Secret trove reveals Abbott’s bold ‘crusade’ to sell OxyContin

Internal documents obtained by STAT show the lengths to which Abbott Laboratories went to hook in doctors and make OxyContin a billion-dollar blockbuster.

Secret trove reveals Abbott’s bold ‘crusade’ to sell OxyContin

This! Gawdayumit! This!

No one should ever speak of addressing the opioid crisis without focusing on THIS!!!

The Suboxone Problem No One is Talking About | Hazelden Betty Ford Foundation

A majority of halfway and recovery houses refuse to accept people that are on buprenorphine. As a result, people in early recovery are often faced with the decision to either: stay on buprenorphine and be homeless or live in a dangerous environment; or, rapidly or immediately quit buprenorphine in order to live in a safe environment and be accepted in the rooms.

The Suboxone Problem No One is Talking About | Hazelden Betty Ford Foundation

Suboxone prolongs and deepens [as opposed to curing or alleviating] the addiction, but still, this should not be happening to people trying to do well by themselves.

So You Thought You Could Get Off Suboxone? 

Why is there no official medical protocol to detox addicts off of Suboxone? The Fix goes to the pharmaceutical companies for answers.

It’s jarring to see a press release referring to opiate addiction as a high competition market for pharmaceutical companies. That, however, is the case, and the heart of the issue when it comes to understanding why Big Pharma enthusiastically went after the market in 2002.

…In the United States accurate data is also hard to come by. WHO estimates the number of opiate addicts (including heroin) to be two million. Figures from The National Alliance of Advocates for Buprenorphine Treatment (NAABT) puts that figure at 5.5 million. …The Center For Disease Control (CDC) reports opioid analgesic consumption increased 300% between 1999 and 2010, and death rates for poisoning involving opioid analgesics more than tripled between 2000 and 2010. 

[In 2013] Suboxone had sales of $1.2 billion. …To give this sum context, Suboxone revenue is three times that of Super Bowl advertiser/provocateur Go Daddy. …In the U.S. more revenue was generated by Suboxone sales than the entire digital music download business. 

…Some patients who have been prescribed the drug decide they want to discontinue it. The reasons vary, ranging from financial pressures arising out of the cost of doctor visits and medication to side effects, potential future side effects and finally, the patient who wants to be 100% drug free.

The medication’s long half-life combined with its tight adhesion to opiate receptors makes tapering particularly difficult. From anecdotal reports, the least disruptive way to achieve a Suboxone-free life is to cut down the amount used very slowly week by week until titration is complete.

This scenario is complicated by two facts:

  • The lowest strength Suboxone comes in is 2 mg. (”Jumping” from a 2 mg dose can be a drawn out and debilitating process that takes months to recover from);
  • RBP warns against cutting Suboxone strips into smaller amounts, and maintains that the medication is not equally distributed in the preparation.

If you ask the doctor who has been prescribing you the drug for months or years, you may find him/her woefully lacking in experience or a plan for tapering.

…While there are lower strength formulations of buprenorphine on the market (that would make tapering a more simple and accurate process) they are created for pain management and are illegal to prescribe to recovering addicts. Physicians routinely prescribe medications for “off label” use, but there are many laws directed towards prescribers of buprenorphine and they have serious repercussions. A doctor could lose his/her license for prescribing a Butrans patch to help taper a patient off of Suboxone.

Getting certified to prescribe buprenorphine is remarkably easy. It requires completion of one eight hour online course. The amount of time in the course agenda dedicated to taking patients off off the drug is nil. No doctor I spoke with recalled the topic of withdrawal from Suboxone being mentioned during the certification process.

So You Thought You Could Get Off Suboxone? | The Fix – Page 0

The article has a bit of a paranoid bent to it but still, fascinating stuff.

 

Is Suboxone a Wonder Drug that Helps Heroin Addicts Get Clean–Or Just Another A Transference of the Underlying Addiction?

The experience of detoxing left Chris with mixed feelings about Suboxone. “On the one hand, it is a good thing,” he says. “It keeps people from stealing and robbing and overdosing. But it really just masks the issue: the addiction. From heroin withdrawals, you move onto Suboxone, and then you have to go through those withdrawals. It’s something that’s going to happen, but a lot of us choose to prolong it.

“In the longer term, he adds, the drug also made him feel “like total shit.”

