U.S. - Intent On Reversing Its Opioid Epidemic, [Maine] Limits Prescriptions

[S.J.B.]

Intent On Reversing Its Opioid Epidemic, A State Limits Prescriptions
Patty Wight
NPR
August 23rd, 2017

A year ago, Maine was one of the first states to set limits on opioid prescriptions. The goal in capping the dose of prescription painkillers a patient could get was to stem the flow of opioids that are fueling a nationwide epidemic of abuse.

Maine's law, considered the toughest in the U.S., is largely viewed as a success. But it has also been controversial — particularly among chronic pain patients who are reluctant to lose the medicine they say helps them function.

Ed Hodgdon, who is retired and lives in southern Maine, was just that sort of patient — at least initially.

Name a surgery, and there's a decent chance Hodgdon has had it.

"Knee replacement. Hip replacement. Elbows. I've got screws in my feet," he says.

Read the full story here.

 

[Jabberwocky]

I listened this when it originally aired not to long ago. It is beyond frustrating how we (the US) restricts doctors from actually being able to do their job. If normal doctors could legally prescribe buprenorphine or methadone, not to mention a whole host of other opioids useful in treating substance use disorder related conditions, I feel like we'd be so much better off. The fact a doctor cannot easily prescribe and appropriate opioid based medication to treat substance use disorder is just one of the realities of a war on drugs, drug users as well as people with substance use disorder.

 

[cj]

What a stupid law. Recreational users just switch to heroin while law abiding citizen suffer.

 

[LucidSDreamr]

^But it makes a great sound bite for conservative voters.

This is beyond disturbing. The cartel needs to step up thier game and target these law abiding chronic pain patients...they need heroin desperately.

I hope the cartel figures out a way to get these ppl drugs

 

[LucidSDreamr]

BTW this is the same state with Governor lepage (evil piece of shit, look him up) that made it legal for families to sue a doctor or medic that did nothing besides administer naloxone to a heroin OD and the person still died. And made it legal for a doctor to refuse treating a heroin overdose (and wise if he doesn't want to be sued)

This state elects conservative animals like this...they get what they deserve

 

[cj]

BTW this is the same state with Governor lepage (evil piece of shit, look him up) that made it legal for families to sue a doctor or medic that did nothing besides administer naloxone to a heroin OD and the person still died. And made it legal for a doctor to refuse treating a heroin overdose (and wise if he doesn't want to be sued)

This state elects conservative animals like this...they get what they deserve

Wow that's freaking insane

 

[herbavore]

Everything about the "Opioid Crisis" spells disaster IMO: superficial and flamboyant media frenzy, ignorant and misguided law enforcement, ignorant and misguided politicians and for-profit rehabs, for-profit prisons and Big Pharma who is never going to be denied their profits.

It reminds me of all the well-intentioned focus on mental health treatment every time we have a school shooting by a screwed up teenager. Suddenly there are a flurry of cries for more treatment, "mental health courts" etc. Then those same people go off and vote to cut their taxes and stop paying for mental health services. "Mental Health Court" turns out to be a way for the state to enforce keeping people unwillingly on unproven medications. Sure, sounds good until you remember that an insane society, driven ultimately by profit, has no understanding of mental health and therefore any attempt to treat or cure it is based on....what? Since this world has precious little understanding of the true roots of addiction, the constant cultural lifelines that keep addiction flowing, how in the hell are we supposed to have confidence in the policies and campaigns to "address" the crisis?

 

[LucidSDreamr]

...along those lines...take a look at Trump's opioid taskforce. Composed of about 5 congressmem with zero medical training including chirs Christie which would be healthy if he started mainlining heroin and put down the 1000 calorie meals 5x per day....and 1 doctor (that researches drug abuse and believes that weed legalization contributes to the opioid epidemic)

Not a single pain doctor (the whole reason opiates are even legal)...not a single harm reduction advocate, not a single law enforcement profeasional, not a single, actual reformed addict, not a single expert in drug trafficking/USPS/cartels, not a single economist, not a single expert in (Chinese) drug manuifactiring ....basically only one person caoable of understanding anything whatsoever related to the topic and some bribe taking ppl focused on fundraising....yup that's the crew that is tackling the opioid epidemic.

Trump's record of appointing ppl to posts they know nothing whatsoever about goes unchecked by his base which is can't understand much besides chants such as USA USA

 

[LucidSDreamr]

...at least we can rest easy knowing that there will just me more and more heroin to replace all the revoked prescriptions. And more jails to house drug users... Yes users.

Every deoartment capable of enforcing or researching opioid funding is having. Budget decimated....

Oh that's right....the wall will keep all the drugs out I forgot

 

[5HT2c]

I agree, this approach is just crazy. We will leave people suffering from pain when we can treat this condition since the beginning of medicine. Also, this probably will reinforce narco-trafficking and drug-related problems.

