CDC Report Finds Overdose Deaths Rose 21 Percent in 2016

A new report released Friday by the Centers for Disease Control and Prevention reveals deaths from drug overdoses in America rose 21 percent last year. That jump is more than the last four years combined. For every 100,000 people, almost 20 died from a drug overdose in 2016, compared to 16.3 the previous year, Bloomberg reported.

The report shows deaths from liver disease, suicide, cancer and HIV have decreased. However, the overall death rate continued to increase. Farida Ahmad, the report’s author and mortality surveillance lead at the CDC says this is because people are dying in larger numbers from other causes, such as drug overdoses, or homicides and firearm-related injuries, both of which also rose last year.

 

The CDC measures 20 causes of death in its report, and although there are slight increases in other categories, Ahmad says drug overdoses show “the most stark increase,” WTKR News reported. Every quarter in 2016 saw an increase in the number of deaths related to drug overdoses.

 

These findings come shortly after President Donald Trump declared the opioid crisis in America a public health emergency. This allows the Trump administration and Department of Health and Human Services to allocate funding and resources to address the crisis under the Public Health Emergency Act. The order lasts for 90 days and can be renewed every 90 days until deemed unnecessary.

 

The president had been heavily criticized over his handling of the epidemic after he announced he would declare the crisis a national emergency but did not. A declaration of national emergency would have allowed for additional funding from the Federal Emergency Management Agency’s Disaster Relief Fund.

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Could This Christian Rehab’s Faith-Based Solution to Drug Crisis Change America?

tc-blue-logo1New York Teen Challenge announced today that it has proposed to the federal government and President Trump a faith-based initiative asking the federal government to recognize faith-based programs and establish a faith-based administration to allocate funding for “Beds and Buildings” to help combat the Opioid Crisis. Jimmy Jack, president and founder of New York Teen Challenge, along with New York Yankee baseball  legend Mariano Rivera and New York Teen Challenge State Director Ramon Rosa Jr., presented the proposal to President Trump. They were invited on the platform to join President Trump at the White House on Thursday, October 26th to hear the president’s declaration announcing the state of emergency regarding the opioid epidemic.

Rev. Jimmy Jack, is a 1985 graduate of Brooklyn Teen Challenge. He and 50 of his family members have all battled with addiction and have gone through the Teen Challenge Program. He truly is a passionate and inspiring leader who has experienced both sides of the drug culture.

After the president’s announcement, Jimmy, Mariano and Ray met with some of the president’s senior counselors and sat with Kellyanne Conway to discuss the details of the proposal.

About the Faith-Based Proposal

The proposal demonstrates that faith-based programs will help expand capacity and add thousands of beds to the existing secular inventory of residential treatment. The cost to rehabilitate 24,000 patients at a secular program would be $8,640,000,0005. A faith-based program like Teen Challenge can rescue the same number of people at a cost of only $840 million, a savings of $7,800,000,000 or 928 percent.

With only 3,678 clinical residential treatment centers, there are not enough long-term facilities in the US to solve the drug and opioid epidemic problem. It has gotten to the point where traditional secular rehabilitation centers are now strained and overburdened with the influx of those seeking help. In 2015, only 2.5 million people received treatment, this represents only 11 percent of the 23 million addicted population. With over $34 billion spent on treatment averaging $162,000 per addict. With most insurance companies only covering 28 days of residential treatment and only use the clinical model, the average addict is excluded from receiving the necessary long-term residential care.

A faith-based program like Teen Challenge will successfully recover 16,800 patients (verses 720 patients in a secular program) at a proven 70 percent success rate. The faith-based model heals 2,233 percent more patients. The return on investment for the federal government funds is noticeably higher, while at the same time providing proven results.

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Victory Retreat Montana is currently a virtual drug & alcohol recovery retreat and soon will be a physical in house retreat.  It uses faith based methodology for bringing addiction recovery to a final end. While we are not a Teen Challenge Facility, we are authorized Teen Challenge Certified Teachers for their PSNC Program.  Visit us at VictoryRetreatMontana.com.  We work across the US and Canada.

Are You an Addict? Signs of a Prescription Drug Addiction

You just may not know you’re addicted when your drug dealer is your doctor.

