Category Archives: News

China to Ban Fentanyl – and Save Thousands of Lives

Nearly 80 Americans die every single day from opioid drugs. Millions are addicted, whether to hydrocodone or heroin or something in between, but most opioid addictions start with prescription drugs. Due to prescriptions being expensive, addicts often turn to street dealers for opioids. At least 75% of heroin addicts began with legal pills.

Drug dealers want profit, and the cheaper they can get their drug supply, the better. Heroin is rather expensive, and prescription opioids aren’t exactly easy to come by in bulk. That’s why Chinese fentanyl imports have skyrocketed over the last couple of years.

Fentanyl is a synthetic opioid, 50 times stronger than heroin. Also, it’s much cheaper than actual opioids, legal or not. Recently, drug dealers have been saving boatloads of money by importing from China. Production, sale, and purchase of fentanyl are illegal in all more developed countries, except for in China, where multiple companies produce and sell fentanyl through the internet, with little to no government regulation.fentanyl-100-times-stronger-than-heroin

Fentanyl is incredibly deadly. The Department of Justice and the Drug Enforcement Agency (DEA) issued a public warning last year regarding the potency and lethality of the synthetic drug. Deaths from fentanyl continue to rise dramatically across the country.

American and Mexican drug cartels buy fentanyl from China in bulk, and then either lace it into drugs or use it to create new drugs. Dealers are saving money at the cost of tens of thousands of lives. This has been going on for years. US government agents have long wondered why the Chinese government stood by, letting it happen.

Starting March 1, 2017, China will ban the production and sale of fentanyl, and more.

The Fentanyl Ban

According to CNN on February 16: “DEA spokesman Russ Baer confirmed that China made the announcement [to ban fentanyl] Wednesday night, after six months of talks between the Chinese and US governments. That included a January visit by acting DEA Administrator Chuck Rosenberg, the first DEA administrator to go to China in more than a decade, to discuss the issue.”

Four chemicals were included in the ban. Three of them are variations of fentanyl, all necessary for drug dealers to create synthetic opioids. The fourth is carfentanil, an even more powerful synthetic opioid which is used to tranquilize large mammals such as elephants. Carfentanil, too, is working its way into American street drugs, and has its own rather large body count.

Because it hasn’t begun yet, the ban’s effect remains to be seen.

However, several government officials are excited, and nobody sees this as a bad thing. Although it may not make headline news every night, the impact fentanyl has made is breathtaking. Fentanyl helps fuel the ongoing opioid crisis, the worst drug crisis in US history. Stopping the source of fentanyl will without a doubt benefit our society. First we must understand the crisis before we can discuss any potential cure.

The Fentanyl Crisis

One must fully realize how lethal fentanyl really is. ONE GRAIN of fentanyl, the size of a grain of sand, can kill a fully grown human being. Police K9 units are overdosing from just sniffing for it. Prince died from fentanyl, and he possessed controlled amounts. Now just imagine what carfentanil does to someone, 100 times more powerful than fentanyl. Here’s what it’s done to our society:

  • In 2014, there were 28,647 opioid-caused deaths in America.
  • This set the record, a 14% increase from the previous year.
  • In 2015, the number of deaths caused by opioids jumped to 33,091.
  • Nearly twice as many people die from prescription opioids than from heroin.
  • More people die from opioids than from guns and car accidents combined.
  • Totals are not yet calculated for 2016, but are expected to be higher than ever.
  • 144 Americans die every day from drug overdoses, mostly from opioids.
  • Also every day, 600 more Americans try heroin for the first time.

No corner of the country is safe from this ongoing epidemic. A quick Google search of any state followed by either the word ‘opioid’ or ‘fentanyl’ will show you the devastation. Although 2014 set a record at the time for overdose deaths, it was last year that fentanyl really began its killing spree.

Just over 8 lbs. of fentanyl was recovered by US authorities in the year 2014. While this is literally enough to kill thousands of people, authorities recovered an incredible 295 lbs. of fentanyl in just the first half of last year. That’s enough to kill two million people.

The worst part of all is how unpredictable the presence of fentanyl is in the drugs people are buying and using. A first-time user has the same odds as a lifetime user when it comes to getting a laced batch. This goes for pills and heroin alike. Proof of this comes from a recent Fox News article covering the ban in China.

The article starts with the story of Carlos Castellanos, a 23-year-old man who had been sober for 10 months until he fatally overdosed from fentanyl. “He was very happy, healthy. He had a girlfriend. He had plans to go back to college. He wanted to be an engineer. He was facilitating meetings to help other people in drug recovery. But the drugs are toxic and they’re everywhere,” said his mother.

What the Ban Means

The DEA believes the ban coming on March 1st will be crucial to reducing overdoses. Melvin Patterson, a spokesman for the agency, told Fox, “The DEA views China’s actions to be four giant steps in the right direction, steps that will ultimately lead to the reduction of numerous overdoses that have occurred throughout the United States, especially the last couple of years.”

Their optimism is rooted in the fact that since October 2015, when China began regulating 116 other synthetic chemicals, “the global supply of those substances plummeted, some as much as 60 percent,” reports Fox. We sure could use a 60% reduction in the amount of fentanyl on the streets.

Another major benefit to the ban in China will be cracking down on drug dealers. Spokesman Patterson said that tracing fentanyl recovered in the future will be easier, since China can be ruled out. “Until now, China had been an exasperatingly indecipherable key piece of the puzzle in the fight against fentanyl trafficking…” says Fox News.

Fighting the Crisis

Nearly every community has been affected in some way by the current drug crisis. Also, new laws are being passed, so money is being heaved toward curing addiction, and each and every state is fighting the crisis. However, the winner of strictest law regarding legal opioids goes to New Jersey.

“In every community it’s a concern now,” says NJ Assemblyman Declan O’Scanlon. “I cannot be too dramatic about this. This scourge knows no socioeconomic or ethnic or geographic bounds.” He has been one of the state’s most outspoken politicians for stopping the addiction crisis. O’Scanlon called the ban in China “heartening.”

He fully supports Governor Christie’s radical new law, which limits every patient’s first opioid prescription to a five-day supply. Cancer patients, chronic pain patients, and those on end-of-life care are excluded. The law also says health insurance companies must cover both inpatient and outpatient drug addiction treatment.

