Category Archives: Opioids

Opioids & Heroin Epidemic

opioid and heroin epidemicThe opioid epidemic is a serious problem in America today. In the late 1990s and early 2000s, prescription opioid drugs were touted as low-risk solutions for chronic pain and other conditions. Thousands upon thousands of people all across the country were led to assume that opioid drugs were relatively safe solutions to temporary or chronic pain, and these days, almost everyone in America knows somebody whose life has been negatively affected by these dangerous drugs.

As the use of prescription opioid drugs became more and more widespread, another equally destructive problem continued to simmer in the background: heroin abuse. In recent years, these two disparate issues have combined into a maelstrom that is ravaging the country. By learning more about the origins of the opioid epidemic, you can insulate yourself against the dangers that this mounting trend poses.

What Are Opioids?

Opioids are a class of drugs that block pain by directly interacting with pain circuits in the brain. In addition to reducing the sensation of pain, these drugs also produce a euphoric high that quickly becomes addictive. When opioid drugs are used in their prescribed concentrations, they can be effective short-term tools for fighting pain, but abusing these drugs quickly results in addiction.

The original opioid was opium, which was used in the ancient world for analgesic and recreational purposes. Opium is extracted from the bud of the poppy flower, and it is also known as the “milk of the poppy.” While opium itself isn’t widely used in the West anymore, every type of synthetic opioid is in some way derived from the substance. For instance, morphine was one of the first isolate opioids to be extracted from opium, and it is still widely used in medical settings today.

Morphine is much more powerful than normal opium, and the first signs of opioid abuse in America began with cases of morphine addiction in the mid-20th century. However, another synthetic opioid known as oxycodone rapidly supplanted morphine as the go-to drug for cases of pain that were moderate to severe. Today, oxycodone is widely known by its brand names OxyContin and Percocet, and it is one of the main drivers of the opioid epidemic.

As medical drugs like morphine and oxycodone gained popularity in the mainstream, another type of opioid steadily crept into American homes from the shadows. Known as heroin, this morphine derivative is of much lower quality than other types of opioid drugs, and since it is made by criminal drug gangs, there is no way for end users to guarantee that their supply is safe. This drug is usually cut with cheaper substances, and long-term users often inject it into their bodies with needles that may or may not be safe.

Heroin powder is white in its pure form, but most types of street heroin are brown due to additives. An even more insidious type of this drug is also available to street users: black tar heroin. It is either gummy or hard as a rock and derives its name from its black color. This type of heroin is the cheapest, but it is also more likely to be filled with pollutants than any other form of this street drug.

In recent years, however, a street drug that’s even more dangerous than heroin has made its debut. While fentanyl is used in hospitals under extreme circumstances, this drug is also manufactured in China and other countries and smuggled into the United States for illicit use. If fentanyl were just another opioid like oxycodone or morphine, it would be easier to lump this drug into the existing opioid crisis. However, fentanyl is a synthetic opioid that is much stronger than others traditionally manufactured in the pharmaceutical industry.

The Centers for Disease Control and Prevention (CDC) has estimated that fentanyl is 50 to 100 times stronger than morphine. As an abused substance, fentanyl had its debut as an incredibly potent designer drug that was mainly used by wealthy coastal elites. As prices of fentanyl have dropped, however, it has been much more widely used.

These days, it’s common to find fentanyl included in bags of street heroin. Many users are unaware of the presence of this drug in their supply, and they may choose to use their regular dose immediately upon receiving a new bag of drugs that has fentanyl in it. The results of this choice can be disastrous. Because fentanyl is so much stronger than normal heroin, it’s far easier to overdose on heroin that has been spiked with this highly potent synthetic drug.

What Is Fueling the Epidemic?

There are a number of factors that are contributing to the ongoing prevalence of the opioid epidemic in the United States. It’s possible to trace the origins of this pressing social issue back to earlier days of heroin abuse in the United States. During the waning decades of the 20th century, heroin became more and more popular throughout the country. When opium production spiked in Afghanistan in the years following 9/11, this problem only became worse.

Today, it appears that a significant amount of heroin is still coming into the U.S. from foreign countries. While cocaine and marijuana seizures on the country’s borders have decreased in recent years, heroin seizures have increased in some areas. Additionally, although there is no statistical information yet available on fentanyl seizures along the border, a U.S. citizen was recently arrested while attempting to smuggle nearly 11,500 fentanyl pills across the San Ysidro Port of Entry. Fentanyl is so powerful that a batch of pills of that size could easily poison a sizeable town.

Despite the fact that fentanyl poses such a danger to users, companies in China and other countries continue to produce this drug. In many cases, these companies often sell fentanyl directly to American citizens over the dark web. In other situations, fentanyl is smuggled into the country for illicit use. However, increased awareness of the dangers of this drug is minimizing the domestic market for fentanyl.

