When addicted parents can't.

https://www.youtube.com/watch?v=8-Csfxctz9k

I found a video that kind of touches on the lives of some children at a school in West Virginia and their experiences with parents who are addicted. A lot of them have been displaced and put in foster care due to their parents addiction. An this school in West Virginia has tried to accommodate and take care of these children in response to the rising number of drug users and addicts in the area. However they don't have enough money necessarily to do everything to support and help these kids.

I was wondering if it would be beneficial for the state to provide money to more schools so that they can better assist these students. Besides more funding what do you all think could be some more possible courses of action the state could take or schools? To possibly support students who may have a parent that is addicted, or in jail because of addiction.

Crypto and Drugs

This is an interesting article and video about how Bitcoin and other cryptocurrencies may be fueling the opioid addiction. It goes into how most drug dealers on the dark web use cryptocurrency when making their deals. The article also touches on the process of finding these illegal drugs and a massive drug trafficking case out in Utah. Check it out!

https://www.cnbc.com/2018/04/13/how-bitcoin-and-cryptocurrencies-are-fueling-americas-opioid-crisis.html

What do you guys think about the article? Do you believe there is a link to the emergence of cryptocurrencies and this crisis?

This article was posted on CNN today about getting off opioids with the help of medical marijuana. I thought it covered some interesting topics. 

https://www.cnn.com/2018/04/29/health/medical-marijuana-opioids/index.html

"There's no pill, there's no spray, no drop, no puff [that] can completely solve this problem," Sulak told Gupta. "But cannabis, when it's used in the right way, can take a big bite out of it."

If there is something that could possibly help with this crisis, even if it's only a little bit, we should pursue it. I also think that the FDA considering marijuana a schedule 1 drug, with the likes of heroin and LSD, is criminal. Below is a link to the DEA drug scheduling page for more information. 

https://www.dea.gov/druginfo/ds.shtml

Any thoughts on the article? Why do you think marijuana is ranked on the same level as heroin and over the likes of cocaine? 

Opioid deaths prompt Ohio to reimagine classroom lessons, starting with kindergarten

Ohio has recently implemented programs in some schools to educate students on drug use and mistreatment of drugs. These programs starts in kindergarten and go all the way until high-school. This program was implemented due to the rising number of deaths from opioid overdoses in 2016 and the rising epidemic in the state. With only 20 minute lessons a day teachers have positive feedback for the program and say the lessons are developmentally appropriate, easy to implement and do not feel like “one more thing” .

"Ohio’s plan, controversial in a state that prizes local control over schools, features lessons that begin in kindergarten. Instead of relying on scare tactics about drug use or campaigns that recite facts about drugs’ toll on the body, teachers are encouraged to discuss real-life situations and ways to deal with them and to build the social and emotional skills that experts say can reduce the risk of substance abuse."

With that and what we discussed in class last Tuesday, do you all think this was a good decision? Did they implement the program well? Do you think their starting to early, by talking with kids about drugs in Kindergarten? What may be some benefits to them having these conversations with kids early, especially those with parents who use drugs? 

https://www.washingtonpost.com/national/health-science/opioid-deaths-prompt-ohio-to-reimagine-classroom-lessons-starting-with-kindergarten/2018/04/20/30db0570-05df-11e8-94e8-e8b8600ade23_story.html?noredirect=on&utm_term=.1097484d84d3

Why a City at the Center of the Opioid Crisis Gave Up a Tool to Fight It

Charleston, West Virginia just recently closed it's needle exchange programs. The Major saying it was drawing crime into the city and flooding the streets with syringes. Some however saying it was a vital resource and was preventing the spread of a possible outbreak of Hepatitis and H.I.V.

"While the exchange was open, the health department also collected data on its patients. These records show at least eight people with H.I.V. among the injection drug users the department tested. All but one live in the city of Charleston. If they share needles in the months ahead, Charleston is at “grave risk for an H.I.V. outbreak just like the one in Scott County,” Dr. Brumage said. “We’re sitting on a powder keg.”

With the program no longer in affect. How do you think Charleston will be affected? Since this program didn't work well for some, what possibly might be an alternative program for the city or what improvement could be made to the needle exchange program, the cities police chief gave some possible new rules in a statement(below).Do you think these rules would work, especially to those who are using and also homeless?

