On average, states with medical marijuana programs saw a substantial drop (24.8%) in opioid overdose fatalities.

Researchers at the Perelman School of Medicine at the University of Pennsylvania say there’s a significant association between legalizing medical marijuana and reducing opioid overdose deaths.

The Numbers

To come to this conclusion, the research team looked at overdose statistics from between 1990 and 2010, comparing death-rates in 13 states with legal medical marijuana programs, to all other states. They found:

• States with legalized medical marijuana programs had a 24.8% lower average annual opioid overdose mortality rate than states which did not permit the use of medical marijuana.
• The life-saving effects strengthened with time. Compared to all other states, in the first year after legalization, on average, states saw a 20% drop in opioid overdose fatalities – by 5 years post legalization, average opioid overdose deaths dropped by 33.7%.
• 60% of American opioid overdose fatalities occur among people with legitimate prescriptions for these medications.

The Explanation

The medical team proposes two likely explanations for the drop in overdose deaths:

1. Though medical marijuana isn’t known as a strong analgesic, some people may find that cannabis offers sufficient pain relief. Others may find that supplementing with cannabis allows for a lower daily opioid dosage.
2. People with more access to medical marijuana may have less incentive to abuse opioids, or they may abuse opioids differently, than people without access to marijuana.

To learn more, visit JAMA Internal Medicine to see the original research results.

An expert in pain management from the College of Pharmacy at Oregon State University says that millions of Americans are living in pain because doctors are afraid to prescribe sufficient pain killers.

Kathryn Hahn, a faculty member at Oregon State University and the Chair of the Oregon Pain Management Commission, says that more than half of all people suffering through chronic pain fail to receive sufficient analgesia and that the gross economic cost of this pain tops $100 billion each year in America alone. She says that too many people are suffering through pain that could be treated were doctors educated and willing to do so - but says that the few hours of training that doctors receive on the use of opiate medications in medical school leaves them under-prepared to deal with the steady need for pain medication they face in the real world.

In articles published in the Journal of Pain and Palliative Care Pharmacotherapy, and The Rx Consultant Hahn said, "We have more sophisticated pain management techniques available now than ever before, but many doctors are not fully informed about all the options available, and also often turn patients away because they're very concerned about the problems with prescription drug abuse.”

Hahn says that many doctors are so uncomfortable about the issue of pain medication prescribing that they prefer to avoid treating chronic pain patients entirely – which in some cases leaves patients unable to find needed medical care. Hahn says, "It's particularly bad with elderly and Medicare patients. Prescription drug abuse is a very real problem, we do have to take necessary steps to address it, but right now the pendulum has swung too far, and legitimate pain problems are not being managed."

Suggestions Hahn offers to improve the outlook for American pain patients include:

• Convincing medical practitioners to accept a patient’s judgment of what is painful

• Expanding access to complementary pain management techniques, such as acupuncture or massage

• Using a wider range of medications to treat pain

• Convincing patients to lock up or adequately secure their pain medications in the home to reduce unwanted diversion

• Convincing doctors to stay up to date with the latest pain management techniques

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By adding a medication called +Naloxone to opiates, researchers managed to "remove" intoxication and addiction while retaining their pain relieving properties. 

Opiates work amazingly well for pain relief, but that effectiveness comes with an inseparable cost: they produce such pleasure that a substantial percentage of those that use them succumb to addiction.

Now, a team of Australian and American researchers think they've come up with something huge - a way for people to use opiates and get full pain relief without getting any of the intoxicating side effects and without any risk of developing an addiction.

Adding the Drug +Naloxone Makes Opiates "Non-Addictive"

Naloxone is an opiate antagonist which instantly reverses the effects of substances like morphine and heroin and it can be a lifesaving medication when administered in time to a person overdosing on any kind of opiate.

By tweaking Naloxone a bit, the researchers developed a new medication called +Naloxone, which targets TLR-4 immune system receptors on cell membranes. TLR-4 receptors work to identify substances such as bacteria, viruses or psychoactive substances like opiates, as they bump against cell walls. When +Naloxone is administered with an opiate, it binds to the TLR-4 receptor and blocks its influence.

The research team had previously demonstrated that opiates bind to TLR-4 receptors in the brain, and though they suspected that TLR-4 receptors played a role in addiction, they weren't sure what that role was.

The Experiment

• For the experimental period, one of group of rats received doses of morphine only and another group of rats received +Naloxone followed by morphine.

