Addiction Resource Center (ARC) Portal

A new online platform that enables people to take a self-assessment,
develop an action plan, and connect to local resources.

Today the Addiction Policy Forum is launching the Addiction Resource Center (ARC) portal. The ARC portal is an online platform designed to assist people concerned about their own substance use or a loved one’s substance use. People can go through a self-assessment, develop an action plan, and discover local resources to address substance use disorder (SUD).

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Local treatment resources in Maryland, Minnesota, New Hampshire and Ohio are included in the first version of the portal. Over the coming year, resource lists will be developed in all 50 states. As part of the ARC portal launch, the Addiction Policy Forum is hosting walkthrough events in these four states for community leaders, impacted families and stakeholders. Please join us!

VISIT ARC PORTAL HERE: ARC Portal

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LEARN MORE ABOUT THE ARC PORTAL:

Join us at these local events (Ohio events located at bottom)

MARYLAND
Thursday, February 1st, 2018
8:30 AM to 9:30 AM
Chaney Alumni Library at the Riggs Alumni Center
University of Maryland
7801 Alumni Drive
College Park, MD 20742
RSVP here

MINNESOTA
Friday, February 2nd, 2018
6:30 PM to 7:30 PM
Earle Brown Heritage Center
6155 Earle Brown Dr
Brooklyn Center, MN 55430
RSVP here

NEW HAMPSHIRE
Friday, February 2nd, 2018
6:30 PM to 7:30 PM
Austin17House
263 Route 125
Brentwood NH, 03833
RSVP here

OHIO
Saturday, February 3rd, 2018
5:00 PM to 7:00 PM
World Harvest Church
4595 Gender Road
Canal Winchester OH 43110
RSVP here

Tuesday, February 6th, 2018
5:00 PM to 6:00 PM
BrightView Health
446 Morgan St.
Cincinnati, OH
RSVP here

On the front lines of drug crisis, US police split on Narcan

BATAVIA, Ohio (AP) — The sheriff of Clermont County firmly believes it’s a call of duty for his deputies to carry a nasal spray that brings people back from the brink of death by drug overdose. Less than 50 miles away, his counterpart in Butler County is dead set against it, saying it subjects deputies to danger while making no lasting impact on the death toll.

The divide over naloxone, the popular overdose antidote, between nearby sheriffs in two hard-hit counties in one of the hardest-hit states for drug deaths shows just how elusive solutions are on the front lines of the U.S. opioid crisis.

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Cincinnati Police Officer assists a gentleman who is experiencing a suspected overdose.

Some police officials cite lack of resources for obtaining, maintaining and tracking supplies and for training in when and how to use it. They worry about taking on new duties they say are better suited for medical workers, divert them from fighting crime and can put them in danger. They get support from some citizens weary of people who overdose repeatedly.

Police who do carry it say that development of a nasal spray called Narcan makes naloxone simple to administer, that the $75 two-dose kits are usually given to them by health departments or community organizations, that it’s not a major burden to track and maintain supplies and that it’s a natural extension of their mission to serve and protect.

“I just say from my personal experience that it is right thing to do,” said Sheriff Steve Leahy, whose Clermont County begins in the eastern Cincinnati suburbs, then rolls across hilly fields into Appalachia. Leahy, part of the early wave of police advocates of naloxone, acknowledges he was more inclined to support it after seeing someone close to him struggle for years with heroin.

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Cincinnati police officers, firefighters, and medics respond to a possible overdose report at a hotel in downtown Cincinnati.

“Don’t get me wrong,” Leahy said. “It doesn’t mean that we’re going to get out of this by hugging everybody, but … you know, no matter what their plight is and how they got to where they are, it’s not for us as law enforcement to decide whether they live or die.”

Butler Sheriff Richard Jones, whose county includes growing northern Cincinnati suburbs, older industrial cities and rural areas, also voices compassion. He lost a brother at a young age to alcoholism and drugs, he said, and he recounts cradling infants twitching from the effects of their mothers’ drug use.

But people using drugs make choices, he said: “Knowing that they can die from it, but they still do it.” (Addiction specialists and federal drug authorities say it’s more complicated than that; repeated uses of a drug can result in brain changes and the disease of addiction.)

And, Jones said, people who overdose can be combative when they come to, he said; an officer bent over giving naloxone could get “a brick to the head.”

