This Week's News in Substance Use: 10/13/17

As Overdose Deaths Pile Up, A Medical Examiner Quits the Morgue , New York Times

“In the state morgue here, in the industrial maze of a hospital basement, Dr. Thomas A. Andrew was slicing through the lung of a 36-year-old woman when white foam seeped out onto the autopsy table.

“Foam in the lungs is a sign of acute intoxication caused by an opioid. So is a swollen brain, which she also had. But Dr. Andrew, the chief medical examiner of New Hampshire, would not be certain of the cause of death until he could rule out other causes, like a brain aneurysm or foul play, and until after the woman’s blood tests had come back.

“With the nation snared in what the government says is the worst drug epidemic in its history, routine autopsies like this one, which take more than two hours, are overtaxing medical examiners everywhere.”

A Veteran New York Litigator Is Taking On Opioid Makers. They Have a History , STAT News

“The tip came from the doctors. Patients on painkillers were becoming addicted to opioids, even though they said they were taking them as prescribed. To Paul Hanly, it had the makings of his next big case. On the hunt for patients, his law firm started advertising, and in 2003, it filed its first suits against Purdue Pharma, the maker of OxyContin.

“Four years later, with Hanly representing 5,000 pain patients, something unusual happened. Purdue settled. It is one of the few instances — maybe the only one, experts say — in which a drug maker agreed to pay individual patients who alleged that it had underplayed the addiction risk of its medications. A decade later, the smooth, stylish Hanly has again set his sights on opioid manufacturers, this time on behalf of cities and counties in five states.”

How the VA Fueled the National Opioid Crisis and Is Killing Thousands of Veterans , Newsweek

“The estimated number of drug deaths in 2016 topped the total number of soldiers killed in the Iraq and Vietnam wars. There’s a grim irony in that statistic, because the Department of Veterans Affairs has played a little-discussed role in fueling the opioid epidemic that is killing civilians and veterans alike. In 2011, veterans were twice as likely to die from accidental opioid overdoses as non-veterans. One reason, as an exhaustive Newsweek investigation—based on this reporter's book, Mental Health, Inc.—found, is that for over a decade, the VA recklessly overprescribed opiates and psychiatric medications. Since mid-2012, though, it has swung dangerously in the other direction, ordering a drastic cutback of opioids for chronic pain patients, but it is bungling that program and again putting veterans at risk.”

The Bronx’s Quiet, Brutal War with Opioids , New York Times

“The bodies turn up in public restrooms, in parks and under bridges, skin tone ashen or shades of blue. The deceased can go undiscovered, sometimes for hours, or days if they were alone when they injected heroin and overdosed.

“Terrell Jones, a longtime resident of the Bronx, was pointing to the locations where overdoses occurred as he drove through the East Tremont neighborhood, the car passing small convenience stores, rowhouses and schools.”

Synthetic Opioids Are Driving an Overdose Crisis , PBS NewsHour

“What’s driving [the narcotic-related] higher mortality rate is a drug called fentanyl. It’s a synthetic opioid that’s roughly 50 to 100 times more potent than morphine. It was found in about 80 percent of autopsies the state did on overdose victims earlier this year.”

A Generation at Risk: Children at Center of America’s Opioid Crisis , NBC News

“At 14, Tori Brinkman is a survivor.Born premature, 15 weeks early and weighing just a pound and half, she spent the first three months of life in a neonatal intensive care unit. And her struggle had just begun.

“Tori recalls being 8 when her mother asked her to carry out a drug deal. When she was 11, her uncle, whom she describes as a father figure, died of a heroin overdose. Left to fend for herself, Tori says she did not even see a dentist or primary care physician — despite her fragile birth — until she was 10.

“Her mother, a [person in recovery from heroin addiction], has been [in recovery] now for three years, but Tori lives with her grandparents.”

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