Historically, one of the biggest impediments to halting the opioid crisis has been domestic opioid manufacturers. For instance, the manufacturers of OxyContin, Purdue Pharma, once claimed in their official materials that their prescription opioids were safer than morphine and other types of opioid drugs. These types of misguided marketing campaigns led many doctors to believe that some opioids were safer than others. In many parts of the country, prescriptions for these drugs increased. For example, in the state of West Virginia, 110 opioid prescriptions were written for every 100 people in 2013 at the height of the opioid crisis. While certainly not all of these prescriptions were illegitimate, the sheer number of pills being prescribed made the drugs much more widely available for use.

The rise of prescription painkillers has even had a bleed-over effect into heroin abuse. According to the National Institute on Drug Abuse (NIDA), using prescription opioid drugs increases the likelihood that you will use heroin. This phenomenon is partially fueled by the fact that this drug is generally cheaper than prescription opioids, and it’s easy to find a supply of heroin even when your doctor refuses to prescribe you any more opioids.

To briefly recap, here are the most prominent reasons why the opioid crisis is still a significant problem in the United States:

  • Medical: Doctors have prescribed much higher doses of opioids than are safe for extended periods of time.
  • Smuggling: Many tons of opioids have come over the U.S. border in recent decades. These drugs continue to be smuggled into the country.
  • Plentiful supply: The dangers of opioids are becoming better known, but these drugs are still widely produced and prescribed.
  • Prescription and illicit overlap: Since both heroin and prescription opioid drugs are widely available, it’s easy for addicts to remain addicted.

What Is Being Done

In recent years, greater attention has been paid to the problems that have arisen from increased opioid drug use in the United States. The Trump Administration declared that the opioid epidemic is a Public Health Emergency in 2017. This declaration has brought more attention to the blight of opioid drugs in American communities, and members of the Trump administration have begun coordinating with local officials around the country. Alongside the highest office in the land, policymakers and medical professionals across the United States are leading a national conversation focused on how to best combat this issue in local communities that each face their own unique problems.

The greater emphasis on border security has also helped decrease the supply of opioids entering our country illegally. While keeping illicit opioids from passing through our points of entry will ultimately require the help of other nations, every border seizure of heroin or fentanyl is another batch of drugs that won’t make it into the hands of Americans who suffer from opioid addiction. The incoming Obrador administration in Mexico has promised to work with the U.S. government to fight the power of the cartels in Central and South America. In addition, better diplomatic relations with China will inevitably lead to decreased fentanyl production.

An increased public awareness of the danger that opioids pose has been the most effective measure in curbing the spread of this epidemic. While stopping the drug supply is one half of the equation when it comes to stamping out the opioid menace, education is another critical part of this initiative. An informed populace will be less likely to make decisions that are harmful, and adults who have been educated regarding the dangers of opioids will pass their knowledge down to their children. In decades past, Americans were largely unaware of the dangers that opioids posed to themselves and their communities. However, the American people have woken up to the problem and many are actively working to find a solution.

Increased prevalence of abuse-deterrent formulations (ADFs) in prescription pills has made it harder for people to abuse drugs like OxyContin and Percocet. However, ADFs aren’t present in the majority of prescription opioids, and they aren’t present in any illicit drugs like fentanyl or heroin.

If more people become aware of the dangers of opioid drugs, and if fewer opioids are made available to the populace, this fire will naturally extinguish itself. In the raging blaze that is opioid addiction, the drugs themselves are the wood and ignorance about the dangers of opiates is the oxygen. When starved of these vital components, any fire has no choice but to go out. By surrounding this problem from all sides, we are making the gradual destruction of this danger to our well-being a guaranteed inevitability.

Vermont Opioid Epidemic

On June 6th, 2017 Dutchess County of New York State filed a lawsuit against 11 pharmaceutical companies on several allegations regarding their production and distribution of prescription opioid painkillers. The lawsuit alleges that pharmaceutical companies have used deceitful tactics to market prescription opioid painkillers, an epidemic that has swept across the nation resulting in several deaths that only continue to increase by the year. Keep in mind, considering the date of the lawsuit, that nothing has come of the it and Dutchess County is not necessarily setting a precedent as 5 other New York State counties have filed similar lawsuits against pharmaceutical companies and individual providers. There are 62 counties in New York State.

vermont opioid epidemicAs has become the norm in a capitalist society like the United States, money is a powerful and nearly undefeated entity. How often do you see money being the driving force behind evil and selfish acts? It’s safe to assume money is the driving force behind the companies and providers turning their back on a public health crisis, even if it didn’t start that way. Addiction is a disease, as is cancer, and the former is much easier to turn your back on.

In addition to the lawsuit against pharmaceutical companies, Dutchess County has named a handful of prescribing providers alleging that they were responsible for promoting opioids for sale and distribution locally and nationally. Dutchess County Legislator, Jerry Landisi, is quoted saying “We have been fighting this war on drugs and addiction, but the enemy has been supplied by these pharmaceutical companies who have chosen to put profit ahead of patient safety.”

The problem is spreading and there does not seem to be an end in sight. Several states are seeing the devastating effects of the opioid epidemic, including Vermont. In fact, Vermont ranks ninth among the National Safety Council’s top 10 states with the highest heroin fatality rates per capita.

So, what gives them a right to blame the companies and prescribers? Is it pure ignorance? As it is for many professionally licensed providers, there are annual continuing education requirements. Any responsible doctor would take note of the rise in deaths due to prescription opioid use.