“It’s not what we’re supposed to do,” said Jones, known for blunt talk on such issues as illegal immigration and Donald Trump’s GOP presidential campaign. “We won’t do it. Period.”

A recent visit with Jones by Associated Press reporters came the morning after a man in Middletown revived by firefighters came back to consciousness in attack mode. He injured a firefighter and tried to bite and punch others.

Such instances are rare, authorities say. Quincy, Massachusetts, police pioneered naloxone seven years ago and have reversed nearly 800 overdoses without a single officer being injured, said Lt. Patrick Glynn.

And advocates for those battling addiction say it seems like a natural situation for police, whose very jobs call for facing sudden threats.

In a Butler County mobile home park where the sheriff’s office has stepped up patrols after complaints of drug activity, Jones’ position has strong support from Brandon O’Hair, 21. Snuggling his newborn daughter, he said he and nearly all his neighbors have had cars or homes broken into by people stealing to fund their heroin habits.

“That’s not what they’re supposed to do; they’re supposed to enforce the law,” O’Hair said of the sheriff’s refusal to stock naloxone. “I think it’s tough love. … The rest of us shouldn’t have to pay for it.”

An AP survey of Ohio’s 88 sheriffs found that at least 68, or a little more than three-fourths, equip deputies with naloxone. Of those, a half-dozen have begun within the past six months, and most others have less than two years’ experience.

It’s hard to say what effect naloxone is having on overdose death rates.

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Medics with the Cincinnati Fire Department nasally administer naloxone to a woman while responding to a possible overdose report at a gas station in downtown Cincinnati.

Accidental overdose deaths in at least 11 Ohio counties where sheriffs have used the antidote for more than two years went up last year. Butler’s did, too, and is on track for another record toll this year. In Clermont, where sheriff’s deputies carry naloxone, the death toll went down last year. Statewide, the overdose death toll soared 33 percent, to 4,050 people, in 2016.

Naloxone is also widely distributed to families and friends of people with addiction. Its availability to police and sheriffs dates back only a few years. And attempts to gauge its effectiveness are hindered by variables including geographical variation in drug potency.

Amy Parker, a native and resident of Butler County, was saved twice by naloxone. She doesn’t know whether it was police or paramedics who administered it when she overdosed on heroin in Indianapolis a few years ago. She eventually ended her drug use and now is a peer drug counselor, leading group meetings for those in rehabilitation.

The talk by the sheriff and residents of her county against police use of naloxone, she said, adds to the stigma of those battling drugs and to their reluctance to seek help. She bristled at the claim by Jones and others that naloxone enables; the saying among advocates, she says, is that the only thing naloxone “enables” is breathing.

“I don’t care how many times it takes,” Parker said. “As long as that person is alive, there is hope.”

For the original article, including a video, visit this link: On the front lines of drug crisis, US police split on Narcan

Contributing to this report were Associated Press reporters Kantele Franko and Andrew Welsh-Huggins in Columbus, Lisa Cornwell in Cincinnati, and AP news researcher Jennifer Farrar in New York.

Lives Lost: One story of opioid recovery

Lisa is alive today because of new tactics in the fight against opioid addiction.

CANTON, OH Every morning, Lisa dissolves a pill under her tongue. She doesn’t mind the flavor: chalky, like children’s aspirin, with a hint of orange.

The pill is Suboxone, a medication that helps Lisa control her cravings for opioids. After years of abusing prescription pills and heroin, and surviving more than a dozen overdoses, she has been sober four months and counting.

Her bills are paid. There is food in the refrigerator. She spends time with her children.

“I’m happy, actually,” Lisa said. “This is the best things have been in a long, long time.”

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But her story is about more than a pill. Lisa is alive and in recovery because Stark County embraced new techniques to fight an opioid epidemic that has killed hundreds locally and thousands across the state.

Medication-assisted treatment, outreach by police officers, the wide-spread use of overdose-reversing naloxone and peer support all played a role in Lisa’s story.

Lisa is 51 years old and lives in Canton. She agreed to speak with The Canton Repository on the condition her last name not be used because of concerns regarding her past associates.

Lisa almost didn’t make it to this point. By her own count, she overdosed at least nine times that landed her in a hospital. That number doesn’t include the dozen or so times her teenage son waited anxiously at her side to blast overdose-reversing naloxone up her nose.

