New Oxy Guidelines For Kids Alarm Lawmakers, But Drs. Say They’re Needed

The Food and Drug Administration’s decision last August to officially approve use and set guidelines for the use of Oxycontin, for certain children as young as 11 has triggered a huge debate among lawmakers, health care professionals, and parents about whether or not the drug is appropriate for treating pain in people under the age of 18.

Image Credit: Pixabay (Public Domain

Image Credit: Pixabay (Public Domain

The new guidelines do not “legalize” Oxycontin, per se – prescription opiates have been prescribed for years off-label – but this is the first time there have been recommended guidelines for doctors to prescribe the powerful drug to children suffering from certain conditions that cause chronic pain.

Some elected officials, as well as candidates running for office including Hillary Clinton, have echoed sentiments of addiction specialists who say the new guidelines will encourage doctors to expand access to a drug at the center of an epidemic of opiate abuse in the U.S. that was responsible for over 24,000 overdose deaths in 2013. They say health care providers need to focus on alternative pain management rather than relying on such an addictive drug to help their young patients.

Unfortunately, many physicians and families are pleased that the FDA has chosen to provide guidelines to doctors treating children with serious, debilitating and sometimes fatal conditions. Opiates are strong painkillers that can alleviate suffering of children with terminal conditions and rare musculoskeletal disorders.

Previously, doctors have had to rely on adult dosing information when prescribing the painkiller to children off-label, which are unsuited to young, very sick kids. The new guidelines help doctors safely administer the controversial drug and prevent accidental overdoses in youngsters.

The FDA says that the intent of the guidelines is to provide safe and reliable information, not expand availability or increase the use of the drug in children. The federal agency approved the drug for treating children ages 11-17 that suffer from severe, long-term pain, such as terminal diseases like cancer or kids recovering from severe automobile accidents. Many children in this age group have already been taking an opioid painkiller to help them cope with their health problems, and the guidelines set standards and dosages for safety purposes.

In addition to giving guidelines for the prescription, the FDA is requiring the drug’s manufacturer, Purdue Pharma LP, to conduct more studies on the drug’s use in children, and to report and keep track of all adverse events connected to the drug’s use in children.

Lawmakers, however, are not convinced that the benefits of the drug’s use in minors outweighs the risk, especially in states where opiate abuse has run rampant in recent years. Some elected officials in states grappling with rampant painkiller abuse are furious. “When we make it easier for kids to get this stuff, we are sentencing ourselves to more opiate addiction and more misery for America,” Gov. Peter Shumlin of Vermont told the Wall Street Journal.


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Does Narcan Offer Opiate Users A False Sense Of Security?

At least 17 states in America, as well as first responders in the District of Columbia, have been trained to publicly administer the heroin overdose antidote called Narcan, and at least 10 states allow for prescriptions to family or friends of drug users who worry that they will lose their loved one to addiction. While the drug has saved an estimated 10,000 lives, many officials are wary of its use, saying that an increase in its availability is causing public health problems.

Image Credit: Pixabay (Public Domain)

Image Credit: Pixabay (Public Domain)

Officials in New Castle, Pennsylvania say the drug is giving users a false sense of, giving them the confidence to engage in more risky behavior with the belief that when they overdose, they’ll be brought back from death. While inarguably, the drug, recently approved for first responders in New Castle, saves lives. But the city has also seen its share of “repeat offenders” – drug addicts that overdose on opiates multiple times in a week, and sometimes, more than one time a day, causing concern and frustration among public officials.

Studies have shown that Narcan, if widely available, could have the public health benefit of slicing fatal heroin overdoses in half. In the United States, over 15,000 people die each year from opioid pain relievers overdoses such as Oxycontin, a rate that has grown rapidly and more than tripled since 1990.

Addiction advocates believe that the medication should be made available over-the-counter since it has little potential for abuse, and even when taken in excess, is nontoxic. Many public health agencies, including the Centers for Disease Control (CDC) and the director of the National Institute on Drug Abuse have supported making Narcan more widely available.

The Food and Drug Administration, (FDA) however, has no policy for allowing over-the-counter usage of medication approved in an injectable form, and is unlikely to approve the antidote in its current form. Experts say that a pharmaceutical company needs to develop a safer form of the drug, preferably an intranasal version, the agency isn’t likely to OK over-the-counter sales.

