Mental Health Association of Portland

Oregon's independent and impartial mental health advocate

The price of addiction: A treatment primer for opioid dependence

Posted by CoffeeX3 on 9th October 2013

From the Portland Business Journal, October 9, 2013

There are a lot of unsung heroes working in the trenches in Portland to help those who have fallen into opiate dependence.

Alison Noice, director of addiction medicine treatment at CODA, is one of them. CODA is the oldest opioid addiction treatment program in Oregon, established in 1969 as part of a state effort to provide methadone treatment.

The clinic in Northeast Portland dispenses methadone to more than 400 people a day. CODA also has transitional housing, outpatient, residential, detoxification and recovery centers in Gresham and Tigard.

CODA's Alison Noice discusses treatments for opioid dependence.

CODA’s Alison Noice discusses treatments for opioid dependence.

[Portland Business Journal writer Elizabeth Hayes] sat down with her recently to ask some questions about treating opioid addiction, which is a huge public health issue in Portland and Oregon. The problem often starts with legitimate use of painkillers and then snowballs or even becomes heroin use.

Hayes: If someone is addicted to opioids, what are their treatment options?

Noice: Someone addicted to opioids could seek treatment in an opioid treatment program, in other words, a methadone clinic. They could receive buprenorphine (Suboxone) treatment either through a primary care physician or through an opioid treatment program. They could seek treatment in an outpatient setting that didn’t include medications. They could seek treatment in a residential setting. Really it’s about how severe is the dependence, what other needs does that person have, what’s their social functioning, what does their environment look like?

Hayes: Under what circumstances would you recommend inpatient?

Noice: You’re looking at the whole person. The person we recommend be in a residential treatment really has very little support internally or externally.

Hayes: Do opioid addicts typically go to a detox facility first?

Noice: Not if we’re going to put them on methadone or Suboxone. On the day we first give one of those to somebody, we expect them to be in withdrawal, so we ask that they not have used for 24 hours. But to be appropriate for the medication, this is somebody who has been using daily that generally still has opioids in their system. One thing that’s important to realize is that the cycle of craving and withdrawal is so very intense that treatments that don’t include medications are often less successful.

Hayes: How effective is abstinence treatment?

Noice: I would never recommend cold turkey. The research shows that straight detoxification, even medically supervised, without subsequent treatment is not effective.

Hayes: Why is that?

Noice: It’s the mechanism in the brain that drives the opioid dependence. The part of the brain that opioids affect is the part that drives some of our most basic functioning, our motivation, our pleasure — not just the happy kind. This is what gets you up in the morning and makes you put on your shoes. The body produces its own opioids, but when you start introducing opioids from outside of the body, it very quickly becomes dependent on this external source. The opioids have essentially hijacked your brain at that point.

Hayes: Can you explain what methadone is and how it works?

Noice: Methadone and Suboxone both are considered opioid replacement therapies. Essentially, the methadone is going to keep that person’s brain stable. When you introduce methadone into the system, it lasts for 36 hours, so that person can focus on living. It keeps the person out of that cycle, alleviates the cravings and suppresses symptoms of withdrawal. If they’re on methadone and use other opioids, there’s some amount of blocking. If you’ve got somebody who’s opioid dependent and you put them on methadone, they don’t get high.

Hayes: How regulated is the distribution?

Noice: It’s very regulated. The methadone bottles are connected to our dispensing machine, which is integrated into our electronic medical records, so we have a lot of regulation that governs how we bring methadone into the clinic, how we inventory it and track it. For us to treat somebody with methadone, they need evidence that they’ve been dependent on opioids for at least one year. They have to have tried other treatments and been unsuccessful. We’re expected to check all the methadone clinics within a hundred miles to see that the person isn’t enrolled somewhere else. We have to do a physical examination. It’s a very structured process. You start them on a low dose. You gradually build them up, so it can take up to a couple of weeks before we’ve stabilized them on methadone.

Hayes: Do they take it every day?

Noice: If not taken every day, you’re not going to get all the benefit from the methadone that you should.

Hayes: Is there any process to wean them off methadone? Is that the goal?

Noice: It depends very much on the person and their progress. When somebody’s been dependent on opioids for a long period of time, they have potentially done long term, if not permanent, damage to their brain. You often don’t know how much damage until you get them stable.