“He saved my life more times than I know,” she said.

Lisa started smoking marijuana when she was 13 years old. In her 20s, she started using methamphetamine, cocaine and prescription pills. Vicodin was the first opioid she tried. Her mother gave her the pill to ease a headache.

“That was the miracle cure for hangovers after that,” Lisa said.

Sometime later, a pain management doctor prescribed Lisa opioids such as Percocet, Vicodin and OxyContin for migraines and pain related to scar tissue. The doctor didn’t ask about her past drug use, she said.

Lisa had a medicine cabinet full of opioids, but she would blow through a month’s worth of pills in a few weeks. The first pain management doctor ultimately dropped Lisa after she got an opioid prescription from a dentist. She found another clinic, but authorities shut it down.

Drugs such as heroin, cocaine or opioid painkillers flood the brain with dopamine, causing a feeling of pleasure. Food, sex and exercise also release dopamine, but can’t compete with surge from the drugs.

Over time, drug use depletes the amount of dopamine in the brain. Addiction takes hold and the brain’s structure changes.

“They have to seek substances to fill that gap,” said Dr. Jamesetta Lewis, of Mercy Medical Center’s Pain Management Center. “That’s when an addiction develops. They have to get more and more substances to bridge that dopamine gap the brain can’t fill itself.”

Unable to get pills, Lisa used heroin. That was about eight years ago. Heroin was cheaper than pills and stronger. She used every day. When she heard about someone overdosing, she’d try to buy the same stuff.

“I never cared if I died,” Lisa said. “I never cared. I just didn’t care. And if I was going to die, that was the way to do it because it was completely painless. You just go to sleep.”

Addiction consumed her life and hurt those closest to her. Her adult daughter started using opioids. Lisa’s teenage son worried every time he left the house or went to school that he’d return to find her dead or in jail. At night he skipped sleep to make sure she didn’t die.

“Growing up seeing your family do that, it does something to you,” he said.

Ready for help

Two Canton Police narcotics officers knocked on Lisa’s door one day this winter.

Detective Mike Rastetter and a supervisor were checking complaints about drug activity at Lisa’s home. They knew Lisa from all the times she had overdosed.

“She looked skin and bones,” Rastetter said. “She looked really bad.”

Lisa was sick from withdrawal and desperate when they knocked. What she didn’t know at the time was that the department had told officers to look for ways to help people addicted to drugs get treatment.

Lisa told the detectives she was going to die if she didn’t get help. They started making calls. About four hours later, Lisa was in a detox bed at the Crisis Intervention & Recovery Center.

“We were fortunate enough that day that it was available,” Rastetter said.

Medication-assisted treatment

Addiction treatment can take different forms. After a week of detox, Lisa went to CommQuest Services’ Regional Center For Opiate Recovery in Massillon, which opened in 2015 specifically to treat opioid addiction. Since then, it has received 2,500 unduplicated referrals from more than 20 counties.

“We talk about recovery being a process of learning to enjoy life and repairing the damage you did while you were using and improving the overall quality of your life,” said CommQuest President and CEO Keith Hochadel.

Lisa’s treatment plan combined counseling and 12-step meetings with daily doses of Suboxone, a combination of naloxone and buprenorphine, an opioid. Suboxone reduces the euphoria and cravings associated with opioids so a patient can focus on recovery.

The thought of getting high is always in her mind, Lisa said, but she counts to 20 and thinks about something else and the craving passes.

“I can function every day,” Lisa said. “I function.”

Starting this month, Stark Mental Health and Addiction Recovery will use two-thirds of a $741,000 federal and local funding package to expand treatment with Suboxone and Vivitrol, a medication that blocks an opioid from making the user high.

But the local treatment community has realized that treating addiction involves more than medication and counseling sessions. Men and women in recovery need help to rebuild their lives and the best guide can be a person who has walked the same road.

Rebuilding lives

When Lisa started at ReCOR, she had to go to Massillon every day to get her dose of Suboxone. She couldn’t drive and everyone she knew who had a car was using drugs. She was able to get a ride with a peer supporter from Stark County TASC.

Peer supporters are individuals in recovery who are trained to help others addicted to drugs or alcohol.

“You actually know what they’re talking about,” said Nicole Osborne, who oversees TASC’s peer supporters. “You actually know where they’re coming from. You didn’t just read it in a book in school.”

