Hydromorph Contin Causing Heart Damage, Infections

patient in hospital bed

Four years ago, the Ontario government decided to ban the use of Oxycontin, hoping to stop the pattern of increased opioid addiction in the province. Unfortunately, like every place banning Oxy, the medical profession needed another drug to take its place. Today, it appears that the drug most used is Hydromorph Contin. And now doctors say it’s causing deadly heart infections.

What is Hydromorph Contin?

Hydromorphone Contin is chemically similar to Oxycontin, but it’s meant to be harder to abuse, and it’s formulated mostly for people experiencing severe, acute pain such as those from accidents like car crashes or cancer. The drugs itself was designed to deter abuse and prevent injection by turning into a thick, gel-like substance when exposed to water.

How Are People Getting Hurt?

Unfortunately, if there is a will, there’s a way, especially when it comes to people with addiction finding new ways to use their drug of choice. Authorities say addicted persons looking to get their fix have discovered a dangerous workaround for Hydromorph Contin. When they want to inject the drug, they use a filter to get the substance into a needle. If a person crushes the pill and does this, tiny fragments of it can get into the syringe, which then is injected into the body. This leads to dangerous heart problems.

The pill shards can scratch blood vessels and organs as they travel, causing significant damage as they make their way to the heart. Usually, that’s where they land, scratching a hole in the heart itself. People have strokes, heart attacks, and get severe infections as a result.

Is Hydromorph Contin Damage Curable?

There is no cure for people with severe heart damage that Hydromorph Contin abuse can cause, and it is usually monitored for life.

Some patients have to have their heart valves surgically rebuilt, a challenging process that often requires multiple surgeries. Heart infections can be treated with antibiotics if the patient is compliant, but doctors say this is a challenge for people with addiction, who have trouble with medical compliance.

Many of the patients are in their 20’s and 30’s. If they get well from heart damage, they often have to see a specialist for life.

 

 

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Oxycontin Patent Expiring in Canada. Now What?

woman writing the word "expired"

In Canada, just like the United States, there is an addiction epidemic currently being fought by communities and the government. Lawsuits against drug makers are also underway. Purdue Pharma, the original manufacturer of Oxycontin, is largely blamed for the opioid epidemic. Their patent in Canada is expiring, leaving the market open to cheaper, generic versions of the drug.

Why Allow More Opioids on the Market?

Many people argue that there should be no more Oxycontin on the market period. The drug has caused devastation across North America.

Purdue Pharma certainly pushed the drug deceptively. An opioid maker without such a checkered past would be a welcome relief to sales representatives and hospitals. But a generic version would also create more opportunities for misuse and abuse. Can a regulatory body police the actions of addictive drugs effectively? There are a lot of misgivings about the benefits of offering a generic version of Oxy.

The truth of the matter is that there are thousands of people in hospital rooms that need a strong painkiller. Cancer, car accidents, spinal injuries, neuralgias, and rare diseases can cause severe pain. Many of these people have more pain than a pill can kill.

OxyNEO Has Replaced Oxycontin in Canada

Last March, Purdue Pharma replaced Oxycontin with OxyNEO, a highly addictive substitute that is time-released and not officially tamper-proof. The drug was created to release slowly and help prevent inexperienced users from abusing it. For regular opioid users, the slow-release formula is likely to cause an overdose.

The federal health minister can decide by November 25 to allow drug companies to make a generic version of the painkiller OxyContin. Several generic drug manufacturers have already expressed interest in making the drug, but law enforcement and addiction advocates are wary.

In the United States, a reduction in Oxycontin prescriptions has been linked to an uptick in heroin addiction, overdoses, and deaths. When users couldn’t get the drug they were addicted to, they turned to street drugs like fentanyl as well. Oxycontin isn’t the only drug tied to the addiction epidemic.

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JPMorgan Chase Dumps Purdue Pharma

dirty money

JP Morgan Chase, the banking giant which handles accounts for Oxycontin manufacturer, Perdue Pharma, has told them to take their business elsewhere.

JP Morgan did not lend money to Purdue, but JPMorgan’s commercial bank managed the company’s cash and bill payments, according to NBC. It’s currently unknown how long the bank handled finances for the pharmaceutical giant. The company is an enormous banker in the United States. According to inside sources, the banker has dropped Purdue Pharma due to its involvement in the opioid industry, and presumably because Purdue faces nearly 2,000 lawsuits in the United States.