It’s better to get them on the medication and out of the dangerous behavior — the high-risk sex, the criminal activity, the injection drug use — and help them build a safe recovery network and then look at taking them off the medication. Some folks we can take off and they do great. For some folks, the symptoms of dependence return, so at that point, it makes more sense to keep them on than to put their life at risk.

Hayes: Do some patients have to be on it the rest of their lives?

Noice: Yes. Some studies say 60 to 85 percent of people return to opioid use off the medications. Part of it is the long-term changes to the brain always put people in a place where they’re more vulnerable to relapse.

Hayes: Do people ever overdose of methadone?

Noice: Overdose deaths associated with methadone are typically not from methadone that’s been prescribed by a methadone clinic.

Hayes: Where are they getting it?

Noice: It’s been diverted. Somebody decided to sell it instead of taking it or it got stolen. Part of the regulations are they have to have a locked box to keep it in and have a plan for where it stays in the home, so it’s away from children and nobody else has access to it.

Hayes: What percentage of your methadone clients are heroin addicts?

Noice: We pulled a six-month subset of admissions from 2012 and 78 percent of admissions were heroin and 22 percent were using pills. What’s exciting about where we are with treatment options is that there are actually three medications that are approved to treat opioid dependence. You have methadone, which we’ve had for more than 40 years, Suboxone and now there’s a new formulation of naltrexone, a 28-day injectable medication called Vivitrol, which is an opioid blocker. We’re not quite there in terms of everybody having the same access to all these medications.

Hayes: Why is that?

Noice: We’re approved to provide all those medications but they’re not all covered the same way.

Hayes: Are there disclosure requirements for people on methadone who are applying for job?

Noice: Not for the employer. If the employer is somebody who requires drug testing, typically that employer contracts out with a laboratory. So if somebody’s prescribed methadone, they should tell the laboratory that’s doing the test that they’re prescribed methadone. That information doesn’t get to the employer, it’s not relevant, they’re not required to disclose it. It’s a protected health condition.

Hayes: What would make the most impact in bringing down the opioid addiction rate in Portland?

Noice: If we could make all of these medications more available and more acceptable, I think we have the potential to have a very significant impact. There is clear evidence that all of these medications work for individuals who are opioid dependent. However, limited understanding, stigma and sometimes clear misinformation all contribute to these medications not being available in ways that will benefit the most individuals

Hayes: Is it hard to see these people going through this?

Noice: When you’re in the middle of it, the small successes can be grand, like that day somebody was confronted by their old dealer and they said no, that’s huge. It’s a very slow process, as you accumulate those moments until somebody has a solid recovery. Those smaller moments can sometimes be outweighed by when things go poorly. But there are so many opportunities for those small victories. When you see somebody come into treatment addicted to opioids and eventually is able to regain custody or their child or finish school or get a job, those are amazing things to see.

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Allied Health Service’s Medford methadone clinic new location opens with little fanfare

Posted by CoffeeX3 on 11th September 2013

From the Medford Mail Tribune, September 11, 2013

A methadone clinic that was forced to move from East Main Street has set up shop on Murphy Road, catching some residents by surprise.

Medford 9 11 2013“I did not know they had moved,” said Jessica Meza, who brought her 6-month-old son, Victor, to the pediatric clinic across the street. “I did know there were complaints at the old location.”

The clinic, run by Allied Health Service, serves 500 patients a day. It was forced to move because it was too close to a day care center, but Allied found a new home at 777 Murphy Road.

Eds. Note – Allied Health Services is a proxy of CRC Health Group, one of the largest national providers and promoters of methadone as a substitution therapy for heroin addiction and for chronic pain typically associated with end-stage cancer.

After a citizen complaint in 2012, city officials discovered that the clinic was within 1,000 feet of the Sunshine Day Care Center on Portland Avenue, a violation of Oregon Revised Statute 430.590.

Meza, a White City resident, said she has mixed feelings about the clinic’s location but didn’t think it would deter her from going to a pediatric clinic that she said provides great care.

“I’m not going to move my baby to a new doctor because they have moved across the street,” said Meza.

She said she’s got mixed feelings about methadone, saying some of her friends have taken it.

“Some of them just are doing it to get high,” Meza said.

On the other hand, many people might benefit from the medication, she said.

“I like to think most people are good,” she said.

Dr. Jim Shames, medical director of Jackson County Health and Human Services, said the new location should be less of a problem to the surrounding neighborhood.

“I think the fact the facility is so much bigger is already making a big difference,” he said.

At the new location, twice as many nurses dispense medications, including methadone and a newer drug known as buprenorphine.

