is cheap to make, easy to procure and extremely potent — up to 50 times stronger than heroin. It is extremely deadly, especially if a user is not accustomed to its strength or takes a concentrated dose. A fatal dose of pure fentanyl can be the equivalent of a pinch of salt. The fentanyl in this case was smuggled from Mexico, sold via the dark web and shipped in the mail — all tactics that have been commonly used to distribute the drug to customers in the U.S. in recent years as the demand for opioids has exploded. Between April and July, agents purchased nine items from “The Drug Llama” on the dark web’s hottest underground marketplace, known as Dream Market. Her specialty was fentanyl pills, called “pressed blues,” where were disguised as oxycodone and stamped with “M30.”

from https://thecrimereport.org

Senate Passes 70-Provision Bill on Opioid Epidemic

Federal funding to combat the opioid epidemic has risen as the crisis has worsened. The spending bill passed in March included $4.7 billion to fight the crisis, including $1 billion for grants for states. Lawmakers are on track to approve $3.8 billion for next year.

The Senate on Monday passed sweeping, bipartisan legislation aimed at combating the opioid epidemic through research, treatment and help for families affected by addiction. The bill, which includes more than 70 provisions, passed with a 99-1 vote. Sen. Mike Lee (R-UT) voted no, the Wall Street Journal reports  To become law, the package needs to be reconciled with a measure passed by the House in June and signed by President Trump. One section from Sen. Orrin Hatch (R-UT) prompts physicians to discuss pain-management alternatives for those who use Medicare. Nearly one in three who use Medicare’s Part D prescription plan received a prescription opioid in 2017. The Senate would give money to the National Institutes of Health to research a nonaddictive painkiller. It would try to stop synthetic drugs from being shipped across the border by requiring foreign shippers to provide electronic data to help U.S. officials target illegal packages.

Federal funding to combat the opioid epidemic has risen as the crisis has worsened. The spending bill passed in March included $4.7 billion to fight the crisis, including $1 billion for grants for states. Lawmakers are on track to approve $3.8 billion for next year. U.S. overdose deaths from all drugs soared to more than 72,000 in 2017, a record, according the Centers for Disease Control and Prevention. That compares with 66,000 deaths in 2016. The report shows how much deadlier opioid drugs have become, with the largest number of deaths traced to synthetic opioids such as fentanyl. The data show a slight decline in deaths in the last month of 2017 and January 2018. “I recognize these provisions are just a start, but we are losing 116 lives every day. And we need to save as many as we can—as soon as we can,” said Sen. Gary Peters (D-MI).

from https://thecrimereport.org

One in 11 Students Have Used Pot in E-Cigarettes

The number is worrying “because cannabis use among youth can adversely affect learning and memory and may impair later academic achievement and education,” said researcher Katrina Trivers of the Centers for Disease Control and Prevention.

A school survey shows nearly 1 in 11 U.S. students have used marijuana in electronic cigarettes, heightening concern about the popularity of vaping among teens, the Associated Press reports. E-cigarettes typically contain nicotine; results published Monday mean 2.1 million middle and high school students have used them to get high. The devices are considered a less dangerous alternative to regular cigarettes, despite little research on their long-term effects including whether they help smokers quit. The rise in teenagers using them has alarmed health officials. Last week, the Food and Drug Administration gave the five largest e-cigarette makers 60 days to produce plans to stop underage use of their products.

Nearly 9 percent of students surveyed in 2016 said they used an e-cigarette device with marijuana, according to the report in the journal JAMA Pediatrics. That included one-third of those who ever used e-cigarettes. The number is worrying “because cannabis use among youth can adversely affect learning and memory and may impair later academic achievement and education,” said researcher Katrina Trivers of the Centers for Disease Control and Prevention. It’s unclear whether marijuana vaping is increasing among teens or holding steady. The devices have grown into a multi-billion industry, but they are relatively new. “The health risks of vaping reside not only in the vaping devices, but in the social environment that comes with it,” said University of Michigan researcher Richard Miech. Kids who vape are more likely to become known as drug users and make friends with drug users, he said, adding that “hanging out with drug users is a substantial risk factor for future drug use.”

from https://thecrimereport.org

Is Fentanyl Deadly to the Touch?

