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Erin L. Winstanley, Ph.D.

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People Are Dying of Drug Overdoses, Despite Lifesaving Medications

Posted: 05/11/2012 8:57 am

For the first time in 83 years, people in the United States are more likely to die of drug poisoning than in a motor vehicle accident. The national prescription painkiller epidemic is largely to blame for this shift, and approximately 41 people in the United States die every day of a drug overdose involving prescription painkillers. Communities have been struggling to deal with not only the mortality associated with this epidemic, but also the increase in crime related to prescription drug trafficking and the rapidly-increasing number of patients needing substance abuse treatment.

The national response to the prescription drug epidemic up until now has focused on education of health care providers and the public; tracking, monitoring, and appropriate disposal of prescription medications; and law enforcement. All of these strategies focus on preventing new incidence of prescription drug misuse, however, they do not offer solutions for people that have already become addicted to these medications. There are an estimated 2 million new nonmedical users of painkillers every year, so it is clearly important to prevent new incidence of prescription drug misuse. However, our response needs to include services for the 1.9 million people that need treatment for painkiller addiction now.

The most proximal intervention to prevent painkiller (opioid) overdose deaths is to administer, either intravenously or intranasal, naloxone, an FDA-approved medication with well-established efficacy and safety. Naloxone, also known as Narcan, is available with a prescription and can be administered to reverse an opioid or heroin overdose -- potentially preventing a fatality. However, very few people seem to be aware of naloxone, and it's unclear how many states require paramedics or first-responders to carry it.

Naloxone is a safe and easy-to-administer drug; even non-medical people can administer it with minimal training. This is important because people, even uninvolved bystanders, who witness a drug overdose may be reluctant to call 911, fearing legal consequences such as arrest on possession charges. Furthermore, emergency responders may not arrive in time to reverse the overdose -- which is more likely to happen in rural areas that have higher rates of painkiller overdose deaths. A pilot naloxone program in Massachusetts estimated that 1,000 overdoses were reversed over a period of four years. Preliminary data from Project Lazarus in North Carolina found that their overdose prevention program reduced the death rate by 38 percent in Wilkes County. There are approximately 188 overdose prevention programs in the United States that are distributing naloxone to drug users and their family members, but this does not seem to be proportionate to the magnitude of the epidemic. To make matters worse, many of the states with the highest rates of overdose deaths have no naloxone distribution programs.

Earlier this month, the FDA held a public workgroup on expanding access to naloxone. The overwhelming consensus among the attendees was that access should be expanded nationally. It's unclear how or when this will happen, however, because the regulatory barriers to making this medication available over-the-counter are formidable. There is only one naloxone distributor in the United States, and existing programs are reporting problems getting naloxone. The most heart-breaking part of the FDA public workgroup was hearing testimony from parents who wished they knew about naloxone before their children died of observed overdoses.

In order to reduce overdose deaths, we need to increase public awareness and access to naloxone. But undermining our efforts to prevent overdose deaths is a much larger philosophical problem -- the wide-spread belief that medications should not be used to treat addiction despite the overwhelming scientific evidence supporting their safety and effectiveness. Patients treated with FDA-approved medications for opioid addiction are less likely to relapse or die. We have waged a war against drugs instead of formulating a science-based response to a public health epidemic for which a life-saving medication is available.

Our national response to the prescription drug epidemic should reflect our understanding of addiction as a chronic relapsing brain disease, and the fact that patients can recover when they receive evidence-based treatment. Addiction is a medical problem, not a criminal problem or moral failing. Health care providers and patients should be making treatment decisions together, able to consider both psychosocial and medication treatment options that best support patients' recovery.

For more by Erin L. Winstanley, Ph.D., click here.

For more on addiction and recovery, click here.

 