As a result, patients don’t have a chance to loiter, Shames said.

Sidewalks lead directly from the bus stop to the clinic, and a security guard ensures that patients don’t hang around outside or cause problems.

“A lot of people’s worst fears are not going to come to fruition,” Shames said.

Most patients do not get a “high” feeling after taking the medication, which is designed to cut down on the craving for opiates, he said.

“Many patients say they finally feel normal,” Shames said.

Kim Sanderson, regional vice president of Allied, said in a prepared statement that the new location was necessary to continue to provide addiction treatment for the Medford area.

“We look forward to continued collaboration with our community partners to help those in need,” she said.

Several local residents said they were surprised to learn the clinic was in the neighborhood — in spite of media reports that publicized the impending move.

“I haven’t noticed any difference,” said Linda Gossman, a 67-year-old grandmother who was aware only that the clinic was planning to move nearby. “I just moved here in June, and I didn’t know at that time that they would be moving here. Had I known, I may not have moved here because of my grandbabies.”

Gossman said that despite her reservations, she understands that the treatment program is important.

Bettegay Damourakis walks around her neighborhood almost every day but didn’t realize the clinic had moved in and hasn’t noticed any of the patients.

“I haven’t even noticed it,” she said.

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Increased use of urine screenings leads to billion-dollar industry, kickbacks, possible rights violations

Posted by Jenny on 3rd August 2013

By Barry Meier, The New York Times, August 1, 2013

Specimen ContainerAs doctors try to ensure their patients do not abuse prescription drugs, they are relying more and more on sophisticated urine-screening tests to learn which drugs patients are taking and — just as important — which ones they’re not.

The result has been a boom in profits for diagnostic testing laboratories that offer the tests. In 2013, sales at such companies are expected to reach $2 billion, up from $800 million in 1990, according to the Frost & Sullivan consulting firm.

The growing use of urine tests has mirrored the rise in prescriptions for narcotic painkillers, or opioids. But the tests, like earlier efforts to monitor opioid prescribing, have led to a host of vexing questions about what doctors should do with the information they obtain, about the accuracy of urine screens and about whether some companies and doctors are financially exploiting the testing boom.

For one, the tests are showing that large numbers of pain patients are not taking prescribed drugs or are taking substances not given them by a doctor. For example, a recently published study of 800 pain patients treated at a Veterans Affairs facility in North Carolina found that one-quarter of them tested negatively in a urine-screen test for a drug they had been prescribed, while 20 percent of patients tested positively for an illicit drug or a narcotic painkiller that was not prescribed.

Such findings are in line with data recently released by Ameritox, one of the country’s biggest urine-screening laboratories. In reviewing some 500,000 tests it analyzed in 2012, the company said that about one-third of the tests failed to detect the drug prescribed by a doctor. In about 75 percent of those cases, the drug at issue was a narcotic painkiller, Ameritox said.

Pill bottle with white pills on Rx padThe simple fact that a patient tests negatively for a prescribed drug does not necessarily mean they are selling it; it could simply mean they decided to stop taking it. Still, doctors say they now face tough choices about what to do with patients when tests show they are not taking prescribed drugs or are mixing them with unapproved drugs or illegal ones.

For example, Dr. Roger Chou, who helped develop urine-screening guidelines for a professional medical group, the American Pain Society, said he believed that the tests were a valuable tool. But he added that he was concerned that doctors, to protect themselves, would use the tests as an excuse to drop, or “fire,” patients rather than steer them into addiction treatment or alternative pain management programs.

“I think that it is problematic from an ethical perspective,” for doctors to fire patients, said Dr. Chou, a professor at Oregon Health & Science University in Portland.

Another specialist, Dr. Daniel Alford, says he typically has a discussion with a patient to describe unexpected test findings and their relevance to pain treatment. For example, if an illicit drug is found, he will tell patients that the use of such a drug also means they are more likely to abuse the narcotic painkiller that he is prescribing them.

But such talks may have only limited success, and some patients continue to test positive for illicit drugs, said Dr. Alford, who is a professor at Boston University. He offers to help them get addiction treatment.

“Some of those patients drop out of the practice and some of them stick around,” he said.

Urine tests are by no means the first technique that doctors have used to try to better monitor how patients are using prescription narcotics. A decade ago, so-called pain contracts — agreements that essentially allowed a doctor to refuse to continue treating patients who tried to get opiods from other physicans — were popular.

