National Prescription Drug Take Back Day – Saturday, October 26, 2013 –
The National Prescription Drug Take-Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.
TRENTON — Seeking to curb the unprecedented abuse of heroin and opiates in New Jersey, state lawmakers Thursday took the first step toward comprehensive reforms of the state’s approach to substance abuse treatment and prevention.
Experts from the medical field spent more than two hours testifying before the Senate Health, Human Services and Senior Citizens Committee, explaining the yawning gap between science and public policy, and offering recommendations on how to narrow it.
Some of the recommendations were simple enough that they could be implemented with an iPhone, but most others would take time and money.
But committee chairman Joseph F. Vitale, D-Middlesex, said opiate abuse in New Jersey has become a public health crisis and a pressing priority in recent months among legislators.
“People need to know that this is as important an issue in terms of health care as any other epidemic,” he said.
Experts were armed with enough statistics to prove it.
The state has had more than 700 opiate overdose deaths since 2009. Forty-six percent of treatment admissions last year were for heroin or opiates. Overdoses lead all accidental deaths in New Jersey, and of those, opiates have been involved in 75 percent, said Dr. Louis E. Baxter, the president and executive medical director of the Professional Assistance Program NJ, a drug and alcohol counseling services.
Camden, Essex, Middlesex, Monmouth and Ocean counties lead the way in overdose deaths, Baxter said.
With a little more than 6,000 beds for 72,000 people seeking treatment, there is a logjam seeking treatment for “this epidemic (that) has spread,” Baxter said.
He and other experts said there are fundamental flaws in New Jersey’s treatment options and access to them, which they suggested is an indictment of the nation’s approach to substance abuse.
Drug addiction is not about drugs, it’s about brains, said Susan E. Foster, the vice president and director of policy research and analysis at the National Center on Addiction and Substance Abuse at Columbia University. It must be diagnosed early, treated individually and monitored regularly for a long time, she said.
Foster, citing a 2005 study by the center, said 3 cents of every dollar was spent on substance-abuse prevention and treatment in New Jersey, while the remaining 97 cents went to “shovel up after the fact — in our jails, in our health care programs, in our schools, assistance programs and even our workforce.”
A “full treatment experience” — detox, medication, therapy — results in a success rate of about 80 percent and at far less cost, Baxter said. Gov. Chris Christie last week said it costs New Jersey roughly $24,000 to treat an addict through the state’s drug court program, but $49,000 to jail them for a year.
Treatment providers are another area with problems.
Less than 6 percent of treatment referrals come from health care providers, she said. Most referrals come from the criminal justice system, she said, “indicating our failure to prevent and treat the disease until the costly consequences occur.”
Foster said in the U.S. there is no reliable estimate on who is providing addiction care. There are few restrictions on who “can hang out a shingle and say ‘I’m providing addiction treatment,’ ” she said, adding that few medical professionals are well enough trained to provide treatment for addiction.
In New Jersey, as in most states, the largest number of people offering treatment are drug counselors, whose minimum requirements are a high school diploma or its equivalent, she said.
“Addiction care is largely disconnected from mainstream medical practice,” Foster said.
Baxter and Foster also recommended, among other things, requiring addiction education in all health care curriculums, participation in the Prescription Drug Monitoring Program, a campaign to educate the public on opiate abuse, and expanding insurance options to include long-term care.
Vitale, the committee chairman, said the meeting was the first step toward “comprehensive” changes to the state’s approach to substance abuse treatment. He said the Christie administration is eager to discuss options, but comprehensive change will be costly and time-consuming.
“We have to have a blueprint,” he said. “And to say that we can’t do it because of the money — we can do it, but it takes time.”
It’s been an epidemic in Ocean County this year, and now it’s being called an epidemic in Monmouth County. And it’s killing teens.
Heroin. Ten dollars a pack. Easy for your kids to get a hold of. Addicting and deadly. So…you might want to say ‘not my kid’ but you will be shocked at the information below:
In the Freehold Regional High School District alone, 721 kids have sought professional help for a heroin addiction. At Manasquan High School, 164 teens are hooked on heroin. 37 young people have died from a heroin overdose so far this year. And it’s everywhere around these beautiful Jersey Shore towns.
So how are your teens’ friends and fellow students getting hooked on heroin? 80 percent begin using with their friends, and then get hooked on it and will hide the addiction and the heroin, using alone…until they overdose.
The Monmouth County Prosecutor’s Office is starting to hit the schools to tell parents and students what is going on and spread the word. Ocean County Prosecutors are doing the same….even more young people have died there from heroin.
And to make matters even worse, the heroin in our area is stronger than around the rest of the country, making it even more deadly.
Here’s what can save your child: Communication. Keep talking about saying NO to drugs. And tell your kids how much you love them. Because of those kids in a recent study who stayed drug free, most said they did so because they did not want to disappoint their parents.
So, next time your kids say they’re ‘hanging out’……don’t assume that everything is okay. Don’t say ‘it’s not my kid.’ Keep your eyes and ears open. Get your kids talking. Love them. And please keep them safe the best way you can.
In a period of nine months, a tiny Kentucky county of fewer than 12,000 people sees a 53-year-old mother, her 35-year-old son, and seven others die by overdosing on pain medications obtained from pain clinics in Florida.1 In Utah, a 13-year-old fatally overdoses on oxycodone pills taken from a friend’s grandmother.2 A 20-year-old Boston man dies from an overdose of methadone, only a year after his friend also died from a prescription drug overdose.3
These are not isolated events. Drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. In 2008, more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription drugs.4
100 people die from drug overdoses every day in the United States.4
What Do We Know?
