Relapse Prevention Through Naltrexone

relapseAddiction is extremely hard to recover from, but it is worth the effort if you are willing to take certain steps to improve your quality of life. It could be argued that there has been no other time in American history when addiction recovery has been more vital, in the wake of a prescription opioid and heroin epidemic. One of the reasons that the epidemic has continued as long as it has is the fact that recovering from opioid addiction is arduous and relapse rates are staggering.

There has been a lot of talk in the news recently about improving and expanding addiction treatment services nationwide, especially in rural America. Additionally, substance use disorder centers need to utilize evidence based treatments in order to mitigate the chances of relapse. A number of treatment centers have begun prescribing patients naltrexone – sold under the brand name Vivitrol ®.

Relapse Prevention

Early recovery can be a trying time, filled with strong cravings to use, coupled with new feelings and emotions that can drive such urges. New research suggests that utilizing naltrexone can dramatically reduce the chance of relapse, HealthDay reports. The study appears in the New England Journal of Medicine.

Naltrexone blocks the euphoric effects of opioid narcotics, which means if an addict were to use oxycodone or heroin they would not experience a high. The participants in the study were all opioid-addicted adults with history involving the criminal justice system. The participants were split into two groups, one receiving monthly naltrexone injections; the other group didn’t receive the drug but was referred to counseling and referrals to community treatment programs, according to the article.

After six months, only 43 percent of the Vivitrol group had experienced a relapse, compared with 64 percent in the other group. What’s more, no one in the naltrexone group had an overdose during the six months, compared to five overdoses in the group that did not receive the drug.

Promising Findings

“We believe our study is the first of its kind to look at the real-world effectiveness of extended-release naltrexone in community settings,” lead author at NYU Langone Medical Center in New York said in a news release. “It may be particularly effective with populations, such as recently released prisoners, who typically don’t have access to other evidence-based daily medications for opiate disorders, like methadone or buprenorphine.”

If you are in need of addiction treatment services, please contact Next Step Intervention. We can help you determine the best course of action for a successful recovery, giving you the tools necessary to prevent relapse.

Meditation Dramatically Reduced Patient Pain

meditationChronic pain affects millions of Americans. Left untreated, one’s quality of life can be severely diminished. In the United States, doctors treating chronic pain almost always turn to prescription opioids for pain management. While there is little question as to whether drugs like oxycodone are effective, the price of pain relief often leads to dependence, addiction and overdose.

The United States has been in the grips of an opioid epidemic for over a decade, a crisis driven primarily by prescription opioids. Government crackdowns and the tightening of prescribing restrictions have resulted in a number of prescription painkiller addicts turning to heroin to fill the gap. Heroin is cheaper and stronger than the majority of prescription opioids, and arguably more deadly for the fact that users are not always aware of what they are using.

Pain Management Alternatives

It may be harder to acquire opioid medications, but that does not mean that they are not being prescribed at alarming rates – still contributing to the problem. It is crucial that pain management experts turn to alternative forms of treatment, methods that do not involve dangerous narcotics.

New research suggests that meditation may be an effective alternative to opioids for treating pain, Medical Daily reports. A research team from Wake Forest Baptist Medical Center found that meditation dramatically reduced patient pain, without the assistance of their body’s “pain-blocking process and opioid receptors.” The research was published in The Journal of Neuroscience.

Meditation On Pain

The study involved 78 volunteers who were injected with either a saline placebo solution or naloxone, according to the article. The participants were separated in four groups; each group had a different variation of treatment, such as:

  • The first group received naloxone and meditated.
  • The second practiced meditation without naloxone.
  • The third group meditated and had a saline placebo.
  • The fourth group received the placebo and didn’t meditate.

The volunteers in the meditation groups saw pain reductions by over 20 percent, the article reports. However, the participants who did not meditate saw an increase in pain.

“Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” said Dr. Fadel Zeidan, assistant professor of neurobiology and anatomy at Wake Forest Baptist Medical Center, in a statement. “Our team has demonstrated across four separate studies that meditation, after a short training period, can reduce experimentally induced pain. And now this study shows that meditation doesn’t work through the body’s opioid system.”

About Holistic Treatment

We, too, understand the importance of using a holistic treatment approach which includes meditation. Prayer or relaxation exercises are proven to lower anxiety and reduce tension by increasing an individual’s spiritual awareness and sense of wellbeing. When volatile emotions are managed, there is less chance of relapse or binging. Over time, a meditation practice can be a long-term tool for achieving and maintaining sobriety and finding joy in life.