“We are here today to save lives,” said the NJ governor upon signing the bill. “New Jersey now leads the way first and foremost in recognizing this is a disease.” Gov. Christie said this because no other state has as strict of a policy.

It makes sense when you consider that New Jersey was home to 1,600 opioid deaths two years ago. A state full of small towns, Fox News reports NJ resident Paula DeJohn’s story in the article linked above. She owns Silverton Memorial Funeral Home, in a community named Toms River, where most people don’t make a ton of money. Over the last couple of years, Paula has noticed some significant changes at work.

“We’ve been seeing a lot of kids… it’s unbelievable. It’s primarily high school kids, but also young people in their 20s and 30s. Before it was rare to see a young person. Now it’s constant,” says Paula. This is because of the rise in opioid deaths, mostly caused by fentanyl. Recently, over just ten days, three dead school-aged victims were brought to Silverton Memorial. “Everything runs down to us,” Paula says.

She went on to say how she has friends who have been affected personally, and sees kids become addicted who she’s known her whole life. The parents do everything to try and stop it, she says.

This is why New Jersey welcomes the ban in China with open arms. Really, everyone can see how much of a positive change the ban will create. David Shirk is a fellow at the DC-based International Center for Scholars, and he spoke with Fox News (linked above) regarding the ban and its possible effects:

“Part of the epidemic isn’t about illicit supply. China’s regulations will make illicit production harder to access. For so many people addicted to opium, it starts with legal access to prescription medicines, which is abused. A lot of the problems at the end of the day contributing to addiction are social and psychological, and the fact that we don’t have a strong support system to help people deal with it.”

In Conclusion

It’s a war we seem to be losing, but nobody can say we’re not fighting. The Obama administration did more than its fair share of work to combat the epidemic, and Trump at least seems to be on board with continuing the good fight. With China banning fentanyl sales and production, cartels will be forced to revert to old methods.

This does not mean the end of opioid addiction.

However, it’s one hell of a start. This ban could very well mean the end of the fentanyl chapter in our current crisis.

Drug Cartels Use Lethal Substitute to Save Money

A warning has been issued by both the Department of Justice and the Drug Enforcement Administration to both police and anyone who purchases drugs off the street about fentanyl, an extremely powerful opioid 50-100 times stronger than morphine. A few grains the size of table salt crystals can kill a full grown human being. Drug cartels from Tijuana, Mexico to all over the US are selling fentanyl disguised as both OxyContin and heroin, according to NBC.

Fentanyl is so lethal that simply handling it is causing major concern among law enforcement. Two New Jersey police officers almost passed out recently, simply from sealing a bag of the stuff during a bust, as reported in the NBC article. Now imagine injecting or snorting fentanyl. That’s how numerous people are dying lately.

From the Far East to a Coffin

It all starts in China, where multiple companies produce and sell fentanyl through the internet. The near impossibility of regulating the large amount of such companies makes for easy access to fentanyl. Therefore, drug cartels in North and South America are importing it from China, and due to its bland white appearance, disguising it as heroin and/or OxyContin, both powerful opioids. Hence the warning from both the DOJ and the DEA.

Assistant US Attorney Sherri Hobson said, “I see this as an experienced prosecutor as like a death sentence for someone who thinks that they’re buying oxy but really they are buying fentanyl because it’s cheaper.” DEA spokeswoman Amy Roderick added to the conversation, saying “It’s extremely profitable for the cartels… They aren’t having to harvest the poppy plants… not having to manufacture that paste into heroin. They are literally just getting a chemical from China.”

More than 50 overdoses in Sacramento, twelve of them fatal, occurred recently due to users buying fentanyl when they believed it to be OxyContin. On the opposite coast, fentanyl has killed more than 100 people every year since 2014 in Erie County, NY. Famous singer Prince died this year in his Minnesota home, reportedly from fentanyl, and a hydrocodone bottle found in his home tested positive for fentanyl, according to CNN. George Marquardt of Kansas is now known as the ‘Walter White of Wichita,’ after it was discovered he had been mass producing fentanyl (among other drugs) for decades, selling them to anyone with the money. In May of this year, Alaska State Troopers reported a spike in deaths caused by fentanyl-laced heroin. No part of the country is safe from this epidemic.

In Conclusion

Last month alone, US authorities seized over 70 pounds of fentanyl, along with some 6,000 counterfeit prescription pills. That’s more than enough to kill the entire population of North America and Japan combined. If that doesn’t hit you like a ton of bricks, then you are literally immune to a ton of bricks.

If eleven SWAT officers experienced “lightheadedness, nausea, sore throats and headaches” just from busting a fentanyl-selling residence in Hartford, Connecticut last month, then surely fentanyl injection and/or inhalation is far worse. The DEA, recognizing how potent fentanyl is, told the Washington Post “…it represents an unusual hazard for law enforcement.”

Imagine now the hazard it represents for those addicted to opioids. Please, if you or a loved one is struggling with an opioids addiction, be careful. Enroll in an addiction treatment facility, or at the very least, seek help from your loved ones. If you are an opioid user, for God’s sake be careful. Every crystal of fentanyl out there (and it is out there) is a death sentence waiting to happen.

No high is good enough to die for.

Opioids: An American Mass Murderer

This country has a serious opioid addiction problem. The number of fatal overdoses from both prescription painkillers and heroin an hour died from an opioid overdose that year. Approximately 2.35 million Americans had diagnosable opioid addictions in America, according to the Substance Abuse and Mental Health Services Administration. Popular painkillers such as OxyContin, Vicodin and Percocet all are opioids and heroin is a stronger, more refined opioid.

Three facts, when all considered together, point to how America got this way. One is that over the course of the last two decades or so, pharmaceutical companies have aggressively promoted opioid painkillers. Two is that this push worked, because the number of prescriptions for opioids written every year is simply outrageous. (See section below titled A Bottle for Every Adult). Three is that 75% of heroin addicts begin with prescription painkillers, whether taken legally or recreationally.

No part of the country is safe from this epidemic. Everywhere you turn, there are horrifying news stories about opioid overdoses and how opioid addiction is rampant. In Oregon, over half of overdoses involve prescription painkillers, and the state sees more than 500 people overdose every year. Republican presidential nominee Donald Trump, in a speech given on September 29th in Bedford, New Hampshire, told the crowd “They said the biggest single problem they have up here is heroin. More than any place, this state, I’ve never seen anything like it…” said Trump.