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When you’re sick or have suffered from a serious injury, the first few days after a visit to the doctor you rely heavily on the prescribed drug to ease the pain and get you through the day. However, you may reach a point where you feel compelled to continue taking the prescription long after you need it. If you think you or a loved one might have a problem with prescription drugs, there are some red flags you should watch out for.

The Cheat Sheet spoke with some of the country’s top addiction experts to learn more about prescription drug abuse.

There is sudden behavior change

One of the first signs of a prescription drug addiction is an abrupt change in behavior. If you suspect the abuse of prescription medication, take note of unusual behavior you hadn’t observed before.

Psychologist Matthew Polacheck, director of outpatient services at the Betty Ford Center in West Los Angeles, said behavioral changes may also be accompanied by cognitive and physical changes. “The first thing we look for is a change in behavior of any kind. [Someone] who never naps comes home and goes to sleep. [Someone] who is passive suddenly becomes more euphoric. More specific behavior includes nodding off, drowsiness, slurred speech, confused thinking, and pupils can also be constricted.”

The drug becomes part of a daily routine

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If you or someone you know can’t seem to go a day without a prescription drug that was meant for short-term use, this is another red flag. Over time, short-term medication should be slowly tapered down until there is no longer a need for it.

Audrey Hope, an addictions specialist at Seasons in Malibu World Class Addiction Treatment, said if there is difficulty in stopping a drug, this should be a cause for concern. “The main sign that you are a prescription drug addict is that you use the drugs every day. You can’t function without them. You rely on them. You need them. You lie to yourself that it is for the ‘pain’ and because ‘the doctor prescribed it.’ You say it is OK to use them,” said Hope.

More of the drug is used than prescribed

Doctor handing pills to a patient

Another sign of trouble is using too much of the prescription and running out of the drug much earlier than expected considering the prescribed amount. Someone desperate for a refill may resort to manipulative behavior to obtain the drug, said Plattor. “Other signs of prescription addiction can include manipulative behaviors such as lying, stealing, using more of the drug than is prescribed, poor decision-making, ‘losing’ prescriptions often, and obtaining a number of prescriptions for the same drug(s) from more than one doctor,” Plattor said.

Misconceptions about prescription drug addiction

man pouring pills into his hand

There are many misunderstandings when it comes to an addiction to prescription drugs. Here are some of the most common ones.

Myth: Pain pills are the only addictive prescription drugs

Pink pills

While pain medications are commonly abused, there are many others that can become addictive. “In addiction treatment, what we see most is opioid abuse. We also see abuse of ADHD medications, such as Adderall or Ritalin. Medications like benzodiazepines can also be substances of abuse. Drugs given for anxiety or depression, especially when given without concurrent psychotherapy, can lead to substance abuse problems,” said Dr. Constance Scharff, the research director of addiction treatment center Cliffside Malibu and author of Ending Addiction for Good.

Myth: I trust my doctor so I don’t need to ask questions

Doctor looking at tablet

Ask questions about your prescription, and don’t just blindly trust your doctor. It’s important to check with your doctor and make sure you understand side effects as well as how much medicine you should take and when to stop. You should also let your physician know if you’re having a hard time stopping your medicine.

Where to get help

Psychologist making notes

If you’re looking for assistance for yourself or a loved one, know there is quality help out there. You can reach out to a support group or consider seeking the services of an inpatient or outpatient detox program. You can start your search online on websites such as VictoryRetreatMontana.com. 

 

For Article Source with edits: Click Here.

“I truly believe no treatment will work on a person with an addiction if the patient hasn’t fully given themselves over to the fact that they have a disease that does not heal itself.”

Margaret F.’s words capture a core belief of the traditional type of treatment program she attended, one common in 12-step-based facilities. Leading professional organizations – including the American Medical Association, American Psychiatric Association, World Health Organization, and American Society of Addiction Medicine (ASAM) – subscribe to the notion that alcohol and other drug addictions are diseases.

However, a growing number of experts are challenging this view. One of them is neuroscientist Marc Lewis, Ph.D., who eloquently elucidates his reasoning in a new book, The Biology of Desire: Why Addiction is Not a Disease. Real-life stories of five different people who have struggled with addiction flesh out the framework he’s constructed from the latest neuropsychological findings.