The role of prescription painkillers
Although many types of prescription drugs are abused, there is currently a growing, deadly epidemic of prescription painkiller abuse. Nearly three out of four prescription drug overdoses are caused by prescription painkillers—also called opioid pain relievers. The unprecedented rise in overdose deaths in the US parallels a 300% increase since 1999 in the sale of these strong painkillers.4 These drugs were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined.4
The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years.6
More than 12 million people reported using prescription painkillers nonmedically in 2010, that is, using them without a prescription or for the feeling they cause.7
The role of alcohol and other drugs
About one-half of prescription painkiller deaths involve at least one other drug, including benzodiazepines, cocaine, and heroin. Alcohol is also involved in many overdose deaths.8
In 2008, there were 14,800 prescription painkiller deaths.4
How Prescription Painkiller Deaths Occur
Prescription painkillers work by binding to receptors in the brain to decrease the perception of pain. These powerful drugs can create a feeling of euphoria, cause physical dependence, and, in some people, lead to addiction. Prescription painkillers also cause sedation and slow down a person’s breathing.
A person who is abusing prescription painkillers might take larger doses to achieve a euphoric effect and reduce withdrawal symptoms. These larger doses can cause breathing to slow down so much that breathing stops, resulting in a fatal overdose.
In 2010, 2 million people reported using prescription painkillers nonmedically for the first time within the last year—nearly 5,500 a day.7
Where the drugs come from
Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions. More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else.7
Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists.10 Roughly 20% of prescribers prescribe 80% of all prescription painkillers.11,12,13
Who is most at risk
Understanding the groups at highest risk for overdose can help states target interventions. Research shows that some groups are particularly vulnerable to prescription drug overdose:
People who obtain multiple controlled substance prescriptions from multiple providers—a practice known as “doctor shopping.”14,15
People who take high daily dosages of prescription painkillers and those who misuse multiple abuse-prone prescription drugs.15,16,17,18,19
Low-income people and those living in rural areas.
People on Medicaid are prescribed painkillers at twice the rate of non-Medicaid patients and are at six times the risk of prescription painkillers overdose.20,21 One Washington State study found that 45% of people who died from prescription painkiller overdoses were Medicaid enrollees.20
People with mental illness and those with a history of substance abuse.19
Where overdose deaths are the highest
The drug overdose epidemic is most severe in the Southwest and Appalachian region, and rates vary substantially between states. The highest drug overdose death rates in 2008 were found in New Mexico and West Virginia, which had rates nearly five times that of the state with the lowest rate, Nebraska.4
There are many different points of intervention to prevent prescription drug overdoses. States play a central role in protecting the public health and regulating health care and the practice of the health professions. As such, states are especially critical to reversing the prescription drug overdose epidemic.
The following state policies show promise in reducing prescription drug abuse while ensuring patients have access to safe, effective pain treatment.
Prescription Drug Monitoring Programs
Thirty-six states have operational Prescription Drug Monitoring Programs.22
Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients. They are designed to monitor this information for suspected abuse or diversion—that is, the channeling of the drug into an illegal use—and can give a prescriber or pharmacist critical information regarding a patient’s controlled substance prescription history. This information can help prescribers and pharmacists identify high-risk patients who would benefit from early interventions.
CDC recommends that PDMPs focus their resources on
patients at highest risk in terms of prescription painkiller dosage, numbers of controlled substance prescriptions, and numbers of prescribers; and
prescribers who clearly deviate from accepted medical practice in terms of prescription painkiller dosage, numbers of prescriptions for controlled substances, and proportion of doctor shoppers among their patients.
CDC also recommends that PDMPs link to electronic health records systems so that PDMP information is better integrated into health care providers’ day-to-day practices.
Patient review and restriction programs
State benefits programs (like Medicaid) and workers’ compensation programs should consider monitoring prescription claims information and PDMP data (where applicable) for signs of inappropriate use of controlled prescription drugs. For patients whose use of multiple providers cannot be justified on medical grounds, such programs should consider reimbursing claims for controlled prescription drugs from a single designated physician and a single designated pharmacy. This can improve the coordination of care and use of medical services, as well as ensure appropriate access, for patients who are at high risk for overdose.
Health care provider accountability
States should ensure that providers follow evidence-based guidelines for the safe and effective use of prescription painkillers. Swift regulatory action taken against health care providers acting outside the limits of accepted medical practice can decrease provider behaviors that contribute to prescription painkiller abuse, diversion, and overdose.
Laws to prevent prescription drug abuse and diversion
States can enact and enforce laws to prevent doctor shopping, the operation of rogue pain clinics or “pill mills,” and other laws to reduce prescription painkiller diversion and abuse while safeguarding legitimate access to pain management services. These laws should also be rigorously evaluated for their effectiveness. View your state’s prescription drug laws.
Better access to substance abuse treatment
Effective, accessible substance abuse treatment programs could reduce overdose among people struggling with dependence and addiction. States should increase access to these important programs.
These recommendations are based on promising interventions and expert opinion. Additional research is needed to understand the impact of these interventions on reducing prescription drug overdose deaths.
The amount of prescription painkillers sold in states varies.4
The quantity of prescription painkillers sold to pharmacies, hospitals, and doctors’ offices was 4 times larger in 2010 than in 1999. Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for one month.
Nearly 15,000 people die every year of overdoses involving prescription painkillers. In 2010, 1 in 20 people in the US (age 12 or older) reported using prescription painkillers for nonmedical reasons in the past year. Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.