Friday, May 22, 2015

States Call on Insurance Companies to Cover Abuse-Deterrent Opioids

The growing demand for prescription opioids with abuse-deterrent properties is a huge step forward in the fight against prescription drug abuse in America. Sadly, insurance companies are not willing cover the new, potentially lifesaving drugs. Last year, Massachusetts passed a law mandating insurances companies to cover abuse-deterrent opioids at the same level as other opioids, NPR reports. In Maine, a bill is under consideration that would require the same, and states from Vermont to California may adopt similar bills.

Currently, there are only three prescription opioids approved as abuse-deterrent by the FDA. While these drugs are more expensive, they reduce the ability of abusers to tamper with drugs so that they can be snorted or dissolved for injection. If insurance companies are unwilling to cover these types of drugs, it is unlikely that they will reach the millions of people abusing prescription opioids.

In the two years after Pfizer introduced an abuse-deterrent formulation of OxyContin, overdoses related to the drug dropped 19 percent, according to a study published last month. The findings are a clear indication of the need for these types of prescription painkillers. Abuse-deterrent OxyContin is more difficult to crush and turns into a gooey gel if it is crushed, making it almost impossible to inject or snort.

Naturally, the insurance companies are arguing against legislation that would require coverage of abuse-deterrent drugs, according to the article. They argue that it will drive up the cost of monthly premiums. What’s more, many in the field of addiction medicine are not convinced that abuse-deterrent drugs will have the desired outcome, and are calling for greater access to addiction treatment.

A former president of the Northern New England Society of Addiction Medicine, Dr. Mark Publicker, says the new opioids are not abuse-proof. Instead, he argues that lawmakers should focus on increasing access to treatment.

Thursday, May 21, 2015

A Call for Specific Details on Drug Overdoses

The prescription drug epidemic and subsequent heroin scourge has crippled millions of Americans, and led to thousands of premature deaths. It may seem that when a person dies of a heroin overdose the death certificate would reflect that cause. However, figuring out how many people die of heroin overdoses is not easy, due to the fact that many states do not require specific details on drug overdoses, NPR reports.

In fact, many states lack current, accurate and complete statistics in their databases. The data that is available is often at least two years old; for instance, statistics on drug overdoses in Pennsylvania are from 2012. The executive vice president for the National Association of Medical Examiners, Dr. Kurt Nolte, helped write a report recommending that every drug found in a person's system be listed on death certificates, according to the article.

"It's critical. It's absolutely critical," says Dr. Nolte. "The interventions for whether it's heroin or other illicit substances are different than, for example, if they are prescription drugs," he says. "And if you can't tell the difference because everybody's classified as multi-drug toxicity, you have no idea what's killing people."

Listing every drug involved in overdose deaths could actually save lives in the future. Gary Tennis, the Acting Secretary for Pennsylvania’s Department of Drug and Alcohol Programs, believes that paramedics would be better prepared to reverse an overdose if more accurate data were available. Last year, at least 28 people in Philadelphia died after using heroin laced with fentanyl, a highly potent opioid analgesic, the article reports.

“You might require more than one administration of naloxone, one might not do it. It’s really useful for our emergency services to have that information that fentanyl’s there,” Tennis said.

Real-time databases enable paramedics to respond more appropriately, potentially saving lives.

Sunday, May 17, 2015

Offering Financial Incentives to Quit Smoking

Quitting a tobacco product of any kind is challenging, especially cigarettes. There are a number of smoking cessation options available, including nicotine replacement therapies, such as gums, patches, and medications. While those methods have proven effective with numbers of people, relapse rates among smokers are still extremely high. New research suggest that providing financial incentives to smokers to quit is more effective than offering free counseling and nicotine replacement therapy, HealthDay reports.

"Roughly 18 percent of Americans smoke regularly -- a percentage that hasn't changed in more than a decade despite the proliferation of new therapies. We desperately need new interventions, and this study shows that financial incentives are likely as good, if not better, than other available interventions," said lead author Dr. Scott Halpern, an assistant professor of medicine, epidemiology, medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania.