The Results

• Rats given morphine only displayed behaviors of animal addiction.
• Rats given +Naloxone and morphine displayed no behaviors of addiction
• Pain tests showed that both groups of rats received equal analgesia
• When looking at brain activity, the researchers observed that the rats given +Naloxone and morphine showed no extra dopamine release

Commentary

Commenting on the significance of the results, lead study author Mark Hutchinson Ph.D. wrote, “Our studies have shown conclusively that we can block addiction via the immune system of the brain, without targeting the brain’s wiring. Both the central nervous system and the immune system play important roles in creating addiction, but our studies have shown we only need to block the immune response in the brain to prevent cravings for opioid drugs.”

The full results are published in the Journal of Neuroscience.

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University of Michigan researchers say that between 2000 and 2009 opiate use and dependency among pregnant women rose by almost 500% and the numbers of infants being born with neonatal abstinence syndrome rose by about 300%.

According to the CDC, opiate abuse is up about 400% from a decade ago, but has this dramatic upswing in general use translated to more pregnant women abusing opiates and to more infants being born dependent?

That’s what University of Michigan neonatal researchers wanted to know and to find out they took a look at hospital billing data from across the US.

The Results

• From 2009 to 2009, neonatal abstinence syndrome (NAS) diagnoses increased from 1.2 per 1000 hospital births to 3.39 per 1000 hospital births – an almost 3 fold increase. Over that same time period the number of pregnant women abusing or dependent on opiates increased by almost 500%, from 1.19 in 1000 to 5.63 in 1000.
• In 2009, an estimated 14 359 infants were born with NAS, which equates to one about every 10 minutes.

Lead study author Stephen Patrick explains that infants born with NAS are smaller and at greater risk of sudden death. Some of the symptoms of NAS include extreme irritability, seizures, muscle rigidity and inconsolable crying. Patrick says that hospital staff can generally identify infants with NAS by their cries alone, saying, "It's like a colicky baby times 10."

To ease the pains of neonatal withdrawal, infants with NAS are generally given methadone and then slowly weaned off opiates over a period of weeks.

The full study results are published in the current edition of JAMA.

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Unless you really need strong pain relief, you’re probably better off without the opiate pain meds often prescribed after minor low-pain surgeries. In a recent Canadian study, about 10% of people given opiates they didn’t really need ended up addicted.

Using opiate painkillers within a week after minor surgery greatly increases your odds of developing an opiate addiction.

That’s the story from Canadian researchers who looked at the medical records of 391,139 patients in Ontario to see whether using opiates after minor surgery was associated with any increased risk of addiction.

The Study

All subjects in the study were over the age of 66 and all had undergone a minor (low pain) surgical procedure, such as cataract surgery, varicose vein stripping or gallbladder removal.

• Of these patients, 7% received a prescription for opiate pain medications within a week of their surgery
• Of those who received opiates, 10% were still using them a year after their surgery date
• Of those who continued to use opiates, many upgraded to more potent opiate medications over the course of that first year of use

The researchers say that patients are often prescribed a standardized post surgery dose of opiate pain medications, regardless of the actual anticipated need for analgesics following low-pain surgeries. Because of this, many patients use opiates needlessly and increase their risk of addiction.

Commenting on the findings, study co-author Dr. Chaim Bell said, “We tried to look at what some of the events are that start people on the road to acute or chronic use of opioids. It's much easier to prevent the initiation of the medication than wean people off it later. Everyone should get pain relief, but the painkiller and the dose should be tailored to the specific patient."

The full study results can be found in the current edition of Archives of Internal Medicine.

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Need pain control but not sure about taking more opiates? Well, Italian and American scientists are working on a solution and they say that manipulating the activity of one of the body’s endogenous chemicals may prove the key to non-addictive pain control medications in the future.

It’s called anandamide, it’s produced naturally in your own brain and when it goes into action it makes everything seem a little bit better…

Coming out of the brain’s endocannibanoid system, anandamide causes effects similar to THC in marijuana – suppressing feelings of anxiety, depression and pain.

Scientists at UC Irvine and wondered if altering the activity of anandamide in the brain would influence the effects, and so they blocked a transport enzyme in brain cells that normally transports the anandamide to areas where it is degraded and destroyed by other fatty acid enzymes.

They found that by blocking the transport of anandamide to ‘destruction areas’ they were able to increase the potency of certain anandamide effects, notably increasing the analgesic effects without increasing intoxication-like effects. They were able to up the pain relief component without causing a high, such as would be seen if a person consumed another similar compound, like THC.

Due to the promising results of the research study, the scientists involved say there’s real potential here to develop potent analgesic medications that evade the sedation, addiction risks and other CNS side effects seen in virtually all strong pain killers on the market today.