Three times a week peer supporters from TASC visit individuals detoxing at the Crisis Center. Rides to treatment appointments are just some of the help they offer.

People addicted to alcohol or drugs put everything else in their lives on hold, Osborne said.

When she meets a new client, she asks the woman about her “life to-do list,” the things she’s avoided or ignored for months or years. That can be getting a driver’s license, finding a home, clearing up arrest warrants or getting a job.

“You need the basics of life,” Osborne said. “You need to know where you’re going to sleep that night. It’s hard to even think about being sober or not using drugs if you don’t have a place to live or no food.”

Peer supporters also link clients to others who can help them stay sober.

Lisa said teaming with a peer supporter removed any excuses she might have had for not going to treatment.

“You don’t have a reason to say, ‘I can’t do it,’” she said.

Police outreach

Lisa is drug-tested regularly in the ReCOR program and said she goes to 12-step meetings almost daily.

Rastetter stops and checks on Lisa and her family about once a month. Right now he’s trying to find her a job.

The 11-year Canton police veteran said he never thought his job would include navigating the maze of addiction services, insurance and housing assistance. Finding local resources on the fly is a challenge, he said, but it’s getting better.

“It’s worth a chance,” Rastetter said. “If we save two or three people’s lives and they get off heroin, then it’s worth it. It really is.”

Lisa is one of about five people the police have helped get into detox, and the department is trying to assist more.

Taking a cue from communities such as Mansfield, Akron and Green, Canton police started a Recovery Response Team in late June. The team includes police, a caseworker from TASC and a Crisis Center nurse. Every week, the team visits individuals who recently overdosed.

“The jails are not equipped to deal with addiction recovery, and I think that looking at this from a health care standpoint and as a health care crisis is very important,” said Lt. John Gabbard, who oversees the initiative.

The police will still pursue drug dealers, but Gabbard asked for patience from residents who might not understand the new approach toward individuals using drugs.

“Give us a chance to convince you that taking the long-term approach of getting them help will be more beneficial to the neighborhood than trying to evict them into someone else’s neighborhood and not dealing with that problem,” Gabbard said.

Looking forward

Now that Lisa’s life isn’t ruled by a daily hustle for drugs, she has a lot of things she wants to do.

She wants to get a job and more furniture for her home. She wants to drive again. She wants to spend time with her family, including her daughter who is now in recovery.

Her plan is to “do things and make memories,” Lisa said. “Ones that I can remember and ones where everybody’s happy.

Relapse is always a risk, and with opioids, the consequence of one slip can be fatal.

Her kids were proud of her recovery.

“Not everyone is as lucky as her to where you can OD as many times as she did and be alive to this day,” her son said.

Article written by: Shane Hoover, Cantonrep.com staff writer

Link to original article here: Lives Lost: One story of opioid recovery

OHSAM president, Dr. Ryan, is the featured speaker in this podcast where they interview experts about addiction and addiction education. Listen at the 1:30 minute mark!

The Cover2 Podcast is an ongoing series of interviews with people who are making a difference in the fight against opioid addiction.  The Cover2 Podcast seeks to raise awareness and to connect users.

Click here for: Podcast – Dr. Shawn Ryan, MD, MBA, ABEM

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Rise In Hospital Visits For Opioids Spotlight The Epidemic

The latest government numbers on opioid-related hospitalizations paint a picture of a country in a drug-related crisis. Between 2005 to 2014, emergency room visits stemming from opioid use rose 99 percent and inpatient stays jumped 64 percent, according to the Agency for Healthcare Research and Quality.

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In 2014 alone, opioid-related hospitalizations totaled 1.27 million.

The spike in hospital visits was driven largely by people ages 25 to 44. The report by the Rockville, Maryland-based agency also noted gender differences in the way men and women used hospital services.

Women were more likely to have inpatient stays, while men were more likely to visit the ER in 2014.  “Our data tell us what is going on. They tell us what the facts are. But they don’t give us the underlying reasons for what we’re seeing here,” Anne Elixhauser, co-author of the report and senior research scientist at AHRQ, told the Washington Post.

“It is no surprise that opioid-related hospitalizations rose significantly during that time period,” Dr. Peter Friedmann, associate dean for research at the University of Massachusetts Medical School and chief research officer at the nonprofit Baystate Health, told HuffPost.