“My girl always says I couldn’t even formulate sentences,” he explains. “I was not articulate. I couldn’t fuck her, excuse my language. I was just totally like a zombie. And then my feet were constantly uncomfortable. I couldn’t sleep without it. My eyeballs would turn into like these huge dishes, big pupils like Mickey Mouse.”

To his dismay, Chris realized that he initially felt even worse when trying to pull back on the Suboxone than when he experienced heroin withdrawal. “You’re exhausted for a very long time. It takes forever to get out of your system,” he says.

“On the other hand,” Bisaga adds, “you do hear the stories of the pharmaceutical industry pushing people to stay on as much medication as possible. Depending on where you stand in this conversation, you can hear arguments on both sides. We rely on science and effective treatments, and we’d like patients to make informed decisions on their future.”

….Saltzman says some of her patients are, for all practical purposes, on the drug permanently, but she doesn’t encourage it. “I don’t like that idea. It’s not a healthy way to live,” she says. “To me it speaks to someone not wanting to look at themselves.”

Is Suboxone a Wonder Drug that Helps Heroin Addicts Get Clean–Or Just Another Way to Stay High? | Village Voice

hmmmm

Dying To Be Free – The Huffington Post

To enter the drug treatment system, such as it is, requires a leap of faith. The system operates largely unmoved by the findings of medical science. Peer-reviewed data and evidence-based practices do not govern how rehabilitation facilities work. There are very few reassuring medical degrees adorning their walls. Opiates, cocaine and alcohol each affect the brain in different ways, yet drug treatment facilities generally do not distinguish between the addictions. In their one-size-fits-all approach, heroin addicts are treated like any other addicts. And with roughly 90 percent of facilities grounded in the principle of abstinence, that means heroin addicts are systematically denied access to Suboxone and other synthetic opioids.

…While medical schools in the U.S. mostly ignore addictive diseases, the majority of front-line treatment workers, the study found, are low-skilled and poorly trained, incapable of providing the bare minimum of medical care. These same workers also tend to be opposed to overhauling the system. As the study pointed out, they remain loyal to “intervention techniques that employ confrontation and coercion — techniques that contradict evidence-based practice.”

…Chrysalis House …has more success than most, with about a 40 percent dropout rate, administrators said, but among those who complete the program, roughly half will relapse within a year. Many, if not all, had previous treatment stays.

…What addicts face is a revolving door, an ongoing cycle of waiting for treatment, getting treatment, dropping out, relapsing and then waiting and returning for more.

…The squeeze of regulation has left the door open for more opportunistic forces, such as cash-only clinics and shady doctors. A vibrant black market has sprung up. 

…Even for doctors trained in addiction medicine — motivated to treat opioid addicts with buprenorphine and able to work within Medicaid’s numerical limits — there are still roadblocks. Kentucky’s Medicaid program, like those of many other states, requires prior authorization before it agrees to pay for the medication. One managed care organization mandates such authorization every month. And negotiations, Kalfas said, can take an illogical turn: Medicaid has tried to deny payment for Suboxone if a patient has failed a drug test while it has also used clean tests to deny payment. Why pay for Suboxone for a drug-free patient?

…Addicts going outside Medicaid face potentially prohibitive costs. At Droege House, a publicly subsidized detox center in Northern Kentucky operated by Transitions, Inc., addicts must pay $410 up front if they want Suboxone and additional fees depending on whether they enroll in an outpatient or a residential program. It can end up costing them thousands of dollars. Laura Duke, who was recently the detox unit’s supervisor, said the cost put the medication out of reach for all but 1 to 2 percent of the addicts she saw.

Dying To Be Free – The Huffington Post

hmmmm

Jeanne Shaheen on the Opioid Crisis – at the DNC

(Keep in mind, while she reels off the number of deaths, that entire population of the state is somewhere around 1.3 million.)

A solid assessment of the crisis, Senator.

I would add that many treatment centers shift the addiction to methadone, which is not a permanent fix. If an addict doesn’t have access to a daily doses they have to rely on illegal drugs again.

We need to investigate and offer non-opioid treatments for opiate addiction.

I would also add that so many of these stories of heroin and other opiod addiction/overdose stories start with medically-prescribed, heavy doses of opiod based drugs.