Lead researcher, UC Irvine Neurosciences Chair Daniele Piomelli commented on the significance of the findings, saying, "These findings raise hope that the analgesic properties of marijuana can be harnessed for new, safe drugs. Specific drug compounds we are creating that amplify the actions of natural, marijuana-like chemicals are showing great promise."

The full research results can be read in Nature Neuroscience

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While adolescent substance abuse, teen drinking and teen smoking have all been in steady decline, over the past 10 years, prescription drug abuse is still on the rise among teenagers 12 – 17 years of age. 60% of American teenagers will have experimented with painkillers before the age of 15 - often, with tragic consequences.

Prescription drugs can be every bit as addictive, every bit as dangerous, every bit as deadly as illegal street drugs.

Every day, 2,500 teenagers use prescription drugs to get high for the first time. The drugs are readily available to them in medicine cabinets, cupboards and drawers around the house.

The tragic experience of losing his 17-year-old son who overdosed with prescription drugs taken with an over-the-counter medication prompted father Gary Neal to start the Not In My House campaign to raise awareness of the issue.

Many parents are not even aware of the possibility that their kid may abuse medications. After all, the idea of purposely abusing prescription drugs didn't go on when the parents were teenagers – then it was still the illegal drugs like Marijuana, Cocaine and Heroin.

The good news is that the medicine cabinet isn’t Afghanistan or Columbia, parents can actually do something to curb the "supply" of prescription drugs. So, part of the Not in My House campaign appeals directly to parents to take action starting with their own medicine cabinets.

Specifically, the campaign recommends that prescription drugs should be stored in a safe place that is not readily accessible to everyone in the house. Parents are also encouraged to take an inventory of prescription medications at home, counting pills left in the bottle or package after every use. Leftover or expired prescription pills should be disposed of properly.

With the second anniversary of his son’s death approaching, Not in My House campaign founder Gary Neal still has a lot of questions and doubts. "Could I have done it better? Could I have done it different? Would the results have been different?"

You never know the answers to those questions because you never get a second chance.

"I've lamented his death every second since he died and will live with it the rest of my life."

The Not In My House campaign is supported by The Partnership for a Drug Free America.

Also, check out the Partnership for a Drug-Free America’s new Web Community

The Partnership for a Drug-Free America has launched a Web-based community to celebrate stories of addiction recovery and bring a human face to the disease of addiction, which currently afflicts 22 million Americans.

The new community, known as Life After is designed to serve as a social network and inspirational showcase where visitors can share stories of hope, celebrate their recovery and find encouragement from friends and family.

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Rural Ohio struggling to cope with opiate abuse and the tragedies that accompany it.

Scioto County Ohio is a place heavy in OxyContin abuse – so common is the addiction in this once prosperous manufacturing center that a whopping one in ten babies born to Scioto County mothers are born with OxyContin already circulating in the blood.

Other facts that paint a staggering picture of the scale of rural Ohio’s prescription opiate problem include:

• By 2007, drug overdoses passed car accidents as the state’s leading cause of accidental death
• Fatal drug overdoses are up 400% from a decade ago
• More people died from drug overdoses in Ohio in 2008 and 2009 than died in the 2001 World Trade Center terrorist attacks

Scioto County authorities say it’s tough to police the distribution of a legal drug. Although they have had some success in shutting down pain pill clinics for over prescribing, there are still 5 in operation within the county alone and several of these are run by convicted felons.

The problem is so bad in Scioto that Ohio Governor John Kasich announced last month an extra 36 million dollars in funding for drug addiction funding – some of it earmarked for a drug addiction pilot project to be run within the troubled county. 

Lisa Roberts, who works as a nurse in the health dept in Portsmouth, the county Seat, says she sees everyday the destruction of the drug that’s just overtaken her community, saying, “Around here, everyone has a kid who’s addicted. It doesn’t matter if you’re a police chief, a judge or a Baptist preacher. It’s kind of like a rite of passage.”

At the national Level, President Obama took time to comment on the massive scale of the prescription drug abuse problem in speech on Tuesday, when he noted that prescription drugs are now killing more people than heroin in the 1970s and crack cocaine in the 1980s did combined.

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Prescription medications supplied by the family medicine cabinet are often a teen’s introduction to hard drug abuse. Convincing people to safely dispose of these unused prescription medications is such a priority for Indiana Attorney General Greg Zoeller that he’s written a bill that proposes drop off points for outdated medications in every pharmacy in the state, hoping to supersede federal requirements that demand that a law officer be present to receive these types of medications.

Should you flush them, chuck them…keep them there for a rainy day?!? If you’ve ever wondered what to do with prescription drugs that are expired or you no longer use, you are not alone – but in Indiana, the answer to your uncertainty may soon be coming to a pharmacy near you.