Banks have always made it a practice to refuse to lend credit to companies with risky ties or lousy credit. Purdue’s ongoing litigation certainly made it easier for the bank to drop them. The company has even considered bankruptcy as a way to free up assets due to the continuing lawsuits.

Opioid Lawsuits Taking a Toll

Purdue recently settled a lawsuit in Oklahoma for a staggering 270 million dollars. The money will now go to fund addiction research and treatment in Oklahoma. In the lawsuit, filed two years ago, Oklahoma Attorney General Mike Hunter said that Purdue helped fuel the opioid crisis with aggressive marketing for their most addictive drug, OxyContin. This marketing included making false claims to doctors to drive more prescriptions, while they downplayed the dangers of addiction.

Purdue says that the bank’s moves don’t affect them.

“Purdue is a streamlined organization with an exciting pipeline of new medicines and significant cash reserves,” the company said in a statement to NBC News. “The company has multiple banking relationships and will not have any interruption to its banking and financial service needs.”

Across the United States, other jurisdictions wait their turn to have representatives from Purdue Pharma face the court. All in all, there are nearly 2000 lawsuits from cities, states, counties, and Indian reservations that are suing various players in the pharmaceutical industry. Many legal insiders compare the opioid trials to the tobacco lawsuits cigarette manufacturers faced in the 1990s.

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Insurers Crack Down on Dental Opioid Prescriptions

female dentist

A recent study revealed that for many teens, opioid abuse begins with wisdom tooth extractions. The unnecessary prescriptions can lead to lifelong addiction, progressing to other opioid usages including heroin addiction. And now, insurers are discouraging opioid use for dental extractions, asking doctors to rely on Tylenol instead.

The study, published in JAMA Internal Medicine last December, found that youths age 16 to 25 who first used opioids after dental care were more than ten times more likely than their peers to be diagnosed with opioid abuse. Startlingly, opioid use disorder often emerges within just a year of getting their first prescription.

The Kansas City Star spoke with United Healthcare’s chief dental officer Ted Wong, who said that the relationship between dental prescriptions and opioid abuse makes sense. He explained that adolescents are more sensitive to drugs like opioids because their brains are developing. Opioid prescriptions for wisdom tooth procedures are common for young people, and nearly 5 million people have their wisdom teeth removed every year.

“That gave us a reason to kind of look at that high-risk population,” Wong said. UnitedHealthcare found that about 70% of their patients were prescribed opioids for pain after having their wisdom teeth removed. Nearly 45% of all opioid prescriptions adolescents took were prescribed by their dentist.

Cigna now limits dental prescriptions to a three day supply and is working to educate dentists about alternatives, such as a combination of Tylenol and Advil.

Because of this increased awareness, other insurers are also making sure dentists in their networks are prescribing a minimal amount of opioids. Cigna, for example, now limits initial opioid prescriptions to a seven day supply. Aetna has written letters to dentists who prescribe high amounts of opiates to let them know that they’re prescribing too much and recommends a seven-day prescription maximum for dental pain.

The American Dental Association has also published guidelines for dentists, including publishing guidelines that tell them to limit their prescriptions for opioids. They also recommend teaching patients how to dispose of any unused pills properly, so others don’t inadvertently abuse them.

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Controversial Fentanyl Test Strips Now Available

test strips

Many drugs that are sold on the street have been tainted with fentanyl, a powerful drug that is 80 to 100 times stronger than morphine. For some users, the tainted drug is too powerful. A controversial test strip that can test for fentanyl can save lives, but some people aren’t too excited about it.

Why Test for Fentanyl?

Fentanyl is taking lives faster than any drug before it, and many users accidentally ingest fentanyl when a drug is laced with it. Harm reduction advocates, who afvocate for spafe spaces and less strict drug laws, say this can save countless lives.

The Fentanyl test strip technology was originally developed by a Canadian biotech company BTNX for urine drug testing. The dru strips, however, also work in liquid heroin or when a water is added to empty baggies of cocaine. In other words, it can test for the presence of fentanyl in liquids.