Despite recent “scare” stories, there’s no evidence that simply touching fentanyl can lead to overdoses. No one disputes that it’s a dangerous drug, but unsupported fears about the effects of exposure could make first responders less willing to help individuals who are overdosing, writes TCR’s columnist on addiction issues. Meanwhile AP reports on a new test strip that can help heroin users detect fentanyl.

Fentanyl—the synthetic opioid that was responsible for up to 40 percent of the deaths by drug overdose in 2017—is routinely described as 50 times stronger than heroin. Government health officials and law enforcement have warned that it is so deadly that even touching it is enough to cause an overdose.

Over the past several months there have been a number of news stories which appear to back up the warning. In Ohio last month, for example, corrections officials announced 28 people (23 guards, four nurses and one inmate) at the Ross Correctional Institution in Chillicothe had fallen ill after exposure to a substance believed to be fentanyl. Pennsylvania corrections authorities were investigating similar incidents.

Fentanyl is far stronger than heroin or prescription opioids—such as Vicodin, OxyContin, and Percocet, which so often lead to heroin and fentanyl abuse or a stint at a rehab for opiate addiction—but is it really so deadly that a contact high can kill you?

No.

If you remember earlier exaggerations of the toxicity and addictiveness of other drugs such as crack cocaine, or the ease of transmission for diseases such as AIDS and HIV, you know that even well-meaning people can get it wrong and that parties with an interest in fear-mongering can deliberately mislead.

(For example, during the “War of the Currents,” Thomas Edison tried to discourage people from adopting AC electricity over his own far less efficient DC electricity by using AC to electrocute animals, as if to say, “See how dangerous AC is?”)

As bad as fentanyl is, it also has become a scapegoat. Whenever there is a rash of drug overdoses, fentanyl is suspected. In just July and August:

  • Dozens of users of the synthetic marijuana drug K2 overdosed in a New Haven park. Authorities said it might have been laced with fentanyl since administering the opioid antagonist Narcan (which most authorities say has no effect on K2 overdoses) seemed to reverse the ODs. (Later analysis found no evidence of fentanyl.)
  • Prisons in Ohio and Pennsylvania (see above) were on lock-down in late August for drug overdoses that may have affected non-users, too, perhaps by skin contact. (One prison attributed it to exposure to a fine white powder later determined to be heroin mixed with fentanyl; the cause of the other overdoses is still unknown.)
  • The U.S. government released a seven-minute video and guidelines detailing safety precautions for law enforcement on the proper handling of fentanyl encountered in the course of their jobs, involving gloves, protective eyewear, and respiratory masks.

Fentanyl is deadly, especially when you don’t know that you are taking it.

Musicians Prince and Tom Petty likely didn’t know what they were taking. Drug dealers often substitute it for other, less powerful opioids, because it is cheaper and because it is easier to smuggle a significant quantity, even through the US mail. However, its potency also makes it difficult for drug dealers to measure properly, so a fatal overdose is far more likely.

There have been reports of K-9 unit dogs that have overdosed just from stepping on fentanyl as well as getting it on their noses and mouths, maybe in their eyes. Special canine first aid kits have been created; Narcan works with dogs, too.

Adding to the danger: police officers haven’t been trained in how to tell if a dog is overdosing. Each dog reacts differently to fentanyl, depending on its personality, temperament, and metabolism. Some become more excited, some become lethargic.

And because they have 20 times the tolerance for opioids as humans, if they do have a reaction, there’s a lot of fentanyl around.

Even so, there’s little evidence that fentanyl is quite that deadly. Junkies and addicts don’t get high by touching fentanyl or heroin because skin is not a good conduit for drugs to enter the bloodstream. (unless you apply an alcohol-based hand sanitizer that can facilitate skin absorption; it took a lot of work to create a transdermal patch for fentanyl that worked.)

Some people in the field dispute this and suggest researchers are using medical-grade fentanyl, which is harder to absorb than the street-quality fentanyl encountered by law enforcement.