From his home in the Netherlands, this Canadian expat and Pro Talk columnist gave me several hours of his time to answer the following questions:

Q: The ASAM defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry” and goes on to say that “dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations… reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” What’s wrong with this?

A: It’s not that all these brain changes aren’t involved in addiction – they are, but they’re also involved in becoming a basketball fan, falling in love, in becoming a jihadist, in developing any new passion. So why would we call addiction a disease that requires medical treatment?

Saying addiction is a disease suggests that the brain can no longer change…that it’s an end state. But no, it’s not end state. -MARC LEWIS

We know that treatment isn’t required by most to overcome addiction, so in that sense it’s not a disease. And the changes in the brain that occur because of addiction are not irreversible. We’ve been talking about neuroplasticity for decades. That is, the brain keeps on changing – due to changes in experience, self-motivated changes in behavior, as a result of practice, being in a different environment.

Saying addiction is a disease suggests that the brain can no longer change…that it’s an end state. But no, it’s not end state.

Q: If addiction isn’t a disease, what is it?

A: First, I’m not saying that addiction is not a serious problem – clearly it can be for many people. In terms of brain change, you could say that neuroplasticity has a dark side. But rather than a disease, I would say that addiction is a habit that grows and perpetuates itself relatively quickly when we repeatedly pursue the same highly attractive goal. This results in new pathways being built in the brain, which is always the case with learning: new pathways are formed and older pathways are pruned or eradicated.

…rather than a disease, I would say that addiction is a habit that grows and perpetuates itself relatively quickly when we repeatedly pursue the same highly attractive goal.-MARC LEWIS

But with addiction, much of this rewiring is accelerated by the action of dopamine, a neurotransmitter released in response to highly compelling goals, creating an ever-tightening feedback loop of wanting, getting, and loss.

As the addiction grows, billions of new connections form in the brain. This network of connections supports a pattern of thinking and feeling, a strengthening belief, that taking this drug, ‘this thing,’ is going to make you feel better – despite plenty of evidence to the contrary.

It’s motivated repetition that gives rise to what I call “deep learning.” Addictive patterns grow more quickly and become more deeply entrenched than other, less rewarding habits. In general, brain changes naturally settle into brain habits – this is the case in all forms of learning. In addition, the habits are learned more deeply, locked in more tightly, and are bolstered by the weakening of other, incompatible habits, like playing with your pet or caring for your kids. [In the book, Lewis describes in detail how addiction changes the brain.]

Q: You note that the neurobiological mechanics of this process involve multiple brain regions, interlaced to form a web that holds the addiction in place and that gouges “deep ruts in the neural underpinnings of the self.”  Yet you go on to say that “brain change – even more extreme brain change – does not imply that something is wrong with the brain.” How can that be?

A: Such brain change may signify that by pursuing a single high-impact reward and letting other rewards fade, someone hasn’t been using his or her brain to its best advantage.

The notion that you never forget how to ride a bike reflects our recognition that normal habits can be deeply ingrained. Thus, deep ruts in the brain don’t make the brain damaged. And new ruts can be formed on top of or beside old ruts. For example, when you lose a relationship, the deep ruts are still there – they can cause pain and create barriers to a new relationship. But then you say, “Enough of that.” And with some effort, you meet a new person and the brain modifies itself, which it constantly does.

The notion that you never forget how to ride a bike reflects our recognition that normal habits can be deeply ingrained. Thus, deep ruts in the brain don’t make the brain damaged.-MARC LEWIS

Psychiatrist Norman Doidge, author of The Brain that Changes Itself reminds us of a classic remark by Alvaro Pascual-Leone, a renowned Harvard neuropsychologist: The brain is plastic, not elastic. It doesn’t just spring back to its former shape. Rather, like Play-Doh [before it hardens], it can continue to be modified from whatever shape it’s currently in.

Q: Why does “The Biology of Desire” assume importance over your subtitle, “Addiction is Not a Disease”?

A: Basically, most of our attention is committed to achieving the goal, not to the goal in and of itself – it’s all about the drive to get to the pot of gold at the end, not the pot itself.