I don't know much about US reality, but it seems that the overdoses and deaths should be dealt in a totally different way of the addicted patients. Could it be that most of deaths were from recreational/novice users and that increasing law enforcement and treatment providers would be just a useless strategy? Do you believe that drug-checking services and harm-reduction interventions would be the best way to tackle the crisis?

 

[LucidSDreamr]

I agree, this approach is just crazy. We will leave people suffering from pain when we can treat this condition since the beginning of medicine. Also, this probably will reinforce narco-trafficking and drug-related problems.

I don't know much about US reality, but it seems that the overdoses and deaths should be dealt in a totally different way of the addicted patients. Could it be that most of deaths were from recreational/novice users and that increasing law enforcement and treatment providers would be just a useless strategy? Do you believe that drug-checking services and harm-reduction interventions would be the best way to tackle the crisis?

When you have politicians in charge of such decisions with no expert help. "shut down the evil pill mills" is a better sound bit than, "help heroin addicts"

 

[cj]

I agree, this approach is just crazy. We will leave people suffering from pain when we can treat this condition since the beginning of medicine. Also, this probably will reinforce narco-trafficking and drug-related problems.

I don't know much about US reality, but it seems that the overdoses and deaths should be dealt in a totally different way of the addicted patients. Could it be that most of deaths were from recreational/novice users and that increasing law enforcement and treatment providers would be just a useless strategy? Do you believe that drug-checking services and harm-reduction interventions would be the best way to tackle the crisis?

In my experience the two sub groups of opiate users most likely to die of overdose are people fresh out of jail or drug treatment who relapse with a lowered tolerance and young kids just getting into IV use. So I don't think expanded or mandatory drug treatment will have much effect on bringing overdose numbers down the opposite effect may actually happen. I do feel like we are seeing less new opiate users because of the bad press opiates are getting and the natural change in drug using habits that happens with each generation. Kids now days are into ecstasy and pot many of them have seen the destructive nature of heroin on older family members so they stay away from that.

The option crises will diminish overtime as my generation (I'm 28) slowly ages out of use. It won't ever go away but public attention will decrease over time.

 

[Erikmen]

Intent On Reversing Its Opioid Epidemic, A State Limits Prescriptions
Patty Wight
NPR
August 23rd, 2017



Read the full story here.

This is a common practice in some European countries, your prescriptions come with a code bar which is basically an adhesive to the document, once you've reach a certain amount, you can't make the purchase and some doctors may be submitted to an audit or warned. It's pretty controlled as the pharmacist will know how much you actually need and you can't get more.

 

[LucidSDreamr]

This is a common practice in some European countries, your prescriptions come with a code bar which is basically an adhesive to the document, once you've reach a certain amount, you can't make the purchase and some doctors may be submitted to an audit or warned. It's pretty controlled as the pharmacist will know how much you actually need and you can't get more.

Its the same in the US as far as YOU not being able to get more. But this law says that people new to pain (recently hit by a car for example) will not be allowed to have pain meds if the total number of pain pill patients in the state is maxed out.

Is that how it is in europe? number on total number of pain patients are capped?

 

[Jabberwocky]

In my experience the two sub groups of opiate users most likely to die of overdose are people fresh out of jail or drug treatment who relapse with a lowered tolerance and young kids just getting into IV use. So I don't think expanded or mandatory drug treatment will have much effect on bringing overdose numbers down the opposite effect may actually happen. I do feel like we are seeing less new opiate users because of the bad press opiates are getting and the natural change in drug using habits that happens with each generation. Kids now days are into ecstasy and pot many of them have seen the destructive nature of heroin on older family members so they stay away from that.

The option crises will diminish overtime as my generation (I'm 28) slowly ages out of use. It won't ever go away but public attention will decrease over time.

That would be pretty cool if that happened. I've read of something similar happening (generationally speaking) with the Portuguese, although of course they're not nearly as fucked as we are with our drug policy ATM...

This is a common practice in some European countries, your prescriptions come with a code bar which is basically an adhesive to the document, once you've reach a certain amount, you can't make the purchase and some doctors may be submitted to an audit or warned. It's pretty controlled as the pharmacist will know how much you actually need and you can't get more.

At the same time, some European countries (less so the eastern ones I read) are more understanding and humane when it comes to using opioids maintenance style therapy to treat opioid use disorder and with chronic pain patients. Switzerland isn't the only place that comes to mind, but in they're case they're far more conservative a culture than the US.

It all boggles my mind sometimes. Really it's impossible to make sense of without understanding the history of (most countrys' current) drug policy(s). The way things are now is far, far from the natural order of things or even approaching any kind of balanced equilibrium when it comes to the harm of substance use versus the harm caused directly by prohibitionist drug policies.

