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Tuesday, October 21, 2014

CVS Fight Against Tobacco

If you happened to venture into a CVS pharmacy this fall, you may have noticed that something was missing at the checkout counter - cigarettes. In September, CVS stopped selling tobacco products, much to the dismay of many long time customers. CVS has taken their efforts one step further, now the company is pressuring other pharmacies to follow their lead, according to The Washington Post.

New rules issued by Caremark, the pharmacy benefits management arm of CVS, will require some customers to pay a $15 co-payment on prescriptions filled at non-CVS pharmacies that sell tobacco products. The new rules will have a two-fold effect, it will encourage customers to fill their prescriptions at CVS pharmacies and put a financial squeeze on other pharmacies in the Caremark network to stop selling tobacco products, according to the report.

“For clients who choose a tobacco-free network, plan members would be provided with a full list of participating pharmacies in advance of any network change,” CVS spokeswoman Carolyn Castel told the newspaper. “A tobacco-free network would include CVS/pharmacy and Target nationally as well as other local or regional pharmacies including numerous independent pharmacies that do not sell tobacco products.”

An unrestricted grant from CVS funded a study which found that 6 percent of customers that filled an asthma or COPD medicine, also made at least one cigarette purchase within the same week. The findings indicated that 5.1 percent of people taking high blood pressure medicines purchased tobacco products and 4.8 percent of those buying oral contraceptives.

The Caremark network includes more than 54,000 pharmacies; more than 20,000 of those are independent pharmacies.

Thursday, October 16, 2014

Prescription Drug Monitoring Programs

The battle against prescription drug abuse continues, with the closing of “pills mills,” limiting refills, and making it difficult to “doctor shop” through prescription drug monitoring programs (PDMPs); many wonder how successful the fight has been and whether or not doctors are taking advantage of PDMP’s? The Office of National Drug Control Policy (ONDCP) and the U.S. Centers for Disease Control and Prevention (CDC) advocate the use of prescription drug monitoring systems.

Researchers from Oregon Health and Sciences University surveyed doctors in Oregon who are registered to use their PDMP, in order to find out the differences between doctors who use the program and those who do not, according to NewsWise.

The survey randomly sampled 650 high frequency PDMP users, 650 low frequency users, and 2,000 non-users, from a database of more than 22,000 clinicians.

The research indicated that 95 percent of doctors registered say they consult the PDMP when they suspect a patient is abusing or diverting medication. Out the doctors registered, 54 percent of doctors reported that they made mental health or substance abuse referrals after consulting it, and 36 percent said they sometimes discharge patients from their practices as a result of PDMP use. Less than half of doctors check the PDMP for every new patient or every time they prescribe a controlled drug. Almost all doctors who use the program say they discuss worrisome data with patients.

Researchers point out that the registered users of the state’s database prescribed controlled substances more frequently than doctors who did not use the PDMP, according to the article.

“Clinicians reported frequent patient denial or anger and only occasional requests for help with drug dependence,” the researchers report in The Journal of Pain.

The findings are published in the peer-reviewed publication of the American Pain Society, The Journal of Pain.

Tuesday, October 14, 2014

Medical Groups Calling for Pregnant Women Drug Screening

The prescription opioid epidemic has had many victims, perhaps the most unfortunate victim being the unborn. In the United States, every hour, a baby is born showing symptoms of opioid withdrawal, according to a study published in the Journal of the American Medical Association (JAMA).

In an attempt to combat the growing number of babies born with neonatal abstinence syndrome (NAS), a number of medical groups are calling for verbal drug screening for pregnant women, followed by a urine test if necessary, USA Today reports.

Babies born with NAS show symptoms including:
  • Vomiting
  • Diarrhea
  • Seizures
  • Tremors
  • Low-grade fever
  • Constant high-pitched crying
Babies that are born premature with NAS may experience respiratory distress.