"the police chief imposed new rules on the program, loosely based on those used by a much smaller exchange run by West Virginia Health Right, a clinic nearby. Participation would be limited to people who could prove — with picture ID — that they lived in the county. Testing for hepatitis and H.I.V. would be mandatory. Needles would be dispensed only in strict one-for-one trades."

https://www.nytimes.com/interactive/2018/04/27/upshot/charleston-opioid-crisis-needle-exchange.html

Robert Downey Jr. Recovery Story

After watching the documentary on Chris Herron the other day about his recovery, I was interested to look into other people that have dealt with addiction and not only recovered but went on to be successful post-addiction. The person that came to mind immediately was Robert Downey Jr., who is apart of the biggest superhero movie of all time, Infinity War (no spoilers, I still haven't watched it).
The article sheds some light on how bad it was, and what it took for him to reemerge as a star in Hollywood. I did not know how big of a part Mel Gibson played in the resurrection of RDJ's career. Check out the article:
https://drugabuse.com/robert-downey-jr-s-incredible-comeback-from-addiction/

You see a lot of stories of people in Hollywood that destroy their careers with drug use. It is nice to see success stories. Do you guys have any thoughts on this?

Money and access to the highest quality treatment definitely helped RDJ. Is there a way that more people suffering from addiction can receive treatment like this? Any ideas?

The moral hazard of writing about opioid addiction using the scientfic method

Take a look at the blog entry (click here).   These researchers wanted to know if increasing access to narloxon creates moral hazard on the part of opioid users.  In other words, would users be less careful in regulating dosage if they knew they were more likely to be saved from an overdose.  The bloggers wrote a working paper which suggests that moral hazard did occur.  Then they were attacked for writing such a paper on such a topic using the techniques that they did.   I think this is one more instance where Carl Sagan would be unhappy with the state of research today.

Opioid use in China

I've become fascinated by the history of opioids in China.  During the nineteenth century, addiction was rampant.  In essence, opioids were used as a weapon by the British Empire against China during the decades in which the British fought to open China to international trade.  When the Communist party took over, they stamped out the use of narcotics and addiction as completely as they could.  But today, things are changing. 

A rapid increase in cancer cases drives demand for pain-reducing drugs and patients lose fears about addiction. The market for painkillers in China grew 20 per cent last year to reach Rmb3.6bn ($530m), according to the China Pharmaceutical Industry Association, more than twice the rate of the overall drug market, which is the world’s second largest. While most painkillers in China are used in surgical contexts, the recent growth has mainly been driven by a rise in a cancer rates from 2.1m new cases in 2000 to 4.3m in 2015, creating demand for management of chronic pain, analysts say. Lung cancer is China’s most common, partly due to high rates of smoking and air pollution.... Rather than arriving on the ships of foreign merchants, now most of the opioids consumed in China are locally produced. With a nearly 40 per cent market share last year, the Yangtze River Pharmaceutical Group’s dezocine was the bestselling painkiller in China, according to CNPIC data. The drug is mostly used after surgery. By contrast, the most popular foreign brand is Bard Pharma’s Oxycodone, with a 6.5 per cent market share. Companies see high growth potential as Chinese painkiller sales are small compared with an overall pharmaceutical market worth nearly $117bn last year, according to QuintilesIMS, the health research company.  (from https://www.ft.com/content/4e482c4c-897e-11e7-bf50-e1c239b45787)   

I wonder if China can manage the use of opioids better than has been done in the United States.

What is Synthetic Marijuana and how does it compare to traditional Marijuana?

https://www.huffingtonpost.com/2013/09/11/synthetic-marijuana_n_3908171.html

"The chemicals in synthetic marijuana are also harder to detect than marijuana in drug tests, and the drug is the second most used illicit drug among high school seniors, behind marijuana itself according to the National Institute on Drug Abuse. While certain chemical compounds of synthetic marijuana were banned in Colorado in 2011, there are possibly hundreds more anonymous compounds that haven’t been identified yet and thus, aren’t illegal.

A lot of people are advocating for legalization of Marijuana these days, but with synthetic marijuana circulating in the market. An it being hard to identify because of certain characteristics in the make up. Would it be beneficial to legalize marijuana, to try and regulate and protect against the sell or producing of this synthetic marijuana or would it not matter?

Everything You Know About Heroin Addiction Is Wrong

Thought this was an interesting short video coming from the point of view of a heroin addict. Clears up some misconceptions about the drug created by Hollywood. It also showed some of the side effects that I never knew were a thing! Give it a watch!