Researchers at Johns Hopkins and Brown University determined the test strips can even detect a small amount of fentanyl in the test strips, which is incredibly useful for harm reduction. After all, just a few grains of fentanyl can be dangerous for a non-opioid user.

“Our findings bring to the table evidence that can inform a public health approach to the fentanyl crisis. Smart strategies that reduce harm can save lives,” said  Susan Sherman, a co-author on the study.

Using the Strips

According to the study, there are several programs in the US already using the test strips. In Los Angeles County, first responders and heath care workers discuss the potential risks and benefits of the strips with patients who use street drugs before they give them out.

They are also handy for first responders, who often handle drugs that people have used to overdose.

The test strips aren’t 100% effective at eliminating the risk of overdose and they can’t tell first responder how much fentanyl is present. However, they offer a clue when somebody is unconvcious and the EMT’s are trying to save a life.

Researchers see the test strips as a way to prevent deaths, but they’re now without opponents. Many people worry it’s just another license for drug users to use without consequence. However, when it’s life and death, it’s hard to see why we should keep people with substance use issues from testing for fentanyl.

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Blue Cross Stops Covering Oxy Jan. 1st, Offers Abuse-Deterrent Opioids

A white male doctor and black femal doctor stand smiling. The woman holds a clipboard.

A few months ago, Blue Cross/Blue Shield, one of the nation’s largest health insurers, announced that they would stop covering Oxycontin, a drug known for its addictive properties as well as its manipulation of doctors through marketing. The makers of Oxy, Perdue Pharma, have also stopped marketing the drugs to doctors, perhaps as a result of dozens of lawsuits stemming from the opioid addiction crisis here in the US.

While many people hail this as a good sign, the Blue Cross/Blue Shield coverage of pain relievers aren’t going to stop doctors from prescribing the medication in its generic form, or other variations of opioids in its place.

A closer look at the changes that Blue Cross is making shows that the company isn’t necessarily shunning opioids. They still plan to cover oxycodone, the active ingredient in OxyContin. Instead, they plan on shifting coverage to new formulations designed to be harder to abuse.

Two New Drugs Blue Cross is Covering

RoxyBond is short-acting (SA) oxycodone formulation with what the FDA says has abuse-deterrent properties, for treatment of pain requiring management with an opioid. It’s the first short-acting opioid to be approved as an abuse-deterrent product. Roxybond is meant for short-term pain relief, rather than chronic pain relief.

Xtampza ER, an extended-release pain reliever, is also considered an abuse-deterrent drug. As an extended-release product, it is more appropriate for consistent or chronic pain and is supposed to be more of a last resort when it comes to pain medication.

What are Abuse-Deterring Opioids?

The FDA is the only entity that can approve the label of “abuse-deterrent” when it comes to addictive drugs.

These types of opioids are still relatively new in the pharmaceutical industry. Abuse-deterrent opioid formulations have properties that make abuse of the drug more difficult and “less attractive” to recreational users. However, they still contain addictive drugs. They also tend to cost more than other opioids on the market, and whether they reduce overall opioid abuse remains to be determined. However, the FDA has been fast-tracking pain medications with these properties in hopes that they can help curb the opioid epidemic.

There is nothing that prevents drug-takers from misusing these drugs by taking too many, and overdose is still possible.

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Perdue Pharma Will Profit From Medication-Assisted Treatment

Perdue Pharma

Perdue Pharma makes Oxycontin, one of the most addictive prescription opioid drugs on the market. They’re a subject of many lawsuits and have been under Congressional investigation for their activities promoting opioid medications to doctors and other medical professionals. Many people say their company has made hundreds of millions of dollars fueling the addiction epidemic. However, the company has now started to dig into a new way to make money from the opioid epidemic. They’ve been quietly working to patent a new form of buprenorphine, a drug that is regularly used to help people get off of opioids.

What is Perdue’s New Addiction Medication?

In the recovery community, buprenorphine better known as a medication-assisted treatment when people take these drugs to stay clean. Perdue’s version is a “fast-acting” form of buprenorphine, which helps control drug cravings, according to CBS reported. While other versions of the drug are available in either tablet or dissolving strips, the Purdue version comes in a “wafer” that dissolves in only a few seconds.