Also arguing against the toxicity of touching fentanyl is the dearth of evidence. Fentanyl is used by medical doctors and veterinarians (it’s one of the World Health Organization’s essential medicines), but as a group, they haven’t reported a slew of accidental overdoses. Large numbers of OD deaths of drug dealers while preparing fentanyl for sale or distribution haven’t manifested either.

That doesn’t make fentanyl safe, just safer than its reputation.

The risk to law enforcement, human and canine, is not so much with getting fentanyl on their hands but rather where we put our hands afterward—the nose, mouth, and eyes—as well as accidentally breathing in or swallowing loose fentanyl specks in the air.

Researchers have determined that we touch our faces every two to five minutes, which gives bacteria and germs access to our eyes, nose, and mouth, all gateways to our insides where we are most vulnerable. These are also places where fentanyl can enter our bloodstream and make us high or potentially overdose.

According to Jeremy Faust, an instructor at Harvard Medical School and an emergency room physician, he has never seen or heard of an OD by skin contact alone with documented evidence such a blood or urine test.

In the absence of evidence, exaggerating the lethality of fentanyl will make first responders overly cautious, less likely or less willing to come into contact with people overdosing.

Whatever they said earlier, the Centers for Disease Control and Prevention, The American College of Medical Toxicology and the American Academy of Clinical Toxicology all now agree that for emergency first responders, the risk of overdosing merely from attending to someone who has taken fentanyl is “extremely low.”

The Drug Enforcement Agency and the White House also agree now that “brief occupational skin exposures to fentanyl and its other potent opioid analogs pose no clinical threat to anyone.”

Not that there’s no risk, but it lies in breathing in fentanyl, accidentally getting it in your mouth–not touching it.

In July 2018, a PhD in neuroscience and pharmacology shot video of a former opioid user touching a large quantity of verified fentanyl to show it had no immediate ill effects.

But while there’s no proof of the opposite, scare stories carry weight with the general public, even among first responders. The so-called “nocebo” effect can make people feel ill without cause like the placebo effect makes you feel good without cause.

Stephen Bitsoli

Stephen Bitsoli

In the early days of AIDS, people worried you could catch the sexually transmitted disease from patients by shaking their hands. The media, always looking for a sensational story, ran with it.

Fentanyl is deadly for its users—by the number of overdoses, half-again as deadly as prescription opioids and twice as deadly as heroin—but with reasonable precautions, it should be safe for law enforcement and EMS to do their jobs without unreasonable fear.

In related news, the Associated Press reports on the newest tool in the fight against opioid overdoses:   an inexpensive test strip that can help heroin users detect fentanyl.

Stephen Bitsoli, a Michigan-based freelancer, writes about addiction, politics and related matters for several blogs. He welcomes readers’ comments.

from https://thecrimereport.org

CA Chiefs Warn Against Home Pot Deliveries

As California considers a proposal to allow marijuana businesses to send home-delivery vans into places where retail stores are prohibited, police chiefs are preparing for the worst. “This will make it easier and more lucrative to rob a delivery person than a liquor store,” said David Swing, president of the California Police Chiefs Association.

The prospect of vans loaded with pot delivering to homes in the upscale San Jose, Ca., suburb of Morgan Hill makes Police Chief David Swing uneasy. Like most cities in the state, Morgan Hill has banned pot shops. As California considers a proposal to allow marijuana businesses to send home-delivery vans into places where retail stores are prohibited, Swing and others in law enforcement say they are preparing for the worst, the Los Angeles Times reports. “This will make it easier and more lucrative to rob a delivery person than a liquor store,” said Swing, president of the California Police Chiefs Association. Noting that drivers would be allowed to carry up to $10,000 in cash, he says, “Robberies are the tip of the iceberg. They can lead to other crimes, including aggravated assaults and homicides.”