In many cases, the drug is a lifesaver, but the total cost of the drug is still costly to public health services. The antidote could lead to more risk-taking behavior, and, as a Catch 22, more fatal overdoses. Only about 50% of overdoses are reached in time to administer the life-saving antidote, and more often than not, paramedics in New Castle said that they had to use two and three vials of Narcan to revive people from overdoses.

“It’s like a double dog dare you. They keep pushing the limits, knowing we’ll be there to bring them back,” Butler, Pennsylvania Mayor Tom Donaldson told local news affiliate WPSI. Sadly, many addicts who overdose on opiates still won’t be reached in time for the medication to be effective.

The best way to prevent opiate overdose is to never pick up the drug, and offer treatment for the disease of addiction for those who are ready. Often it takes an extreme circumstance such as an overdose for an individual to hit bottom and admit they have problem with drugs. Once an individual recognizes they need to change, there must be accessible treatment options available in the community and a support system to guide them along the way.


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California Fights Prescription Drug Abuse

Prescription drug abuse has become a serious problem in the U.S. and California is leading the way in putting this to a stop. Most people do not realize how much of a problem prescription drug abuse has really become. Our lives are busy and
no one wants to complicate theirs by thinking about something that does not directly affect them.

Many teens abuse prescription drugs taken from the family medicine cabinet

A person addicted to prescription drugs did not intend to get that way. Sure, they started out following the doctor’s orders, but when the pain came back earlier or the anxiety just would not go away, it was too easy to take another pill. These people would tell themselves that it would get better tomorrow while in reality they compounded their problems by taking more pills and depending on an artificial crutch to get them through the day, the week, and even the month.

Eventually, people who abuse prescription drugs have to get more pills from their doctor or from another doctor. The situation can escalate as their body develops a tolerance for the drugs they’re abusing. California has recognized this as a vital facet of the war on prescription drugs. They have introduced new legislation to have coroners statewide report all prescription-related deaths. The intention here is to begin a paper trail that leads to the doctors who are willing to put pills in addicts’ hands.

Not all addicts get their drugs from doctors. They may purchase them from friends, steal them from family, or as is the case with teenagers who abuse prescription drugs, they may just find them in their parents’ or grandparents’ medicine cabinets.
Therefore, it is important to get rid of all prescriptions you are no longer using and to put all prescriptions that you need to use in a safe and secure place. It is also important to encourage anyone you know who show signs of this terrible problem to seek treatment.

Some addictions, such as those to painkillers, can be dangerous to quit cold turkey. Thankfully, many drug treatment centers that previously specialized in alcohol and “hard” drugs, now also treat prescription drug abuse. It is even possible to find treatment centers that will work with your health insurance provider to give you quality care.

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Opana: The New Painkiller of Choice to Abuse

Oxymorphone, known most commonly as Opana, is a powerful painkiller of the opioid variety that is available in extended-release and instant-release form. Opana is a Schedule II drug in the United States, meaning it has approved medicinal qualities but also has a high potential for abuse. Opana is a very long lasting drug, which is another reason why people are choosing to abuse it instead of other prescription painkillers.

The prescription painkiller Opana is six to eight times more powerful than morphine

Opana, when injected by its abusers, can be responsible for causing a fatal blood disorder called thrombotic thrombocytopenic purpura. This disorder, which may result in kidney failure and death, imposes a limit on blood flow to organs by forming clots that form in small blood vessels. However, kidney failure is not the only risk that is carried with this disorder. The disorder also causes a person to be at a higher risk for getting a stroke or brain damage.

As the popularity of prescription painkiller abuse has risen, more people now die from prescription drug abuse than from heroin and cocaine combined. The recent rise in popularity of Opana specifically is due to OxyContin being changed in 2010. The drug OxyContin, which was heavily preferred by people who abuse prescription painkillers, now has a different chemical composition which makes it difficult for the user to snort or inject the drug to achieve a high similar to heroin.

Opana is more potent per milligram than OxyContin, which increases the chance of a user overdosing due to not knowing the specifics about the dosage of the drug. The drug is available in 5 milligram and 10 milligram dosages for its instant-release version, while its extended-release version is available in 5, 10, 20, 30, and 40 milligram variations.