Let’s look at the numbers

National Heroin/Opioid Statistics

  • In 1999 there were 7,523 deaths due to prescription opioids
  • In 2015 there were 29,728 deaths due to prescription opioids
  • In 1999 there were 2,675 deaths due to illicit opioids
  • In 2015 there were 19,884 deaths due to illicit opioids

If you’re wondering why pharmaceutical companies and individual providers are being held accountable, the above statistics should be telling. Not only have patients become addicted to pain management medications prescribed by their doctors, they seem to be seeking out the drug after the prescription has lapsed.

To the naysayers that may point to our population growth in America, which has grown 14% between 1999 and 2015. The population growth of 14% pales in comparison to the 295% increase in prescription opioid deaths over the same time frame. If we’re aiming for population control then we have the answer.

There are some states that are considered to be doing it “right”, most notably, the state of Vermont, which is just a mere ninety miles from the center of Dutchess County, NY.

Now that we’re shifting away from the most recent lawsuit in New York, let’s see what their neighbors are up to, besides filing lawsuits.

Vermont Opioid Statistics

  • In 2010 there were 38 deaths in Vermont due to prescription opioids
  • In 2016 there were 38 deaths in Vermont due to prescription opioids

Wait, the opioid deaths did not increase 295% in Vermont? Yes, the same number of people died at the hands of prescription drugs but they must be doing something “right” in Vermont.

Before we dive into the treatment programs and legislation associated with Vermont’s success let’s widen the spectrum again briefly. On a national level, for those addicted to opioids the people closest to them are the most dangerous enablers. In 2015, a survey determined that 36% of people that misused a prescription pain reliever received the drug directly from their doctor. Another 54% of misuses were taken, bought or given to the person by a friend or relative. The remaining 10% fell into the following categories:

  • 9% bought from a drug dealer or stranger
  • 9% obtained the prescription pain reliever “some other way”

It’s not the dark alley dealer we have to worry about. It’s the people that are supposed to care about our health and well-being.

How is Vermont Preventing Prescription Opioid Misuse?

While the following list is seemingly vague, we get an idea of what programs and prevention tactics are being employed and we’ll take a close look at a couple of the programs and the elements that make them successful. Vermont reportedly has the following prevention and treatment programs in place:

  • Mandatory Prescriber Education
  • Opioid Prescribing Guidelines
  • Eliminating Pill Mills (VT doesn’t have them but also doesn’t have legislation to eliminate/prevent them)
  • Prescription Drug Monitoring Programs
  • Increased Access to Naloxone
  • Availability of Opioid Use Disorder Treatment

Particular to mandatory prescriber education and opioid prescribing guidelines, at first glance, it could seem like just more charting in an attempt to decrease liability with a smoke screen of caring for the patient. However, it seems the amount of charting that needs to occur cannot be fudged or faked as there are too many stipulations in place that call upon the doctor to be, well, a responsible doctor! For example, when prescribing an opioid painkiller the prescriber must evaluate the benefits and risks, including risk of misuse. Additionally, the provider will need to produce a diagnosis that supports prescription opioids and consider and document the possibility of a non-opioid alternative as well as a non-pharmacological treatment.

These doctor and patient education attempts will help prevent the patients from confusing the drowsy eye warning on the bottle as a “wink, wink” suggestion, much like Lucille Bluth, of the cult television show, Arrested Development.

Beyond the Initiation Point

If you’re looking for a hole in Vermont’s approach, you must read on to determine if you feel it’s a credible approach. What’s been described in the preceding section is a small part of the process, the opioid initiation stage. How should we expect doctors, especially ones that see dozens of people on weekly basis, monitor opioid use after the initial prescription?

For general practitioners that aren’t seeing improvement in their patient’s condition they must be comfortable with a referral to a pain management specialist and/or a substance abuse specialist. Mainly, don’t be so damn arrogant! Some of the risk indicators are listed below:

  • Treatment goals are not met despite escalating doses.
  • The patient’s history and/or a screening indicate high risk for misuse, abuse, diversion, addiction, or overdose.
  • The prescriber knows or suspects based upon reasonable grounds that the patient has engaged in misuse of opioids or other substances.
  • The patient obtains prescriptions from multiple prescribers and/or multiple pharmacies.
  • The patient has been prescribed multiple controlled substances

Relating back to the more charting phenomenon, it seems that a common theme within Vermont’s model is documenting their treatment of the patient. Vermont’s laws indicate that the patient must be seen within 365 days of the initial prescription, otherwise the provider will be held accountable for being in violation of a state law. The annual review of a patient’s prescription mirrors the initiation stage and what’s important about the annual requirement is that patients that are misusing or are addicted have to come back and evaluate their use themselves. That way the provider and patient are being held accountable. The annual reevaluation period has the following salient elements:

  • Reevaluation of effectiveness and safety of the pain management plan and the patient’s adherence to the treatment regimen.
  • Potential for non-opioid/non-pharmacological treatments.
  • Functional status examination of the patient.
  • Review of the Controlled Substance Treatment Agreement and Informed Consent, and any revisions to the conditions.
  • Assessment of co-morbid conditions.
  • Related actions that may prompt adjustments to treatment, including aberrant behavior, early refills, or other factors reasonably suggesting risks associated with misuse, abuse, diversion, addiction, or overdose.