“The surge of opioid use disorder and opioid-related overdose deaths that started in the late ’90s continues unabated in most of the U.S. Overdose deaths are the tip of the iceberg,” Friedmann said.

A U.S. Centers for Disease Control and Prevention report published in June found that between 2010 to 2015, North Carolina hospitals saw a 12-fold increase in patients suffering from endocarditis, an infection of the heart, that was linked to drug dependence.

“As the U.S. opioid epidemic continues to grow, hospitalizations for infectious complications associated with injection drug use are likely to increase,” the report said.

The AHRQ report follows a New York Times Upshot analysis of data from health agencies around the country that estimated drug overdose deaths will top 59,000 in 2016. That’s up from 52,404 overdose deaths in 2015, a 19 percent increase that would be the largest such jump in U.S. history.

According to the Times, the numbers are expected to rise again in 2017.

Link to the original article with informative video here:  Rise In Hospital Visits For Opioids Spotlight The Epidemic

By Erin Shumaker 6/20/2017

Drug Deaths in America Are Rising Faster Than Ever

The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50.

Although the data is preliminary, the Times’s best estimate is that deaths rose 19 percent over the 52,404 recorded in 2015. And all evidence suggests the problem has continued to worsen in 2017.   Image result for Drug overdose deaths in Philadelphia and San Francisco Drug overdose deaths since 1980 have surged in Philadelphia despite a shrinking population; most heroin there is powdered. They have remained relatively flat in San Francisco, where most heroin is black tar.

Because drug deaths take a long time to certify, the Centers for Disease Control and Prevention will not be able to calculate final numbers until December. The Times compiled estimates for 2016 from hundreds of state health departments and county coroners and medical examiners. Together they represent data from states and counties that accounted for 76 percent of overdose deaths in 2015. They are a first look at the extent of the drug overdose epidemic last year, a detailed accounting of a modern plague.

The initial data points to large increases in drug overdose deaths in states along the East Coast, particularly Maryland, Florida, Pennsylvania and Maine. In Ohio, which filed a lawsuit last week accusing five drug companies of abetting the opioid epidemic, we estimate overdose deaths increased by more than 25 percent in 2016.

“Heroin is the devil’s drug, man. It is,” Cliff Parker said, sitting on a bench in Grace Park in Akron. Mr. Parker, 24, graduated from high school not too far from here, in nearby Copley, where he was a multisport athlete. In his senior year, he was a varsity wrestler and earned a scholarship to the University of Akron. Like his friends and teammates, he started using prescription painkillers at parties. It was fun, he said. By the time it stopped being fun, it was too late. Pills soon turned to heroin, and his life began slipping away from him.

Mr. Parker’s story is familiar in the Akron area. From a distance, it would be easy to paint Akron — “Rubber Capital of the World” — as a stereotypical example of Rust Belt decay. But that’s far from a complete picture. While manufacturing jobs have declined and the recovery from the 2008 recession has been slow, unemployment in Summit County, where Akron sits, is roughly in line with the United States as a whole. The Goodyear factories have been retooled into technology centers for research and polymer science. The city has begun to rebuild. But deaths from drug overdose here have skyrocketed.

In 2016, Summit County had 312 drug deaths, according to Gary Guenther, the county medical examiner’s chief investigator — a 46 percent increase from 2015 and more than triple the 99 cases that went through the medical examiner’s office just two years before. There were so many last year, Mr. Guenther said, that on three separate occasions the county had to request refrigerated trailers to store the bodies because they’d run out of space in the morgue.It’s not unique to Akron. Coroners’ offices throughout the state are being overwhelmed.

 

Drug overdose deaths in six Ohio counties, 2010 to 2017

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Totals for 2017 assume that overdose deaths continue at the same rate through the remainder of the year. Source: Butler County Coroner’s Office; Cuyahoga County Medical Examiner’s Office; Hamilton County Coroner; Montgomery County Alcohol, Drug Addiction & Mental Health Service; Montgomery County Sheriff’s Office; Summit County Department of the Medical Examiner

In some Ohio counties, deaths from heroin have virtually disappeared. Instead, the culprit is fentanyl or one of its many analogues. In Montgomery County, home to Dayton, of the 100 drug overdose deaths recorded in January and February, only three people tested positive for heroin; 99 tested positive for fentanyl or an analogues.