The new study involved more than 2,500 CVS Health employees. The participants were split into five groups:
  • Individual Reward (based on their own performance)
  • Collaborative Reward (based on their group’s performance)
  • Individual Deposit (requiring an upfront deposit of $150 with subsequent matching funds)
  • Competitive Deposit (competing for other participants’ deposits and matching funds)
  • Usual Care (including free smoking cessation aids and informational resources)
The researchers conducting the novel study found that 16 percent of those who were part of the reward groups were still smoke free after six months, compared with 10 percent in the deposit programs and 6 percent in the usual care group. CVS will use the findings to launch an employee anti-smoking program called “700 Good Reasons,” according to the article.

Employees that smoke who would like to participate will be asked to deposit $50. If, after a year, the participating employees test negative for tobacco, they will get their $50 back, as well as $700 more.

“When compared to the estimated $4,000 to $6,000 incremental annual cost associated with employing a smoker over a non-smoker, a $700 to $800 incentive paid only to those who quit seems well worth the cost,” senior author Kevin Volpp, MD, PhD said in a news release.

The findings appear in the New England Journal of Medicine.

Friday, May 15, 2015

Potential Cocaine Surge if Colombia Stops Using Glyphosate

The country of Colombia has a long history with cocaine, from the coca fields to production and international distribution. Efforts to curb cocaine production in Colombia have been a major priority for decades here in the United States. While America’s efforts have drastically diminished the presence of the highly addictive drug throughout the states, cocaine still finds its way across the border.

One of the largest cocaine prevention efforts is a joint herbicide spraying program between the U.S. and Colombia. While the herbicide, glyphosate, proved effective, a new report by the World Health Organization (WHO) finds that glyphosate may cause cancer, Time reports. After 20 years of spraying glyphosate on Colombian coca fields, the new finding may end the program - resulting in a cocaine production boom.

More than 4 million acres of the Colombian coca fields have been sprayed with glyphosate, a chemical which has been linked with tumors in rats and mice, according to the article. The WHO report points out that there is some evidence suggesting that coca field workers are at an increased risk of developing non-Hodgkin lymphoma.

A nationwide study was conducted concerning hospital visits. The research indicated that people who lived in coca production areas had a higher incidence of rashes, respiratory problems and miscarriages between 2003 and 2007.

In response to the report, Colombian President Juan Manuel Santos has urged the Colombian National Narcotics Council to discontinue aerial spraying of glyphosate.

“The risk does exist,” Santos said. “We need a system that is more efficient and less damaging.”

However, glyphosate is the world’s most commonly used herbicide, says William R. Brownfield, head of the U.S. State Department’s Bureau of International Narcotics and Law Enforcement Affairs.

“There is not one single verified case… of cancer being caused by glyphosate,” said Brownfield.

The WHO report was published in The Lancet Oncology.

Sunday, May 10, 2015

One in Five Teens Will Try E-Cigarettes

E-cigarettes continue to gain popularity as more and more young people turn to the devices as a source of nicotine. In reality, there has been little research which has pinpointed the dangers of e-cigarette use, and many argue that the devices are not an effective smoking cessation device. A major concern regarding e-cigarettes is the fact that there is practically no regulation and the nicotine e-juices which users vaporize come in host of fruity flavors which appeal to teenagers. In fact, new research suggests that teenagers are just as likely to try electronic cigarettes as traditional cigarettes, Science Daily reports.

"E-cigarettes have become increasingly popular among Canadians," said David Hammond, lead author on the report and a professor in the School of Public Health and Health Systems at Waterloo. "Now one in five youth will try vaping before graduating high school."

Researchers at the Propel Centre for Population Health Impact at the University of Waterloo found that approximately 20 percent of teenagers between 15 and 19 try e-cigarettes, the same percentage of teenagers who experiment with traditional cigarettes. However, unlike the United States, Canada has not approved the sale of e-cigarettes containing nicotine.

"There is no question that e-cigarettes are a harmful consumer product because of all of the chemicals users inhale. However, because they don't produce smoke, they are significantly less harmful than smoking," said Professor Hammond, who testified to the House of Commons Standing Committee on Health in November.

The University of Michigan’s Monitoring the Future survey found that U.S. teenagers in middle and high school are more likely to use e-cigarettes more than traditional tobacco products. Researchers argue that the rise in use is the result of teens’ belief that e-cigarettes are less harmful. While most e-cigarette shops age verify their customers, it is still quite easy for teens to purchase the devices online.

The findings were published in Tobacco Use in Canada: Patterns and Trends.