We need to cut that pipeline off and make not-addictive pain killer options available from the get-go.

(Pssst, I’m referring to medical MJ,ladies…)

America’s debilitating addiction to the War on Drugs 

Nixon’s domestic-policy adviser, John Ehrlichman, …revealed the true aim of the Drug War was to criminalize the administration’s “two enemies: the anti-war left and black people.”

…More than $1 trillion later, Nixon’s war has hollowed out urban black communities, [and] visited death upon downtrodden whites in rural America.

…Despite strides toward a more sane national drug policy, the deeper infrastructure of the War on Drugs remains fundamentally unaltered under Obama. Work focused on public health has not replaced paramilitary anti-trafficking efforts, known as interdiction, at home or abroad.

…Obama even carried over George W. Bush’s DEA chief, Michele Leonhart, who would refuse to admit, under House grilling in 2012, that marijuana is a less dangerous drug than crack cocaine.

…Despite the carnage, prohibitionist policies enforced through military interdiction and domestic incarceration have done little to curb the American drug habit. …[The Government Accountability Office] found that “none of the goals” of the Obama drug strategy have been met.

…On any given day in America, nearly 470,000 people are behind bars for drug offenses. That represents a fifth of the total incarcerated population of 2.2 million. …Nearly a quarter of the roughly 744,000 Americans now in jail – 184,000, according to the Sentencing Project – are locked up for drugs.

….For taxpayers, the Drug War imposes huge costs: nearly $55 billion a year. Harvard economist Jeffrey Miron …found state enforcement of drug prohibition – accounting for cops, judges, jails and prisons – costs more than $25 billion a year, with more than $5 billion spent fighting pot.

…As a result, the Drug War is costing taxpayers more than ever. Obama’s 2017 drug budget seeks $31 billion, an increase of 25 percent from when he took office.

Why America Can’t Quit the Drug War | Rolling Stone

Grrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

Prescription addiction: Doctors created the problem

We have a long way to go. Instead of safer pain therapeutics, patients are now being offered expensive new medications that only treat the consequences of the opioid epidemic. With 259 million opioid prescriptions being written yearly, it turns out side effects — such as constipation — are a big enough business to warrant its own Super Bowl commercial.

Unintended consequences: Painkiller pills to heroin
There are other grim signs. We now know that heroin has made a resurgence and 80% of new heroin users start off using pain pills, which contain the same type of base ingredients.

Prescription addiction: Doctors must lead us out – CNN.com

sigh…

Neuroscientist And Former Addict Explains What We Get Wrong About Addiction

I know what scientists are looking at when they say addiction is a disease. I don’t dispute the findings, but I dispute the interpretation of them. They see addiction as a chronic brain disease — that’s how they define it in very explicit terms. My training is in emotional and personality development. I see addiction as a developmental process.

What I emphasize is that the disease label makes it worse. You have experts saying, “You have a chronic brain disease and you need to get it treated. Why don’t you come here and spend $100,000 and we’ll help you treat it?” There’s a very strong motivation from the family, if not the individual, to go through this process, and then the treatments offered in these places are very seldom evidence-based, and the success rates are low. 

Neuroscientist And Former Addict Explains What We Get Wrong About Addiction

hmmmm

NYU Study Finds 3/4 of High School Heroin Users Started with Prescription Opioids 

Nonmedical use of prescription opioids (a.k.a.: pain-killers, narcotics) such as Vicodin, Percocet, and Oxycontin has become increasingly problematic in recent years with increases nation-wide in overdoses, hospital treatment admissions, and deaths. Use also appears to be contributing to heroin initiation, which has increased in recent years, as the demographics of users are shifting. Those previously at low risk — women, whites, and individuals of higher income — are now using at unprecedented rates.

NYU Study Finds 3/4 of High School Heroin Users Started with Prescription Opioids – ScienceNewsline

No shit, Sherlock? Connect the dots people!!!

Portugal Cut Addiction Rates in Half by Connecting Drug Users With Communities 

Fifteen years ago, the Portuguese had one of the worst drug problems in Europe. So they decriminalized drugs, took money out of prisons, put it into holistic rehabilitation, and found that human connection is the antidote to addiction.

Portugal Cut Addiction Rates in Half by Connecting Drug Users With Communities Instead of Jailing Them by Johann Hari — YES! Magazine

hmmmm