Tag Archives: opioids

Crackdown on painkillers amid addiction fears.

Two painkillers are to be reclassified as class C controlled substances amid concerns people are becoming addicted to them and misusing them.

The drugs – pregabalin and gabapentin – are also used for epilepsy and anxiety.

The move, announced by the Home Office, means it will now be illegal to posses the drugs without a prescription and it will be illegal to supply or sell them to others.

The government acted after experts said tighter controls were needed.

The Advisory Council on the Misuse of Drugs raised concerns about the drugs – amid reports of a rising number of fatalities being linked to the drug.

The law change will still mean the drugs are available for legitimate use on prescription, but there will be stronger controls in place.

What is Gabapentin – https://thedrugclassroom.com/video/gabapentin/

full story

Opioids: Why ‘dangerous’ drugs are still being used to treat pain – BBC

The widespread use of opioids to treat pain frequently prompts concerns about addiction and even deaths. So, why are these sometimes dangerous drugs still being given to patients?

Much stronger than many of the other options, opioids are among the world’s most commonly prescribed painkillers.

These drugs – including morphine, tramadol and fentanyl – are used to treat pain caused by everything from heart attacks to cancer.

But in the UK they were recently linked to the deaths of hundreds of elderly hospital patients, while the US is battling a well-documented opioid epidemic.

Why not just use other painkillers to avoid the risk of harm?

A worldwide problem

Opioids work by combining with receptors in the brain to reduce the sensation of pain – and they are highly effective.

However, opioid receptors are present in areas of the brain responsible for breath control and high doses can dangerously reduce the rate of breathing – the cause of almost all opioid deaths

full article on the BBC

Study Suggests Kratom Alkaloids Could Be Beneficial in Reducing Morphine Dependency

Kratom is a psychoactive drug that comes from the leaves of an Asian plant in the coffee family called Mitragyna speciosa. Users swear by it, saying it helps with opioid addiction. The U.S. Food and Drug Administration (FDA), however, calls it a dangerous opioid with no medical use. Scott Hemby, a professor of pharmaceutical science at High Point University in North Carolina, published a study in the journal Addiction Biology that concludes that the primary alkyloid in Kratom could have therapeutic benefits for treating opioid addiction. The two psychoactive ingredients are mitragynine (MG) and 7-hydroxymitragynine (7-HMG). In rats given the option of self-administering either of the drugs, they quickly did for HMG, but not MG.

This suggests that HMG is addictive, but MG is not, but it still affects the same receptors in the brain as opioids.

https://www.biospace.com/article/july-6-research-roundup-morphine-dependency-alzheimer-s-diabetes-migraine-and-more/

Crackdown on prescription opioids followed by increase in ‘dark web’ purchases, study finds

Illicit online opioid purchases surged after the government cracked down on prescription painkillers, a new study has found.

With the United States grappling with a metastasising opioid addiction crisis, the US Drug Enforcement Agency (DEA) in 2014 tightened restrictions around drugs containing hydrocodone. The change made it more difficult to obtain and refill prescriptions for the widely user painkiller.

Many of the people who have become addicted to opioids in recent years have first developed a dependency on the drugs after being legally prescribed painkillers. Law enforcement officials were seeking to dam that outlet to addiction.

full story

Misuse of opioids such as tramadol and fentanyl is ‘global epidemic’, report finds

The misuse of pharmaceutical opioids is fast becoming a “global epidemic”, with the largest quantities being seized in African countries for the second year in a row, according to a UN report.

While huge attention has been paid to the opioid crisis in the US – where the misuse of prescription drugs like fentanyl dominates – figures released by the United Nations Office on Drugs and Crime has revealed seizures in Africa of opioids now account for 87% of the global total.

Unlike in the US, the seizures – concentrated in west, central and north Africa – have largely consisted of the drug tramadol, followed by codeine.