 

More PR Efforts?

Richard Sackler, a member of Purdue’s board, is listed as one of the inventors on the new drug. The Sackler family, known for their philanthropy in the art world, controls Purdue Pharma and have made hundreds of millions of dollars off of Oxycontin and other opioids.

In the past few years, while Perdue has been mired in lawsuits, the company has also been trying to salvage their name/brand. They have offered grants to various state drug treatment programs. Last week, Purdue donated $3.4 million to the developer of an over-the-counter version of naloxone, an opioid-antagonist meant to reverse fatal overdoses. And the release of buprenorphine they are developing will be offered for free to some drug treatment programs for indigent clients.

 

The Bottom Line

Perdue Pharma is fighting over 1000 lawsuits across the US. They’re under heavy scrutiny and continue to be investigated by news organizations. They’ve often lead heavy-handed PR efforts and efforts to obfuscate their efforts to push more narcotic prescriptions. While the Sackler-owned Perdue has promised to stop marketing opioids to doctors, they’ve remained silent on a second opioid manufacturing company they own – making no promises about generics at all.

In the end, it’s about the bottom line. They will do what it takes to remain profitable, it seems. Hopefully, doctors will recognize the hypocrisy and choose a different version of buprenorphine for their clients.

 

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ACLU Sues to Help Man in Maine Get Medication-Assisted Treatment in Jail

medication assisted treatment

The ACLU is assisting a man from Caribou, Manie in suing for the right to continue his addiction treatment medication while he serves his upcoming jail sentence. If the lawsuit is successful, it will create a persuasive precedent and pave the way to create fundamental changes in how jails and prisons treat inmates with substance use disorders.

Zachary Smith, 30, filed his civil rights lawsuit in federal court Thursday against the Aroostook County Sheriff’s Office and Maine Department of Corrections. The current jail policy of prevents inmates from continuing their medication-assisted treatment, such as Suboxone or methadone, while incarcerated. The assumption seems to be that while in prison drugs and alcohol are unavailable, therefore, treatment isn’t needed. Most jails allow twelve-step meetings to be brought in from the outside and allow inmates to have sponsors and participate in these meetings. In most cases, access to treatment is limited, and few inmates have constant contact with the outside world. There are still plenty of drugs smuggled into these settings, which makes temptation run high.

In most jails and prisons, prisoners are deprived of their medication-assisted treatment. If on the drug while incarcerated, inmates most often go into withdrawal, which is physically painful and sometimes medically dangerous. Withdrawal symptoms such as sweats, mood swings, vomiting, and even seizures are commonly lived out in a cell. People in withdrawal usually aren’t even allowed to go to the jail clinic – causing addicts to seek relief wherever they can get it. People deprived of their medications are also highly likely to relapse upon release.

The complaint says that Smith’s medications “will cause him physical and psychological suffering, will expose him to heightened risk for other serious medical conditions and could trigger a relapse into active addiction, potentially resulting in overdose and death.”

The U.S. Department of Justice recently launched an investigation into whether Massachusetts prison officials are violating the law by denying prisoners’ medication-assisted treatment. The outcome of that case will impact many states, including Maine.

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Lucemyra: FDA Approves New Medication-Assisted Treatment

FDA approved Lucemyra

Lucemyra has been on the market in the UK to assist with opioid withdrawal symptoms for about twenty years, but its use in the US has only just been approved. The FDA cleared the drug last Wednesday via fast-track to give American doctors another tool for fighting the opioid epidemic.

Lucemyra alone is not to be considered treatment for opioid use disorder, the FDA says. However, clinical trials prove that it can reduce the severity of withdrawal symptoms that patients experience when they cease opioid use completely. This can give a person with an opioid use disorder a lifeline to help them get clean once and for all. Combined with therapy, 12-step programs and other tools, Lucemyra can help people find their way to recovery without the torment of many withdrawal symptoms.

FDA Commissioner Dr. Scott Gottlieb says that this makes the drug an important tool that warranted quick approval. “The physical symptoms of opioid withdrawal can be one of the biggest barriers for patients seeking help and ultimately overcoming addiction,” he said in a press release. “The fear of experiencing withdrawal symptoms often prevents those suffering from opioid addiction from seeking help. And those who seek assistance may relapse due to continued withdrawal symptoms.”