In Colorado, a golden retriever nearly died from consuming heroin thrown over a fence into a dog daycare, presumably by someone being chased by police. This September, 28 opioid overdoses occurred in the city of Huntington, West Virginia in a four-hour span. Even in Hawaii drug overdose deaths rose 83% from 2006 to 2014, creating the island chain’s own opioid epidemic. Every corner of the country is being affected.

From Prescriptions to Needles

Three out of every four heroin addicts began with prescription pills, as mentioned previously. Some used the pills recreationally and graduated to heroin, but many others simply substituted heroin for the painkiller they were legally prescribed. In a 2014 report by Al Jazeera on opioid addiction, several members of a heroin treatment center were interviewed. One unnamed man’s story is eye-opening: “I was hurting so bad that I ended up punching a four-by-four, breaking… three fingers… to get pain meds from my doctor. I’d do that several times.”

At that point in the interview, another man speaks up, stating how he’s heard of people deliberately taking a baseball bat to their wrists just to get more opioids from their doctors. Several of the people being interviewed chime in, saying how heroin is much cheaper than the prescriptions fueling their addictions.

A Bottle for Every Adult

There are far too many painkillers floating around this country. Vivek Murthy is America’s current Surgeon General, and he is well aware of America’s opioid epidemic. Just a couple of months ago, every doctor in America received this letter from Murthy, explaining how the nation is in crisis regarding opioids, and recommending more careful prescribing methods. During a speech on the topic, Murthy revealed an astonishing truth regarding prescriptions in the US. “We have currently nearly 250 million prescriptions for opioids written every year. That’s enough for every adult in America to have a bottle of pills and then some.”

More opioid prescriptions are written annually in America than there are people in Canada, Italy and Japan combined. However, it wasn’t always like this. In fact, starting with the drug war in the 60s and 70s, doctors became more and more skeptical of prescribing opioids. The term ‘opiophobia’ was even coined in the early-to-mid 1990s, referring “to a phenomenon in which exaggerated concern about the risks associated with opioids prevent appropriate medical use of opioid analgesics,” according to the Pain & Policy Studies Group.

It was in the late 90s that big pharmaceutical companies began excessively pushing opioid medication, especially the company Purdue with their drug OxyContin. From here, the story of how big pharma, the medical industry, and the pure nature of addiction created an epidemic begins.

OxyContin, and how the Medical Community was Duped

Part of the opiophobia was exaggerated, due to the drug war being waged by the country, but a part of it was also based in truth. Doctors were fearful of prescribing opioids because they thought it would lead to addiction. Originally, these opioid medications were reserved for patients with severe pain, say, from cancer or another life-threatening disease. However, with the push from companies like Purdue Pharma, opioid medication not only began to get prescribed again, it began to be given to patients for all types of pain, not just severe chronic pain.

OxyContin first hit the market in 1996. The opioid was heavily marketed by Purdue. As a part of the sales pitch, Purdue manufactured hats, swing music CDs, and even a gorilla plush toy. HBO Last Week Tonight host John Oliver can be seen with this plush toy during a segment the show did on the opioid epidemic recently. Purdue even went so far as to make promotional videos for OxyContin, clips of which can also be seen in the Last Week Tonight episode. It gets worse from here.

Purdue’s first promotional video for the opioid was released in 1998, called I Got My Life Back. The film featured seven people whose lives had changed for the better due to an OxyContin prescription. One charming grandmother says in the video that her relationship with her grandchildren has grown because of the drug’s pain-relieving effects.

Another promotional film released by Purdue around this time was called From One Patient to Another, and one particular claim made in the video is bewildering. The narrator says, “Less than 1% of patients taking opioids actually become addicted.” Not only has time and science proven this to be completely untrue, the source of the claim is shoddy at best. Taken from a letter to the editor of the New England Journal of Medicine by the Boston Collaborative Drug Surveillance Program (BCDSP), the ‘fact’ is not peer-reviewed and only regards one hospital’s findings. The BCDSP simply observed 11,882 patients over time, finding “four cases of reasonably well documented addiction in patients who had no history of addiction.”

Through these widely publicized videos, Purdue Pharma told doctors nationwide that opioids are not addicting, and based its information on one research team’s letter to the editor of a medical journal. They also told the American public that pain can be relieved (and life can be better) with a prescription for OxyContin.

The OxyContin Crisis: Precursor to the Modern Epidemic

The advertising worked. In its first year on the market, OxyContin yielded $45 million in sales for Purdue. They had a hot item, and seemingly every doctor wanted in. The crisis began to form once people began getting addicted to OxyContin.

In 2001, an article was published by the Associated Press regarding OxyContin abuse in Appalachia (a multi-state region on the eastern seaboard). The article tells the story of multiple West Virginian young adults losing the battle with OxyContin. One 18-year-old girl shot herself in the head when she couldn’t find more. Some girls in the area were prostituting themselves for the drug. Kristen Rutledge, interviewed in the article, says she would lie to her father and say drug dealers were threatening her, in order to get more money for OxyContin, which her and her friends called ‘hillbilly heroin.’

It’s not Addiction, it’s just Pseudo-addiction

Around this time, OxyContin-related deaths and overdoses were springing up across the country. In 2002, the New York Times reported how OxyContin deaths were higher than previously thought in 32 US states. Of course, Purdue Pharma became aware of this spreading crisis, and in another highly publicized video, the company’s own Dr. Alan Spanos explained what was really going on: “Pseudo-addiction is when a patient is looking like a drug addict because they’re pursuing pain relief,” said Spanos. “It’s relief-seeking behavior mistaken as drug addiction.”

Doctors with a lot of patients and not a lot of time were attracted to the idea of a non-addictive painkiller. By 2000, OxyContin sales rose to $1.1 billion and over 6 million prescriptions were being written annually. For the first half of the decade, doctors handed out OxyContin like candy to people with all degrees of pain, and more and more people became addicted.

Then, in 2007, it all came crashing down.

Caught in a Lie

In Guilty Plea, OxyContin Maker to Pay $600 Million read the headline of the New York Times business section on May 10, 2007. The article explains how Purdue Pharma misbranded their drug OxyContin, pleading to “criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused.” The total amount of all fines paid was $634.5 million, which is an awful lot for what is essentially false advertising. Obviously an incredible amount of damage was already done.

