Health & Fit: Opinion: A key tool to fighting the opioid crisis is in short supply - Johnson & Johnson Finds Agreement in Ohio on Opioid Crisis - PressFrom - US
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Health & Fit Opinion: A key tool to fighting the opioid crisis is in short supply

19:50  21 october  2019
19:50  21 october  2019 Source:   popsci.com

As the nation's opioid crisis grew, the pills got stronger

As the nation's opioid crisis grew, the pills got stronger An Associated Press analysis of drug distribution data released as a result of lawsuits against the industry also found that the amount of opioids as measured by total potency continued to rise early this decade even as the number of pills distributed began to dip. The reason: Doctors were prescribing — and the industry was supplying — stronger pills. "It shows it wasn't just the number of pills being shipped that increased. The actual amount of opioids being prescribed and consumed went up," said Anna Lembke, a Stanford University professor who researches opioids and is serving as a paid expert witness for plaintiffs in the litigation.

Most people agree that the federal government should tackle public health crises , and there is a particular consensus about the current epidemic involving opioids . The White House announced last fall that President Trump was “mobilizing his entire administration to address drug addiction and

When President Trump took office, the opioid crisis was devastating communities across America. Part 2 is cutting down on the supply of illicit drugs by cracking down on the international and domestic drug supply chains that devastate American communities.

Editor’s note: The opinions in this article are the author’s, as published by our content partner, and do not necessarily represent the views of MSN or Microsoft.

a hand holding a remote control: Naloxone, available as a nasal spray called Narcan or in injectable form, resuscitates 100% of people who overdose if administered quickly.© AP Photo/Patrick Semansky Naloxone, available as a nasal spray called Narcan or in injectable form, resuscitates 100% of people who overdose if administered quickly.

Forty-seven thousand Americans died of opioid-related overdoses in 2017—similar to the number of deaths from car accidents and gun violence.

That number could have been much lower had more people received naloxone, a medication that reverses opioid-related overdose.

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The opioid crisis is so complex and so large — drug-related deaths now exceed those caused by cars, H.I.V. or guns — that there is no single solution. Among the partial ones: prescription drug monitoring programs

Key Points. At Tuesday's State of the Union address, President Trump vowed to end the opioid crisis . ( Opioids are a class of drugs that include heroin and prescription pain relievers, such as "My administration is committed to fighting the drug epidemic and helping get treatment for those in

Naloxone is safe, non-addictive and highly effective. And it does more than save lives: When used shortly after overdose, naloxone reduces the likelihood of long-term brain damage from diminished blood flow.

Available as an injection or nasal spray, naloxone can be administered by anyone trained to do so—assuming, that is, someone has it on hand at the scene of the overdose.

Police, firefighters and medical first responders are increasingly equipped with naloxone.

However, the true first responders to an overdose often aren't professionals but the friends, family and peers of people who use heroin and other opioids. Relatively few of these "laypeople" have access to naloxone, which is available via community distribution, a doctor's prescription or, in states that allow naloxone to be sold without a prescription, from a pharmacy.

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That doesn’t mean that all such patients should have been treated with high-dose opioids (surely some decisions to initiate the medication by their doctors were ill-advised), but what happens to these patients after the fact should not be based on cookie-cutter logic.

Combating the opioid epidemic is a top priority of Massachusetts Attorney General Maura Healey. To that end, the AG is working on all fronts across the office with a team comprised of health care experts, law enforcement, advocates, and public policy experts that is dedicated to tackling heroin, fentanyl

While at least 41 states allow pharmacists to dispense the medicine without a prescription, many pharmacies fail to actually stock it. In California, only a quarter of all pharmacies carried naloxone last year.

As opioid-related deaths have soared, there's been an increase in programs working to get naloxone into the community. Health centers like Prevention Point Pittsburgh, for example, train people likely to witness overdose on how to recognize the signs and give them free naloxone.

However, the most recent available data suggest that relatively few communities with high rates of opioid-related deaths actually have such programs.

Even emergency medical personnel, or EMS, may not have naloxone when they need it.

Most US states only authorize intermediate- and advanced-level EMS to carry and administer the drug. But in many parts of the country—particularly rural and tribal areas—EMS with basic training are often the only medical first responders immediately available in emergencies.

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Last April, The Baltimore Sun ran an op-ed essay by a woman in mourning. Her sister, a “middle-class suburban mom,” had become addicted to alcohol and opioids and died. Two years earlier, The Wall Street Journal published the names and photographs of some of the 300

to dispense opioids should become a key harm reduction tool in Canada. today, Tyndall argues that dispensing opioids under medical supervision to street drug users will be key to fighting the Health officials have warned that the total opioid deaths — driven by illicit fentanyl overdoses — for

Phil Bryant et al. around each other: Surgeon General Jerome Adams, right, directs a session on naloxone administration in Jackson, Mississippi.© AP Photo/Rogelio V. Solis Surgeon General Jerome Adams, right, directs a session on naloxone administration in Jackson, Mississippi.

One impediment to increased naloxone access is the argument that reviving overdose victims will encourage opioid use.

Naloxone critic Dr. Harold Jonas, founder of the website Sober.com, has warned health care providers that naloxone creates a safety net, making people think "they don't need treatment for substance abuse and … continue using at will."

