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Opioid epidemic
Categories: Opiates

Attorneys general from over three dozen states are urging health insurers to review their coverage policies for pain treatment to help reduce the role that prescription painkillers continue to play in the deadly opioid epidemic. More than 40 Americans die each day from overdoses involving…

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Millions more are at risk of developing a dependency – in 2014 as many as 10 million people reported using opioids for non-medical reasons.
  • The economic toll of the epidemic is costing the U.S. economy an estimated $78.5 billion annually.
  • State and local governments alone spend nearly 8 billion dollars a year on criminal justice costs related to opioid abuse.
  • According to the CDC, opioid overdoses kill 91 Americans every single day, and more than half of those deaths involve prescription opioids.
  • The AGs emphasize how the “unnecessary over-prescription of opioid painkillers” significantly contributes to the problem:

    • Although the amount of pain reported by Americans has remained steady since 1999, prescriptions for opioid painkillers have nearly quadrupled over the same period.
    • The four-fold increase in prescriptions perfectly matches the four-fold increase in opioid overdose deaths during the same period.
    • A “dramatic increase in supply” has made it easy to obtain prescription opioids without having to resort to the black market.
    • Over 50 percent of people who misuse opioids report that they obtained them free from a friend or relative, while another 22 percent misused drugs that they obtained directly from a doctor.

    Illegal opioids like heroin remain a serious problem that must be addressed, the AGs say, but the role played by prescription opioids cannot be ignored.

    “Incentivizing” opioid alternatives

    “All else being equal,” the AG letter says, “providers will often favor those treatment options that are most likely to be compensated, either by the government, an insurance provider, or a patient paying out-of-pocket. Insurance companies thus are in a position to make a very positive impact in the way that providers treat patients with chronic pain.

    “When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective non-opioid alternatives, ranging from non-opioid medications (such as NSAIDs) to physical therapy, acupuncture, massage, and chiropractic care. Insurance companies can play an important role in reducing opioid prescriptions and making it easier for patients to access other forms of pain management treatment.

    Status quo unacceptable

    “In the near future, working in conjunction with other institutional stakeholders (such as State Insurance Commissioners), we hope to initiate a dialogue concerning your members’ incentive structures in an effort to identify those practices that are conducive to these efforts and those that are not. We hope that this process will highlight problematic policies and spur increased use of non-opioid pain management techniques. The status quo, in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable. We ask that you quickly initiate additional efforts so that you can play an important role in stopping further deaths,” the AGs said.

    Here at Novus, we are 100 percent behind any intelligent effort that can help reduce the proliferation of prescription opioids. Other, less risky treatment options do exist, and they should be encouraged.

    Categories: Opiates

    Speaking to a National Press Club Luncheon in Washington, D.C., recently, FDA Commissioner Dr. Scott Gottlieb said, "We've watched over a 10 or 15 year period this epidemic grow in proportion. And even as we've tried to take measures to intervene in various ways, the epidemic was always 5 steps…

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    withdraw Opana ER from the market, based on a new analysis of the risks associated with the drug’s illicit use. Opana ER, an extended release, tamper- or abuse-resistant formulation of the opioid oxymorphone hydrochloride, drove one the deadliest outbreaks of HIV/AIDS and Hepatitis C in a decade, along with overdose deaths, among addicts in Indiana.

    Studies showed that the formulation, when abused and injected, released an excipient that caused autoimmune phenomena that contributed to the alarming spread of disease associated with its abuse. The drug was also more prone to injection than other abuse-resistant formulas in use today.

    “I recently have seen media reports stating that Endo is participating in a re-launch of the old version of Opana ER,” Dr. Gottlieb said. “This is the version of that drug that Endo had previously withdrawn from the market when it launched its reformulated version of Opana – because that older version didn’t purport to have abuse deterrent features.”