Purdue was not the only pharmaceutical company to be exposed for such wrongdoing. The next year, Cephalon, Inc. was brought up on charges of promoting drugs for uses unapproved by the Federal Drug Administration. They had to pay $444 million in fines and also enter into a corporate integrity agreement to disclose their payments to physicians.

The most shocking instance of a pharmaceutical company lying to the public involves Insys and their fentanyl-based product Subsys. A former manager and a former sales rep were both arrested on anti-kickback charges. “The two former Insys employees are accused of making payments to doctors as part of what officials call a ‘sham’ educational program to prescribe millions of dollars’ worth of the fentanyl spray to patients,” according to the article by HG. This is scary stuff,

The Epidemic Continues

Zoom ahead to the year 2008. Two of the seven people featured in Purdue Pharma’s 1998 promotional video died from opioid abuse, and a third claimed that losing her health insurance saved her life. When she had the insurance, OxyContin was being delivered to her. “I lost my house. Oh yeah, I’ve lost cars. I lost a lot,” she said in an interview. Once the insurance was gone, so was the drug, and she believes that saved her life. The level of irony is unbelievable.

Still the drug continued to flourish. By 2010, OxyContin single-handedly accounted for 30% of the painkiller market. The year 2014 set the all-time high for drug overdoses in the US, and opioids played a major role.

The Centers for Disease Control (CDC) has recently issued a guideline for the safe prescribing of opioid painkillers for patients with chronic pain. The CDC first recommends using non-opioid therapies, attempting to avoid opioids altogether. However, because opioid medications are the perfect solution for those who actually need them, the CDC recognizes that these non-opioid therapies will not work for everyone. If opioids become necessary, the CDC recommends doctors “start low and go slow.” This means prescribing a lower dosage and for less time.

Dr. Anna Lembke of Stanford University believes these guidelines are not applicable to the whole country. “It’s easy to say ‘use non-opioid alternatives,’ but in a lot of rural areas, patients don’t have access to things like physical therapy and mindfulness meditation, and insurance companies won’t pay for it.” Her point is valid. In a country with 250 million opioid prescriptions, her point becomes truth.

In Conclusion

Opioid medication suppliers are in no hurry to slow their sales down. In fact, a new drug is currently being marketed that counteracts the constipation associated with opioid medication use. (It was even advertised during this year’s Superbowl). There will likely be no shortage of opioid painkillers in America anytime soon. However, simply removing the drug from existence would create more problems than it would solve. Many people legitimately rely on opioid medications for a pain-free life.

What we need is more funding to treatment centers, and more availability of Naloxone, an anti-overdose drug that saves thousands of lives. Substance abuse treatment facilities only reach 10% of those that need treatment. For those already addicted, Naloxone can save their lives. In many cases, it already is.

In a documentary called Death by Fentanyl, a Revere, Massachusetts fireman is interviewed about Naloxone. What he says actually says it all. “We tend to have more overdoses than we do fires, so it’s a piece of equipment we can’t go without now.”

What we can go without is a nation plagued by opioid addiction.

DEA Orders Production Cut for Opioids in 2017

Each year, the Drug Enforcement Agency (DEA) sets regulations on the amounts of controlled drugs that are allowed to be manufactured. Over the past three years, the DEA allowed 25% more opioid production than usual. The year 2014 set the record for deaths from drug overdoses, and over 60% of them involved opioids. Citing a decline in demand, the DEA earlier this month has ordered opioid manufacturers to cut production by 25% or more, starting next year.

When setting regulations on the amount of a drug to be produced, the DEA must take into account medical usage, scientific usage, export needs, industrial requirements, and also a reserve stock. The majority of the cuts will be made to this reserve stock, and the cuts will affect almost all Schedule II opioids.  (All drugs are divided into Schedules, according to the Food and Drug Administration. Schedule II opioids include oxycodone, fentanyl, hydrocodone, and morphine, among others. For a complete list of Schedules, click here).

The DEA has reported that the demand for opioids has decreased. This is based on sales data represented by the number of prescriptions written by those registered with the agency. However, the current opioid epidemic in America was not overlooked. In its press release, the DEA stated “The 2015 National Survey on Drug Use and Health (NSDUH) released last month found 6.5 million Americans over the age of 12 used controlled prescription medicines non-medically during the past month, second only to marijuana and more than past-month users of cocaine, heroin, and hallucinogens combined.”

Details on the Opioid Production Cuts

In 1970, Congress passed the Controlled Substances Act (CSA), which established a federal drug policy. The CSA created regulations for the manufacture, importation, distribution, possession and use of almost all substances. The CSA also created the Schedule system and the Aggregate Production Quota (APQ), which is what’s being cut next year. The DEA establishes an APQ for over 250 different Schedule I and II substances each year, according to the press report.

For next year, the reserve stocks of most Schedule II opioids will be cut, meaning a 25% reduction, but in the case of hydrocodone and a few other unnamed opioids, the cuts will be 33%. According to the press report, “The purpose of quotas are to provide for the adequate and uninterrupted supply for legitimate medical need of the types of schedule I and II controlled substances that have a potential for abuse, while limiting the amounts available to prevent diversion.” This ‘diversion’ of substances with a ‘potential for abuse’ currently has America in an opioid epidemic.

Just because of Demand Reduction?

Hopefully these production cuts can make a difference. Although a reduction in demand was cited as the main reason for production cuts, the DEA knows we are in an epidemic. In a June press release, Administrator Chuck Rosenberg said, “We tend to overuse words such as ‘unprecedented’ and ‘horrific,’ but the death and destruction connected to heroin and opioids is indeed unprecedented and horrific. The problem is enormous and growing, and all of our citizens need to wake up to these facts.” According to the DEA’s own 2016 National Heroin Threat Assessment Summary, the number of heroin users has recently tripled, and so has the number of heroin deaths.

The following graph, published in 2014 by the National Institute on Drug Abuse, brings up two important points. One is that yes, there is a reduction in the number of prescriptions written from 2012 to 2013, but two is that there is an absurd number of prescriptions being written regardless.

opioid-prescriptions-written

Perhaps this is why in July of this year, six US Senators co-wrote a letter to the DEA calling for stricter limits to be placed on opioid pills. In the text of the letter were some alleged facts regarding the APQs for opioids over the last 22 years. “Between 1993 and 2015, DEA allowed aggregate production quotas for oxycodone to increase 39-fold, hydrocodone to increase 12-fold, hydromorphone to increase 23-fold, and fentanyl to increase 25-fold.” While it would be bold to say the DEA is at fault, it is hard to look past the fact that 14 billion opioid pills dispensed per year in this country.