Was there anything that stood out to you in the video? Did you learn anything?

To solve the opioid crisis, call addiction what it is...

Dr. Jay Butler is the chief medical officer of the Alaska Department of Health and Social Services and he posted this opinion piece about what needs to happen in order to solve this opioid crisis. Addiction is a life-threatening emergency, a chronic disease, and a preventable condition. The piece expands on why he believes this way and what will happen when we start to think of addiction this way.

http://juneauempire.com/opinion/2018-04-24/solve-opioid-crisis-call-addiction-what-it

Do you agree with his opinion? Do you believe that if we were to start calling addiction what it is that we would finally start to solve this opioid crisis? Do you agree with the measures that he suggests along with calling addiction a life-threatening emergency, a chronic disease, and a preventable condition?

The Big Pharma Family the Brought us the Opiod Crisis

This article gives a little more history on the Purdue Pharma company, along with some information we already read in Dreamland. 

"Last week, flacks at Purdue announced that the company will no longer be flooding doctors’ offices with sales representatives hawking OxyContin, the now-notorious opioid painkiller. This move may be the closest admission of guilt we will ever see from Purdue Pharma — or the patriarchs of the Sackler family that gave it birth."

In Dreamland we see that there were some  actions taken against Purdue Pharma, for their "misbranding", involving a payout. But, was that enough? Should they have had to do more? What are y'all thoughts?

https://inequality.org/great-divide/big-pharma-firm-brought-us-opioid-crisis/

Dear Honorable Jeff Sessions

Dr. Sanjay Gupta addresses an article to Jeff Sessions ultimately saying that marijuana could be the key to saving opioid addicts. Dr. Gupta states that he was not initially impressed with the affects of medical marijuana, but just as many others, has found a new opinion for the powerful plant. Marijuana, can actually be deemed a more effective pain killer than opioids in that it is safer and more applicable to many pains.

Using marijuana as a means to get off opioids speaks to the usefulness of marijuana. Marijuana can help combat the withdrawal symptoms when stopping opioid use and can help ween users off in a healthy and efficient way.

https://www.cnn.com/2018/04/24/health/medical-marijuana-opioid-epidemic-sanjay-gupta/index.html

Addiction to opioids is at the forefront of the American health crisis, and marijuana, supported by many and attacked by many, could serve to help the opioid crisis. With medical marijuana serving as an alternative to opioids, and even a way to get off them, what will Big Pharma have to say about this?

Methadone not covered by Medicare

https://www.cbsnews.com/news/opioid-treatment-gap-in-medicare-methadone-clinics/

Medicare does not cover Methadone, which is the most effective of three medications used to treat opioid addiction. I find this quite interesting. According to the article, this is because Methadone doesn't meet the requirement of Medicare's Part D drug program since it can't be sold in a retail pharmacy. What do you think is the biggest obstacle to get this drug approved for coverage? With methadone treatment centers on the rise, will Medicare continue to bar people from obtaining this treatment?

Slowing down Prescriptions

https://www.statnews.com/2018/04/23/air-force-boldface-opioid-crisis/

This article talks about a former Air Force pilot who decided to change his life path and become a doctor. A few things caught my attention here. First, is the term "doctor shopper". This term makes it seem like any patient can obtain an opioid prescription, a little too easily. Next is the fact that there are still doctors out there who have not yet cut back on their opioid prescriptions. I think doctors should be doing their due diligence before prescribing such painkillers. I like the connection the author uses between flying off a runway and doctors prescribing medications. If something does not feel right, you start using the brakes and slowing down to figure out the root of the problem.

Regulated opioids not helping chronic pain sufferers

The man discussed in this article faces immense spinal nerve pain and is on a regulate dose of Percocet but the drug hardly, if at all, helps curb the pain. He is now looking into a cannabis base pain reliever as an alternative as he is afraid of becoming addicted to opioids.

https://www.dnj.com/story/news/2018/04/23/opioid-epidemic-tennessee-alternative-pain-relief-cbd-treatment/516000002/

Many people are looking towards alternative cannabis based pain relievers instead of opioids today. Do you think it is feasible that doctor's begin to embrace cannabis rather than turning to prescribing opioids in the near future?

Losing two sons to opioids

Becky Savage lost two of her sons to opioids but they were not addicts. They used the drugs alongside alcohol during a high school party and the next day they did not wake up, they were dead. Becky now speaks to students about the dangers of opioid use.