The Comprehensive Addiction and Recovery Act (CARA)

addictionAddiction treatment and prevention are crucial if we are ever to get a handle on the prescription opioid and heroin epidemic in the United States. As presidential candidates criss-cross the country, addiction is a major talking point – especially in some of the most rural areas. Everyone is interested in learning how the potential leaders will tackle the problem, a crisis that is stealing 78 lives every day, according to the Centers for Disease Control and Prevention (CDC).

On top of an interagency effort to curb overprescribing, expand access to the life saving drug naloxone and create more substance use disorder treatment facilities Senators have been working to pass the Comprehensive Addiction and Recovery Act.

A Fighting Chance

The Comprehensive Addiction and Recovery Act (CARA), if passed, the bill authorizes the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use. After concerns that there would not be enough funding for the bill to be effective, an amendment to the bill was put forward for an additional $600 million in funding. On Wednesday, the amendment failed to receive the 60 votes needed to approve the additional funds, The Washington Post reports. Despite the amendment being voted down, Senate Democrats said they will not block the legislation over funding.

“There certainly is no desire to take the bill down over that through the caucus at large,” said Sen. Sheldon Whitehouse (D-R.I.), an author of legislation. “If somebody’s so mad about that that they just can’t bring themselves to vote for it, that will be their personal decision.”

The Big Picture

The democratic Senators choice to not block the bill because of the vote on Wednesday is indicative of how much attention the crisis deserves. While the amendment had the support of Senators from both sides of the aisle, there are a number of republicans who feel that the bill had enough funding to adequately address the opioid epidemic, according to the article. One could argue that some lawmakers do not fully grasp the true scope of the problem.

“It just seems ill-advised, to say the least, to appropriate more money when in fact there’s already $571 million available to deal with this epidemic,” said Senate Majority Whip John Cornyn (R-Texas).

This is a story we will continue to follow.

Needle Exchanges Have Funding On The Way

needle exchangeIt is fair to say that people are going to continue to use both prescription opioids and heroin despite the recent interagency actions of the Federal government which are doing what they can to assist states that are struggling to address the crisis. Of late, there have been three areas that have been the focus topics, some of which are controversial.

In a number of states, opioid addicts and their loved ones can acquire the life saving drug naloxone without a prescription. The drug, if administered in a timely manner, can reverse the deadly symptoms of an opioid overdose. There have also been reports of opioid addicts having to wait lengthy periods for a bed at substance use disorder treatment facilities, which is why the White House is calling upon Congress for $1.1 billion to expand access to treatment throughout the country.

Arguably, needle exchange programs remain to be controversial, despite the fact that they not only reduce the transmission of disease, they also provide a forum for addiction counselors to reach addicts that they would otherwise not see. Historically, many lawmakers have been opposed to such programs, arguing that they promote continued drug use; however, every lawmaker is aware that the opioid crisis in America has reached epidemic proportions and they are coming to see that they may have to think outside the box.

A Federal Ban On Needle Exchanges

Every day, needle exchanges operate throughout the country, but they do so without any financial support from the federal government. Needle exchange programs do a lot of good and with the spike of opioid addiction there is a much higher demand for clean needles – a reality which is spreading the programs thin.

In an attempt to assist such programs, last month Congress passed a measure that would lift a ban on funding needle exchanges, WBUR reports. While the measure’s passing could easily be considered to be a paradigm shift, the funding cannot be used for purchasing syringes – which can account for a third of the facilities overhead.

The funding can only be used for:

  • Staff
  • Vehicles
  • Counseling
  • Outreach

Baby Steps

It could easily be argued that the measure is lacking, but anything helps and we can only hope that this measure will be amended after Congress sees what the good needle exchange programs do for communities that have been hit hard by the opioid epidemic. Without expanded access to clean needles, the problem is only exacerbated.

“It is really an important and historic moment for us at syringe exchanges,” said Mark Casanova, Executive Director of Homeless Healthcare Los Angeles, which runs a syringe exchange. “But it doesn’t go far enough.”