Abusers of Opana are willing to take drastic measures to achieve their drug, even if it means
robbing a pharmacy. In Fort Wayne, Indiana, a man recent threatened a pharmacy worker with death if he didn’t hand over Opana. The man was apprehended shortly after leaving the store. This incident and others show that those addicted to Opana and other prescription painkillers can be just as dangerous as those addicted to more common street drugs, and the rise of prescription drug abuse is posing new challenges to law enforcement and to society in general.

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OxyContin: The Crouching Tiger

The abuse of prescription drugs like OxyContin by the younger generation is a growing concern for society. The drug gives the user a sense of euphoria, replacing anxiety with sleepy relaxation — a relaxed high if you will. One out of ten seniors in high school seniors have admitted to using narcotic painkillers to get high, and when it comes to OxyContin, the number
seems to be increasing among the youth. The drug provides an experience that is attracting an increasing amount of users. It is looked at as a “party” drug instead of an extremely addictive substance.

Is OxyContin abuse a crouching tiger that’s leading to the return of heroin as a favorite drug of abuse among youth?

The public’s flawed belief in what an addict looks and acts like is thought to be a factor in the growing number OxyContin users and its acceptance among the younger population. One of the especially troubling things about this addiction is the ease of use for the addicts; the fact that the effects are not immediately noticeable. As a result, the young people who are using it don’t see the harmful effect in their peers.

In California, emergency room visits for the misuse of OxyContin rose 152 percent between 2004 and 2008, with an even steeper increase was noted among those under 21. Some drug experts believe that the abuse of this drug is leading to the return of heroin as a favorite among youth in the state of California.

However, California is not the only state where the abuse of prescription drugs is a problem. In 2009, the state of Oklahoma consumed as much hydrocodone (the painkiller in Vicodin) as California, despite the fact that the population of Oklahoma is one tenth the size of the population of California. With a growing number of users, oxycodone, the active narcotic in OxyContin, is catching up quickly. Thousands of young Oklahomans have fallen prey to oxycodone and OxyContin, and even more to hydrocodone painkillers like Lortab and Vicodin.

This painkiller epidemic is so severe that it is leading to an overload of public facilities offering detoxification services for hydrocodone and OxyContin.

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Newborn Opiate Addiction and Withdrawal

One of the saddest facts about prescription drug abuse is that a pregnant mother who abuses medicine will pass the effects to her unborn child. Unfortunately, it has become more and more common for newborn babies to be born addicted to prescription medications like OxyContin, Percocet and Vicodin. The Los Angeles Times reports that in 2009, more than 13,500 infants were born with neonatal abstinence syndrome (NAS); this translates to approximately one such birth every hour.

In the U.S., an infant is born addicted to opiate drugs every hour

A recent New York Times article tells the story of one child that was only a few days old and had to be placed on methadone because his withdrawal symptoms were so severe. His mother abused OxyContin in the early stages of her pregnancy without her doctor’s knowledge. She tried to quit while pregnant but became so ill that the survival of her unborn child was in doubt. Her doctor prescribed methadone for the duration of her pregnancy. After his birth, her son was placed on the same drug.

Babies that are born addicted to pain killers cry excessively, get diarrhea, have stiff limbs and tremors and may refuse to eat and shake due to drug dependency and withdrawal. They are frequently treated with methadone, a drug that helps people deal with addiction to opiates, only to be weaned off of it later on. Treatment for a drug-addicted newborn can cost tens of thousands of dollars.

An increasing number of doctors are face with the difficult decision whether to continue to treat a pregnant woman who is addicted with opiate drugs, like Vicodin, or to just cut them off. Pregnant women who quit cold turkey face the risk of miscarriage and their babies may suffer seizures in utero. Doctor’s frequently must complete their own risk benefit analysis since few academic or scientific studies have been completed on newborn opiate withdrawal or the treatment of infants with methadone. There have also been few studies on the effects of a mother’s use of painkillers on her unborn child.

Methadone, a synthetic opioid drug, is used to assist people who are addicted to opiate drugs. According to the New York Times, it is the most commonly prescribed drug for opiate-addicted newborns because it helps to treat the symptoms of withdrawal. In addition to being treated with methadone, some infants who are born addicted are given morphine or Phenobarbital. The best treatment is of course to help mothers who abuse
drugs kick their habit before they become pregnant.