Basically, most of our attention is committed to achieving the goal, not to the goal in and of itself – it’s all about the drive to get to the pot of gold at the end, not the pot itself.-MARC LEWIS

According to recent advances in addiction neuroscience, there is a “wanting” system (desire) that’s mostly independent of the “liking” system. “Wanting” is really what drives addictive behavior. In the book, I talk about eating pasta – before you eat it, your attention is converged on getting that food into your mouth. But once it’s there, your attention goes elsewhere; perhaps back to the people you’re dining with or the TV show you’re watching. How much attention you pay to the taste of that bite of food is a drop in the bucket compared with the amount you spent to get it to your mouth.

Desire and expectancy make up most of the experience. The “wanting” part of the brain, called the striatum, underlies different variations of desire (impulsivity, drive, compulsivity, craving) – and the striatum is very large, while pleasure itself (the endpoint) occupies a relatively small part of the brain. Addiction relies on the “wanting” system, so it’s got a lot of brain matter at its disposal.

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Patients Treated with Naloxone Continue to be at High Risk of Overdose: Study

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A new study finds 10 percent of people saved by the opioid overdose antidote naloxone die within a year of treatment.

“Patients who survive opioid overdoses are by no means ‘out of the woods,’” lead study author Scott Weiner, MD, Director of the Brigham Comprehensive Opioid Response and Education Program at Brigham and Women’s Hospital, said in a news release. “These patients continue to be at high-risk for overdose and should be connected with additional resources such as counseling, treatment and buprenorphine.”

The study, presented at the annual meeting of the American College of Emergency Physicians, found half of patients who died within a year of naloxone treatment died within one month of treatment, Health Day reports.

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President’s Commission on Opioid Crisis Calls for Nationwide System of Drug Courts

 

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President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report on Wednesday, calling for expanding drug courts into all 94 federal court jurisdictions. The commission also recommended easier access to alternatives to opioids to treat pain, The Washington Post reports.

Drug courts are specialized court programs that target criminal defendants and offenders, juvenile offenders, and parents with pending child welfare cases who have alcohol and other drug dependency problems.

The commission made more than 50 recommendations, including requiring doctors and others who prescribe opioids to demonstrate they have received training in safely providing the drugs before they can renew their licenses to handle controlled substances with the Drug Enforcement Administration.

Providers should be required to check prescription drug monitoring databases to ensure patients aren’t “doctor shopping” for prescription drugs, the commission said. In some states, use of the databases is voluntary, the article notes.

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The tide is FINALLY turning: Big Pharma billionaire ARRESTED, charged with CONSPIRACY & BRIBERY OF DOCTORS!

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I almost never thought I’d see the day when a Big Pharma founder and owner was finally arrested for running a criminal drug cartel, but that day has arrived.

“Federal authorities arrested the billionaire founder and owner of Insys Therapeutics Thursday on charges of bribing doctors and pain clinics into prescribing the company’s fentanyl product to their patients,” reports the Daily Caller News Foundation, one of the best sources of real journalism in America today.

Addictive drugs that include opioids, we now know, are claiming over 64,000 lives a year in the United States alone.

From the DCNF:

The Department of Justice (DOJ) charged John Kapoor, 74, and seven other current and former executives at the pharmaceutical company with racketeering for a leading a national conspiracy through bribery and fraud to coerce the illegal distribution of the company’s fentanyl spray, which is intended for use as a pain killer by cancer patients. The company’s stock prices fell more than 20 percent following the arrests, according to the New York Post.

Kapoor stepped down as the company’s CEO in January amid ongoing federal probes into their Subsys product, a pain-relieving spray that contains fentanyl, a highly-addictive synthetic opioid. Fentanyl is more than 50 times stronger than morphine, and ingesting just two milligrams is enough to cause an adult to fatally overdose.

The series of arrests came just hours after President Donald Trump officially declared the country’s opioid epidemic a national emergency. Drug overdoses led to 64,070 deaths in 2016, which is more than the amount of American lives lost in the entire Vietnam War.

As the opioid crisis has developed, more and more states have begun holding doctors and opioid manufacturers accountable for over-prescribing and over-producing the highly-addictive painkillers.

“We will be bringing some major lawsuits against people and companies that are hurting our people,” Trump said Thursday. He also spoke about a program similar to Nancy Reagan’s “Just Say No” initiative.