The fear that life-saving interventions encourage reckless behavior—a concern historically used to oppose everything from condoms to seat belts—is called "moral hazard."

There is no peer-reviewed, empirical evidence that naloxone use encourages opioid use. But this argument remains pervasive.

Often, politicians combine moral hazard with budgetary arguments to oppose broader naloxone distribution.

The prices of some naloxone products have been rising. Between 2009 and 2016, naloxone manufactured by Amphastar almost doubled in price, from US$20.34 to $39.60 per dose.

Trump administration announcing nearly $2B in opioid grants

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Lawmakers on Capitol Hill weigh in on funding for addiction and the Current Opioid Crisis . While there has been much debate among lawmakers on how the government should approach opioid abuse in the U.S., it is also recognized that communities themselves are key to fighting the opioid crisis .

WebMD Health News. Opioids : A Crisis Decades In the Making. Today, Purdue Pharma publicly supports state and federal programs to fight the opioid epidemic, including encouraging prescribers to consult prescription-drug-monitoring program databases and repeating the CDC’s call to shorten the

In 2017, the city of Middletown, Ohio, spent almost $35,000 on naloxone administered by EMS in 966 opioid overdose calls—up from $11,000 and 532 calls in 2016.

Citing cost, Middletown Councilmember Dan Picard has said the city should refuse to resuscitate people who overdose repeatedly.

Since the opioid crisis disproportionately hurts low-income communities like Middletown, our team of health policy and epidemiology researchers at the University of Michigan conducted a study to determine whether naloxone is a good use of the scarce resources available to reduce opioid-related deaths.

Our study, published in International Journal of Drug Policy, found that naloxone is extremely cost-effective.

We analyzed the cost-effectiveness of giving naloxone to three different groups: laypeople, police, and firefighters and EMS.

When all three groups have naloxone, it costs about $16,000 per year of "high-quality" year of life saved. We accounted for quality of life as well as quantity, since problematic substance use increases the risk of hepatitis, HIV and other health serious illnesses.

As life-saving interventions go, $16,000 per high-quality year of life is an excellent deal. The public defibrillators used to revive people in cardiac arrest come out to around $53,797. And a breakthrough class of new cancer drugs run $100,000 to $150,000 per high-quality year of life saved.

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That ’s something that Canadian health officials are banking on, as the country is still trying to grapple with a cross-country drug epidemic. Many of the overdoses have been driven by fentanyl, the relatively-cheap and extremely-powerful opioid that has ravaged parts of the U.S. and Canada, partly

But the opioid crisis is changing the landscape. After an H.I.V. outbreak among injection drug users in Scott County, Ind., in 2015, health officials opened Last month, the police chief imposed new rules on the program, loosely based on those used by a much smaller exchange run by West Virginia Health

Naloxone actually saves society money when we take the lost economic productivity from fatal overdoses into account, we found. Hard-hit communities may see naloxone as an expense—but they’re actually saving the city money by keeping more of its workforce alive.

This finding holds even when we add in a city’s criminal justice costs associated with opioid use.

Naloxone would remain cost-effective even if the "moral hazard" concerns were true. We found that overdose rates would have to rise 20 percent for lay distribution of naloxone to cease being cost-effective—a large margin of error for an unsubstantiated worry.

Our research determined that the most cost-effective strategy is to distribute naloxone to all three groups: laypeople, police and firefighters, and EMS.

If low-income communities can’t afford that much naloxone, however, the next-best scenario is to give the medicine to laypeople plus at least one first responder group—either police and fire or EMS.

Getting naloxone into lay hands is so critical because many overdose witnesses hesitate to call 911 due to fear of arrest, stigma or loss of government benefits like subsidized housing. No matter how many first responders have naloxone, the victims in those cases cannot benefit from it. They need someone close by, like another person using opioids, to revive them.

But emergency responders should have naloxone as well since overdose witnesses may not always have naloxone or be able and willing to use it.

Sometimes, a single naloxone dose can save two lives.

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Culture is contributing to the opioid crisis in the US; drug companies ease supply , and lobbying raised the demand from doctors, while they and patients were “Since 9/11 the US has been in the state of perpetual war. And increasingly we’ve had a growing economic disparity that has created tremendous

The opioid crisis is still getting worse. Yet even as the crisis continues to grow, federal, state and local efforts to contain it have fallen woefully short . Governments at all levels should be using the best technology available to consolidate data from doctors, pharmacies and distributors that can be used

In 2018, clinicians in North Carolina treated a pregnant patient who had recently overdosed. Friends had used naloxone to reverse the overdose, allowing her to enter treatment for substance use.

A few months later, she gave birth to a healthy baby.

Tarlise Townsend is a PhD student in Health Policy and Sociology at the University of Michigan.

Freida Blostein is a PhD Candidate in Epidemiological Science at the University of Michigan.

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Opioid Crisis Cost U.S. Economy $631 Billion in Four Years, Study Shows .
The report examines the cost of opioid misuse on a variety of areas, including health care expenditures and law enforcement.The report, authored by Stoddard Davenport, MPH; Alexandra Weaver, ASA, MAAA and Matt Caverly, examines the cost of opioid misuse on a variety of areas, including health care expenditures, law enforcement and criminal justice programs and early mortality.

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