Treating Neuropathic Pain With Prescription Opioids

neuropathic-painWhile prescription opioids are highly addictive and have led to an epidemic in the United States, there is no question prescription opioids are great for treating pain. When people go to a hospital with a minor injury they might receive Tylenol 3 (codeine) or Vicodin (hydrocodone), if a patient is in need of surgery they are given something a lot stronger, such as morphine or fentanyl. People who are living with chronic pain are often prescribed monthly supplies of opioids and are at a heightened risk of developing a dependency to the drugs which can lead to addiction.

The treatment of chronic pain over the last 15 years played a large part in creating the opioid epidemic that we face today. This is a fact which suggests that physicians need to adopt different prescribing practices, and look to alternative forms of pain management treatment. Opioids have long been the go-to treatment for all forms of pain, but it turns out that treating certain types of pain with opioids may counter health improvements.

The Nerve of Prescribing Opioids

The American Chronic Pain Association states that neuropathic pain often involves nerve fiber damage which sends the wrong signals to other pain centers. Neuropathic pain can be difficult to live with, diminishing one’s quality of life. So it is not all that surprising those doctors will prescribe opioids for neuropathic pain. However, new research suggests that patients prescribed opioids for neuropathic pain experienced no improvements in physical functioning, compared to patients treated with alternative therapies, Medical Daily reports. The research was published in the journal Pain Medicine.

“Opioids can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned,” said Geoff Bostick, lead author of the study.

Researchers analyzed data from 789 patients, some of the participants were using opioids to treat the neuropathic pain. The participants provided self-reported baseline measures of function before the study, and then again after six and twelve months of treatment, according to the article. The patients using opioids for neuropathic pain saw no improvements in physical functioning, compared to patients using other therapies.

Hindering Improvement

If using prescription opioids during the healing process does not improve physical function, it begs the question of whether or not they should always be used. Bostick points out that improving movement and function may be more important than pain relief. If we consider all the risks of using opioids, it is hard not to agree with him.

Prescription Opioids: Who Should Be Held Accountable?

prescription opioidsWhen considering who is responsible for the prescription drug epidemic in America, it becomes difficult to determine where to point your finger. Some people blame doctors for rampant over prescribing, others would like to hold as accountable the pharmaceutical industry or the FDA for approving highly addictive prescription opioids for home use. The truth it seems is that there are a number of different entities which had a hand in creating the crisis we face today.

Naturally, some states have taken a harder hit than others, the byproduct of state laws which made it possible for people to gain greater access to powerful opioids, such as OxyContin (oxycodone). Data shows which states have had the highest opioid overdose rates. The Centers for Disease Control and Prevention (CDC) reports that West Virginia leads the nation in the rate of fatal drug overdoses. In the year 1999, which is often considered the time when the opioid problem began, the fatal overdose rate was 4.1 per 100,000 people. By 2010, West Virginia’s rate was 28.9 overdose deaths per 100,000, which was mainly attributed to prescription opioids. The staggering surge in opioid overdose deaths in the state has some lawmakers demanding accountability.

Wholesale Prescription Opioids?

The attorney general of West Virginia has filed a lawsuit against one of the nation’s largest prescription drug wholesalers, the Insurance Journal reports. Attorney General Patrick Morrisey has accused San Francisco-based McKesson Corporation of violating state consumer protection laws and the Uniform Controlled Substances Act.

The lawsuit claims that one of the major factors that contributed to West Virginia’s prescription drug abuse problem was McKesson Corp., which failed to detect, report and stop suspicious drug orders, according to the article. Between 2007 and 2012, McKesson distributed 99.5 million doses of hydrocodone and oxycodone to West Virginia.

“This failure is one cause of many for the state’s prescription drug overdose rate, decreased worker productivity and the wasteful expenditure of precious state resources,” Morrisey said.

Collective Responsibility/Collective Solutions

While, if the allegations are true, McKesson Corp. should share some of the costs of the problem the company had a hand in creating throughout the state, prescription drug distribution companies did not act alone. The industry itself needs to be held accountable and changes need to be made regarding the handling of pain management and how pharmaceutical companies are allowed to market.

“The flooding of prescription pills into our state is a very serious problem that involves all parts of the pharmaceutical supply channel,” said Morrisey. “No one group or industry sector is solely responsible for this problem; a solution must involve many actors, including doctors, pharmacies, wholesalers, manufacturers and government bodies.”