Law enforcement leaders and city officials statewide have lined up to oppose the delivery proposal under consideration by California Bureau of Cannabis Control chief Lori Ajax. They were among the thousands of people who packed three public hearings recently held by the bureau on new marijuana regulations. The League of California Cities, which represents the state’s 482 municipalities, has joined with the police chiefs in a campaign to kill the delivery proposal. The groups have set up a website, StopWanderingWeed.com, asking Californians to “protect our children and schools” by signing a petition to oppose the rule change. It features a cartoon showing schoolchildren reacting gleefully to the arrival of a delivery van with a marijuana leaf on its side. The United Food and Commercial Workers union, which represents many of the state’s cannabis industry employees, put up Facebook ads opposing the proposal. The group sees deliveries as a threat to legal pot shops.

from https://thecrimereport.org

Rural Jails Grapple With Opioid Epidemic’s ‘Revolving Door’

One of the biggest barriers to fighting the spreading opioid epidemic in rural northeast Washington is the lack of providers authorized to prescribe  drugs for treating opioid dependence. That’s why local jails need support for providing medication-assisted treatment, says a local doctor.

In 2013, Dr. Barry Bacon saw two problems: an area overrun with opioid addiction, and a revolving local county jail door that sweeps addicts in as quickly as it shoves them out.

The now-60-year-old Spokane, Wa., physician, along with another doctor who worked in the  jail in Stevens County in northeastern Washington state, hatched a plan to offer people treatment while they’re locked up.

“Ninety-five percent of people in the jail were dealing with an opioid addiction at some point and the fallout from a life out of control,” Bacon says, anecdotally. “Options [for treatment] were limited, and we were basically just punishing people for dealing with addiction.”

Bacon’s efforts to use what’s known as medication-assisted treatment — where patients are prescribed one of three drugs approved by the FDA to treat opioid dependence — is part of a national conversation about how to address the opioid epidemic.

Along with a behavioral health counselor, Bacon started volunteering his time seeing Stevens County inmates in Colville, Wa., offering to start them on Suboxone, which contains the drug buprenorphine and is considered by many experts as the standard of care for opioid addiction.

After about a year, Bacon says nine out of the 19 people he’d started treating were doing “measurably better.” They were no longer taking illegal drugs. They were moving their lives forward in work, school, housing and familial relationships, he says — what he considers a major success.

But by 2015, Bacon had to stop prescribing to new patients in the jail. He was maxed out on the number of people he could legally prescribe Suboxone to, he says. (To prevent abuse, doctors are limited on the number of patients they can prescribe these drugs to.) Bacon continued to treat those patients until 2017 when he resigned from his job as a physician in Northeast Washington Health Programs and moved out of Stevens County for personal reasons.

The problem was, few other physicians in the area were authorized to prescribe the drug, he says. Due to a lack of money, knowledge or willingness of health providers, or some combination of the three, Bacon says he could no longer continue seeing patients in Stevens County.

“I was treating more people in Colville than all of Stevens County combined,” he says. “Patients were scrambling. Some bailed and said, ‘I guess I’ll just wean myself off.'”

Bacon believes the biggest barriers in rural northeast Washington, which extend to the jails in that area, are the lack of providers authorized to prescribe the drugs as well as those willing to become authorized.

Studies show that treating people with methadone or buprenorphine before they’re released from incarceration, and connecting them with services in the community afterward, increases the likelihood they’ll continue treatment and reduces the risk of death after release. Drug treatment behind bars has also been shown to reduce crime, recidivism and the cost to taxpayers.

Now, five years after Bacon began treating people in the Stevens County Jail, three corrections officials in those northeast rural counties say people addicted to opioids continue to cycle through their jail doors. Bacon aims to work with providers and jails in Ferry, Stevens and Pend Oreille counties to begin prescribing Suboxone again.

“I recognized how important this was and how few are doing it in rural areas,” Bacon says. “It’s really good medicine, and not just the drug, but in terms of restoring lives to sanity.”

There are approximately 47,700 Washingtonians addicted to opioids, according research from University of Washington professors Marc Stern and Lucinda Grande. More than half of those people, about 25,500, will exit the doors of a Washington jail this year, Stern and Grande estimate.

“The numbers showed us that the jails are the epicenter of the opioid crisis,” Stern says. “So in some ways, the jail is unfortunately the perfect place to address this problem. It’s where you can change behaviors and turn someone’s life around.”

Stern and Grande’s research — a survey of 33 jails across the state, of various locations and sizes — shows a “high level of interest” for medication-assisted treatment among jail administrators. A lack of resources, as in doctors legally authorized to prescribe the drugs, and in money available in jails’ budgets to pay for them, as well as gaps in knowledge, were among the biggest barriers, Stern says.