Also hard to look past are the facts that the pharmaceutical companies are pushing for the prescription of opioids, and that medical institutions have been over-prescribing opioids for years now.

Big Pharma wants Big Opioid Numbers

According to the Associated Press and the Center for Public Integrity, opioid medicine manufacturers employ lobbyists and spend millions to “help kill or weaken measures aimed at stemming the tide of prescription opioids.” As a matter of fact, over the past decade, nearly $900 million has been spent advocating and lobbying for pharmaceutical companies, versus the $4 million spent on opioid limiting. Also over the last decade, the opioid industry has contributed to 7,100 state-level political candidates, has averaged 1,350 lobbyists in all fifty states, and has used the Pain Care Forum to influence opioid regulations on the federal level.

Dr. Andrew Kolodny, the founder of Physicians for Responsible Opioid Prescribing, says, “The opioid lobby has been doing everything it can to preserve the status quo of aggressive prescribing. They are reaping enormous profits from aggressive prescribing.” Evidence suggests he’s right. Actually, in 2007, Purdue Pharma, creators of Oxycontin, pled guilty to charges of misbranding and of misleading regulators, doctors, and patients. The dangerously addictive quality of the drug was criminally misrepresented, and Purdue Pharma paid $34.5 million in fines.

The lead lobbyist for Purdue Pharma is also part of the Pain Care Forum.

Doctors Prescribe too many Opioids

According to a national survey, 99% of doctors prescribe opioid medicines for longer than the recommended three-day period. 23% of doctors prescribe a month’s worth of them. Also, 74% of doctors consider morphine and/or oxycodone (both opioids) to be the most effective pain treatment medicines, but National Safety Council (NSC) research suggests the most effective pain treatment meds to be over-the-counter.

Something else 99% of doctors have done is seen a patient who was seeking pills for recreation or seen evidence of drug abuse in a patient, but only 38% of doctors refer such patients to get help. A mere 5% treat the abuse themselves. As published by the NSC, other findings among doctors include:

  • 71% of doctors prescribe opioids for chronic back pain, and 55% prescribe them for dental pain – neither of which is appropriate in most cases.
  • 67% of doctors are, in part, basing their prescribing decisions on patient expectations; however, a National Safety Council poll in 2015 showed 50% of patients were more likely to visit their doctor again if he or she offered alternatives to opioids.
  • 84% of doctors screen for prior opioid abuse, but only 32% screen for a family history of addiction – also a strong indicator of potential abuse.

Aetna and other big Insurance Companies have started putting these companies on “Super-Presciber” Watchlists.

Opioid Epidemic

It’s rather doubtful that any conspiracies are occurring, and it’s highly doubtful that the DEA and big pharma do not care about the skyrocketing number of opioid-related deaths. Regardless, though, we are amidst an opioid epidemic, and much more has to be done before we are in the clear.

An estimated 36 million people worldwide abuse opioids, with over 2 million of them here in the US. Up to half a million Americans abuse heroin. The correlation between non-heroin opioid abuse and heroin abuse is astounding.

The Substance Abuse and Mental Health Services Administration published in 2013 findings that show the “heroin incidence rate was 19 times higher among those who reported prior nonmedical pain reliever (NMPR) use than among those who did not.” (For the record, NMPR abuse is a fancier way of saying opioid pill abuse). Furthermore, 80% of heroin users had previously abused other opioids, whereas only 1% of opioid pill abusers had previously done heroin. It seems Schedule II opioids are a gateway drug to heroin.

Also, as seen in the following graph, the heroin incidence rate itself has been steadily rising for over ten years:

heroin-usage

Drug overdose is the number one cause of accidental fatality in America, and opioid-related deaths are fueling this disaster. The sale of prescription pills quadrupled from 1999 to 2010, and hit record numbers in 2014. Prescription pill overdose and death also quadrupled over this time, and also hit a record number in 2014. Surely this is no coincidence.

What is being done?

Aside from cutting production of opioids by up to 33% next year, the DEA also instituted its 360 Strategy last year to help combat the opioid epidemic. The strategy is comprised of three initiatives, together designed to “not only fight drug traffickers but also to make communities resilient to their return.” The three initiatives are:

  • To coordinate enforcement actions that target drug traffickers and suppliers
  • To advocate responsible prescribing methods by an increase in awareness of the heroin and prescription drug epidemic among manufacturers, wholesalers, medical institutions and pharmaceutical companies
  • To empower communities with whatever necessary to combat the epidemic

Head of Philadelphia’s DEA division Gary Tuggle says, “DEA’s 360 Strategy recognizes that we need to utilize every community resource possible to reach young people and attack the heroin and prescription drug epidemic at multiple levels.”

Earlier this year, the Centers for Disease Control (CDC) issued its 2016 Guideline for Prescribing Opioids for Chronic Pain. Adherence to this guideline ensures “safer and more effective chronic pain treatment.” According to the text of the guideline, 20% of patients with non-cancer pain symptoms receive an opioid prescription. In 2012 alone, nearly 260 million opioid prescriptions were written in the US, which was the approximate number of adults living in the US at the time.

Making the new CDC guideline most necessary is the fact that “rates of opioid prescribing vary greatly across states in ways that cannot be explained by the underlying health status of the population, highlighting the lack of consensus among clinicians on how to use opioid pain medication.”

So essentially, the big pharmaceutical companies push for more opioids to be purchased by medical professionals, who in turn over-prescribe opioids, which then leads to opioid dependence in patients. This vicious cycle needs to be cut off somewhere, and hopefully the production cuts for 2017 are a good start.

At a hearing in June of this year, Senator Richard Durbin (one of the six to write a letter to the DEA) pointed out that in 2014, (the year with the most drug overdoses ever), the DEA allowed enough opioid production “for every adult in America to have a one-month prescription.”

In response, DEA Administrator Chuck Rosenberg said, “I think we’re part of the problem.” Hopefully now, the DEA becomes even more a part of the solution.