The figures were disclosed in the latest UN world drug report, which noted that opioids were the most harmful global drug trend, accounting for 76% of deaths where drug-use disorders were implicated.The report said that while fentanyl and its analogues remain a problem in North America, tramadol – used to treat moderate and moderate-to-severe pain – has become a growing concern in parts of Africa and Asia.

The report added that the global seizure of pharmaceutical opioids in 2016 was 87 tonnes, roughly the same as the quantities of heroin impounded that year.

The figures on pharmaceutical opioids were rivalled by global cocaine manufacture, which the agency said had reached the highest level ever reported in 2016, with an estimated 1,410 tonnes produced.

Most of the world’s cocaine comes from Colombia, but the report also showed Africa and Asia emerging as cocaine trafficking and consumption hubs.

From 2016-17, global opium production also jumped by 65% to 10,500 tonnes, the highest estimate recorded by the agency since it started monitoring global opium production nearly 20 years ago.

“The findings of this year’s world drug report show that drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts,” said the UNODC’s executive director, Yury Fedotov.

“Non-medical use of prescription drugs has reached epidemic proportions in parts of the world,” he added. “The opioid crisis in North America is rightly getting attention, and the international community has taken action.

“However … the problems go far beyond the headlines. We need to raise the alarm about addiction to tramadol, rates of which are soaring in parts of Africa. Non-medical use of this opioid painkiller, which is not under international control, is also expanding in Asia. The impact on vulnerable populations is cause for serious concern, putting pressure on already strained healthcare systems.”

Despite the increase in availability and production, the report disclosed that the number of people worldwide using drugs at least once a year remained stable in 2016 at around 275 million people – or roughly 5.6% of the global population aged 15-64 years. Drug use among the older generation (aged 40 years and above) has been increasing at a faster rate than among those who are younger.

Despite that, global deaths directly caused by drugs use increased by 60% from 2000 to 2015, with mortality among people over the age of 50 increasing from 27% of these deaths in 2000 to 39% in 2015. About three-quarters of deaths from drug-use disorders among those aged 50 and older were among opioid users.

Read full article here: https://www.theguardian.com/global-development/2018/jun/27/misuse-opioids-tramadol-fentanyl-global-epidemic

How do we find and treat the ‘hidden cohort’ of patients dependent on opioid painkillers? 

ORAT – Opioid Risk Assessment Tool (ORAT)
‘People who are addicted to painkillers are a really complex group,’ says Jon Royle, chief executive of the Bridge Project. ‘You’ve got people who are prescribed painkillers and who are also using illicit drugs and have complex addiction issues. And you’ve got other people who were prescribed them to manage pain legitimately, so where the pain relief is required and where it has become an actual addiction problem is no longer clear cut.’ Among the patient group are those with complex emotional, psychological problems, who are taking anything to make themselves better, he explains. ‘So there are a lot of issues to work with when you get into this cohort.’

At the Bridge Project, based in Bradford, staff had experienced success in running a benzodiazepine withdrawal service for the past seven years, targeting patients in primary health care and GP practices.‘Doing that kind of work in primary care, we were also coming across a great deal of patients addicted to prescribed painkillers as well,’ says Royle. As with the benzos, ‘these patients are never going to roll up at an addiction treatment service on the high street – but that doesn’t mean that there’s not tens of thousands of them out there, people who’d say “I’ve never been near an illegal drug in my life”.’

So they decided to develop a model along similar lines to the benzodiazepine scheme, going into GP practices with the highest levels of prescribing and using the Opioid Risk Assessment Tool (ORAT) – which sits alongside the patient record system, Emis – to screen patients. They then worked with GPs to review the patients’ prescribing and liaised with specialist doctors and addiction practitioners to offer treatment, detoxification and support such as cognitive behavioural therapy (CBT). The response has been ‘really good, with far better outcomes than with opiate users’, says Royle – success he attributes to planting the service within primary care.