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07:43 PM on 05/16/2012
IGNORANCE about information content is. the incompetency of people running around in white coats prescribing drugs is the main fact if you genuinely want the truth to be told. they are over medicating with toxins and destroying the 2nd 1st most important organ in ones body, liver! the liver then begins to tear down the heart outputing toxins. yes, the liver speaks to the heart... Chinese Medicine 101! = 35% DIET!
3.) supplements! Aging is a condition, don't care what anyone says. It is a condition as youth is. When the body begins to age is looses sooooooooooooooo many important hormones, minerals, etc... it is IMPERATIVE to help your BRILLIANT machine recalibrate as far back to youth as possible. that's where your supplements come in. ANYONE over the age of 40 MUST take a minimum of 19 -21 supplements every day if not every other day with a break 1 day a week. in TANDEM one must take at least 1 if not 2 days a week whereby one FASTS and allow your BRILLIANT machine to find stasis. people under the age of 40 can do well just taking 10 proven supplements/day, predominantly endogenous! = 10%!
07:43 PM on 05/16/2012
If one wishes to live a long-term healthy life one MUST:
1.) have a positive consciousness - at its core! = 50%
2.) eat well! no it doesn't have to be organic... it has to be as natural as possible and reduce the carbs to a minimum and step-up the protein. (don't give a dam what the MDs and Nutritionist say)! research has proven that 'fat'...animal fat is NOT the culprit to 'Dis Eases'.
07:42 PM on 05/16/2012
The so-call life saving medication is why people are dying. Synthetics do NOT do anything to secure long-term health or optimal quality of living no matter how the pharmaceutical industry and the FDA spin. TOXINS are TOXINS! Just as sugar is sugar! Sweet-n-low is worse than regular sugar. The body is unable to tell the difference.
01:28 PM on 05/14/2012
The give out these mind altering drugs like they are candy. The Pharamceuticals should pay dearly for this.
12:56 PM on 05/14/2012
My father overdosed on heroin in April 2009. I don't know if this drug could have saved his life or not, but it saddens to me know there was a possibility of saving his life and that if he'd access he could still be alive. I had never heard of this and really hope that this can save peoples lives.
12:21 PM on 05/16/2012
Im sorry for your loss.
12:36 AM on 05/14/2012
My child didn't make it. He died of heroin overdose. He could have been saved by Naloxone/Narcan. Those are three facts that are incontrovertible. Naloxone/Narcan has but ONE purpose - it reverses opiod overdose. It does not encourage drug usuage. Believe me no one addicted to opioids became addicted because there is an antidote drug - and no one continues to do drugs because there is an antidote drug. I was a clueless parent. Now I am a parent whose child is gone forever but who NOW has the knowledge of how I might have helped him (recognizing overdose signs, rescue breathing & Naloxone injection or nasal spray). I could save you or your child but it's too late to save my son. My recommendation to anyone who has a child, friend or family member who has the disease of addiction is to make it your Top Priority to become educated and reach out to the Harm Reduction Community for accurate information and access to this life-saving drug. Where to start? Go to this site, type in your city and zip and get connected to the only people out there who'll give you the tools you need to keep someone alive. Don't be like me. Mother's Day is a sad day for mothers like myself and we don't want you to join our ranks. Take action now. Overdose Prevention Alliance: OD Prevention Program Locator:
www.overdosepreventionalliance.org
04:36 PM on 05/11/2012
Survival of the fittest
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Hazumu
My micro-bio is no longer empty.
03:19 PM on 05/11/2012
There will be no Narcan readily available for the same reason conservatives want to ban abortion and comprehensive sex education. They WANT there to be undesirable consequences to certain activities. They want out-of-wedlock sex to hurt, and they WANT out-of-(their)-bounds drug use to kill.

Alcohol by-itself use itself still kills more people per capita than unsanctioned opiate use.

So, why are we expending all this energy to police this 'problem' in just this way?
10:44 PM on 05/11/2012
Erin L. Winstanley writes as if health and life matter for all. If you don't agree with this then god help you and yours...

Unfortunately, there is no antidote to alcohol poisoning/overdose but if there was I am quite sure Erin L. Winstanley would be thoughtful and compassionate enough to support its use!
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maybesomeday
If you take short cuts your always gonna come up s
09:53 PM on 05/13/2012
Yup and I'm sure she would also encourage you to keep overdosing because this narcan can prevent your death in most cases.

I think the only way to prevent drug overdoses is to make sure doctor's stop prescribing these powerful drugs to begin with. But that's not her priority, that's not even in her sights as an alternative practice.
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maybesomeday
If you take short cuts your always gonna come up s
09:50 PM on 05/13/2012
The bigger problem for me is how physicians are making these drugs so available to people who honestly don't need the drugs in the first place.

Secondly wha this lady is saying is that this drug nacan can prevent deaths because god forbid doctors do the right thing and stop prescribing these drugs so freely. There's no money in doing that and his writer isn't promoting prevention, she's promoting an alternative to death when a drug user overdoses. But sure let those doctor's keep on prescribing. Keep on making these drugs available to anyone that stubs their toe and needs powerful narcotic's to relieve that pain, rather than do what was done 10 years ago which is to not prescribe these dangerous medications in the first place.

What's she saying you can remain a drug addict but make sure you have something to revive you if you take an overdose. She completely over shot her point in prevention and instead okayed the idea of taking the pain killers, just make sure you keep the reversal medications in your medicine cabinet for emergencies. What a joke.
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05:04 PM on 05/14/2012
Actually they did prescribe these medications 10 yrs ago, and there are actually people who legitimately need these meds on a daily basis and you can not tell me there aren't. What doctors should do is screen their patients more adequately and only give them as a last priority. There are people who go to the doctors with legitimate problems but exaggerate their pain, so therefore the doctor will prescribe them instead of trying alternative treatments first. Then these people will turn around and sell them or abuse them. The people who actual need them will not abuse them. Overall she is making a statement pertaining to people who are unfortunately known addicts in which treatment has failed, who are in danger of an overdose whether from prescription meds or street drugs. Narcan could save their life if in the right hands.They are already cracking down on rogue doctors but they can't control all of them, the doctors need to be responsible in the first place.
05:14 PM on 05/15/2012
Speaking as a pharmacist, I can say that a large part of the problem is that people get opiates who do not need them. It is quite hard, though, to screen patients in a practical way. Stubbed toe vs. pinched nerve (confirmed by imaging), sure. Chronic back/neck pain? Post-op pain? Neuropathic pain? Dental pain? You simply cannot tell someone they don't need pain medication and expect that to be enough. That's asking to get complaints or lawsuits. Thus, the focus on recognizing addiction/dependence and treating it. As the poster mentions, addiction is a medical condition that there is a solid base of evidence for treating.
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giftsthatpurr
zestful life
02:55 PM on 05/11/2012
This problem has been building for some time. Among the elderly it is huge! They beg health care providers for more of their "pain pills", and if they don't get them they suffer "rebound effect" which is actually pain, so the cycle of going from doctor to doctor continues. What you have suggested as a solution is one good way to treat these addicitions, and there are others as well.