For example, “some [jail officials] were not aware that patients can die from complications such as dehydration due to vomiting and diarrhea, or suicide due to distress from opioid withdrawal symptoms,” he writes in the report.

Fourteen of the 33 jails surveyed offer at least one of the three drugs approved to treat opioid dependence, the most common being buprenorphine (one of the active drugs in Suboxone).

None of the smaller facilities included in the survey (average population of less than 50 people) offered medication-assisted treatment.

“It’s the smaller places that are really challenged in resources and knowledge,” Stern says. “It’s disproportionately harder to provide good health care in a small jail.”

The Washington State Opioid Response Plan calls for “jails and prisons to initiate and/or maintain incarcerated persons on medications for opioid use disorder.”

This year, the state has applied for a federal grant worth about $21 million to increase access to medication for opioid treatment in jails and the community generally, says Charissa Fotinos, deputy chief medical officer for the state Health Care Authority.

“Many jails in the state are interested in starting people on medication-assisted treatment or continuing it,” Fotinos says. “One challenge jails have had is the medication is expensive. People’s Medicaid is suspended, and jails don’t have a way to pay for buprenorphine.”

She adds that one of the state’s priorities is to target people released from jails and prisons “because they’re at the highest risk for a fatal opioid overdose.”

Additionally, the American Civil Liberties Union of Washington is suing Whatcom County on the west side over its refusal to offer this treatment to jail inmates. A decision in favor of the ACLU would be “groundbreaking” and could set a statewide precedent, ACLU spokesman Doug Honig says.

The need for opioid treatment in three of Eastern Washington’s northern rural counties is apparent to those who watch the jail population cycle in and out of custody.

Although none of the jail facilities in Ferry, Stevens or Pend Oreille counties currently track how many people pass through their doors struggling with opioid dependence, there are some general indicators.

For example, felony drug charges filed in Stevens County, with a population of about 43,700 people, shot up from 35 in 2013 to 131 in 2017. As of June, prosecutors had already filed 50 felony drug cases, though not every charge involves opioids. For the tri-county area that includes Ferry and Pend Oreille, 33 percent of all criminal charges filed in 2017 involved drugs.

Additionally, the opioid prescription rate for those counties — 106, 97 and 104 respectively per 1,000 people — is significantly higher than the statewide rate of 77.

Consider the Ferry County Jail, a 45-bed facility in Republic, as an example. Both the jail’s superintendent, Shawn Davis, and the Ferry County prosecutor, Kathryn Burke, agree that drug addiction and the crime that comes with it are significant issues.

But there are currently no providers in Ferry County who can prescribe buprenorphine or methadone, Davis says.

“The population of locals in the jail is growing due to drug charges and the heroin epidemic,” he says. “We typically have one or two people on a rolling basis that require that attention or treatment.”

Beyond the logistical barrier, Davis says he is concerned about inmates potentially abusing or selling their drugs to others, which is a common objection from jail administrators across the country. But, he says, if someone comes into the facility with a prescription, the jail is required to provide the appropriate medication. Short of that, inmates can be left to go cold turkey or are taken to the hospital.

“It’s hard to prevent prescription drugs from being smuggled back into the population,” Davis says. “Inmates will swallow hydros, for example, go back to their room and throw them up and hand them off. It’s amazing what people are willing to do to get some kind of high when they’re addicted.”

Davis says he is generally not supportive of medication-assisted treatment, which he believes is essentially trading one addiction for another.

Additionally, Ferry County’s therapeutic drug court specifically restricts participants from taking drugs such as buprenorphine and methadone, Burke says. Generally, drug courts are carrot-and-stick alternatives to traditional prosecution where participants agree to complete court-ordered drug treatment, and in exchange their charges can be dismissed.

However, Burke acknowledges that “some people probably really do need it, so if we had the ability to do it in our jail, I wouldn’t oppose it.”

For Bacon, the lack of providers in Ferry County is precisely why a medication-assisted treatment program is high priority.

