Heroin Increase Tied to Opioids

Heroin Increase Tied to Opioids

Can the concern over an increasing use of heroin actually mean that a discussion about opioid prescription practices might ensue?

The Center for Disease Control gave a hint this week. In a statement issued by its director, Tom Frieden, MD MPH it seemed the agency wants to use the heroin problem as a way to address opioid prescribing practices.

“Heroin use is increasing at an alarming rate in many parts of society, driven by both the prescription opioid epidemic and cheaper, more available heroin. To reverse this trend we need an all-of-society response—to improve opioid prescribing practices to prevent addiction, expand access to effective treatment for those who are addicted, increase use of naloxone to reverse overdoses, and work with law enforcement partners like DEA to reduce the supply of heroin.”
The CDC  links a rampant heroin addiction epidemic across the United States to the rise in people who are addicted to prescription opioids. Those individuals addicted to prescription opioids are 40 times more likely to be addicted to heroin, according to the findings.

The findings, which appeared in a Vital Signs report published in CDC’s Morbidity and Mortality Weekly Report, found that heroin use has more than doubled in the past decade among young adults aged 18–25 years. While the increase has affected most demographic groups, the report said the greatest increases were occurring in groups with historically lower rates of heroin use, including women and people with private insurance and higher incomes.

CDC is urging health care providers and states to lead efforts that can curb the growing epidemic, including addressing prescription painkiller addiction, increasing access to substance abuse treatment services, and expanding access to and training for administering naloxone to reduce opioid overdose deaths.

According to a story on pharmacist.com, the National Alliance of State Pharmacy Associations said it has seen more states implementing policies giving pharmacists prescriptive authority for naloxone. California, Idaho, New Mexico, and Vermont have a statewide naloxone protocol or prescriptive authority for pharmacists. It includes a very specific outline for educating pharmacists on naloxone administration. North Dakota, Illinois, Ohio, Kentucky, Virginia, and Connecticut are considering similar legislation.

In the meantime, for medical providers, how to treat the chronic pain patient in an atmosphere where federal agencies are ramping up the dialogue and pressure on prescribing opioids is a challenge.

Dr. Richard Radnovich, a nationally known pain medicine specialist from Boise, Idaho told us recently, “The problem is that we have blurred the lines between two distinct problems: chronic pain treatment and substance abuse. The DEA is concerned with the latter. Medical providers just need to do a good job with the former: that is, show that they are using opioids for a legitimate medical purpose; and provide adequate medical care and supervision.”

Authored by: Ed Coghlan

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Marihuana use tied to job at the White House.

The last three presidents have admitted marihuana use at some time in their life.

They can manipulate these myths anyway they want but it won’t make them true.

John S

Cathy true

I am a long turn person with severe chronic pain.I agree that true chronic pain people need to have the right amount of meds to control their pain.People with this kind of pain have to understand that they will live with pain 24/7.They have to work with their Drs.to set an amount of meds that help bring their pain levels they have to a reasonable level.The urine needs to be tested and a pill count on a monthly basis.If they follow the contract correctly they should be given the meds the dr. And patient agree on.A good dr will know if the meds are being used as ordered within a short period of time.I have never had a problem. My pills and urine levels have always been correct.Chronic pain is hard to live with 24/7.They must understand that no matter how bad the pain is you can not take extra meds that day.They have to find other things to help you.Ice packs,learn to get your mind on other things,like reading a book,learn how to focus on other things,ect.We need to be in a separate group from the drug users.If a Dr.sees he has a user pretending to have chronic pain he should offer to get them help.Doctors should not just cut them off.That could be the very reason they buy drugs off the street. Again chronic pain people should be in a different group.most of us have long medical records.I have been on the same meds for many yrs.I have not ask for or felt like I needed an increase in my meds.

Kim Miller

These “opioid addicts” are NOT one in the same as legitimate chronic pain patients! There’s the disconnect. When these reports continually lump people unfortunate enough to suffer from incurable, nontreatable, chronically painful diseases or conditions with addicts, you get results that truly mean nothing. Nothing except that there needs to be a huge change in the way these statistics are compiled.

Every time one of these reports comes out, I wonder how much harder it just got for pain patients to receive adequate, humane pain control in this country. It’s ridiculously difficult already and continues to become more difficult with each misrepresentation of the facts that gets released by the DEA, the NIH, PROP, or any number of “gotcha” media sources wanting to entice readers with a juicy story about those “drug addicts”.

It’s way past time for the pain community to tell how these faulty reports effect our lives in unbelievably negative ways! We are drug tested, pill counted, and made to see our doctors to an outrageous degree, so much so, it’s a huge financial and physical burden. Still, the actual ” drug addicts” continue to get their drugs. Legitimate pain patients continue to pay the price for THEIR behavior.