ORAT – Dependency detector

Prescription drug addiction: government launches investigation

Public Health England will review prescription of medicines including opioid painkillers

The government has ordered an investigation into the growing problem of addiction to prescription drugs such as painkillers and medicines to treat anxiety and insomnia.

Steve Brine, the public health minister, has acted after it emerged that one in 11 (8.9%) patients treated by the NHS in England last year was given a drug that can induce dependency.

Fears about excessive prescription has also been boosted more than 100% rise in the number of antidepressants prescribed in England over the last decade and the fact antidepressants prescribed in England over the last decade and the fact that prescription of addictive medicines has increased by 3% over the last five years.

Full story – https://www.theguardian.com/society/2018/jan/24/prescription-drug-addiction-government-launches-investigation

Drugs and driving: the law

It’s illegal to drive if either:

  • you’re unfit to do so because you’re on legal or illegal drugs
  • you have certain levels of illegal drugs in your blood (even if they haven’t affected your driving)

Legal drugs are prescription or over-the-counter medicines. If you’re taking them and not sure if you should drive, talk to your doctor, pharmacist or healthcare professional.

The police can stop you and make you do a ‘field impairment assessment’ if they think you’re on drugs. This is a series of tests, eg asking you to walk in a straight line. They can also use a roadside drug kit to screen for cannabis and cocaine.

If they think you’re unfit to drive because of taking drugs, you’ll be arrested and will have to take a blood or urine test at a police station.

You could be charged with a crime if the test shows you’ve taken drugs.

Prescription medicines

It’s illegal in England and Wales to drive with legal drugs in your body if it impairs your driving.

It’s an offence to drive if you have over the specified limits of certain drugs in your blood and you haven’t been prescribed them.

Talk to your doctor about whether you should drive if you’ve been prescribed any of the following drugs:

  • amphetamine, eg dexamphetamine or selegiline
  • clonazepam
  • diazepam
  • flunitrazepam
  • lorazepam
  • methadone
  • morphine or opiate and opioid-based drugs, eg codeine, tramadol or fentanyl
  • oxazepam
  • temazepam

You can drive after taking these drugs if:

  • you’ve been prescribed them and followed advice on how to take them by a healthcare professional
  • they aren’t causing you to be unfit to drive even if you’re above the specified limits

You could be prosecuted if you drive with certain levels of these drugs in your body and you haven’t been prescribed them.

The law doesn’t cover Northern Ireland and Scotland but you could still be arrested if you’re unfit to drive.

Penalties for drug driving

If you’re convicted of drug driving you’ll get:

  • a minimum 1 year driving ban
  • an unlimited fine
  • up to 6 months in prison
  • a criminal record

Your driving licence will also show you’ve been convicted for drug driving. This will last for 11 years.

The penalty for causing death by dangerous driving under the influence of drugs is a prison sentence of up to 14 years.

Other problems you could face

A conviction for drug driving also means:

  • your car insurance costs will increase significantly
  • if you drive for work, your employer will see your conviction on your licence
  • you may have trouble travelling to countries like the USA

( source: https://www.gov.uk/drug-driving-law )

NHS ‘creating drug addicts’ as figures show surge in prescriptions for powerful opioid painkillers

he number of prescriptions for powerful painkillers in England has nearly doubled in 10 years, it has been reported.

The surge in people taking opioids such as morphine has prompted doctors to warn that people are becoming addicted in greater numbers.

The family of drugs also includes codeine, tramadol and fentanyl, which is many times stronger.

According to the BBC, some 28.3 million opioids were prescribed by GPs in 2017, the equivalent of 2,700 packs an hour.

The figure is around 10 million more than the number of opioid prescriptions in 2007.

Opioids are prescribed to treat severe pain only after consultation with a GP or a pain specialist.

Full article – https://www.telegraph.co.uk/news/2018/03/16/nhs-creating-drug-addicts-figures-show-surge-prescriptions-powerful/