    The Commissioner said he wouldn’t speak about regulatory intentions regarding specific drugs, but that the agency will “address oxymorphone products more generally.” He said a study already commissioned is looking at the possibility that oxymorphone “is more likely to be abused than other Schedule II opioids, including through illicit routes of administration such as snorting and injection.”

    “I’m announcing that study for the first time. If the scientific results of this study demonstrate that this ingredient has qualities that make it more likely to be abused, FDA would consider taking regulatory actions that could limit patient exposure to oxymorphone.”

    Novus is the best way to get your life back as painlessly as possible.

    Call to speak to one of our experienced & caring detox advisors today!

    Categories: Legal, Opiates

    Former White House 'Drug Czar' says more is needed to "make a significant impact on the trajectory of the worst health crisis of our time." After saying for months he would declare the opioid crisis a national emergency, which his own special commission has urged since July, President Donald J.…

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    Categories: Legal, Opiates

    It will take years of sustained, coordinated efforts to "contain and reverse" the prescription and illicit opioids epidemic, says a new, far-reaching report to the Food and Drug Administration from the National Academies of Sciences, Engineering, and Medicine. Contrary to current thinking,…

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    download a free PDF copy of Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use.

    Categories: Legal, Opiates

    A group of public health officials and doctors have filed a "Citizen Petition" with the Food and Drug Administration (FDA) asking the agency to remove ultra-high dosage unit (UHDU) opioid painkillers from the market. The petition specifically targets oral and transmucosal painkillers providing…

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    A study of nearly 90,000 pediatric patients, ages 13 to 21 years, has found that new, persistent opioid use following surgery “may represent a significant pathway to nonmedical opioid use among adolescents.” In fact, compared to a control group of non-drug-using, non-operative…

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    Physicians from lower-ranked medical schools prescribe nearly three times as many opioids per year as graduates from top-tier institutions, says a new study by two Princeton University economics professors. Clinical use of prescription opioids has quadrupled since 1999, almost exactly…

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    study was published as a working paper for discussion by the National Bureau of Economic Research (NBER), the largest economics research organization in the country.

    Striking relationship

    “Using data on all opioid prescriptions written by physicians from 2006 to 2014, we uncover a striking relationship between opioid prescribing and medical school rank,” wrote the paper’s authors, Janet Currie, PhD, and Molly Schnell, a PhD candidate. “Even within the same specialty and county of practice, physicians who completed their initial training at top medical schools write significantly fewer opioid prescriptions annually than physicians from lower ranked schools.”

    It’s unlikely that these differences in prescribing decisions were due to some sort of differences in the patients seen by doctors from higher- and lower-ranked schools. The study points out that the evidence was the same across geographic regions, across specialties, and even within the same hospitals.

    “The relationship between medical school rank and propensity to prescribe opioids persists even among specialists who attended different medical schools but practice in the exact same hospital or clinic-where patients can be assumed to be relatively homogenous in their need for opioids,” the study said.

    This additional evidence, they said, suggests “a causal effect of education rather than patient selection across physicians or physician selection across medical schools. Altering physician education may therefore be a useful policy tool in fighting the current epidemic.”

    Overall, physicians from Harvard wrote fewer than 100 opioid prescriptions a year, compared to physicians from the lowest-ranked schools who wrote 300 a year. But the most striking differences were found among general practitioners, who accounted for nearly half of all opioids prescribed during the study period.

    Harvard grad GPs wrote an average of 180 opioid prescriptions a year, while GPs from the lowest-ranked schools averaged 550 prescriptions a year.

    Meanwhile at Harvard…

    A year ago, the Obama White House asked medical schools “to sign a pledge” to require students to study new guidelines from the CDC for safe opioid prescribing before they graduate. According to a MedPage Today report, “of the nation’s 170-plus medical schools, 61 signed on.”