Of the aforementioned elements, especially within the one year mark, what sticks out the most the requirement to assess for comorbidity. Yes, the patient may have come with back pain due to recent surgery however, he or she may have developed an addiction over time, especially due to the vulnerability a physical ailment can create. Those suffering from an injury or that are in recovery cannot always participate in regular activities, may be bed ridden at times and feel alienated from their social group. All of those elements could result in depressive symptoms, which put someone at much higher risk to misuse or abuse drugs.

As indicated earlier, addiction is a disease and must be recognized and treated as such. While Vermont is seeing their most significant decrease in prescription opioid misuse in the 18 to 25 age range, the Substance Use and Mental Health Services Administration found that the rates for mental illness and substance use disorders were the highest (35.1%) for people in the same age range.


While the opioid epidemic is alive and well, it’s a welcome sight to see Vermont attempting to increase their treatment capacity to deter the effects to their residents. Much like the tobacco industry’s settlement with 46 states in 1998, the wave of lawsuits may force the pharmaceutical companies to take more responsibility for ignoring or downplaying the addictive nature of opioids. In the tobacco settlement the tobacco industry agreed to make ongoing payments to the 46 states involved to fund anti-smoking campaigns and public health programs. With the current climate of healthcare and the increasing cost, a similar settlement could be applied to the opioid epidemic. In the meantime, other states should be following in the footsteps of Vermont because, just like tobacco, much of the damage is already done. The patients are hooked. What makes this even worse is that many of those hooked started with trying to get help. We’ve learned quite a bit since the time period of doctors recommending smoking. Let’s not be so naive again.

Fentanyl & Carfentanil Deadly for Law Enforcement

It’s a well-established fact that fentanyl and carfentanil, two of the most deadly opioids known to man, are killing people by the thousands. Fentanyl is an opioid medication used for surgery and chronic pain, and it is 50-100 times more powerful than morphine. Carfentanil, its stronger cousin, is up to 100 times more powerful than fentanyl, and is used to tranquilize large mammals such as elephants.

Both substances are being masked as prescription pills or heroin by drug dealers on the street, and both substances are so deadly that even a few grains can kill. Overdoses from the substances have risen as much as 500% over the last few years according to the CDC. No part of the country is safe. From Alaska to Maine, Hawaii to Florida and all states in between, America is in the midst of a fentanyl/carfentanil crisis.

“Fentanyl is being sold as heroin in virtually every corner of our country… a very small amount ingested or absorbed through your skin can kill you,” said DEA Deputy Administrator Jack Riley to Law Enforcement Product News. Riley said this as part of a warning from the DEA to all US law enforcement, a warning about the dangers of being exposed to fentanyl or carfentanil during drug busts.

Near Deadly Exposure for Law Enforcement

These two drugs are so deadly, that as part of the warning issued by the DEA, a video was released, and it is available to view here.

Deputy Administrator Riley is the spokesperson, and his message is clear. Fentanyl exposure can be deadly. Riley urges all officers to “transport it directly to a laboratory, where it can be safely handled and tested.” He says not to field test it, and to never bring it back to the office. Here’s why:

  • Recently in New Jersey, two officers survived a powder blast of fentanyl to their faces. Investigator Kallen and Detective Price of the Atlantic County Task Force were sealing a bag of confiscated fentanyl when a cloud of the powder came out of the bag and the officers inhaled it. “I felt like my body was shutting down,” said Det. Price. “I thought that was it. I thought I was dying.” Inv. Kallen added, “You actually felt like you were dying. It was the most bizarre feeling that I never ever would want to feel again.”
  • In Hartford, CT last month, eleven SWAT team officers were exposed to a cloud of fentanyl being blown about the crime scene. Several of the officers experienced lightheadedness, nausea, sore throats and/or headaches. The entire team was taken to the hospital.
  • All over the country, law enforcement officers as well as firefighters are now carrying Naloxone, an anti-overdose drug. Well, now, because of the fentanyl crisis, officers in places such as Vancouver, Canada and St. Louis, MO, are carrying it for themselves. Exposure to the drug can be so deadly so quick, that the anti-overdose drug may have to be administered to an exposed officer.

Conclusion (or lack thereof)

As if it’s not bad enough fentanyl is killing drug users and putting law enforcement at risk, police dogs sniffing for drugs are being exposed as well. The invasion of fentanyl (and carfentanil – even deadlier but less commonly found) has made being a cop even harder and riskier of a job.

Fentanyl and carfentanil are so hazardous, officers must wear the same suits worn by scientists avoiding the Ebola virus when handling them. These are full-body, level A hazmat suits. Imagine what damage these drugs do to the human body, able to kill in less than three minutes.

130 people die every day from opioid overdoses in this country. Remove fentanyl and carfentanil from the equation and that number goes down.