Fentanyl isn’t new. But over the past three years, it has been popping up in drug seizures across the country.

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Most of the time, it’s sold on the street as heroin, or drug traffickers use it to make cheap counterfeit prescription opioids. Fentanyls are showing up in cocaine as well, contributing to an increase in cocaine-related overdoses.

The most deadly of the fentanyl analogues is carfentanil, an elephant tranquilizer 5,000 times stronger than heroin. An amount smaller than a few grains of salt can be a lethal dose.

“July 5th, 2016 — that’s the day carfentanil hit the streets of Akron,” said Capt. Michael Shearer, the commander of the Narcotics Unit for the Akron Police Department. On that day, 17 people overdosed and one person died in a span of nine hours. Over the next six months, the county medical examiner recorded 140 overdose deaths of people testing positive for carfentanil. Just three years earlier, there were fewer than a hundred drug overdose deaths of any kind for the entire year.

This exponential growth in overdose deaths in 2016 didn’t extend to all parts of the country. In some states in the western half of the U.S., our data suggests deaths may have leveled off or even declined. According to Dr. Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, and an expert in heroin use in the United States, this geographic variation may reflect a historical divide in the nation’s heroin market between the powdered heroin generally found east of the Mississippi River and the Mexican black tar heroin found to the west.

 This divide may have kept deaths down in the West for now, but according to Dr. Ciccarone, there is little evidence of differences in the severity of opioid addiction or heroin use. If drug traffickers begin to shift production and distribution in the West from black tar to powdered heroin in large quantities, fentanyl will most likely come along with it, and deaths will rise.

Drug overdose deaths in Philadelphia and San Francisco
Drug overdose deaths in Philadelphia and San Francisco Drug overdose deaths since 1980 have surged in Philadelphia despite a shrinking population; most heroin there is powdered. They have remained relatively flat in San Francisco, where most heroin is black tar.

First responders are finding that, with fentanyl and carfentanil, the overdoses can be so severe that multiple doses of naloxone — the anti-overdose medication that often goes by the brand name Narcan — are needed to pull people out. In Warren County in Ohio, Doyle Burke, the chief investigator at the county coroner’s office, has been watching the number of drug deaths rise as the effectiveness of Narcan falls. “E.M.S. crews are hitting them with 12, 13, 14 hits of Narcan with no effect,” said Mr. Burke, likening a shot of Narcan to “a squirt gun in a house fire.”

Early data from 2017 suggests that drug overdose deaths will continue to rise this year. It’s the only aspect of American health, said Dr. Tom Frieden, the former director of the C.D.C., that is getting significantly worse. Over two million Americans are estimated to be dependent on opioids, and an additional 95 million used prescription painkillers in the past year — more than used tobacco. “This epidemic, it’s got no face,” said Chris Eisele, the president of the Warren County Fire Chiefs’ Association and fire chief of Deerfield Township. The Narcotics Anonymous meetings here are populated by lawyers, accountants, young adults and teenagers who described comfortable middle-class upbringings.

 Back in Akron, Mr. Parker has been clean for seven months, though he is still living on the streets. The ground of the park is littered with discarded needles, and many among the homeless here are current or former heroin users. Like most recovering from addiction, Mr. Parker needed several tries to get clean — six, by his count. The severity of opioid withdrawal means users rarely get clean unless they are determined and have treatment readily available. “No one wants their family to find them face down with a needle in their arm,” Mr. Parker said. “But no one stops until they’re ready.”

About the data

Our count of drug overdoses for 2016 is an estimate. A precise number of drug overdose deaths will not be available until December.

As the chief of the Mortality Statistics Branch of the National Center for Health Statistics at the C.D.C., Robert Anderson oversees the collection and codification of the nation’s mortality data. He noted that toxicology results, which are necessary to assign a cause of death, can take three to six months or longer. “It’s frustrating, because we really do want to track this stuff,” he said, describing how timely data on cause of death would let public health workers allocate resources in the right places.

To come up with our count, we contacted state health departments in all 50 states, in addition to the District of Columbia, asking for their statistics on drug overdose deaths among residents. In states that didn’t have numbers available, we turned to county medical examiners and coroners’ offices. In some cases, partial results were extrapolated through the end of the year to get estimates for 2016.