    Harvard Med was one of those that refused to make the “pledge” to implement the CDC guidelines, saying that safe opioid prescribing is already part of the curriculum. But a group of Harvard med students said they weren’t satisfied with their education on opioids. So a group of them organized additional training on better opioid prescribing practices and how to more effectively treat addiction using the opioid overdose reversal drug naloxone (trade name Narcan).

    MedPage said their efforts took place “amid a surge in deaths from opioid overdoses, which killed an estimated 28,000 people in the United States in 2014. And at least half of those deaths involved a drug prescribed by a doctor.”

    Take it to the next step

    The 61 schools that accepted the White House’s pledge to implement the CDC guidelines have begun enhancing their opioid training.

    The NBER study’s Molly Schnell told MedPage that if the CDC training turns out to be effective, and if her medical education research gets “sufficient attention,” she and others could start to examine medical education and training “on a more granular level.”

    “One thing we would love is to start working with medical schools to maybe know what they’ve been teaching and see if we can pinpoint which strategies are most effective,” Schnell said.

    Meanwhile, here at Novus we help patients get their lives back from opioid dependence every day. Our development of innovative opioid detox protocols shows we’re on board with improving treatment methodologies. We congratulate those enterprising, proactive Harvard students, and all the med schools, seeking to find better ways to make a difference.


    The state of New Hampshire has filed suit against OxyContin manufacturer Purdue Pharma for its alleged role in helping create the opioid epidemic afflicting the nation. New Hampshire, which President Donald Trump recently dubbed a “drug-infested den,” is number two in the country for opioid…

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    sued opioid distributors over its drug crisis, the first such case brought in a tribal court.

    Back in 2007, Purdue was fined $634 million by the federal government for charges related to its “misbranding” of OxyContin. At that time, it was the largest fine ever levied against an American corporation. Purdue also reached a $19.5 million settlement with 26 states and the District of Columbia. New Hampshire wasn’t among those states that benefitted from the Purdue settlement.

    Most recently, in 2015, the drugmaker agreed to pay $24 million to resolve a lawsuit by the state of Kentucky.

    “To defeat the epidemic, we must stop creating new users, and part of that is making sure these highly addictive and dangerous drugs are marketed truthfully and without deception and in such a way as not to minimize addiction risks or overstate benefits to patients,” said Ann Rice, the state’s Deputy Attorney General. “New Hampshire continues to experience a severe opioid epidemic. Last year alone nearly 500 overdose deaths occurred – almost ten times more than in 2000.”

    Purdue’s reply

    Purdue provided a response to the New Hampshire lawsuit in a statement to the media:

    “While we vigorously deny the allegations, we share New Hampshire officials’ concerns about the opioid crisis, and we are committed to working collaboratively to find solutions. OxyContin accounts for less than 2 percent of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone — all important components for combating the opioid crisis.”

    The rash of litigation related to the opioid epidemic may not be over. According to a June report, some 20 state attorneys general have announced their own investigations into the roles played by pharmaceutical companies involved in opioid manufacturing and distribution.

    If you or someone you care for is experiencing dependence or addiction to opioids, or any drugs or alcohol, don’t wait until it’s too late. Do something about it now. Call Novus today.

    Categories: Get Help, Overdose

    Let them die. Three strikes and you're out. This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who've already been saved twice before by the city's overworked paramedics. A third overdose? Just refuse to send the ambulance and paramedics.…

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    Let them die. Three strikes and you’re out.

    This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who’ve already been saved twice before by the city’s overworked paramedics.

    A third overdose? Just refuse to send the ambulance and paramedics. Period.

    Picard’s shocking idea was picked up by the news and went viral across America. It drew all kinds of fiery protests on social media from outraged people around the country.

    But Picard says he’s desperate. He says the city just can’t afford to keep racing ambulances and teams of paramedics to the scenes of overdoses, and injecting expensive doses of Narcan into overdose victims who they’ve already saved multiple times before.