An essential piece of that work, Bacon says, will be connecting people with services and resources after they’re released from jail.

Throughout Washington, there is a patchwork of medication-assisted treatment in jails — from Spokane County’s methadone program, to Ferry County’s complete lack of providers, to Whatcom County’s refusal to provide such treatment to Island County’s full-tilt support. In Spokane, eight people have died in the jail since June 2017, including one woman on Aug. 25. Several of the deaths are suspected to be drug related.

Last week, the Spokane County medical examiners ruled that one of the eight people, 52-year-old David Good, died after choking on his own vomit and that “opiate and methamphetamine intoxication” played a role. Jail medical staff had directed that Good be checked every 15 minutes. But 32 minutes passed from a guard’s last check and the time Good was found not breathing, according to internal records.

In Island County, located north of Seattle, before the jail started prescribing Suboxone, inmates were transported two counties away to receive opioid treatment, Chief Jail Administrator Jose Briones says.

“We have a captivated audience, and we can put them through treatment rather than warehouse them and set them on the same track they were on before,” Briones says. “We’re not going to have people suffering through withdrawals in our facility.”

Briones adds that Island County’s drug court does not exclude people who take buprenorphine or methadone.

He acknowledges that his budget for medication spiked from $8,000 to about $20,000 in the past two years, as counties typically take on the medical expenses for people in their custody. But, he says, “with modern corrections, it’s the right thing to do. The transportation was an issue and it’s expensive, but with the direction we’re taking our facility, we want to do evidence-based treatment.”

Island County started its treatment program in March of this year and is collecting data to gauge its effectiveness, Briones says. It’s too early to draw any conclusions, but similar programs elsewhere in the U.S. have shown success.

In Rhode Island, for example, where the state prison and jail systems are combined, a preliminary review of the treatment program shows post-release overdose deaths plummeted by 61 percent.

Aside from the life-saving potential, Stern, the UW professor, points to data from the Washington State Institute for Public Policy showing that drug treatment in prisons, and in the community after a person is released, have huge cost-saving impacts.

Additionally, a 2006 report from WSIPP shows that in-custody drug treatment can reduce crime by 5.7 percent and save nearly $8,000 per patient, when considering damage to crime victims, benefits to taxpayers and the cost of providing the treatment.

“For a moment, you have your hands on 50 percent of the opioid dependent people in the state at a time when they’re malleable,” Stern says, emphasizing that the most effective treatment includes a plan after a person is released.

“If you invest money in this problem, including outside the jail, you can actually make your money back.”

Mitch Ryals is a 2018 John Jay Rural Justice Reporting Fellow. This story was originally published in The Inlander. Readers’ comments are welcome.

from https://thecrimereport.org

Should Purdue Pharma Profit From Opioid Antitodes?

Purdue Pharma has been accused of helping cause the opioid epidemic, including in a new Colorado case. Now the firm’s former chairman, Richard Sackler, is being criticized for patenting an opioid that eases withdrawal symptoms.

After hundreds of lawsuits against pharmaceutical giant Purdue Pharma, Colorado’s attorney general is suing the OxyContin creator for its “significant role in causing the opioid epidemic,” the Washington Post reports.

The lawsuit claims Purdue Pharma deluded doctors and patients in Colorado about the potential for addiction with prescription opioids and continued to push the drugs.

“Purdue’s habit-forming medications coupled with their reckless marketing have robbed children of their parents, families of their sons and daughters, and destroyed the lives of our friends, neighbors, and co-workers,” Colorado Attorney General Cynthia Coffman said Thursday in a statement.

“While no amount of money can bring back loved ones, it can compensate for the enormous costs brought about by Purdue’s intentional misconduct,” he continued.

In 2016, there were more than 63,000 drug overdose deaths in United States, and more than 66 percent of them were attributed to opioids, according to the most recent data from the Centers for Disease Control and Prevention.

The CDC states that both illegal opioids and prescription opioids, which are commonly used to treat pain, have been associated with addiction, overdoses and death.

The company “vigorously” denied the accusations.

It comes amid news that the company’s former chairman and president, Richard Sackler, has patented a new drug to help wean addicts from opioids.

