Reducing overdoses

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A new leader in the Open Society Institute shares a sensible perspective on reducing overdoses:

Looking ahead, reducing drug overdoses will require major shifts in how we approach substance use.

First, and possibly most importantly, Maryland needs to connect individuals struggling with addiction to high-quality addiction treatment that is integrated with their primary care. Primary care providers should be monitoring the long-term health and progress of those struggling with addiction, ensuring that the substance use treatment they are receiving dovetails with an overall health strategy.

Next, we need better monitoring of how often pain medication is prescribed. Research indicates there is an increase in the prescription of opioids that is not driven by clinical necessity. Many public health officials have identified the rise in prescriptions of opioids as a significant factor driving pharmaceutical overdose deaths, which quadrupled between 1999 and 2010, and as a gateway to other substances such as heroin.

Additionally, we need to educate patients that prescription drugs are, in fact, highly addictive and should be used with caution. A strategic and hard-hitting public awareness campaign would help people better understand the slippery slope from prescription drugs to street drugs.

And finally, we must undo the stigma that paralyzes individuals struggling with addiction that deters them from seeking help. This will require a shift in public policy — beginning at the highest levels — from criminalization to a focus on the medical and public health implications of addiction.

Faith of a different sort

athiesm-and-faithDJ Mac wraps up a series of posts on pharmacology with a post focused on our faith in pharmacology.

Holy grails are few and far between. Pharmaceutical holy grails are no different. They are as rare as a moderate position in the Scottish independence debate. We have a few prescription drugs licensed to treat addiction and some make things significantly better, some have modest impacts, and some appear to have little impact. Regardless of impact, what a great deal of faith we place in molecules to manage complex bio-psycho-social problems like addiction – or depression for that matter. It looks as if our faith often exceeds the pharmacology.

. . .

If we encourage our clients to trust in medication to do the work at the expense of doing the tough job of behavioural change, then we let our clients down. Too high a faith in pharmacology is disempowering. It’s not that medication doesn’t make an impact; it clearly does. My worry is that we place too much belief in medication and this may cause us to miss out on the otherwise rather obvious fact that recovery from addiction does not take place primarily because the prescription is right. While many recovering people can identify the part that prescribing played and are grateful for it, we don’t often see clients coming back to their prescribers saying “I want to thank you because your prescription was just right and because it was great it met my pharmacological deficits and I got into recovery.”

No, what they will say is “Thank you, you were great. You helped get me on my way, you connected me up to the right people and assisted me to sort out my problems. You had time for me and you listened to me. You supported me and believed in me.” That’s more efficacious than any drug.

It’s a great post. Read the rest here.

Drug Overdose Deaths Are Increasing Pretty Much Everywhere

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These images speak for themselves. Here are a couple of important sentences:

Between 1999 and 2009, drug poisoning deaths grew by 394 percent in rural areas and 279 percent for large metropolitan areas, according to the CDC’s county-level look at the data.

According to the CDC, roughly 60 percent of all OD deaths in 2010 were caused by prescription drugs, with three-fourths of those cases involving painkillers.

The work of advocates like these is growing more important.

Blue indicates a lower overdose rate and red indicates a higher rate (13+ per 100,000)
Blue indicates a lower overdose death rate and red indicates a higher overdose death rate (13+ per 100,000)