AMCC National Day of Awareness and Safe Disposal

American-Medicine-Chest-ChallengeFar too often, prescription drugs end up in the wrong and/or unintended hands. People prescribed opioids will take the drugs until the pain subsides and then leave the unfinished pill bottles in the medicine cabinet to collect dust. A practice which may be relatively harmless when you are a living alone. However, it is a different story when it comes to families.

Many teenagers and young adults come across prescription opioids for the first time in the family medicine cabinet. Those who decide to take the unused medications, such as oxycodone or hydrocodone, are at risk for addiction or worse – overdose. The CDC reports that 44 people lose their life to prescription opioid overdoses every day in America. Naturally, mitigating the harm that can accompany non-prescribed painkiller use is crucial in the fight against the opioid epidemic that has been crippling families for over a decade.

American Medicine Chest Challenge

One way to keep prescription opioids out of the wrong hands is to safely dispose of unused or unwanted medication. Throughout the year, there are times when people can dispose of the medications at predetermined sites, giving Americans an opportunity to have an active role in the fight against the nation’s worst epidemic in modern times.

This month, the American Medicine Chest Challenge (AMCC), a community-based public health initiative, will hold the sixth-annual National Day of Awareness and Safe Disposal, according to a news release. On November 14th, families are encouraged to safely dispose of their unwanted medications at more than 1500 collection sites across the country. Both families and individuals can find a list of disposal sites at AmericanMedicineChest.com or by downloading the free app AMCC Rx Drop.

The Challenge

Families are encouraged to take the American Medicine Chest Challenge, an opportunity to not only take stock of the potentially dangerous drugs in their home, but also learn more about prescription drug abuse in order to better inform children as to the dangers.

“The American Medicine Chest Challenge can help save the lives of our children,” said Angelo M. Valente, CEO of AMCC. “On November 14th we encourage all Americans to take the 5-Step American Medicine Chest Challenge and find a location to safely dispose of your unused, unwanted and expired medicine.”

The five-step challenge encourages families to:

  • Take inventory of their prescription and over-the-counter medicine
  • Secure their medicine.
  • Dispose of unused, unwanted, and expired medicine in their home or at an AMCC disposal site.
  • Take their medicine(s) exactly as prescribed.
  • Talk to their children about the dangers of prescription drug abuse.

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Please contact Next Step Intervention if you are struggling with prescription drugs. We can assist you in finding the right treatment which will help you start your journey of recovery.

Prescription Drug Take-Back Movement

prescription-opioidsThe Epidemic

The prescription opioid epidemic in the United States has led to a rise in addiction and premature deaths resulting from opioid overdoses. After years of over prescribing, these highly addictive narcotics have flooded American communities, crippling individuals and devastating families.

Solutions

Nationwide efforts have been made to combat this deadly crisis, such as prescription drug monitoring programs (PDMPs), the closing of “pill mills,” and the creation of prescription drug take-back programs. Collectively these methods have proven effective; PDMPs have diminished the ability to doctor shop – the act of going to multiple doctors for the same type of drugs. Prescription take-back programs have made it more difficult for these types of drugs to fall into the wrong hands.

Curbing the problem comes at a cost. Individual states are spending millions of dollars on programs such as these. Three years ago, Alameda County, CA, created an ordinance requiring big pharma to offset the costs of prescription drug take-back programs. The county prevailed, but the pharmaceutical companies were not going to lose without a fight.

The Fear

The pharmaceutical industry feared, and they were right in doing so, that other parts of the country would follow the Alameda County initiative. After two previous attempts to get the ordinance overturned, the U.S. Supreme Court denied an industry request to review the lawsuit over the Alameda County prescription drug take-back program ordinance, The New York Times reports.

Three industry trade groups claimed the ordinance was unconstitutional. They believed that the law violates interstate commerce and discriminates against out-of-state companies through the shifting costs to drug makers.

Joining the Fight

Since the Alameda County ordinance passed, others have followed suit. Two more counties in California and one in Washington have adopted similar laws, according to the article. Scott Cassel, chief executive at the Product Stewardship Institute non-profit which supports take-back programs, found that at least a dozen other local governments around the country are considering similar ordinances.

“I think we’ll see a groundswell of both local and state governments,” says Cassel.

Facing Addiction Head On

Efforts which force the hand of pharmaceutical companies to share some of the burden of an epidemic they helped to create is a step in the right direction. However, simply making it more difficult for addicts to get their hands on prescription opioids is not enough. Many addicts will turn to the cheaper, stronger alternative – heroin.