The American Opioid Epidemic


Between 2000 and 2014, American rates of death from opioid overdose have tripled from three deaths per 100,000 people to nine per 100,000. That adds up to 28,647 deaths in 2014. While the number of heroin overdoses has made a rapid climb, the majority of the lethal overdoses involve prescription opioids  –  and the heroin crisis is closely tied to prescription drugs, since many users become addicted to a prescription opioid before switching to the street drug. In March 2015, U.S. Department of Health & Human Services Secretary Sylvia M. Burwell announced an initiative targeting three priority areas to tackle the opioid epidemic and help save lives. These include: improving prescribing practices, expanding access to and the use of medication-assisted treatment, and expanding the use of naloxone.

The abuse of opioids, a group of drugs that  includes heroin and prescription painkillers has had a devastating impact on public health in this country. According to the CDC approximately 100 Americans died from drug overdose every day in 2010. Prescription drugs were involved in well over half of the 38,300 recorded fatal overdoses and opioid pain relievers were involved in 16,600 of those deaths.

Overdose Deaths Involving Opioid Analgesics

Research shows that many non-medical users obtain prescription medications from family and friends.

How Different Misusers of Pain Relievers Get Their Drugs

Today, more Americans die from drug overdoses than car crashes or gun fatalities. In total, drug overdoses killed 47,000 people in the United States in 2014, the latest year for which data is available. That’s 130 deaths per day, on average.


The majority of those deaths – 29,000, or 80 per day – involved an opioid.

Between 1999 and 2014, the overdose epidemic spread from a few concentrated pockets in Appalachia and northern New Mexico to nearly every corner of America. The opioid overdose crisis began early in central Appalachia, a region encompassing much of West Virginia and eastern Kentucky. The largely rural area – dominated by physically taxing industries, including coal mining, agriculture and timbering – was susceptible to the pain-relief promise of prescription opioids such as OxyContin and Vicodin. These painkillers were aggressively marketed throughout the 1990s and early 2000s. As prescriptions proliferated, so did misuse and abuse. In central Appalachia, as in many parts of the country, the prescription painkiller epidemic also fuelled the influx of a cheap, alternative opioid: heroin. As painkiller-related deaths began to fall in the early 2010s following federal and state crackdowns on prescription opioids, heroin-related deaths began to rise.

In the west, New Mexico showed earliest signs of the looming overdose crisis, but Utah was not far behind. The state’s overdose death rate climbed steadily during the early 2000s, driven by growing prescription opioid dependence. But Utah lawmakers took action early. In 2007, they established a two-year public health-based program to combat painkiller misuse. Over the next three years, prescription opioid-related overdose deaths dropped more than 25%, but the success was short lived. After funding ran out in 2010, deaths began to climb again. Drug overdose deaths in Utah continue to be fueled by prescription painkiller misuse, often in combination with other depressant drugs . Though heroin deaths have made a smaller impact in the state, they are also on the rise. Now, six years after the Prescription Pain Medication Program program ended, the Utah house of representatives declared drug overdose deaths to be a public health emergency, and passed a slate of new public health measures, including the legalization of needle-exchange programs.

New England Opioid Overdose RatesNew England is grappling with a more recent scourge. Since 2013, New Hampshire, Massachusetts, and other north-eastern states have seen large spikes in overdose deaths attributed to increasing heroin use and the introduction of a new deadly drug: Fentanyl. Fentanyl, a synthetic opioid 50 times more potent than heroin, first appeared in the region around 2012, making its way down from Canada. Suppliers often cut the drug into heroin or other substances before selling it to users who may not know exactly what they’re buying. Because of its strength – and users’ unfamiliarity with it – fentanyl has proven particularly deadly.

In the face of these new challenges, Massachusetts and other north-eastern states have begun to expand prevention efforts and access to treatment programs. Naloxone, a drug that can reverse opioid overdoses, has become more widely available throughout the region and local harm-reduction initiatives are being tested.


Meanwhile, Fentanyl has surfaced in several more states, including Ohio and Florida.

Florida, once known as the prescription drug capital of America. began cracking down on “pills mill” clinics in 2010. Soon after, the state’s drug overdose death rate took a downward turn, declining through 2013.But by 2014, deaths were inching back up in Florida too.

Florida did a good job of cracking down on the supply side, but at the same time they actually cut treatment funding. Not addressing the demand side of the problem has contributed to the continuing of the epidemic.

Though postponed for a few years, Florida’s overdose crisis has progressed along a familiar pattern: a wave of prescription opioid abuse followed by heroin and, soon after, fentanyl.

More recently, fentanyl has cropped up in a previously unseen form: fake Xanax pills. The “death pills”, as they have become known, have also been found in California, Indiana and other parts of the mid-west.

Opioid Overdose DeathsIn October 2015, the President issued a Memorandum to Federal Departments and Agencies directing important steps to combat the prescription drug abuse and heroin epidemic. You can find it here.

In March 2016 HHS awarded $94 million to health centers in Affordable Care Act funding to help treat the prescription opioid abuse and heroin epidemic in America. This funding covers 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand the delivery of substance abuse services in health centers, with a specific focus on treatment of opioid use disorders in underserved populations.