“Super-Prescribers” are being Placed on Aetna Watchlist

Picture a bottle of opioid pills, such as oxycodone. Now think about 280 million bottles of opioid pills. That’s how many are given to patients annually. The actual number of pills given out per year is in the billions. In a society all too familiar with substance abuse, it seems no wonder we are in the midst of an opioid-abuse epidemic. Due to the epidemic, Aetna, a very large American health care company, has begun notifying those doctors who prescribe the most opioid pills (super-prescribers); they notified 951 of them in fact.Aetna Watchlist Super-Prescribers

The Facts

The near-thousand doctors notified made up the top 1% of opioid prescribers, now being called super-prescribers. Over 8.5 million insurance claims were analyzed, and only doctors who had prescribed opioids a dozen or more times were included. Had these doctors prescribed at the average rate, nearly 1.5 million less opioid pills would be in public hands. Granted, the vast majority of the patients given opioids needed them medically, but still, plenty of the drugs end up in an abuser’s hands. Not to mention, doctors who routinely prescribe large amounts of opioids were excluded.

Aetna sent the same message to each and every doctor: “You have been identified as falling within the top 1 percent of opioid prescribers within your specialty.” This simple sentence is not a warning so much as a strong suggestion to ensure all opioid prescriptions are necessary. High refill rates may be needed in some cases, but without a doubt some refill rates could stand to be curbed or even ended. 14,838 people died from opioid overdoses in the year 2014 alone.

The Reasons

Harold Paz is the chief medical officer of Aetna. Speaking to the Washington Post, but really speaking to the doctors on the Aetna watchlist, Paz said, “We’re asking you to look at your practice…and identify if the way you’re prescribing narcotics is best practice. And if it’s not, here’s an opportunity to improve.” Nothing criminal is suspected of happening.

This is simply a major step being taken by an insurance provider to help try and end the opioid crisis. According to a recently published article by Journal of the American Medical Association, almost 60% of us leave our leftover prescriptions at home once done with them, and 20% of us give them away. This game of telephone with drugs needs to stop. Please if you’re reading this, do not share your prescription pills and in fact keep them well hidden. If you no longer need them find out how to properly dispose of your excess drugs.

Aetna is not alone in this battle. Other insurance companies have launched similar campaigns to help stop the abuse. Consumers for Affordable Health Care believes lowering the opioid prescription rate will even benefit the insurance companies themselves. This is because the medicine is expensive but also because overdoses lead to other diagnoses that are also expensive. Yes, it may also be about money with the insurance companies, but nevertheless the morals are in the right place.

Cigna, another rather large insurance provider, currently has programs to reduce opioid prescriptions. Their goal is to lower the rate by 25%. Anthem, another insurance company, launched the Pharmacy Home Program, which aims to reduce the amount of people who attempt to receive multiple prescriptions from multiple doctors and therefore receive multiple bottles of pills. This is known as “doctor shopping” and is punishable by law.

The Hope

We can only pray that somehow the opioid abuse problem in America stops. This is a good thing that Aetna and other insurance companies are doing, but it will not stop the problem by itself. Education on drug abuse at early ages and a whole lot of human help is required, but it is not impossible.

Heroin Overdose: A Picture of Abuse

I can describe a cactus. I can tell you about its thick, bulbous leaves, and how they’re covered in spines. I can explain how the cactus has dry, tannish spots on its leaves, and how tall the cactus is. I can literally read the dictionary definition of ‘cactus’ to you, but if you have never seen a cactus, all of my words are useless. Take a look at one, though, and you know exactly what a cactus looks like, no words required.

Sometimes a picture says it all.

Such is the case with this couple from Ohio. Both are passed out from heroin use, inside a vehicle, with a small child in the rear seat. The story makes you cringe, but it’s a story that needs to be heard.

heroin overdose ohio

What Happened?

Last Wednesday in East Liverpool, Ohio, James Acord was pulled over by Officer Kevin Thompson. Acord was driving erratically and weaving in and out of traffic. He told Officer Thompson he was bringing his girlfriend, Rhonda Pasek, to a nearby hospital. She was passed out in the passenger seat. An affidavit from the arrest says Acord’s head was “bobbing back and forth,” and that “his speech was almost unintelligible.” Immediately after speaking to the officer, Acord fell unconscious himself. That was when Officer Thompson noticed a little boy in back of the car.

Rhonda Pasek’s 4-year-old son was in the back seat, witnessing his mother and her boyfriend overdose on heroin before his very eyes.

Officer Thompson noticed Pasek turning blue and called emergency medical technicians to the scene. The technicians administered Narcan, a powerful anti-overdose drug, to Pasek, possibly saving her life.

Acord pled guilty to the charges of operating a vehicle while impaired as well as endangering the welfare of a child. He was sentenced to one year in jail, had his driver’s license revoked for three years, and was fined $475. Pasek pled non-guilty to the charges of endangering the welfare of a child, disorderly conduct, and public intoxication, and has a bond set for $150,000.

Setting an Example

The pictures of them unconscious in the vehicle were taken by the arresting officer. Less than a week after the incident, the city of East Liverpool decided to publish the pictures on the city Facebook page. Their reason for doing so, (from the page):

We feel it necessary to show the other side of this horrible drug. We feel we need to be a voice for the children caught up in this horrible mess. This child can’t speak for himself but we are hopeful his story can convince another user to think twice about injecting this poison while having a child in their custody.

The pictures are graphic, but they reveal so much about the heroin epidemic that has swept our country. Heroin addiction is so awful that couples with children are passing out behind the wheel. These two were made examples by a state that knows firsthand how terrible the heroin epidemic can be.

Ohio has a Heroin Problem

“We are well aware that some may be offended by these images and for that we are truly sorry, but it is time that the non drug using public sees what we are now dealing with on a daily basis.” This was published along with the pictures on the East Liverpool Facebook page. The city speaks from experience.

Heroin overdoses rose by over 70% in Ohio from 2012 to 2013. The following year, they rose by 300%. Ohio had the second most drug overdose deaths of all fifty states in 2014. The Centers for Disease Control (CDC) called Ohio’s heroin problem “an emerging threat to public health and safety.” As of this year, 18 Ohio residents die per week of heroin. 92% of those imprisoned in Ohio have a history of drug addiction. The Ohio State Bar Association (OSBA) website sums it up well: “Heroin addiction is an epidemic in Ohio, affecting countless individuals and families.”