“More than 20,000 Americans died of synthetic opioid overdoses last year, and millions are addicted to opioids. And yet some medical professionals would rather take advantage of the addicts than try to help them,” Attorney General Jeff Sessions said in a statement. “This Justice Department will not tolerate this.  We will hold accountable anyone – from street dealers to corporate executives — who illegally contributes to this nationwide epidemic.  And under the leadership of President Trump, we are fully committed to defeating this threat to the American people.

President Trump is bringing the war to Big Pharma’s doorstep

Under President Trump, who continues to fight to end the drug cartels and health care monopolies that are destroying this nation, we may see more and more drug companies finally facing the legal scrutiny they deserve for engaging in the mass medical murder of Americans with dangerous, deadly drugs.

And then there’s the question of vaccines, the autism cover-up and the criminal racket run by the CDC, Big Pharma and the lying mainstream media. When that medical fraud and corruption scandal blows sky-high, we may see dozens of pharmaceutical officials going to prison.

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Trump declares opioid crisis a ‘public health emergency’. Fentanyl to come off the market ‘immediately’!

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Calling it a “national shame” and “human tragedy,” President Trump on Thursday declared the opioid epidemic crippling American communities a “public health emergency” and pledged federal resources to help combat the growing problem.

“Addressing it will require all of our effort, and it will require us to confront the crisis in all of its real complexity,” Trump said during a speech in the East Room of the White House.

“As Americans, we cannot allow this to continue,” Trump said. “It is time to liberate our communities from the scourge. … We can be the generation that ends the opioid epidemic.”

Trump spoke to an audience at the White House that included family members of those affected by the opioid crisis, as well as several administration officials and elected leaders.

The president, who said “not one part of American society has been spared” from the crisis, stopped short of calling it a national emergency, something he previously promised he’d do. The announcement follows months of debate on how to tackle the problem.

‘We can be the generation that ends the opioid epidemic.’

– President Trump

Trump himself has gone on record more than once saying he would declare the crisis a national emergency. Such a designation would allow states to tap into the same federal funds typically reserved for natural disasters like hurricanes through the Stafford Disaster Relief and Emergency Assistance Act.

Instead, Trump signed a presidential memo that directs acting Health and Human Services Secretary Eric Hargan to declare a public health emergency under the Public Health Services Act — which directs federal agencies to provide more grant money to combat the epidemic.

White House officials say the step helps cut through regulatory red tape and gives states more flexibility in how they use federal funds to fight the problem.

The designation will also allow changes such as expanded access to medical services in rural areas.

It doesn’t, however, create any additional funding.

The emergency declaration will last 90 days but can be renewed.

In 2015, 33,091 people died from opioid overdose, while 12.5 million people misused prescription opioids, according to the most recent statistics available from the Department of Health and Human Services.

The president on Thursday also revealed plans to take an “evil” opioid off the market immediately as well as the government’s intention to bring lawsuits against some of the drug makers, though he did not provide specifics. He also vowed to crack down on heroin imports from Mexico and fentanyl imports from China.

Pharmaceutical fentanyl is an opiate drug that’s up to 100 times more potent than morphine. In the past, drug dealers used it to spike the potency of the heroin they sold but traffickers are now selling fentanyl by itself.

Drug deaths involving fentanyl increased nearly 600 percent from 2014 to 2016, The Washington Post reported. There were 582 fatal overdoses linked to the synthetic drug in 2014. Last year, the number jumped to 3,946.

Trump also discussed the alcohol addiction that claimed his older brother Fred’s life in 1981.

“[Fred] had a problem with alcohol, and he would tell me, ‘Don’t drink, don’t drink,’” Trump said.

The president said watching his brother as well as other friends struggle with addiction is what set him on a no-drug, no-alcohol, no-cigarette path.

“There is nothing desirable about drugs,” Trump said. “They’re bad.”

Trump vowed to tackle the opioid crisis on the campaign trail, but critics claim his administration has been slow to act.

Trump created a presidential commission that in August recommended he declare the crisis a national emergency.

“Your declaration would empower your Cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life,” the Commission on Combating Drug Addiction and the Opioid Crisis wrote. “It would also awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will.”

However, White House officials told reporters Thursday morning that a national emergency declaration was not necessary in the case of opioids.

The public health emergency will “reorient all of the federal government and executive branch resources toward focusing on providing relief to this urgent need.”

Past instances of public health emergencies include the H1N1 influenza outbreak in 2009.