While noting the difficulty of making predictions, Mr. Anderson reviewed The Times’s estimates and said they seemed reasonable. The overdose death rate reported by the N.C.H.S. provisional estimates for the first half of 2016 would imply a total of 59,779 overdose deaths, if the death rate remains flat through the second half of the year. Based on our reporting, we believe this rate increased.

While the process in each state varies slightly, death certificates are usually first filled out by a coroner, medical examiner or attending physician. These death certificates are then collected by state health departments and sent to the N.C.H.S., which assigns what’s called an ICD-10 code to each death. This code specifies the underlying cause of death, and it’s what determines whether a death is classified as a drug overdose.

Sometimes, the cases are straightforward; other times, it’s not so easy. The people in charge of coding each death — called nosologists — have to differentiate between deaths due to drug overdose and those due to the long-term effects of drug abuse, which get a different code. (There were 2,573 such deaths in 2015.) When alcohol and drugs are both present, they must specify which of the two was the underlying cause. If it’s alcohol, it’s not a “drug overdose” under the commonly used definition. Ideally, every medical examiner, coroner and attending physician would fill out death certificates with perfect consistency, but there are often variations from jurisdiction to jurisdiction that can introduce inconsistencies to the data.

These inconsistencies are part of the reason there is a delay in drug death reporting, and among the reasons we can still only estimate the number of drug overdoses in 2016. Since we compiled our data from state health departments and county coroners and medical examiners directly, the deaths have not yet been assigned ICD-10 codes by the N.C.H.S. — that is, the official underlying cause of death has not yet been categorized. In addition, the mortality data in official statistics focuses on deaths among residents. But county coroners typically count up whichever deaths come through their office, regardless of residency. When there were large discrepancies between the 2015 counts from the C.D.C. and the state or county, we used the percent change from 2015 to calculate our 2016 estimate.

We can say with confidence that drug deaths rose a great deal in 2016, but it is hard to say precisely how many died or in which places drug deaths rose most steeply. Because of the delay associated with toxicology reports and inconsistencies in the reported data, our exact estimate — 62,497 total drug overdose deaths — could vary from the true number by several thousand.

 

Full article with citations can be found here:

Drug Deaths in America Are Rising Faster Than Ever

Written by: Josh Katz, June 5th 2017

GOP bill would devastate efforts to end the opioid epidemic

OHSAM President Dr. Shawn Ryan is co-author of this striking contribution about the potential newly proposed health care bill and how families and individuals suffering from opioid addiction will be among the hardest hit.

Of the many emotions evoked by House passage of the American Health Care Act, the Republican bill to repeal and replace the Affordable Care Act (aka Obamacare), sadness and fear were among the most pervasive. While the legislation reduces the benefits and increases the coverage costs for almost every demographic of our country, families and individuals suffering from opioid addiction will be among the hardest hit. In places like Ohio that are being ravaged by addiction, that is unacceptable.

In 2015, 52,000 Americans died from overdoses; that’s 144 a day. The opioid and prescription drug epidemic is clearly a national crisis. Entire communities are collapsing because of a lack of resources to push back against the rising tide.

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Congressman Tim Ryan, is a Democrat who has been representing Ohio’s 13th District since 2002. He is a member of the House Appropriations Committee. 

Last year, Congress took some concrete steps towards fighting back. Last July, the Comprehensive Addiction and Recovery Act was signed into law, creating a comprehensive framework to address substance use disorder and key resources for communities. Congress also passed the 21st Century CURES Act, which included $1 billion for states to help with the local response to this ongoing epidemic. While these programs are positive efforts to confront this crisis, the Affordable Care Act has played a central role in getting people the treatment they need.

The Affordable Care Act made it possible for Americans suffering from substance use disorder to get access to quality treatment – many for the first time in their lives. Through the inclusion of substance use disorder treatment as an essential health benefit, the extension of the parity law to the small group and individual market, and the expansion of Medicaid, millions of Americans were able to gain the coverage they desperately needed to treat addiction. The House Republican health care bill, on the other hand, would not only roll back these advancements, but it could rip health coverage away from the 2.8 million Americans still struggling with addiction.

Shawn Ryan
Shawn A. Ryan is the president and CMO of BrightView Addiction Treatment, an assistant professor in the Department of Emergency Medicine at the University of Cincinnati, president of the Ohio Society of Addiction Medicine and chair of Payer Relations for the American Society of Addiction Medicine. 