The OSBA site also deals with some legislation recently passed in Ohio to combat the problem. The Attorney General’s Office has established a Heroin Unit for prosecution support and extending education. A plethora of laws have been passed recently to further criminalize heroin dealers. The site says the state “is mounting a vigorous fight against heroin.” Casey’s Law was passed in 2012, strengthening the rehabilitation process for heroin addicts by allowing for court-ordered involuntary drug treatment by request. The Ohio Automated Rx Reporting System requires those receiving opioid-based prescriptions to undergo a patient review process.

Countless more legislation is being tossed at the heroin epidemic in Ohio. Unfortunately, Ohio is not alone in this fight. The heroin epidemic is national, not contained within any state’s borders. Although Ohio has it bad, America has it bad, and the numbers prove it.

America has a Heroin Problem

Current estimates show there to be about 900,000 heroin users in America, with 586,000 of them addicted. Approximately 10,000 people die from heroin overdoses a year. To put that in perspective, by the time you finish watching a two-hour movie, three people will have fatally overdosed on heroin. The people overdosing are not suicidal maniacs running around with multiple needles in their arms, either. The CDC determined 81% of drug overdose deaths to be unintentional. Regardless of what the picture on the East Liverpool website may look like, and regardless of what you may have in your mind as an image of a heroin addict, these are real people, most of them young, and they need help. The average of an American heroin addict is 23.

We part with more words posted alongside the picture of James Acord and Rhonda Pasek on the East Liverpool Facebook page: “The poison known as heroin has taken a strong grip on many communities not just ours, the difference is we are willing to fight this problem until it’s gone and if that means we offend a few people along the way we are prepared to deal with that.”

Maryland Governor Spends $3 Million to Fight Drug Abuse & Crime

Maryland Governor Larry Hogan

Maryland Governor Larry Hogan

The state of Maryland has a heroin problem. Baltimore has even been dubbed the “heroin capital of America.” Studies have shown 1 in 10 Baltimore residents to be heroin addicts. The rest of the state is plagued as well, with overdose rates soaring in multiple counties. The state of Maryland also has a crime problem. The FBI recently named Maryland as the ninth most dangerous state in the country, more dangerous than Michigan, California, and even New York.

Maryland Governor Hogan Pledges Millions

To help stop the madness in Maryland, the state’s governor, Larry Hogan, pledged $3 million earlier this month. Approximately one-third will be spent providing heroin coordinators to every region in the state, and the rest will be used as funding for the Safe Streets Initiative. Heroin coordinators will provide data-sharing between law enforcement agencies, the state’s attorney offices, the Health Department, and the general public. This is essential to combating the problem, as research yields results which can then be rendered. Basically, the more that is known, the more that can be done about it.

The Safe Streets Initiative is the main focus, a program designed to reduce violent crime in Maryland. Over $2 million was allocated to it, and it has proven itself to be effective for crime reduction in Maryland in the past. The first Safe Streets Initiative was launched in Annapolis in 2008, and the second in Salisbury in 2010. After showing success, seven more were launched. Similar to what heroin coordinators will be doing, the Safe Streets Initiative utilizes data-sharing, however more so acts as the governing body behind policy. Personnel of the initiative ensure protocol is being followed, and that all agencies involved in justice for violent crimes are coordinated and open with one another.

Among Other Things…

Eighteen heroin coordinators will be employed, covering all regions of the smaller-sized state. Also, nine Safe Streets Initiative locations will receive ample funding to now include “the Heroin and Opioid Emergency Task Force to devise a plan to address the… growing heroin epidemic across Maryland.”

While large portions will be allocated to funding new positions within both the task force and Maryland law enforcement agencies, a plethora of other helpful things will be funded. These include adding beds to treatment centers on the Eastern shoreline, increased funding to drug-dealer apprehension, a public awareness campaign on addiction, and training law enforcement on how to properly administer anti-overdose medication.

Fighting Crime and Drug Abuse at the Same Time

The Heroin and Opioid Emergency Task Force will perhaps be the most effective part of Governor Hogan’s initiative. On top of the aforementioned actions being taken to fight the epidemic, the task force implemented Peer Recovery Specialists into every Safe Streets Initiative in the state. (One exists in every major county’s police department, ensuring all regions are covered).

Peer Recovery Specialists will specialize in giving treatment to those arrested who have drug addictions. According to Maryland Governor Hogan’s office, “Peer Recovery Specialists are individuals in recovery from substance abuse or co-occurring mental health disorders that have been trained and certified in specific areas of knowledge and skill sets which allow them to provide effective recovery and support services.”

All those arrested in Maryland deemed by the specialists to have substance abuse problems will receive treatment. “Throughout Maryland, from our smallest town to our biggest city, heroin is destroying lives,” said the governor of an already crime-ridden state. We hope $3 million is enough.

Tara Bealer: College Professor. Community Activist. Heroin Dealer.

The story of a heroin dealer all too often ends with an overdose. In the case of 42-year-old Northampton Community College professor Tara Bealer, the story begins with an overdose.

Tara Bealer Arrested

Tara Bealer Arrested

Last year, Tara Bealer was living a normal life with her daughter in Nazareth, Pennsylvania. She was a sociology professor at both Stroudsburg University and Northampton Community College. She had recently founded Renew LeHigh Valley, a program designed to employ local young professionals in various fields. Everything about Bealer seemed wholesome.

Then, on November 21, a heroin overdose occurred inside the Bealer residence. During the course of the investigation, “heroin packaging was found,” according to Police Commissioner Randall Miller.

Leading a Double Life

The discovery of heroin packaging was not enough to charge Bealer with a crime, but she was under watch by the police. Then, in January, an anonymous tip was given to the police about Bealer. She was apparently selling up to 50 bags of heroin a day out of her home. The investigation from November promptly continued, and police discovered “cash, 68 used bags of heroin, and straws for inhaling the drug,” according to LeHigh Valley News.

She was arrested and committed to Northampton County Prison on the following charges: four counts of felony possession of a controlled substance with intent to deliver, one count of felony endangering the welfare of a child, six counts of misdemeanor possession of a controlled substance, two counts of possession of marijuana, and a whopping 71 counts of misdemeanor drug paraphernalia possession.