 

[S.J.B.]

Its the same in the US as far as YOU not being able to get more. But this law says that people new to pain (recently hit by a car for example) will not be allowed to have pain meds if the total number of pain pill patients in the state is maxed out.

Is that how it is in europe? number on total number of pain patients are capped?

To be clear, the law discussed in this story set a maximum daily dose of opioids (equivalent to 100 mg of morphine) for all patients, with some cancer patients, hospice patients, and some others being exempted. However, due to push-back, the law has been changed to allow exemptions more broadly for "incurable, chronic conditions."

 

[LucidSDreamr]

Thanks. Not as absurd of a law. The DEA does just fine to limit the amount of overall prescriptions (or meds to fill them at least) by making up thier own laws by intimidating pharmacies.

 

[cduggles]

...along those lines...take a look at Trump's opioid taskforce. Composed of about 5 congressmem with zero medical training including chirs Christie

Guess what? This is what they came up with! Not bad!

President’s opioid commission releases recommendations

Source

The Federal Commission Gov. Chris Christie heads to tackle opioid abuse wants President Trump to declare opioid addiction a national emergency and throw the full weight of the Federal government behind curbing it.

Those include:

* increasing capacity to open treatment to thousands of Americans and eliminate barriers.

* mandating prescriber education with the help of medical and dental schools.

* enhancing access to Medication Assisted Treatment (MAT), which has proven to reduce overdose deaths and decrease use of heroin.

* allowing Naloxone dispensing by standing order and put it in the hands of all law enforcement.

* adding Fentanyl detectors to land borders and post offices to stop its flow.

* enhancing interstate data sharing to allow states to better track patient-specific prescription data.

* regulating patient privacy laws specific to addiction to ensure information about substance abuse disorders is shared with medical professionals.

* enforcing the mental health parity and Addiction Equity Act – which prohibits health plans from imposing less favorable benefits for mental health and substance use diagnoses.

We did talk with Joseph Vitale, chair of the Health and Human Services Committee about access to residential treatment for New Jersey opioid addicts.

“Yes, there are if you have commercial insurance you can get ahead, but again we are going back to the mindset that we have to have for everyone and we don’t,” said Vitale.

The interim report is just a start.

What US Attorney General Jeff Sessions Plans to Do Instead - Depressing

 

[LucidSDreamr]

^ N^ thanks for the info...very good job. on the presidents side of things. I've never heard of a "fentanyl detector" but I'm sure there are ways around whatever they are doing such as packaging on something not permeable to the detector. Or if its for detection trace amounts on packaging just wash it all off and seal the back airtight shut. In theory I really like that idea. I wonder what percentage of heroin actually has no fentanyl and if heroin will keep making its way past that as long as there is no fent in it...which you would hope there is.

Sessions missed the entire cause of the epidemic because he's so old his brain doesn't work. The cause of the ODs being fent, the numbers were never this high when it was pills alone and normal heroin. ..at least the presiden't panel got that right I'm impressed, you would think there would be communication with sessions...or maybe they just lest sessions do it separately so the president doesn't get blamed for all the non drug abusing patients that get fucked over.

I'm SURE FOR A FACT that sessions or his cronies or their wives or best friends are on opiates, people at that age get into lots of pain. That just shoes how brutal these bastards are, they know very well how real chronic pain is...they know they will never have a problem getting opioids prescribed to them and their circle because they are politicians and can walk into any doctors office and tell them exactly what they want and get it. They punish the people that don't have that power. Why? I can't come to any other conclusions besides ignorance or downright cruelty and hatred towards the middle and lower class.

 

[amnda3351]

We recently moved here from florida.my husband has been on the same dose of prescription Dilaudid for about 4 years. It was higher before that but it was cut down. He has done well on the dose he is on for those for years. When we moved to Maine last year they caught his dose by about 20 pills. They also made him sign a pain contract. The last 6 months his doctor has been giving him the hardest time and reducing his pills. At his last visit they jad a huhe argument and in the course of thia argument he said that some days his nack hurts ao nad he takes his pills every 6 hours on the dot and other days he only takes 1 or 2. She told him ne had violated his pain contract and gave him a script for only 50 pills ( about half his normal script) and told him to find a new Dr. He doesn't abuse his pills( i was a heroin addict, I'd know if he was) he can be called in anytime for a pill count and have exactly if not more than what he should but now he is in so much pain he can barely walk. He is trying to take the smallest ampint of pills possibly but he had to go the ER today for a work note because it is so bad. He has no idea where to find a doctor who will prescribe him pain pills and i don't know what to tell him. I know what withdrawl feels like and i can't imagine him dealing with that on top of hia backpain. any advice? We are more than willing to travel for a doctor.