Indiana’s Attorney General, Greg Zoeller has just written a bill that he hopes to turn into a state law mandating that pharmacies create safe disposal drop off sites for people’s unwanted pharmaceuticals – and although federal law requires that a law officer be present for such receivables, Zoeller’s bill will bypass that requirement as it enlists pharmacists as front line soldiers in the fight against prescription drug diversion.

With prescription drug addiction second only to alcohol addiction in sheer numbers, there can be little debate about the need to reduce access to those who might experiment with, or abuse, unwanted or outdated medications. The new law would help to curb whose hands these unwanted drugs fall into, as it also makes sure the medicines are properly disposed of through incineration. 

Rep. Kevin Mahan, R-Hartford City is also sponsoring the bill. Prior to his position at the House of Representatives, he was a County Sheriff in Blackford. He is passionate about the bill after witnessing damage caused by unused prescription drugs including accidental overdoses, suicides and even kids selling the unused drugs at school.

Environmentalists are also in favor of the bill because of the pollution caused by people flushing their old tablets and syrups down household toilets, which in turn threatens wildlife and fish by contaminating their water.

Activists hope that House Bill 112 will garner strong support and influence states within the US that do not already have pharmaceutical disposal laws in place.

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According to the DEA, in 2002 alone, OxyContin caused 146 deaths and contributed to another 318. Doctors prescribe the popular pain medication because they were told by its manufacturer Purdue Pharma that the drug was less addictive and less prone to abuse than any other pain killers on the market. Despite these problems, OxyContin had become one of the leading opioid painkillers on the market. In 2001, OxyContin was the highest sold drug of its kind, and in 2000, over 6.5 million prescriptions were written, according to the Drug Policy Alliance (http://www.drugpolicy.org/drugbydrug/oxycontin/).

Last week, a United States district court had a different opinion. After hours in court and testimonies from former OxyContin addicts and family members of those who had died from OxyContin, U.S. District Judge James Jones imposed a fine of $630 million dollars and criminal charges against company officers of Purdue Pharma L.P. Officers of the company were charged with misbranding the drug. Over the years they heavily downplayed the risk of OxyContin, with horrific results to many families. Hundreds of addicts have died as a result of the drugs widespread availability. A memorial site (OxyAbuseKills) lists many victims, often young people in their prime.

OxyContin caused just as many problems for patients trying to overcome pain as it did for drug users. Many patients found that the pain of OxyContin withdrawl was far worse then the pain they were being treatment for, according to a spokesperson for ChooseHelp Treatment Centers (http://www.choosehelp.com) – a renowned rehab provider that offers specialized OxyContin treatment programs.

The abuse of prescription drugs is a big problem in Florida, and newly released DEA statistics show that prescription drug overdoses account for three times as many deaths as illicit drugs like cocaine or heroin.

Just under 1000 Floridians died after overdosing on illicit drugs like cocaine or heroin last year.

Over 3000 people died in Florida last year after overdosing on prescription medications like opiate based painkillers, or drugs like xanax.

Floridians are 3 times more likely to die from the overdose of a legal prescription medication than from drugs like crack cocaine, meth amphetamine or heroin. DEA officials call it an epidemic, and say that across the US, almost 7 million people are abusing prescription drugs – an 80% increase in just 6 years.

Jeff Beasley, a DEA agent in Florida, described the challenges involved in prescription drug abuse suppression - saying, “You have health care providers involved, you have doctor shoppers, and then there are crimes like robbing drug shipments. There is a multitude of ways to get these drugs, and that’s what makes things complicated.”

Florida has considered mimicking the lead of 38 other states that have enacted legislation allowing for the sales tracking of certain medications, but all previous efforts in Florida have stalled due to privacy concerns.

Lisa McElhaney a police officer who works in the Broward County Pharmaceutical Drug Diversion Unit summed it up saying, "The abuse has reached epidemic proportions. It’s just explosive.”

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Top US Army medical officials have raised concerns about possible pain killer abuse and addiction among troops insured in Iraq. Prescriptions for pain-relievers to injured US troops have surged from 30,000 a month to 50,000 since the Iraq war began.

According to Army Col. Chester "Trip" Buckenmaier III, of Walter Reed Army Medical Center in Washington, the jump in outpatient prescriptions paid for by the government suggests that doctors rely too heavily on narcotics. Most of them prescribed for orthopedic injuries from the strain of long deployments.

According to a 2005 survey of over 16,000 service members narcotic painkillers were the most abused drug in the military. 4% surveyed in 2005 admitted abusing prescription narcotics in the previous 30 days, with 10% doing so in the last 12 months.