“When a child’s first days in this world are in agony, that certainly should be a concern to all of us,” Van Ingram, Executive Director of the Kentucky Office of Drug Control Policy, told the newspaper. “We need to do all we can to prevent this.”

States reporting a rise in babies born with NAS include:
  • Kentucky
  • Tennessee
  • Florida
  • Vermont
The universal screening of all pregnant women is also being called for by the American Medical Association and the Association of State and Territorial Health Officials, the article notes.

Thursday, October 9, 2014

Treating Substance Use Disorder and Mental Illness

Treating substance use disorders is a tall order due to the many factors that accompany the disease of addiction. It seems like more often than not people who seek help for addiction are also dealing with a co-occurring mental illness - most commonly depression, anxiety, and/or bi-polar disorders. Successful treatment and long term recovery rests on professionals addressing both the substance abuse and the mental illness.

 Health professionals often hold polarizing beliefs on which issue to address first. While treating both issues concurrently is optimal, that option is not always available. New research suggests that treating substance abuse issues in a person with severe mental illness will reduce the risk they will commit violent acts, reports HealthDay.

Researchers followed 278 patients closely over six month period after the participants were admitted into outpatient treatment program for substance abuse and mental illness.

“We were surprised to find that the severity of the patient’s psychiatric symptoms was not the primary factor in predicting later aggression. Rather, the patient’s substance abuse was the factor most closely associated with future aggression,” study co-author Clara Bradizza of the University at Buffalo Research Institute on Addictions said in a university news release.

“Our findings suggest that treatment attendance is very important for these individuals and treatment programs should include interventions that are likely to decrease substance abuse, as this may provide the additional benefit of reducing the risk of later aggression among dual-diagnosis patients,” Bradizza said.

Removing addictive substances from the mental health equation will always allow for more successful results when addressing any co-occurring disorder. Drugs and alcohol only serve to amplify mental illness’ like depression and anxiety.

The findings appear in the Journal of Substance Abuse Treatment.

Tuesday, October 7, 2014

Deadly Misconception: Prescription Opioids Less Dangerous Than Heroin

There exists a deadly misconception that prescription opioids, drugs like OxyContin (oxycodone) and Vicodin (hydrocodone), are less dangerous than illegal drugs because they come from a pharmacy. This is a grave miscalculation which has led to countless overdoses among many young adults who abuse prescription opioids. While prescription narcotics will always be dangerous, in many states there is access to the opioid overdose antidote drug naloxone which could save one’s life, provided the drugs are at hand.

A new study has found that many young adults who abuse prescription opioids are not prepared to deal with an overdose scenario, due to the common belief that prescription drugs are less dangerous than heroin, HealthDay reports. The findings come from interviews of 46 young adult New Yorkers that abuse prescription opioids, ages 18 to 32.

“What we found is that when it comes to how to handle an overdose, prescription opioid users who weren’t using drugs for official medical reasons were less savvy than, say, more traditional heroin-using populations,” study author David Frank of the CUNY Graduate Center in New York City told HealthDay. “In fact, they tend to have a pretty severe lack of knowledge and a lot of confusion about it, despite the fact that most have experienced overdoses within their drug-using network.”

Despite the fact that a large percentage of prescription opioid users wind up making the transition to heroin at some point, the study showed that many prescription opioid abusers who have yet to make the jump to heroin consider themselves to be very different from people who use heroin, Frank said.

Almost all the participants either knew someone who had overdosed on prescription opioids, or had overdosed themselves; yet the participants tended to believe:
  • Prescription painkillers are relatively harmless.
  • Prescription painkillers are less addictive than heroin.
  • Prescription painkillers are less likely to cause an overdose.
What’s more, the majority lacked basic knowledge regarding overdose prevention or what to do in the event of an overdose; sadly, most were unaware of the naloxone option, those that were aware of the drug believed that it was difficult to acquire or expensive. The researchers pointed out that in the state of New York naloxone is distributed freely at needle exchange programs and official harm reduction centers.

The study can be viewed in the International Journal of Drug Policy.