She said, "We've talked to our kids about drinking, but we had never talked to them about prescription drugs, because it wasn't even on our radar."

This is quite common in that alcohol is freely discussed and students are educated, but prescription drugs are ignored and forgotten. Simply educating children early on of the dangers associated with prescription drug use could help to prevent many overdoses in younger age groups. 

Is it surprising that these two were able to use prescription drugs in high school and eventually overdose during their first use alongside alcohol? How can we better educate under-18 year olds about the dangers of prescription drugs and alcohol?

https://www.cnn.com/2018/04/20/health/turning-points-becky-savage-opioids/index.html

Educating in Classrooms

https://www.washingtonpost.com/national/health-science/opioid-deaths-prompt-ohio-to-reimagine-classroom-lessons-starting-with-kindergarten/2018/04/20/30db0570-05df-11e8-94e8-e8b8600ade23_story.html?noredirect=on&utm_term=.36623578c290

I like this article because teaching young people about opioid crisis in an effective manner is essential. I remember taking human growth and development in 4th and 5th grade. Although it may not have been the best lectures, at least starting the discussion and being introduced to the topic made a big difference. Giving these elementary school children the opportunity to learn about what is going on in their community will prepare them to face the situation better.

Kentucky joins Arkansas in fight against big pharma

Kentucky has brought a case against Johnson & Johnson on the basis of deceptive marketing of their opioids. Violation of the Kentucky's Consumer Protection Act is being focused on as the driving force behind the suit. Johnson & Johnson has failed to respond, but a subsidiary, Janssen Pharmacuetica said, "Our actions in the marketing and promotion of these medicines were appropriate and responsible."

https://www.nbcnews.com/storyline/americas-heroin-epidemic/kentucky-sues-johnson-johnson-subsidiaries-over-opioid-epidemic-n867121

Will other states follow in Kentucky and Arkansas' footsteps in bringing a legal battle to big pharma's front door. Basing the case on a violation of Kentucky's Consumer Protection Act was clever in my opinion. For cases to be successful against big pharma, should the current laws protecting consumers around the nation be used to sight possible violations made by big pharma in misleading the consumer?

Alternatives to Addictive Opioids

https://www.theguardian.com/us-news/2018/apr/20/opioid-crisis-n001-drug-painkiller-solution-lab-san-francisco

This article gave me some hope for the near future, in terms of the pharmaceutical industry's contribution to the problem. If doctors start prescribing this new medication, N-001, instead of things like Oxycontin, chances are we will start seeing less of an addiction problem in the U.S. This is a solid step in the right direction. What do you think? Do you think that this is another company trying to profit off of the crisis or do you think these people have the right intentions, which is to attack the root cause of the issue?

$100 billion bill introduced to address opioid crisis over 10 year.

Sen. Elizabeth Warren and Rep. Elijah Cummings have introduced a bill that would make $100 billion available to deal with the opioid crisis over a ten year period. The funding will be sent to communities that have immense opioid problems and be used for treatment instead of enforcement. They believe sufferers of the opioid crisis should be treated as if they had a medical disease rather than as criminals.

http://thehill.com/business-a-lobbying/383787-warren-cummings-seek-100b-to-fight-opioid-epidemic

This bill is definitely a step in the right direction, but do you think it will gain support and eventually be passed? Will our governmental leaders work to address the opioid crisis through bills similar to this or use the bills to push their agendas?

Addiction is Preventable

https://www.usatoday.com/story/opinion/2018/04/19/opioid-crisis-emergency-disease-public-health-column/529183002/
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The last section of this article (Opioid addiction is preventable) caught my attention. Opioid addiction is preventable if you remove people from homelessness, joblessness, or loneliness. In a world with Facebook, do you think loneliness is becoming more prevalent? We spend less time together as a community compared to how much we post online. Do you think social media has contributed to our loneliness as a society?

Should big pharma pay for opioid epidemic?

Arkansas is bringing suit against big pharma for misleading consumers regarding their opioids. The value being pursued is to be determined, but will be put towards mental health clinics, drug courts, treatment centers and other forms of treatment. Pharmaceutical companies responded by saying they realize the opioid crisis and are working towards a solution while not speaking to their part in the crisis. The big question surround this legal bringing is whether tax payers of the big pharmaceutical companies should bear the cost of the opioid epidemic.

https://www.cnn.com/2018/03/30/health/arkansas-opioid-lawsuit/index.html

Should pharmaceutical companies be held responsible for the opioid epidemic and the costs? Can the blame be placed solely on big pharma or is this just pointing a finger at someone in hopes of finding a solution?