What is Opioid Withdrawal Like?

Opioid withdrawal can be intense and vary. People just getting off of opioids, when withdrawing rapidly, can be anxious, agitate, and experience a variety of mood swings. Physical symptoms include muscle aches, runny nose, sweating, nausea, vomiting, diarrhea. A person with an opioid use disorder will also experience strong cravings for their drug of choice.

For people who have merely been on opioids for a while, but not abusing their medication, doctors help them create a plan for tapering and lowing the amount of drug taken. However, this is dangerous in more than one way for a person with an opioid use disorder, and temptation is the major worry.

Clinical studies will be required to evaluate the safety of Lucemyra. Right now, the FDA only recommends that people take thedrug for a maximum of 14 days.

Are There Any Side Effects?

All drugs have potential side effects, and it’s up to you and your doctor to weigh the pros and cons of any medication-assisted treatment.

According to the FDA, Lucemyra can cause low blood pressure, slow heart rate, sleepiness, sedation and dizziness. There is a risk of abnormal heart rythmns. Some people have fainted when taking Lucemyra. Lucemyra has not been established in children or adolescents less than 17 years of age.

 

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Purdue Pharma “Fights Opioid Epidemic” – Too Little, Too Late?

Perdue pharma

Purdue Pharma is one of the largest opioid makers in the country and the subject of countless lawsuits in the past few years. They’ve received scrutiny over their choices to market and push Oxycontin on the doctors, and in February, they promised to stop actively marketing the drug. Now, this opioid maker is making efforts to help the people that are now addicted to their drugs. But is it just another PR campaign to mitigate the company’s bad reputation?

 

Critics say that all of this is “too little, too late.” Thousands have died from what even lawmakers say are irresponsible and maybe even illegal practices to push the drug. However, the dire consequences of opioid addiction make it so many localities can’t discriminate between funds. For many people addicted to opioids across the US, there simply isn’t enough help available. The federal government’s Opioid Commission is considered pretty much a “bust”, with lots of recommendations and few monetary resources to implement them. Many states are spending too much money simply on saving lives with tools such as the opioid-antagonist Naloxone. Budgets are tight in areas where the most vulnerable are finding addiction pervasive.

 

What Purdue Has Done to Help Fight Addiction

 

·      Purdue has partnered with the National Sheriffs’ Association to give free naloxone overdose-antidote kits and training to front-line officers. Total, the second phase of this program will allow total funding of the program up to $850,000 since its inception. 

 

·      They have funded pill disposal boxes in pharmacies, clinics and police stations in various states, including North Caroline.

 

·      They have run a radio campaign in Connecticut warning of the dangers of opioid abuse.

 

·      Lawsuits they have lost have inadvertently funded treatment for addiction in places like West Virginia, where the opioid epidemic is still raging. (This is inadvertant funding, but the settlements for lawsuits still help cities and states.)

 

Why People Aren’t Buying it

 

·      OxyContin sales dropped in recent years, from $2.8 billion in 2012 to $1.7 billion in 2017, with many competitive drugs on the market, especially generic drugs.

 

·      Purdue almost exclusively sells and manufactures various opioid drugs. They have only promised to quit marketing Oxycontin.

 

·      Alongside running ads warning about opioid abuse, they also have been marketing a new medicine to treat opioid-induced constipation, which is just another drug in their line of products.

 

·      In 2007, Purdue Pharma pleaded guilty in federal court to misleading doctors and patients about OxyContin’s risk of addiction and potential for abuse. They agreed to pay $600 million in fines, but did not stop marketing the drug until there was a nationwide outcry as the opioid crisis progressed.

 

·      The company press releases never use the words “addicted” or “addictive” in any statements or literature, preferring to use the words “use” and “abuse”, which minimizes the opioid crisis.

 

 

Purdue is far from the only bad actor in the addiction crisis, but they are certainly the most well-known and litigated against. There are lawsuits on the state level, county level, and city level across the country. Most recently, last week, Greenville County, South Carolina filed suit against several opioid manufacturers, including Perdue. The lawsuit accuses pharmaceutical manufacturers and distributors of participating in a “scheme to change prescriber habits and public perception.”

 

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