Administered by the HHS Health Resources and Services Administration (HRSA), these awards to health centers across the country will increase the number of patients screened for substance use disorders and connected to treatment, increase the number of patients with access to MAT for substance use disorders and opioid treatment, and provide training and educational resources to help health professionals make informed prescribing decisions. This $94 million investment is expected to help awardees hire approximately 800 providers to treat nearly 124,000 new patients.

Research demonstrates that a whole-patient approach to treatment through a combination of medication and counseling and behavioral therapies is most successful in treating opioid use disorders. In 2014, over 1.3 million people received behavioral health services at health centers, This represents a 75 percent increase since 2008 and was made possible with support from the Affordable Care Act (ACA) and the Recovery Act.


Opioid Treatment Options are Available

If you can’t stop taking a drug even if you want to, or if the urge to use drugs is too strong to control, even if you know the drug is causing harm, you might be addicted to opiates. Are you thinking about opioid treatment? Here are some questions to ask yourself:

  1. Do you think about drugs a lot?
  2. Did you ever try to stop or cut down on your drug usage but couldn’t?
  3. Have you ever thought you couldn’t fit in or have a good time without the use of drugs?
  4. Do you ever use drugs because you are upset or angry at other people?
  5. Have you ever used a drug without knowing what it was or what it would do to you?
  6. Have you ever taken one drug to get over the effects of another?
  7. Have you ever made mistakes at a job or at school because you were using drugs?
  8. Does the thought of running out of drugs really scare you?
  9. Have you ever stolen drugs or stolen to pay for drugs?
  10. Have you ever been arrested or in the hospital because of your drug use?
  11. Have you experienced an opioid overdose?
  12. Has using drugs hurt your relationships with other people?

If the answer to some or all of these questions is yes, you might have an addiction. People from all backgrounds can get an addiction. Asking for help is the first important step. Visiting your doctor for a possible referral to opioid treatment is one way to do it. You can ask if he or she is comfortable discussing drug abuse screening and opioid treatment. If not, ask for a referral to another doctor. You can also contact an addiction specialist about opioid rehab. There are 3,500 board-certified physicians who specialize in addiction and opioid treatment in the United States.

Pharmaceutical Incentive Programs: Feeding Addictions


Plenty of companies offer incentive programs, or what are essentially performance-based payments. Realtors receive bonuses for closing deals on expensive homes. Journalists receive bonuses for winning a Pulitzer Prize. Heck, even the NFL doled out more than $121 million last year through its incentive program! But nothing has the impact like Pharmaceutical Incentive Programs.


Let’s switch gears for a moment.

The National Institute on Drug Abuse reported in 2011 that 52,000,000 Americans over age 12 had abused prescription pills at least once, and the number of reported prescription pill addicts was 8,760,000. Where are all of these pills coming from? Over 80% of them come right from the doctor’s office. A major role of pharmaceutical company representatives is to visit doctor’s offices in hopes of convincing the office to buy their pills from whatever brand they represent. Long sentence shorter, big pharma competes for business, from big hospitals to your local family practice.

Now let’s combine the two ideas from the two previous paragraphs.


Pharmaceutical incentive programs offer large incentives.

The incentive is usually monetary, but can even include a trips around the world. With such stakes, surely pharma reps are pushing their companies to the max. One very vicious side effect of all this pill-pushing is the rampant addiction and abuse of prescription pills in the US.


The Pain Pill Epidemic

From 1999 to 2010, sales of opioid-based pain medications such as Vicodin, Percocet and OxyContin quadrupled. The United States consumes 99% of the world’s hydrocodone (Vicodin), 80% of the world’s oxycodone (Percocet & OxyContin), and 65% of the world’s hydromorphone (Dilaudid). Either we are all in excruciating pain or there exists some serious discrepancies.

Something else happened to quadruple during the time period of 1999 to 2010. Opioid overdoses rose from 4,000 annually to 17,000 annually. In 2014, more people died from opioid overdoses than ever before. The more pain medication prescribed the more overdoses that occur; this seems to be a direct relationship.



Purdue Pharma is the manufacturer of OxyContin, a powerful opioid painkiller. OxyContin was released to the market in 1996, and in its first year garnered $45 million in sales. Not bad. In 2000, the drug garnered $1.1 billion. That’s a 2,000% increase. Then, ten years later in 2010, OxyContin garnered $3.1 billion! These are incredible sales, and account for approximately one third of the entire painkiller market.

In 2007, Purdue Pharma was brought up on a criminal charge of misleading the “FDA, clinicians, and patients about the risks of OxyContin addiction and abuse by aggressively marketing the drug to providers and patients…” It took three years after the charges were filed for Purdue Pharma to make OxyContin less susceptible to abuse.


The Struggle Continues

The case of Purdue Pharma is one of many that exemplify the desire for profit being greater than the desire for healing. Take Insys Therapeutics, for another example. They manufacture a product called Subsys Fentanyl, a painkiller spray ingested orally. Now subject to investigations, Insys Therapeutics has been peddling this extremely strong opioid (100x stronger than morphine) for fifteen years, and makes approximately $300 million annually. Meanwhile, well over 1,000 deaths from overdoses of Fentanyl have occurred, including the death of Prince.