Creating greater access to substance use disorder treatment facilities is of the utmost priority. Educating the public about the nature of prescription drug abuse, and the options available for recovering from addiction, will go a long way in the fight against this insidious issue.

Recovery

Recovery is difficult process, but one that is well worth it. There are a number of different avenues to take on the road to recovery. At Next Step Intervention, we provide a variety of treatment options to choose from if you are looking for a new way of life – one free from addiction. If you are struggling with prescription opioids or any other mind altering substance, please do not hesitate to reach out for help.

DEA Crackdown On Prescription Opioid Narcotics

Operation-PillutedPeople in the United States consume the majority of prescription painkillers made worldwide, which has led to a prescription opioid epidemic. While efforts to curb the problem, such as prescription drug monitoring programs, have yielded some promising results, many addicts have turned to heroin, a cheaper and stronger alternative – creating a new problem. Nevertheless, the fight to end the prescription opioid crisis continues, and on Wednesday, the U.S. Drug Enforcement Administration (DEA) announced the results of a four-state prescription drug crackdown, Reuters reports.

The DEAs “Operation Pilluted,” set its sights on the illegal distribution of prescription opioid narcotics. The operation yielded 280 arrests, including:

  • 22 Doctors and Pharmacists
  • $404,828 in Cash Seized
  • 202 Weapons
  • 51 Vehicles

“DEA is committed to reducing the destruction brought on by the trafficking and abuse of prescription drugs through aggressive criminal enforcement, robust administrative oversight, and strong relationships with other law enforcement agencies, the public, and the medical community,” said DEA Special Agent in Charge Keith Brown in a statement. “The doctors and pharmacists arrested in Operation Pilluted are nothing more than drug traffickers who prey on the addiction of others while abandoning the Hippocratic Oath adhered to faithfully by thousands of doctors and pharmacists each day across this country.”

Over the course of 15 months, agents involved in Operation Pilluted, observed and arrested people on federal and state criminal charges, according to the article. The operation was headed up by the DEA’s New Orleans Field Division, which resulted in the arrests of individuals in Louisiana, Arkansas, Alabama and Mississippi.

The south, arguably, has been hit the hardest by the prescription drug epidemic. Federal and state officials have been working tirelessly over the last several years to implement prescription drug monitoring programs aimed at doctor shoppers, and to shut down pill mills which were flooding the streets with powerful narcotics. Prescription drug companies have been urged to create abuse-resistant pain medications, drugs that make it more difficult for abusers to tamper with the medications.

The DEA called Operation Pilluted its largest-ever prescription drug operation.

If you are struggling with prescription opioids do not hesitate to call for help.

CVS Agreed to Pay $22 Million for Oxycodone Charges

VicodinThe State of Florida earned reputation for being an easy place to acquire large quantities of highly addictive prescription opioids. Up until the last few years, pain management facilities in Florida, otherwise known as “pill mills,” were places that people could be seen by doctors and leave with multiple prescriptions for opioids, such as OxyContin ® (oxycodone) and Vicodin ® (hydrocodone). It was often the case that abusers would attend multiple clinics in a week and amass loads of pills and then turn around and sell them on the streets for inflated prices.

After a number of years of these types of illicit activities, the state began to crack down; pill mills were closed up, a number of doctors lost their licenses, and some pharmacies had their licenses revoked for dispensing excessive amounts of oxycodone. In 2012, two CVS pharmacies were believed to be selling oxycodone pills that were not prescribed for legitimate medical purposes, Reuters reports. CVS Health Corp has agreed to pay $22 million to resolve the federal investigation.

The DEA had alleged that the two pharmacies were “filling prescriptions far in excess of the legitimate needs of its customers.”

According to a DEA news release, “CVS acknowledged that its retail pharmacies had a responsibility to dispense only those prescriptions that were issued based on legitimate medical need. CVS further acknowledged that certain of its retail stores dispensed certain controlled substances in a manner not fully consistent with their compliance obligations under the Controlled Substances Act and the related regulations.”

Just to give you some perspective, in 2011, the average pharmacy in America ordered approximately 69,000 oxycodone dosage units, according to the DEA. The two CVS pharmacies in question, located less than 6 miles from each other, ordered more than three million units together – during the same time period.

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