The human costs of the opiod epidemic

A recent NPR story talked about the costs of the epidemic:  "There are many different types of costs associated with the opioid epidemic: including emergency response, health care, criminal justice, rehabilitation and lost productivity. It's no wonder the total estimated burden from the epidemic is enormous. Health care research firm Altarum put the figure at $1 trillion since 2001. The White House Council of Economic Advisers estimates that, including lost productivity because of opioid deaths, the total economic cost from the opioid crisis reached $504 billion in 2015 alone."  (see here for the link)

Family members struggle to find money to pay all of these costs for their addicted loved ones.  Here is a good example:  "When I met Destini Johnson's parents last summer, they talked about missing days of work to drive their daughter to rehab or treatment, delaying retirement to pay for the additional costs, and caring for Destini's two young children. By that point, their daughter's addiction had already spun off a string of dramas, including prostitution, homelessness and an arrest on drug charges. Katiena Johnson expressed deep frustration that rehab programs were too few and too short-term, and — after several failed attempts — had become far too expensive for the Johnsons to afford at about $50,000 a month.  Now, if Destini lives, she will require intensive, expensive long-term nursing. Her mother hopes state insurance will foot the bill for the weeks-long ICU stay. Still, the bills could outlive Destini.  "I got a call from ... a collection agency, and I hate getting stuff like that while she's in this condition," Katiena Johnson says. "The second day she was in here, I got a court paper rolled up on my door for damage at some kind of apartment complex." In all the discussion about the cost of opioid addiction, Johnson says, there are few words about the toll it takes on families."

Increasing employment rate may not help the opioid crisis.

There was an interesting study done at Princeton found that increasing employment opportunities in economically struggling areas does not lead to decreased opioid use. While past studies have found that with economic struggles, opioid use increases, this study finds that aiding job prospects is not a simple fix. The article identifies that most of the opioid addictions stem from legal prescriptions and in relatively well off areas.

https://www.sciencedaily.com/releases/2018/04/180417155621.htm

Does this study help redirect some of the focus of drug users away from low income areas to middle class areas that are able to get their drugs from doctors? It does not seem that there is a simple answer to how to fix the opioid epidemic, but this study helps to identify what is not working currently.

There is Always Some Profit

https://www.politico.com/states/new-jersey/story/2018/04/17/patrick-kennedy-profits-from-opioid-addiction-firms-368780

I found this article quite interesting. It is about Patrick Kennedy, a former Democratic representative and mental health advocate on Trump's opioid commission. It is stated that he has made well over $1 million in earnings between 2014 and 2016. The article goes on to discuss how Kennedy is a part of non-profit organizations who seek to help those who are addicted to drugs. Kennedy pushes for anti-opioid drugs to reach the market, as well as for insurers being required to pay for mental health services.

Based on what you read here, what do you think about this politician? He is making moves in the right direction and asking for the change we need to see in how we combat the opioid crisis. At the same time though, the treatment plan for opioid addiction is starting to look like just another business plan to profit off those in need.

Daily News of The Opioid Crisis In The Media

Here's article that appeared on Time.com this morning, reporting the death Matthew Mellon, who was the former Chairman of the New York Republican Party’s Finance Committee, husband to Jimmy Choo co-founder Tamara Mellon, and most recently made famous with cryptocurrency, turning a $2 million investment into $1 billion.

According to the article: "Mellon battled with his addiction to Oxycontin for years and revealed to Page Six in 2016 that he was spending $100,000 a month on the drugs while taking about 80 pills a day. The doctors kept writing prescriptions like they were Smarties. "It’s very irresponsible," Mellon said, adding he became addicted after suffering an injury. "Oxycontin is like legal heroin. And it needs to be addressed.""

I just wanted to share this to show how the opioids crisis is constantly appearing in the media every daily. This also shows how wide the opioid epidemic is (i.e. not affecting just one class or group of people), and the lax regulations for prescription writing and the ease of access to opioids.

4 part series on opioid crisis

The Hill, an online magazine about Washington politics, has a new series.  The first installment was published yesterday (see here).  It points out that 115 people a day die from overdoses.  It has some great charts that really put the notion of an epidemic or crisis in perspective.