Our country is suffering. We should be moving forward, not backward. We fully recognize that passage of this legislation might make political sense to some, but doing so is leaving behind millions of Americans most in need. This epidemic is costing our nation $700 billion in health, crime and lost productivity, but that is nothing compared to the toll it is taking on our communities. These men and women are not strangers – they are our friends and neighbors, our brothers and sisters. There is a reason over 435 addiction and mental health groups nationwide have spoken out against this House Republican health care bill: it’s because it would leave people in need without coverage or access to care.

This legislation still needs to pass the Senate before it can be signed into law by President Trump. We urge the Senate to do the right thing and toss out this bill. It is dangerous and short-sighted, and it would be devastating for our nation’s struggle to end the opioid and prescription drug epidemic that is ravaging every corner of the United States of America.

Link to article here: GOP bill would devastate efforts to end the opioid epidemic

Ohio Attorney General Sues 5 Drug Companies Related to Opioid Crisis

The Ohio attorney general sued five drugmakers on Wednesday, accusing the companies of perpetrating the state’s addictions epidemic by intentionally misleading patients about the dangers of painkillers and promoting benefits of the drugs not backed by science.

Attorney General Mike DeWine said the companies created a deadly mess in Ohio that they now need to pay to clean up.

“This lawsuit is about justice, it’s about fairness, it’s about what is right,” DeWine said in announcing the complaint filed in Ross County, a southern Ohio community slammed by fatal drug overdoses from painkillers and heroin.

A record 3,050 Ohioans died from drug overdoses in 2015, a figure expected to jump sharply once 2016 figures are tallied.

DeWine wants an injunction stopping the companies from their alleged misconduct and damages for money the state spent on opiates sold and marketed in Ohio. The attorney general also wants customers repaid for unnecessary opiate prescriptions for chronic pain.

“These drug companies knew that what they were doing was wrong and they did it anyway,” DeWine said.

The drugmakers sued by DeWine are Purdue Pharma; Endo Health Solutions; Teva Pharmaceutical Industries, and its subsidiary, Cephalon; Johnson & Johnson and its subsidiary Janssen Pharmaceuticals; and Allergan.

They variously manufacture OxyContin, Percocet and a host of other painkillers that DeWine said represent the heart of the problem.

Christina Arredondo said her 24-year-old pregnant daughter, Felicia Detty, died after a painkiller addiction led to heroin and overdose. She said she’s hopeful the Ohio lawsuit can begin to curtail the epidemic by fighting it “from the top.”

“It’s not like they’re going out to buy some cocaine on the street,” she said. “They’re going to the doctor for a torn ligament in their shoulder, or migraines, or having a tooth pulled.”

Janssen on Wednesday called the lawsuit’s accusations legally and factually unfounded. The company said it acted appropriately, responsibly and in the best interests of patients.

Another defendant, Purdue Pharma, said it shares DeWine’s concerns about the opiate crisis and is committed to working together on a solution. It won’t say if it’s challenging the lawsuit.

Teva Pharmaceuticals says it’s still reviewing the lawsuit and is unable to comment.

Endo declined comment. A message was left seeking comment with Allergan.

DeWine, a Republican expected to run for governor next year, joins other states that have filed similar lawsuits. His move comes after years of calls for such action by Ohio Democrats.

Democratic candidate Nan Whaley, Dayton’s mayor, is airing online video spots in which she criticizes sitting Republicans for doing too little to solve the heroin and opioid epidemic. Whaley says taking on drug companies for their role in the crisis will be her highest priority as governor.

Another gubernatorial contender, Democratic state Sen. Joe Schiavoni, said he had previously called for such an action.

“I hope that whatever financial settlement this lawsuit might bring will be put toward helping the victims of this epidemic,” he said. “In the meantime, the General Assembly must do more to provide the resources our counties desperately need now for drug treatment and other services.”

In 2015, Kentucky settled a similar lawsuit with Purdue Pharma for $24 million.

Oregon reached a settlement in 2015 with opioid painkiller manufacturer Insys for off-label promotion of Subsys, a fentanyl spray more powerful than heroin. It was also among 27 states that reached a settlement with Purdue, the maker of OxyContin, in 2007.

Link to article here: Ohio attorney general sues 5 drug companies related to opioid crisis