Since the commission released its report, Health and Human Services Secretary Tom Price has stepped down from his post while Trump’s pick for drug czar, Rep. Tom Marino, withdrew his nomination.

At an event at the Heritage Foundation earlier Thursday, Attorney General Jeff Sessions said it’s important to “reestablish the view that people should say no to drugs.”

“I do think this whole country needs to not be so lackadaisical about drugs,” he said. “Much of the addiction starts with marijuana. It is not a harmless drug.”

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My comment on the above is that the addiction liability begins with Big Pharma and the doctors who prescribe them for anything else but to relieve extreme pain during the last days of life.  At that time, they were being misused by doctors as well.  I am a nurse who worked during those times.  A doctor would verabally say to a nurse, “sleep him through”.  That meant to overdose him with so much morphine so as to end life.  No – I never honored those doctors’ orders because my job is to heal, not kill; however, most nurses did it.  I believe God is the One to decide when one dies.  So, throughout time, it’s the doctors who should be made to be accountable for their sins by holding them as murderers and drug dealers.  Do you have an opinion on that?


Recovering from prescription drug addiction (or any other addiction), please visit VictoryRetreatMontana.com to learn how you can fully recover and leave addiction as dust in the wind.

Lawmaker wants to legalize use of prescription painkillers for death sentences

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A state senator in Maryland is now calling for lethal injection to be reinstated in the state for certain crimes, and he wants to use the same drugs that are already killing thousands of Americans each year to get the job done: heroin and fentanyl.

Hartford Country Republican Senator Robert G. Cassilly would like to see lethal injection used for crimes such as serial murders, murders of witnesses or law enforcement officials, murders that take place during a sex offense or hate crime, and killing two or more people in a single incident.

He expressed his intention to ask the Maryland General Assembly to restore capital punishment during the legislative session next year; it was repealed in 2013 during the administration of Governor Martin O’Malley. The last execution in the state took place back in 1993.

His comments came just five days after a Maryland business park shooting saw three deaths and two injuries. The victims had been gunned down by a co-worker at the Advanced Granite Solutions office in Edgewood. The suspect then allegedly drove to Delaware, where he shot another individual. Radee Prince is being held on $2.1 million bond. He faces life in prison without parole for several first-degree murder charges.

Cassilly said: “There’s got to be a penalty that says, ‘Look, you’ve killed; now it can actually get a whole lot worse from this [if you re-offend] because we will hold your life over your head.”

He came up with the idea of using heroin and fentanyl in order to counter an argument commonly used by lethal injection opponents – that the process is painful.

“What we’ve seen is a mix of heroin and fentanyl obviously must not be too painful,” he said, “because we see people pumped up with [the antidote] Narcan on the verge of death, probably practically dead…they turn back around and they want to do [heroin and fentanyl] again.”

Senator Cassilly’s brother is State’s Attorney Joseph Cassilly, who believes that choosing these substances for lethal injections would also send a message to the population about just how deadly a combination it is and hopefully help deter people from taking these drugs and becoming yet another tragic statistic.

Opioids inhibit respiration by blocking the brain from signaling to the body to breathe; those who take higher doses of it essentially forget how to breathe. At 100 times stronger than heroin, just a few grains of fentanyl can kill somebody, and the growing trend of heroin laced with fentanyl has been a key driver of the opioid crisis in the U.S.

Nevada already planning a lethal injection with fentanyl

Last month, Nevada announced plans of its own to use fentanyl in lethal injections. Murderer Scott Raymond Dosier is set to be injected with fentanyl, Valium, and the muscle relaxant cisatracurium, which is related to curare. The injection will take place next month in what will be the state’s first execution in more than a decade.

States that have the death penalty have been having trouble sourcing drugs for executions in recent years, prompting them to turn to new combinations. Many pharmaceutical makers are opposed to having their drugs associated with executions due to concerns about their reputation – nevermind the fact that their drugs kill countless innocent people each year.

Sources include:

NaturalNews.com

Baltimore.CBSLocal.com

Patch.com

IBTimes.co.uk

TheDailyBeast.com


An final end to drug & alcohol recovery is as close as this website: VictoryRetreatMontana.com

How many opioid painkillers do surgery patients need? New prescribing recommendations unveiled

recovery_room25769053_mHow many prescription pain pills should a patient receive after breast cancer surgery? Or a hernia repair? Or a gallbladder removal?