Talk at length with your doctor(s) about any prescriptions recommended or given to you, or to your loved ones. It might even be a good idea to get a second or third opinion, given how many medical companies are under the sway of big pharma.

Vivitrol for Opioid Dependence


People do recover from opioid dependence. Vivitrol can provide the extra push addicts need.

So, how does Vivitrol work?

opioid-dependenceOpioids such as methadone produce a limited buzz to control cravings. Anyone who is trying to get clean knows that a ‘buzz’ will often lead an addict to seek a better buzz. Vivitrol dulls the brain’s receptors so users don’t feel cravings and won’t get a high even if they take opioids. Also, unlike methadone, Vivitrol is not a controlled substance; it cannot be abused and there is no illegal market for it. One of the best thing about Vivitrol surrounds how it’s administered: as a monthly shot. Vivitrol is a new form of an old drug — naltrexone — that was developed in daily pill form in the 1970s and never caught on. It wasn’t until researchers created an injectable, long-acting version that clinical studies showed the drug’s promise.

It was just like: Wow, this medication is a magic bullet for treating opiate dependents. Taking a monthly shot can be a godsend for addicts who find it difficult to wrestle daily with the decision to swallow a pill to stay clean. When the Washington County MD Detention Center began a test pilot of Vivitrol for opioid dependence in late 2011 they worked in conjunction with The Washington County Health Department. A total of 246 shots to 83 people was documented in the program’s 3 1 / 2 years. The results were gratifying: Only two patients used illegal drugs or alcohol while receiving the medication. To the best of the department’s knowledge, the 81 others have remained clean.


So it works, but is it safe?

In the early stages, jails and institutions proved to be excellent testing grounds for the new injectable drug. They house a high number of drug offenders, provide a place for addicts to detox before receiving Vivitrol and are populated with people who are likely to have Medicaid or Medicare to help pay the costs. At up to $1,000 per shot, Vivitrol is the most expensive option for treating opioid dependence. It is highly recommended to be clean from all opioids before receiving the first Vivitrol injection. If not, the shot will send the addict into severe and immediate withdrawl.


Reviews on Vivitrol for Opioid Dependence

Addicts have given, overall, very good reviews on Vivitrol. Some have said:

“I am a 28 y/o male, I used all drugs from about 12 but opiates and then IV heroin for about 10 years straight. I went through at least 7-8 rehabs and detoxes and endless county jails. In all those years I never had been able to stay clean more than a month on purpose. I’ve been clean now 1 year 8 months and a day. Vivitrol saved my life w ithout a doubt. I was on it for 13 months w ith intensive out patient treatment and as many NA meeting as I could get to in a week. “

“I have been a heavy opiate user for 15 years. I did have years staying “clean” using soboxone but once I got divorced I became depressed and relapsed. My addiction took off and I ended up using IV heroin and at that point trying to go back and use soboxone to stay clean was impossible. It took a overdose and 30 day treatment to make the decision to get the injection and it saved my life, best drug in the world .”

People do recover from opioid dependencies, but often to do so they also need to deal with other issues in their lives. If you stop taking Vivitrol and you haven’t developed coping strategies you may relapse. A reputable detox, a 30 day rehab at an accreditated facility and treatment planning that includes a monthly Vivitrol injection is akin to starting a long road trip with a map and a full tank of gas.

Death by Overdose

Death by Overdose, these words are scary to hear today. With prescription drugs and heroin quickly flooding schools throughout the United States we tend to hear this more and more. According to the National Institute on Drug Abuse there was over 25,000 Deaths from Prescription Drugs and over 11,000 Deaths from Heroin in 2014. Opioids are the most common type of prescription drug abuse that results in death by overdose. Respiratory failure is typically the cause of death in cases of opioid overdose.

Prescription painkillers, such as OxyContin and Vicodin, were responsible for more than half of all drug overdose deaths. Most people who start abusing prescription opioid drugs quickly find themselves turning to illicit street drugs such as heroin for a cheaper and faster way to get high. An estimate of 45 percent of people who use heroin also are addicted to prescription narcotic painkillers.


No Fear of Death

There is an extreme rise in death by overdose amongst teens and young adults throughout the united states. Many reports showing that young adults ages 19 to 25 are particularly at risk for a fatal overdose. The national overdose death rate for that age group is 12.7 percent per 100,000.

Many say these young people have no fear of death, the truth of the matter is they are victims of a horrible disease that is consuming them and like many others before them they may end up paying the ultimate price, their life. To beat their addiction and prevent themselves from becoming another death by overdose statistic there is an immediate need for addiction treatment.


Getting the Help You Need

If you are suffering from an addiction to drugs the first step is admitting that you have a problem and asking for help. This could be reaching out to a loved one, turning to your doctor or making a very important phone call to an addiction treatment center.

For years you have battled with addiction, leaving you life on the line. Today is the day you take your life back and get the help you truly need.