If you are struggling with opiate abuse (or are concerned about someone else who is), be sure to get more information from resources like the American Addiction Foundation website.

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One of Many Overdose Deaths

Tyler Macleod was a young man that was well-liked by everyone and had a full life ahead of him. Unfortunately, will never have the future he deserves thanks to an addiction to heroin that took his life.

Everyone wanted to be Tyler’s friend, he was fun loving and loved the beaches and surfing. During adolescence, Tyler started experiencing symptoms of depression and began smoking marijuana. His parents tried to help him by transferring him to a new school but that did not keep the addiction from growing.

After receiving a phone call from a school counselor that informed his parents that he was using harder drugs, Tyler’s parents took him to drug rehab program and made him attend narcotics anonymous meetings daily. This helped for a while but soon his parents started to find foil and needles which made them know that he was smoking and injecting the drug.

Tyler’s parents did everything that they knew to do and loved their son so much they would have done anything possible to save
their son. After cleaning up for about a month, Tyler ran away. This was his parents’ worst nightmare as they feared that he was out “chasing a high” again. The night before he was found dead Tyler called home to tell his parents that he wanted help again to turn his life around. But in the end, the drug addiction won out and left his family and friends mourning the loss of this young life. This case, a tragedy on a small scale, is made even worse because it’s a tragedy that is occurring all over the nation, one son or daughter at a time.

Seeking Treatment and Getting Help

Similarly, this growing epidemic in California, and the rest of the nation, can only be treated one person at a time.

Addiction to opiates requires a residential and highly monitored rehab program. The process takes longer than thirty days as getting the drugs out of the person’s system is merely the beginning of the process.
A lot of teens and young adults start with an addiction to prescription pills such as OxyNEO but when this addiction becomes too expensive they turn to heroin. Some of the heroin found on the streets is in white powder form that can be “snorted” and there is also a black tar that is even more prevalent but has to be smoked or injected.

Signs to Look for if You are Concerned about a Teen’s Drug Use

Some of the signs of addiction to look for may include:

  • tired eyes and unable to keep eyes open (known as nodding)
  • sores on skin on any area of the body
  • small constricted pupils
  • a lack of personal hygiene
  • burn marks on hands and fingers – particularly on the thumb and index finger
  • unsocial attitude toward others and and wanting to be alone

If a friend or relative is showing signs of this terrible addiction, please get them help as soon as you can.

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Doctors Prescribing Opioids Facing Double Edged Sword

Though it may seem surprising to some, it turns out most doctors dealing with prescription dependent patients are at some level aware of their patient’s addiction problems and prescription abuse.

Ana Lembke, a California addiction psychiatrist, specifically cites an example of opioid prescriptions meant to address muscle pain being overused by a patient to the tune of 1,200 pills in one month. CURES, Controlled Substance Utilization Review and Evaluation System, was put in place in California to monitor patient prescriptions and deter these kinds of abuses. However, as Lembke explains, doctors often face a choice between being morally irresponsible in giving addicted patients opioid prescriptions and being medically irresponsible in not providing adequate treatment for a potentially real physical pain being suffered by the patient. 

He Also Has to Answer for the Patient’s Real Pain

The problem is further compounded by increased media attention on this growing problem and the rise of prescription painkiller overdoses as the leading cause of death for addicts.

The Doctor’s Dilemma

Doctors often feel they are ostracized as villains by a public that does not fully understand the internal conflict some doctors face. It can be very difficult, if not nearly impossible, for a person who has been trained to help all people regardless of circumstance, to turn an addicted patient away because they suspect prescription abuse, no matter how self-evident the problem is.

Most doctors want to do the right thing, but because of this mental dilemma, they find themselves restricted and often seek out reassurance from an outside source before proceeding. They may ask a colleague to consult or request that a reputable psychiatrist confirm the addiction diagnosis before refusing a prescription. Still for some doctors it is too difficult to push past the mental block of being obligated to help, to fully realize that these excess prescriptions help no one.