With the country facing an epidemic of opioid pain medication abuse, the answer should be simple: Just enough to ease patients’ immediate post-surgery pain.

But surgical teams have lacked an evidence-based guide, or even rules of thumb, to help them prescribe powerful opioid pain medications wisely.

Until now.

A new tool developed at the University of Michigan is now available online for free use by any team that performs 11 common operations. It’s based on data and surveys from surgery patients across the state of Michigan, and on research by U-M researchers who study pain control and surgical quality.

The new Opioid Prescribing Recommendations for Surgery are just a start. The team behind them hopes to add more types of operations and medications to the list, and to refine the recommendations based on additional research into what patients actually use, and how providers can counsel them about safe opioid pain medication use.

The recommendations were created by the Michigan Opioid Prescribing and Engagement Network, in collaboration with the Michigan Surgical Quality Collaborative, both based at the U-M Institute for Healthcare Policy and Innovation.

“It’s embarrassing to admit this, but we’ve never had any evidence to inform how much opioid we prescribe to surgical patients. These recommendations provide a crucial first step for improving the safety of opioid prescribing,” says Jay Lee, M.D., a general surgery resident at Michigan Medicine, U-M’s academic medical center, who helped create the recommendations.

Grounded in evidence

Michigan-OPEN researchers have previously shown that when patients are prescribed fewer pills, they consume fewer pills with no changes in pain or satisfaction scores.

So, they focused their first prescribing recommendations on a range of common operations, from hysterectomy and colon surgery to appendectomy and breast biopsy. They give recommended numbers of pills to prescribe to patients who have never taken opioid painkillers before their operation.

Six percent of these “opioid naïve” patients were still taking opioid pain medications three to six months after their operations — long after their surgery pain should have eased, according to U-M research published earlier this year. That suggests problematic use that could lead to addiction to the medications or even to use of illicit drugs such as heroin.

The new guide aims to prevent this kind of new chronic opioid use by giving detailed amounts of hydrocodone, oxycodone, tramadol and codeine/acetaminophen in an easy-to-print chart.

The amounts aren’t arbitrary. They represent the actual maximum opioid use reported by three-quarters of actual surgery patients. Most patients actually took far less, from 0 to 5 pills, even when they were prescribed more by their surgeon or other provider.

Resources for providers and patients

Many of those patients had their operations at the 72 hospitals taking part in MSQC, which gathers and analyzes surgery-related data to help surgical teams find ways to improve and learn from others. Funded by Blue Cross Blue Shield of Michigan, and based at U-M, it provided a rich source of information about what patients were prescribed, what they used, and how they fared after surgery.

The new recommendations have already met with positive response among the surgical teams taking part in MSQC, who first received them earlier this month.

“They’re all very much aware of the crisis caused by overprescribing opioids, and have embraced these recommendations as an effective tool to begin addressing this problem,” says Lee. “These recommendations have tremendous potential for driving continued improvement. As counseling and pain management strategies improve, patients will use less opioid medication.”

The Michigan-OPEN team has also created a brochure about post-surgery opioid medication use that surgical teams can give to patients.

The website where the recommendations are posted also includes talking points about pain expectations and medication use to guide care team members.

“Reducing the number of pills we prescribe protects our patients as well as our community from the harms of opioid dependence, addiction, and overdose. We know it’ll take involvement of the community to help fix this problem,” says Joceline Vu, M.D., a surgical resident who worked on the recommendations with Lee and Michael Englesbe, M.D., a co-director of the Michigan-OPEN effort and surgery professor at U-M.

“Patients trust us when we prescribe opioids to treat pain after surgery,” Vu continues. “It’s our responsibility to teach them about the potential harms and how to dispose of opioids safely.”

Taking back the leftovers

Even if surgical teams adopt the new prescribing recommendations, patients will likely have pills left over. That’s why the Michigan-OPEN team has also developed a map that can help Michiganders locate a prescription drug drop-off location near them.

They’ve also created materials to help healthcare facilities hold prescription drug takeback events together with local law enforcement agencies. One such event, held in late September at eight sites around Michigan, collected 17,500 opioid pills — and tens of thousands of other medications that could be abused.

Find more information at: https://opioidprescribing.info/

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