This Week's News in Substance Use: 9/22/17

Jess Keefe

The Latest Obamacare Repeal Bill Doesn’t Include Opioid Funding Once Deemed Critical , The Daily Beast

“Gary Mendell, who leads the anti-addiction group Shatterproof, said Graham-Cassidy hits Americans struggling with addiction harder that the Senate’s previous efforts to repeal Obamacare.

“‘This bill further betrays promises to address the epidemic and it would endanger the lives of millions of Americans fighting to overcome opioid addiction,’ Mendell told The Daily Beast. ‘Instead of using the opioid epidemic as a talking point, they need to go back to the drawing board and come up with actual solutions.’

“Other supporters of Graham-Cassidy have acknowledged that it would leave certain states with more limited resources to both treat their Medicaid population and, more specifically, the opioid crisis. But they argued that bill was worth passing anyway because of the other reforms it would make to the federal health care system, and because of procedural limitations confronting the chamber.”

CVS Health Moves to Limit Access to Opioid Painkillers , The Wall Street Journal

“One of the largest managers of pharmaceutical benefits in the U.S. says it will start limiting the duration and dose of some prescriptions for opioid painkillers, in an effort to combat widespread addiction.

“CVS Health Corp., which administers drug benefits for employers, insurers and some state Medicaid programs, said it would limit opioid prescriptions to seven days or less for certain patients with acute pain who haven’t previously taken an opioid painkiller. That will be a big change, given that many CVS-covered patients with acute pain receive opioid prescriptions for 20 days or more, Troyen Brennan, CVS’s chief medical officer, said in an interview.

“CVS will also limit patients with chronic pain to a maximum daily dose of 90 morphine milligram equivalents, or MMEs, a standard unit of measure in pain medicine, Dr. Brennan said.”

FDA Warns On Mixing Opioid Addiction Treatments, Other Meds , Associated Press

“The Food and Drug Administration issued new warnings Wednesday about the dangers of combining medication for opioid addiction with anti-anxiety medicines and other drugs that also slow breathing and brain activity. The FDA warned that mixing such drugs can cause difficulty breathing, coma or death, so it should be done with caution.

“The agency said a growing number of people fighting opioid addiction with methadone or buprenorphine also take other prescription drugs that slow action of the central nervous system. The warning lists several dozen brand-name and generic drugs that could be risky, including Ambien and Lunesta for insomnia, Valium and Xanax for anxiety, muscle relaxers Soma and Zanaflex and antipsychotic drugs Abilify, Invega, Saphris and others.

“The agency stressed that treating opioid addiction with medication can outweigh those risks and is crucial to curbing the U.S. opioid epidemic, along with counseling, rehabilitation and other support.”

‘The Pills Are Everywhere’: How The Opioid Crisis Claims Its Youngest Victims, The New York Times

“At the children’s hospital in Dayton, Ohio, accidental ingestions have more than doubled, to some 200 intoxications a year, with tiny bodies found laced by drugs like fentanyl. In Milwaukee, eight children have died of opioid poisoning since late 2015, all from legal substances like methadone and oxycodone. In Salt Lake City, one emergency doctor recently revived four overdosing toddlers in a night, a phenomenon she called both new and alarming.

“’It’s a cancer,’ said Mauria Leydsman, Penny’s grandmother, of the nation’s opioid problem, ‘with tendrils that are going everywhere.’

“While these deaths represent a small fraction of the epidemic’s toll, they are an indication of how deeply the American addiction crisis has cut.”

41 States to Investigate Pharmaceutical Companies Over Opioids , NPR

“The attorneys general of 41 U.S. states said Tuesday that they're banding together to investigate the makers and distributors of powerful opioid painkillers that have, over the past decade, led to a spike in opiate addictions and overdose deaths.

“The coalition issued subpoenas seeking information from opioid manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceuticals and Allergan, as well as additional subpoenas to Purdue Pharma. In addition, the group is demanding documents from distribution companies AmerisourceBergen, Cardinal Health and McKesson.

“’Our subpoenas and letters seek to uncover whether or not there was deception involved, if manufacturers misled doctors and patients about the efficacy and addictive power of these drugs,’ New York Attorney General Eric Schneiderman said during his press conference announcing the investigation. ‘We will examine their marketing practices both to the medical community and the public.’”

America’s Opioid Problem Is So Bad It’s Cutting into U.S. Life Expectancy , The Washington Post

“On Tuesday, researchers from the Centers for Disease Control and Prevention published an analysis showing the crisis has actually negatively impacted life expectancy in the United States.

“Seven researchers contributed to the analysis, which was published in the Journal of the American Medical Association. The contributors crunched the numbers recorded by the National Vital Statistics System Mortality file, a storehouse of death data from all 50 states and the District of Columbia, from between 2000 to 2015.

“It found that the average American life expectancy grew overall from 2000 to 2015, but that the astounding rise in opioid-related deaths shaved 2.5 months off this improvement.”

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Fixing the broken treatment system starts now

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