And the Legitimate” Criminal Doctors

There are also issues with doctors who ignore abuse for the sake of profit, and that issue should not be neglected. However focusing too much attention on those doctors who seek out abusers for monetary gain does not address the larger issue of a problem within the medical culture itself. Doctors are human after all, and they are just as susceptible to emotion and internal conflict as anyone else. Since the social culture around prescription painkillers has changed, perhaps the medical culture surrounding these opioids needs to be altered as well. Medical professionals need to be better trained in how to keep aware of their emotions and other external motivating factors that might mislead them into thinking that over-prescribing a patient is medically acceptable.

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Heroin Overdose is Just the Tip of Southern California’s Drug Problem

This past Wednesday, Carlie Coulter, age 22, died of a heroin overdose. She had been struggling with addiction since the
age of 18. Her family is now joining with other parents out there to try to help end this surge of drug related deaths in younger people in Southern California.

An OC Police Officer Holds Up Heroin Paraphernalia

Heroin is becoming an epidemic in the area, not just on the streets, but among middle and upper class youngsters too. While many kids start out with prescription drugs such as OxyContin, Xanax or Klonopin, heroin offers a much cheaper high.Smokeable heroin allows users to get high without having to deal with needles.

The LA County Sheriff’s office reports that there have been at least six heroin overdose deaths since August 2011. There is no word as to whether these were injectable or smokeable heroin though, or any other information on the victims. According to Cary Quashen, founder of Action Family Counseling and Action a Parent and Teen Support Program, “we’ve lost more than a dozen Santa Clarita kids this year to drugs.”

Clearly, this problem is just getting worse, not better. Carlie’s parents have joined Cary Quashen and others to make sure that the public is aware of the problem, and to try to do something to change it. Many point to a lack funding for rehab programs, but that isn’t the sole solution to the problem. We need to focus on education for parents and teens, to help keep kids off of drugs, and to help parents identify drug use as soon
as possible. Coulter had in fact been in a rehab program for heroin at House of Hope in San Pedro. She had been doing well and staying away from drugs, as far as her family knew, but as is often the case, she had a relapse.

Authorities and concerned citizens are pushing for changes, from stricter laws for those found dealing to additional funding for education programs in the local schools. Drug abuse is something that has to be brought out into the open and dealt with, not swept under the rug. The only winners in that case are the dealers themselves. The losers, of course, are the loved ones left behind.

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An Inside Look at Prescription Drug Abuse

The economic conditions over the past few years have caused a high level of financial and emotional stress for millions of people. In order to cope with this increased level of stress, many people have self medicated with alcohol and prescription drugs.

The Sign of the Times for Drug Use in America

Although adult alcohol abuse has been a common problem in this country for a long time, the number of people abusing prescription drugs really started increasing in the last several years. In the state of California for example, prescription drug abuse has reached epidemic levels.

The fallout has included police raids involving hundreds of large illegal prescription drug operations. One particular raid that involved a medical clinic in west Los Angeles, resulted in the recovery of thousands of prescription pills and evidence of over twenty three million dollars of fraudulent sales.

Prevention (of the Addiction) is the Best Medicine

In order to deal with this epidemic, there needs to be continued police efforts in shutting down illegal drug operations, but there also needs to be strong efforts in getting professional help for those who are addicted to prescription drugs. One of the prescription drugs many people are addicted today is OxyContin, which is often prescribed by doctors to relieve moderate to severe chronic pain symptoms. Many of these symptoms are related to recovery from an accident, surgery, or even chronic lower back pain. In many cases individuals who have become addicted to prescription painkillers typically start out only using it on a temporary or ‘as needed’ basis. However, as their pain and need continues, so does the possibility of becoming addicted.

Although Oxycontin has proven to be an effective drug for relieving pain, it should be noted that it also has some severe withdrawal side effects. These include muscle weakness, nausea and anxiety attacks; and worst of all, the possibility of becoming severely addicted.
In closing, the first step in overcoming any addiction is for the person to admit that they have a problem. Next, they need to be willing to receive help. Until a person honestly acknowledges that they have a problem and want help,it is unlikely that they can successfully overcome their addiction. Another important factor for overcoming addiction is getting help and support from friends and family. When a person is suffering from an addiction, they don’t need to be condemned or judged, they instead need to feel ‘hope’, and also that someone actually loves and cares about them. There is a way out from addiction, and always a possibility for a better life.

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