The trouble didn’t stop there.

The True Self Appears

Bealer posted the $50,000 bail after being arrested and still faces the above-mentioned charges. However, since posting bail, Bealer has failed two marijuana drug tests and was charged with a DUI for alcohol in February, her third DUI offense. She now must wear a SCRAM bracelet, which monitors alcohol use 24/7. Literally embedded in the skin, the bracelet can detect alcohol consumption at any level.

To Bealer’s credit, four other drug tests came back negative, and she has yet to miss either a court session or a drug rehabilitation class. She is allowed contact with her daughter while on bail, however her teaching positions have been suspended.

The fact of the matter is that drug dealers have no visual identity. From the man on the street to literally the woman teaching sociology at the local community college, drug peddlers can be anywhere.

Kilogram of Elephant Tranquilizer, Carfentanil, Seized in Canada

 

Carfentanil is the sedative zookeepers and veterinarians use to tranquilize elephants and other extremely large mammals. It is 100 times stronger than Fentanyl, which is 100 times stronger than morphine. Unfortunately, it is also a recent addition to heroin, and it is killing people at alarming rates. July in Ohio this year produced 141 overdoses from Carfentanil laced heroin. Recently, well over 50 overdoses were reported in the Pennsylvania area.

In June, the largest illegal concentration of Carfentanil to date was discovered at a mail center in Vancouver, Canada. Weighing one kilogram, the amount discovered is enough to kill the entire population of Canada and NYC combined. Over 50 million fatal doses can be made from the one kilogram seized.

 

How was it found and what is it used for?

The package was discovered by the Canadian Border Services Agency in a mailroom in Vancouver. Addressed to a man named Joshua Wrenn in Calgary and sent from China, the package said it contained printer accessories. This isn’t the first time Carfentanil was seized in Canada, although the first seizure was much less substantial.

Drug dealers use Carfentanil as an additive to heroin, making the drug much more potent. The problem is that less than a microgram can be fatal, and drug dealers surely aren’t out to save lives. The amount of Carfentanil put into heroin, when added, is impossible to detect.

Forensic chemist Brian Escamilla weighed in on the fatal aspect of such little Carfentanil being needed to kill. Escamilla said, “You’d have to really be looking, especially if you mixed it with another drug like heroin — there’d be a hell of a lot more heroin in there than there would be Carfentanil, and so it would just be a blip on the screen. Whether the toxicologists pick that up or not … that could easily be missed.”

 

Elephant sedatives are becoming an epidemic?

Use of Elephant tranquilizers and similar substances in heroin is becoming an epidemic. In Canada alone, this is the second Carfentanil bust. Fentanyl is also commonly used in heroin. Over the last six years, Canada has seen 84 seizures of Fentanyl. British Columbia has even declared a public health emergency regarding the two substances.

Let’s bring it home. Carfentanil as used in heroin is a relatively new phenomenon. Still, busts have occurred in Ohio, Pennsylvania, and even Florida. Regarding Fentanyl, major busts have recently occurred in New York, Maryland, New Hampshire, and even in Georgia. Respectively, 6,000 doses, 510 grams, 2.5 kilograms, and 40 kilograms were seized.

Unfortunately, do enough research and you can find a bust for Fentanyl or Carfentanil in every state; apparently now too, other countries. As if there were not enough reasons to avoid heroin, the risk of there being elephant tranquilizers in it should be enough to make anyone stray. As Jim Nice, police chief of Akron, OH said in an interview with CBS, ““Most of the deaths from heroin overdoses are coming from too much fentanyl being cut into that.” Carfentanil, remember, is 100x stronger.

Drug Take Back & Disposal Programs

Up until 2010, people with leftover or unwanted prescription medication didn’t have a lot of options when it came to disposing it. The Controlled Substances Act of 1970, or CSA, recommended one of three ways: self-disposal through flushing or discarding, giving them to police officers, or contacting the DEA. Then, forty years later, in October of 2010, the Secure and Responsible Drug Disposal Act was passed. The act amended the CSA to allow for (and fund) drug disposal sites and drug take back programs.

Since then, numerous sites and programs have been in action. We will discuss the importance of having these sites and programs, where you might be able to find one, and also the extracurricular benefits drug disposal offers.

Why do this?

The main reason for initiating drug take-back and disposal programs is for public safety. Studies from the New York Department of Health show that 2,500 kids a day abuse their first prescription pill. For 12 and 13 year olds, the prescription pill is the drug of choice, and abuse of medication has come to be known as “pharming.” 4.5 million American children have “pharmed” and trust that they are getting the pills from friends and family. Go home and open your medicine cabinet. What’s really in there?

According to the Food and Drug Administration, “…more than 30 reports of accidental exposure to the powerful pain medication in fentanyl patches – most of them in children under two years old” have occurred to date. Twelve cases were fatal. Who knows how many children overdose from prescription pills acquired easily from a cabinet?

The secondary reason for these programs is environmental protection. When pills are discarded, flushed, or even passed naturally through the body, trace amounts end up in both the soil and the water. While studies show the impact on humans is negligible, the impact on microorganisms and the surrounding environment are less understood. A quote directly from the study done by the National Library of Medicine reads, “…recent monitoring studies have detected low levels of a wide range of pharmaceuticals … in soils, surface waters and groundwaters…”

Removing countless pills from the hands of minors and protecting the environment at the same time sounds like a heck of a payoff from implementing these programs.

How can I dispose of my meds?

There are now plenty of ways to safely discard unused or unwanted medication. The DEA offers annual drug take back days. Start here by seeing if there is a local collection site near you. (Note to reader: at the time of this publication, the website read that collection sites are still being confirmed, and will be searchable ASAP). Also, along the same line, is an organization known as MedReturn. They set up safe collection sites that are available for use every day. Click here to find a MedReturn site near you.

If reaching a collection site is not possible, Pharmaceutical Research and Manufacturers of America (PhRMA), recommends the following for home disposal. Do not flush or dump into the sink any medications without checking to see if they can safely be flushed. Now, remove all pills from all containers, place them into a plastic bag, and fill the rest of the bag with pungent waste, such as coffee grounds, food waste, cat litter, etc. The idea is to deter any human or animal from ingesting the drugs, even after disposal. For any sharp objects being discarded, place them in disposal containers made of hard plastic.