How Opioids Work

Opioid drugs can be found as both prescription medications such as vicodin or illicit street drugs such as heroin. Opioids look like chemicals in the brain and body, attaching to nerve cells called opioid receptors. There are three types of opioid receptors: mu, delta, and kappa, each playing a different role.

Opioids Act on 3 Main Areas of the Nervous System and Brain

Opioids act on 3 main areas of the nervous system and brain. When opioids act on the limbic system (controls emotions) it can create feelings of pleasure, relaxation and contentment. When acting on the brainstem (controls the body automatically, ie. breathing) opioids can slow breathing and reduce feelings of pain. When opioids act on the spinal cord (receives sensations from the body and sends to them to the brain), they can decrease feelings of pain.

The Use of Opioids Determine the Effects

Regardless to if you are using an prescription opioid medication or an illicit street drug such as heroin, its effects will be determined by how much you take and how often you take it. When opioids are injected they take effect much faster than any other means of ingestion and with more intense effects. When taken by mouth it can take much longer to see effects, however this is a much safer way to use an opioid drug.

Opioid Abuse

Regardless to if you are using a prescribed opioid drug, abusing an opioid medication not prescribed to you or using an illicit drug such as heroin there are many dangers associated with it.

Regular use of any opioid drug can result in a tolerance, requiring larger doses of the drug to achieve the desired effects. Prolonged use at any dose can result in the body developing a dependency to opioids, discontinuing its use often results in uncomfortable even painful withdrawal symptoms.

Stopping Opioid Use when Dependent

Depending on the severity of the opioid dependency you may be weaned off the drugs over several weeks to months. This process will gradually lower doses until you eventually do not need the medication and are no longer experiencing withdrawal symptoms.

If you have a severe dependence to opioids you may require professional treatment within an Addiction Rehabilitation Facility to help you.  There you will undergo medical and therapeutic treatment to help you stop use of opioid drugs, lessen symptoms of withdrawal and help you develop the skills needed to maintain your sobriety, preventing you from returning to opioid use.

Teen opioid use

There is a dangerous trend plaguing our nation’s youth. Parents do not know how to handle it, many unsure on where to turn.

In the United States there is an estimated 2.1 million people suffering from an opioid dependency, according to the Nations Institute on Drug Abuse in 2012.

It is no surpise as opioid prescription drugs are the most commonly prescribed pain relievers today.
These medications are extremely addictive and potent that even those taking them for true medical purposes are developing dependencies despite following directions of the prescribing doctor.

It is not only prescribed opioids that are on a rise for abuse, millions of Americas youth are turning to illicit drugs such as Herion for the powerful euphoric and numbing opioid effects.

What is Opioid Abuse?

As a parent you feel you have taught your child right, shared with them the dangers of drugs and addiction, steering them in the direction to keep them on the right track in life. Despite all of our effeorts as parents, some times our children find themselves mixed up in the wrong things. It is important that you know what opioid abuse is.

Teen opioid abuse can happen in many different ways; taking larger doses of an opioid medication than prescribed or taking one that was not prescribed to them, taking the drug by others means than it was prescribed (crushing pills into a powder to be snorted), or taking illicit opioid drugs such as Heroin. All of these means of opioid abuse puts your teen at great risk of developing an addiction and in great danger of overdose and death.

Opioids work by attaching to brain receptors to diminish perceptions of pain, as well as affect areas of the brain associated with pleasure, creating a sense of euphoria, relaxation, and a high. This makes opioid drugs appealing to youth and a highly abuse drug.

Treatment for Opioid Abuse

Treatment for teen opioid abuse takes place in a residential treatment facility. The process begins with detoxification, allowing your teen to get past the major physical symptoms of withdrawal associated with opioids.

He/she will then move onto an assessment to determine the severity of their addiction and create a treatment plan tailored to their individual needs. At this point your teen will move through the rehabilitation process with medication assistance, medical treatment, therapy, individual counseling, group counseling and chemical dependency education.

There is no quick fix for opioid addiction, it is important to seek treatment immediately and help to create a sober environment for your teen, encouraging them throughout the treatment process and offering them the support they need to maintain lifelong recovery.

What Are Opioids

Opioids come in three different forms: natural, semi-synthetic, and synthetic. These are all narcotics that derive from the opium poppy or are made synthetically in laboratories for pharmaceutical purposes. Opioids are often abused and affect the brain receptors that are responsible for the release of neurotransmitters. This allows people to cope with high levels of physical pain that would otherwise be intolerable.

When used correctly, prescription opioids or “pain killers” are an effective tool for pain management.

When abused, opioids can be taken orally, or by snorting, smoking, or injecting.  Abuse of opioids leads to a high risk for addiction.  Physical addiction typically occurs around 6 weeks of the initial opioid abuse, but psychological addiction/dependency can be noticed in as little as 48 hours.

Once the addiction occurs, opioid-dependent people will experience physical and psychological withdrawals if they stope abusing. Symptoms of withdrawal include: severe flu-like symptoms, pain, depression, and anxiety.  After the sever or acute withdrawals have been overcome, post-acute withdrawal settles in and for a much longer period of time. The brain is damaged damaged by opioids and physical healing of the brain typically begins 12 to 18 months after sobriety.