Ken Reese

It’s the restrictions not the addiction that caused this problem. People that have legitimate pain cannot get significant relief from their doctor so they hit the street.

Of course, no one is linking the heroin surge to the fact that opiates are HARDER to get.
Nor are they linking cheap Heroin to the record setting production of Afghan poppies, guarded by the USA all these tears.
See TED Talk:
Everything you know about addiction is wrong.

brenda myers

I think heroin addiction is increasing because patients in pain , dont get help from Md’s-since the DEA has gone opiate craziness. They are sick of rediculous pain contracts and so they are turning to street drugs-and if I had a connection I would do the same thing. When your pain is bad enough-you WILL do something/anything to get relief

Margo

I’m so tired of fighting my disease, fighting for adequate treatment and being stigmatized for needing pain medication. I’m so tired of the “alternative therapy ” mantra, the inability to choose the treatment that works best for me and doctors ignoring me. I’m tired of hearing about all the care the addict will receive when I have lost everything. They made a choice to abuse. I did not choose for a doctor to cut a nerve during a surgery leaving me in pain forever. I won’t take heroine. I wouldn’t know where to find it. I am tired of this. I live in enough pain. The 2 issues are now one and I’m amazed at the lack of concern for the chronically ill. I really don’t care what heroine addicts do. Nobody seems to care about legitimate patients. Take our medication away. We’ll suffer and guess what…heroine will still be around. Great job .

Jay Star

“Medical providers just need to do a good job with the former: that is, show that they are using opioids for a legitimate medical purpose; and provide adequate medical care and supervision.”
Explore other options instead of trying to make a criminal out of a patient because he/she need something different. to combat the pain and try to live a productive life!

Terri Lewis PhD

Dr. Radnovitch is completely correct. The lines have become very blurred in the public conversation. The failure of our public health and policy leadership to distinguish these issues is simply inexcusable and is furthering significant harm to patients. The rescheduling of opioids has further compounded this harm to patients who are being forced unnecessarily away from proven medications which have been successfully used in the face of lifelong injury, illness, and disability. To expose these individuals to risks associated with off label prescribing practices, unregulated injections, mechanical devices, and pumps is short sighted and has the potential to compound the effects of existent illness and injury. In short, hope and prayer are not treatment plans. We need public policies that are measured for effectiveness and research that directs solutions.

WOW – 40 Times more likely to use HERION . If that was true I would have turned to HERION years ago. Of course the current political climate is Anti Opiate so why not use the HERION spin to scare the LOW Information crowd into believing that all pain killers are the – Devils Brew.

In the 60’s and 70’s we saw HERION as the back alley high and the main source of income for organized crime. Today it’s in our schools and in every neighborhood in America – but so is BEER – WINE & MALT Liquor.

The problem is here to stay and taking pain medicine from people that suffer is only going to increase the demand for HERION. I’ve said it a thousand times – people in severe pain will find a way to lessen that pain.

The government will not solve this problem, not as long as they continue to subsidize the manufacture of HERION in some countries as a way to finance what’s needed. Blame the doctor or blame the patient – that mentality just doesn’t sit well with me.

Thank you,

John S

Hi Ed,

I’m still alive, but dealing with the usual problems with chronic illness management.

I think we forget that heroin is itself an opioid, what is known as a prodrug for morphine. Heroin, or diacetyl morphine metabolizes quickly, within minutes, into morphine, especially when injected intravenously.

But heroin is so pure these days, that some people eat it, or insufflate it, especially chronic pain patients who have been cut off their prescription opioids, or are under medicated because of nonsensical maximum morphine equivalent daily dose rules. This is what I’m going though — undertreated pain because of my hospital system’s policy of only prescribing so much opiate, even though my tolerance for opiates has grown into a “Monsterito size” during the last 30 years.

People are self medicating, because of policies of institutionalized medicine, what I call the Medical Industrial Complex (apologies to Ike), that ignore the needs of long-time chronic pain patients maintained on opioid therapy for 10 years or more.

Morphine is a viable pain drug, even when supplied in its diacetyl form. But living in a country with a paranoic fear of “addiction”, heroin has been outlawed since 1914. Other, more enlightened countries still include diacetyl morphine in their arsenal of powerful pain killers, while we continue to reduce ours, and spend limited research dollars on anti-diversion, instead of increased analgesia for people living with chronic intractable severe pain.

I don’t wish to confound my initial point with simple facts, so I’ll summarize with the simplest fact of all when it comes to treating pain of this sort:

Treat people with adequate amounts of legal pain relievers, and you’ll see a reduction in heroin use by sick people. It’s that simple.