A more recent survey in 2008 has not been released.

A recent court testimony states that at least 20 soldiers in an engineer company of 70 to 80 soldiers at Fort Leonard Wood, Mo., shared and abused painkillers prescribed for their injuries. "The groundwork for this toxic situation was laid out through the continual prescription of highly addictive, commonly overused drugs," said Capt. Elizabeth Turner, the lawyer for one defendant in the case.

In response to six suicides and seven drug-related deaths among soldiers in Warrior Transition Units, aggressive efforts are now underway to manage prescription drugs, says Col. Paul Cordts, chief of health policy for the Army surgeon general.

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A Columbia University study on online drug retailing shows how easy it is to buy controlled drugs without the need of a prescription.

The vast majority, over 85%, of online pharmacies will sell controlled medications like OxyContin or Ritalin without asking for a doctor's prescription.

Joseph Califano, head of Columbia University's National Center on Substance Abuse and Addiction led the study of online pharmacies, and summarized the findings as, "Anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse."

Columbia researchers visited 365 online drug-stores and found that 85% of these would sell controlled drugs without needing a prescription. The total number of online pharmacies, however, was down 37% from a year earlier - a trend attributed to law enforcement efforts online.

The DEA reports that 80% of purchases made at online pharmacies are for controlled drugs, while in retail pharmacies such medications account for only 11% of purchases.

The Senate passed a bill earlier this year that strengthens the regulatory language against the illicit sale of medications online – that bill awaits House approval.

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With an estimated 6 million people abusing pain pills daily and doctors hesitant to prescribe even to people with a legitimate need, pharmaceutical companies are soon to unveil new (and strange) abuse-free formulations.

A lot of people with serious and chronic pain can’t get the drugs they need because even more people with or without serious and chronic pain abuse narcotic pain killers. Doctors are increasingly hesitant to prescribe appropriately to legitimate pain patients, and with an estimated 6 million Americans abusing prescription drugs at any one time - doctors are in an understandable quandary.

Prescription pain medications are abused by taking more than the recommended dosage, by exceeding the recommended dosage frequency or by taking the medication in ways other than specified. Abusers, for example, might crush and snort a medication intended for time released relief, experiencing all the potency at once - and a considerable high. More simply still, just chewing the tablets can accelerate absorption, and the intensity of the high.

In response to the abuse potential of narcotic type drugs, pharmaceutical companies are testing new formulations less easily manipulated for a quick high. Tablets with active ingredients entombed in a thick and viscous gel are one solution, which consultant Doctor Lynn Webster claims cannot be administered in any way other than their intended manner.

Other formulations in the works include the soft and gummy Remoxy, a test product for Oxycontin, and Embeda, which is a pill-form morphine containing a narcotic antagonist.

Embeda works as promised when patients consume the pill whole, as directed. Should a patient consume, in any way, a broken tablet; the narcotic antagonist gets released - eliminating the effects of the medication.  

These new tablet formulations await final FDA approval, before an expected release to market next year.

While critics contend that addicts will find a way to get the high they crave, pain patients are hopeful that with increasing controls on pain med abuse, they will find it easier to get drugs in the quantities they say they need, to keep pain at bay.

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OxyContin, a potent opiate and one of America’s most often abused prescription medications, may soon come to market in tamper resistant plastic coated tablets that are designed to prevent abuse.

A group of FDA health advisors have recommended that Purdue Pharma’s new and “improved” version of OxyContin receive FDA approval.

Oxycontin, which outsold all other analgesics last year with sales of 2.3 billion dollars, was developed initially as a long lasting extended release form of the strong pain killer oxycodone. Drug abusers quickly learned that by breaking open the tablets and either snorting or injecting the medication, they had access to a substantial quantity of a potent narcotic and could attain a heroin-like high.

Due to its ease of abuse, the drug is widely used recreationally and due to its addictiveness, it has caused substantial social problems. Oxycontin was involved in the overdose deaths of actor Heath Ledger, and recently, DJ Am (Adam Goldstein).

Purdue Pharma was found guilty of misleading doctors about the abuse risks of OxyContin in 2007 and fined nearly $700 million in damages.

Purdue Pharma’s latest version of the medication encases each tablet in a tamper resistant plastic-like coating. This encapsulation makes it harder for abusers to break open pills to access the medication inside for injection or snorting.

The FDA panel has called the new formulation of “limited” improvement, but said that it may be better than what is currently on market.

Purdue Pharma has said that it will use this new plastic coating for all OxyContin products and doses, dependent on FDA approval.

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