Three top current and former employees for Purdue pleaded guilty to federal criminal charges in 2007, admitting that they had falsely led doctors and their patients to believe that OxyContin was less likely to be abused than other drugs in its class. Now, a new business venture is adding to the outcry.

The Financial Times reported that Sackler, whose family owns Purdue Pharma, a multibillion-dollar company, patented a new drug this year that is a form of buprenorphine, a mild opioid that is used to ease withdrawal symptoms.

Some are expressing outrage that the Sacklers, who have in essence profited from opioid addictions, may soon be profiting from the antidote.

“It’s reprehensible what Purdue Pharma has done to our public health,” said Luke Nasta, director of Camelot, a New York-based treatment center for drug and alcohol addiction. He told the Financial Times that the Sackler family “shouldn’t be allowed to peddle any more synthetic opiates — and that includes opioid substitutes.”

from https://thecrimereport.org

The Evidence on Safe Injection Sites is Mixed

As drug-related deaths rise to record numbers, at least a dozen U.S. cities may open supervised injection sites, where people can use illicit drugs with trained staff present, ready to respond in case of an overdose. Scientific studies on such facilities have produced mixed results.

As drug-related deaths rise to record numbers, at least a dozen U.S. cities may open supervised injection sites, where people can use illicit drugs with trained staff present, ready to respond in case of an overdose, NPR reports. The future of such proposals is uncertain. A California bill that would greenlight a pilot injection site in San Francisco awaits the governor’s signature, but the U.S. Justice Department has vowed to crack down on any such site. Critics say supervised injection sites encourage drug use and bring crime to surrounding areas. Proponents argue that they save lives and can help addicts reconnect with society and get health services.

At least 100 supervised injection sites operate around the world, mainly in Europe, Canada and Australia. Peter Davidson of the University of California San Diego says research points to the benefits, especially in preventing deaths among society’s most vulnerable. No death has been reported in an injection site. A 2014 review of 75 studies concluded such places promote safer injections, reduce overdoses and increase access to health services. Supervised injection sites were associated with less outdoor drug use, and they did not appear to have negative impacts on crime or drug use. In another review in the International Journal of Drug Policy, criminologists from the University of South Wales found that the evidence for supervised injection is not so strong as previously thought. Only eight studies met the researchers’ standards for high quality design. Of those, the findings on the effectiveness of supervised injection were uncertain, with no effect on overdose mortality or needle sharing. “Nobody should be looking at this literature making confident conclusions in either direction,” says Keith Humphreys, an addiction researcher and psychiatry professor at Stanford University.

from https://thecrimereport.org

Vote Possible Next Week on Senate Opioid Package

The measure would reauthorize the Office of National Drug Control Policy. States could get a total of $500 million a year through 2021 for grants created under the 21st Century Cures Act to combat drug addiction.

Senators reached a deal on a bipartisan package to address the opioid crisis, paving the way for a vote next week, reports Politico. The agreement comes after weeks of negotiations between lawmakers over provisions like requiring Medicaid to cover treatment at more inpatient facilities and loosening privacy restrictions for substance-abuse patients’ medical records. Neither provision made it into the final deal, but they are part of an opioid response package passed by the House this year. Sen. Lamar Alexander (R-TN) led negotiations.

The deal would authorize new funding for states to fight drug addiction, expand access to medication-assisted treatment, grant the National Institutes of Health more authority to research and develop non-opioid pain therapies and require the U.S. Postal Service to crack down on shipments of illicit fentanyl. It would also reauthorize the Office of National Drug Control Policy. States would get a total of $500 million a year through 2021 for grants created under the 21st Century Cures Act to combat drug addiction. The bill would also create new comprehensive opioid recovery centers offering an array of treatment services, and it would require the Department of Health and Human Services to develop guidelines for recovery housing, which is unregulated. The bill would require HHS and the Department of Justice to conduct a study on the effect that federal and state opioid prescribing limits have had on patients — and specifically whether such limits are associated with higher suicide rates. A number of issues need to be reconciled in conference, such as the House-passed easing of privacy protections and the costly provision to require Medicaid coverage for substance abuse treatment in larger inpatient centers.

from https://thecrimereport.org