    High cost with no apparent return

    The cost to the small city of 50,000 souls for the first half of this year is already on track to exceed $100,000 – just on Narcan alone. The city’s costs treating overdoses and deaths are way over last year. By mid-June, the city had already responded to 100 more overdoses than it did in all of 2016. And there’s already been 51 overdose deaths this year in the city while there were only 74 all last year.

    Not only that, only one of the hundreds of overdose victims treated repeatedly over the past year or two has agreed to seek drug treatment. Over and over again, victims wake up from the shot or two of Narcan that snaps them out of the opioid embrace of death, get up and just walk away.

    From the news clips, it looks like the cops and paramedics know all the repeat heroin abusers in the city by now. And it’s not a friendly scene. It’s dark, it’s serious and it’s depressing as hell.

    City Manager Doug Adkins says, “We can’t arrest our way out of this. I can’t keep it out of the city. It’s a Middletown problem. It’s a southwest Ohio problem. It’s an Ohio problem. It’s a national epidemic.”

    Once, twice, goodbye? Not quite.

    When Picard asked Adkins if there was a law that the city must respond to all calls for EMT, Adkins replied: “If we want to get out of the business, we have the right to get out of the business,” the suggestion being that the city could privatize emergency medical services and not be liable for the hundreds of rescues.

    But Picard wasn’t proposing an “instant death sentence” for three-time losers. In fact, he suggested a program that would allow overdose victims a chance to extend the city’s expensive life-saving services.

    Paramedics would respond only twice to the same overdose victim – a database would have to be built to ID and track victims. But now, victims would receive a summons to appear in court, and would be required to do community service after being treated.

    And if they don’t show up in court, or don’t complete the service, and then they overdose a third time? The hammer drops. Paramedics would not be dispatched.

    Will it ever happen?

    The fact is, even though Middletown may not be legally bound to respond to calls for emergency overdose treatments, it’s unlikely that such a rule will ever be adopted.

    According to a report in the Cincinnati Enquirer, city manager Adkins has ruled out the idea, partly because of all the negative attention it’s received. “This isn’t going to go anywhere,” he said. “Even if it was, I’m not sure I would want to face the lawsuits that could come from it.”

    As for Picard, his council term expires at the end of the year, so he’s not currying public favor for a re-election. After nearly eight years, and all the attacks he’s received in the social media, he’s had enough.

    “During the last four or five days, life has not been good,” he told the Enquirer.

    His Facebook page contains tons of comments “lambasting” him:

    • You are a disgrace to humanity! said one.
    • “Have fun in hell!” read another.
    • “It costs $0.00 to be a decent human being,” another post said.

    “My goal was not to stop treating overdoses, it was to solve a financial problem – not to stop the drug problem,” Picard told the Enquirer. “If we dispatch, then we have to treat. I have no problem with that.”

    Deserve every chance

    Fortunately, the city of Middletown, OH, has abandoned the 3-strikes idea. Perhaps the court intervention might be a workable idea, especially along with specific attention on helping victims coax their need to get clean into action for treatment and recovery.

    It’s been our experience here at Novus that people with addiction problems do possess the desire to recapture sobriety and get their lives back. It can be deeply buried, but with the right help, it finds its way from darkness into light.

    The secret, of course, is “the right help.”

    Categories: Opiates, Overdose

    In 1999, North and South Dakota were the only states in America with zero deaths from drug overdoses. America’s escalating prescription opioid epidemic had begun a few years earlier, and everywhere else in the country drug deaths were increasing. The highest drug overdose rates in the country…

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    incredibly powerful and deadly – 50 to 100 times more potent than morphine. As a result, scores of users are dying every day after shooting up or snorting these deadly mixtures.

    At Novus, our specialized medical opioid detoxification protocols are helping save lives every day, setting people back on the road to recovery.

    If you or someone you care for is at risk because of opioids, whether prescription or illicit, don’t wait – call Novus today. We’re here to help people get their lives back, and we can help you.

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