Insurance restrictions cut opioid prescriptions

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Opioid prescriptions are helping fuel an epidemic of addiction. (Image via frankieleon)

A new report by the Centers for Disease Control and Prevention suggests changes by insurance companies can make a dramatic difference in how many people receive potentially risky prescriptions for opioids that are helping fuel America’s heroin epidemic.

The prescription drugs, typically given for pain relief, can lead to dependence. Some people addicted to the pills switch over to other drugs like street heroin, which is becoming increasingly deadly. The problem runs deep: “In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids,” the CDC said.

The CDC report covers data in Massachusetts, where accidental opioid-related overdose deaths increased 45 percent in a year.

Blue Cross Blue Shield of Massachusetts put in restrictions that require doctors and patients both to sign off on a risk assessment; someone must also get pre-approval by the insurance company before getting the drugs. Quantity limits also bar first-time users from getting months-long supplies.

In the end, prescribing rate for all opioids decreased 14.7 percent, which doesn’t sound dramatic. The CDC said the average monthly number of prescriptions dropped by 14,000. What does that actually mean?

“Overall, the estimated quantity of opioids dispensed before and after implementation of the program indicate that approximately 21 million fewer opioid doses were dispensed in the first 3 years after implementation.”

The CDC recommends that opioids should not be the first-line therapy for chronic pain, and initial prescriptions should have limited quantities. The U.S. Surgeon General is also pushing to reduce opioid prescriptions.

Blue Cross also kept tramadol out of the program. Tramadol is thought to have a lower abuse potential than some other opioids. The data doesn’t suggest that tramadol was regularly substituted for the other other opioids, however. And the study doesn’t look at “how patient pain and function were affected by limiting access to opioid prescriptions.”

DEA reverses plan to outlaw Kratom

kratom2aAfter a barrage of complaints, the Drug Enforcement Administration filed notice this morning that it will reverse its controversial decision to outlaw Kratom – a plant abused for its opioid-like effects but now showing promise in treating opioid withdrawal symptoms.

According to a notice filed in the Federal Register on Wednesday, the DEA “has received numerous comments from members of the public challenging” its decision to outlaw two drugs found in Kratom.

On Aug. 30 the agency filed notice in the Federal Register that it intended to place kratom’s active ingredients, which are opioids on Schedule I, a list of drugs such as heroin that have no accepted medical and have a high potential for abuse.

Among those questioning DEA’s swift decision to outlaw the drug were 51 members of Congress who signed a letter to DEA acting Administrator Charles Rosenberg asking the agency to “engage consumers, researchers, and other stakeholders, in keeping with well-established protocol for such matters.” The DEA moved quickly, giving people only 30 days to weigh in on the ban.

Kratom is derived from a tree grown in Southeast Asia. It has become increasingly marketed and sold to recreational drug users as an alternative to controlled substances. Kratom is legal but is on the DEA’s “drugs of concern” list.

Law enforcement has seized kratom in various forms, including powder, plant, capsules, tablets, liquid, gum/resin and drug patch. Because the identity and purity levels are uncertain and inconsistent, “they pose significant health risk to users,” according to a DEA news release announcing the intention to ban kratom.

However, research financed by the National Institutes of Health at the University of Mississippi and University of Massachusetts found that a kratom extract, mitragynine, could be useful in treating opioid withdrawal.

In 2010 the schools applied for a patent. According to the patent application, “the present invention contemplates that kratom extract may also be useful for the treatment of other addictive drugs besides opiate derivatives.”

In the letter sent by lawmakers to the DEA, outlawing kratom “will put a halt on federally funded research and innovation surrounding the treatment of individuals suffering from opioid and other addictions — a significant health threat.”

The ban proposed by DEA would sunset after two years and the agency could downgrade kratom to less restrictive Schedule 3 to 5 — drugs that are less addictive and have some medical use.

The DEA will accept comment from the public until Dec. 1. During that time the Food and Drug Administration will conduct a scientific and medical evaluation of Kratom.

Linda Mautner, who blames her son Ian’s suicide in July 2014 on addiction to kratom, said she was not discouraged by the DEA’s action on Wednesday. Mautner,  who established a foundation to help addicts and alcoholics in early recovery, said she is “all for research.”

“A waiting period is good,” Mautner said. “If they (DEA) are going to get this nailed down, they certainly need to review all sides.”

 

 

Want the secret recipe for powdered alcohol? It’s for sale

The secret manufacturing process for Palcohol, the controversial just-add-water adult beverage, is being auctioned off to the highest bidder in 128 countries.cocktail-2

Palcohol’s creators announced the auction in an email on Monday – 12 days after California became the 34th state to ban the product before the first single-serve pouch hit the shelves..

“Instead of manufacturing and distributing Palcohol ourselves, we have decided to auction off the secret manufacturing process to the highest bidder in each country,” according to the email announcing the auction. “”We’re doing that because individuals/companies in each country have a much better understand of the liquor laws and distribution channels for that country.”

Creator Mark Phillips thought he had invented an ingenious way to make alcohol more portable and accessible by decreasing its size and weight. But lawmakers around the country rebelled, claiming it would increase alcohol abuse. Continue reading “Want the secret recipe for powdered alcohol? It’s for sale”