The agreements, however, proved to be of limited value, so pain specialists turned to diagnostic questionnaires that were supposedly able to predict whether a patient was likely to abuse a narcotic because of factors like a family history of substance abuse. The predictive value of such questionnaires, however, is still not clear. One review found that 60 percent of patients who abused opioids scored low, rather than high, on one widely used screening questionnaire.

Girl holding urine sampleSubsequently, doctors have turned to urine tests. There are two basic types and they vary markedly in accuracy and cost.

The basic screen is known as qualitative test. Typically, a patient leaves a sample in a cup imbedded with sensitized strips designed to detect various classes of drugs like opioids, amphetamines, barbiturates and cocaine.

Such tests, however, have high rates of false positives, findings that a drug is present when it is not, and false negatives, findings that fail to detect a drug that is present. While the tests detect some drugs in a class, they may not detect others. In the case of narcotic painkillers, methadone and some other opioids are detected but oxycodone, the ingredient in OxyContin and Percocet, is not, experts said.

The use of qualitative tests has increased sharply in recent years as a growing number of states have passed laws requiring recipients of welfare and other types of public assistance to undergo drug screening. The American Civil Liberties Union has challenged such laws, saying they violate Constitutional protections against unreasonable search.

In the case of pain patients, suspect samples are subjected to a more sophisticated and costly kind of test known as a quantitative analysis. In it, precision techniques like mass spectrometry are used to detect the presence of drugs, said Jennifer Strickland, the director of clinical strategy for Millenium Laboratories, a major testing company.

The simpler qualitative tests are considered fairly easy to beat, but sophisticated drug abusers can also fool quantitative tests as well. To fool a doctor, a patient might need to take a prescribed drug for only a day or two before a test for it to show up in a screen, Ms. Strickland said. The patient could have sold the rest of the prescription.

“There is a lot of information out there,” about how to try to beat tests, she said, referring to several Web sites.

The annual costs of running regular quantitative tests to monitor a pain patient can run into the thousands of dollars. And with big money at stake, the growth of the urine screening industry has also opened the door to charges of illegal profiteering and other questionable activities.

cash-kickbackIn 2010, for example, Ameritox agreed to pay $16.4 million to settle charges that it had paid kickbacks to physicians who sent tests to laboratories. And last year, another testing company, Calloway Laboratories, paid $20 million to resolve claims brought by the State of Massachusetts that it funneled cash to operators of drug treatment facilities in exchange for test work.

Millennium Laboratories is under federal investigation, Reuters reported. The company said it was cooperating with the inquiry. Meanwhile, other urine-testing companies are aggressively marketing their services to physicians by trumpeting the big profits that await if they test their patients.

For example, a brochure distributed by one testing company, Liberty Diagnostics of Pasadena, Calif., declares that doctors can “Average $400 Profit per Screen” with “No Additional Overhead” like added staff or equipment. The brochure, which was obtained by The New York Times, also has a chart titled “Potential Profit Payout to Doctor” that states that doctors who perform 10 urine screens a week can make $155,000 annually from the tests plus an additional $133,000 for reviewing the results and discussing them with patients.

In a telephone interview, an executive of Liberty Diagnostics, Timothy P. O’Brien, declined to discuss the brochure and would not confirm its authenticity. A former sales representative for the company, after hearing a reporter’s description of the brochure, said it was genuine.

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Methadone becoming a big killer

Posted by CoffeeX3 on 11th December 2011

From the McMinnville News Register, June 4 2011

Last year, a single prescription drug killed 101 people in Oregon.

Karen Gunson, MD

Karen Gunson, MD

No, it wasn’t the narcotic opiate oxycodone, dispensed primarily under the brand name OxyContin, or its cousin hydrocodone, under the brand name Vicodin. It was methadone, distributed under an array of little-known brand names.

A pure synthetic, methadone is best known for its use in getting addicts off heroin. While equally addictive, it doesn’t provide the euphoric high, so helps facilitate a more manageable two-stage withdrawal.

However, methadone has come into painkilling vogue of late as a cheaper alternative to semi-synthetics like oxycodone and hydrocodone.

According to records kept by the U.S. Drug Enforcement Administration, the amount of methadone distributed in Oregon grew 23-fold between 1997 and 2006, the most recent year for which records were immediately available. It has, in fact. quietly become the most-prescribed narcotic opiate in some parts of the state.

As a result, according to State Medical Examiner Karen Gunson, a robust black market has developed.

Ironically, Gunson said addicts are prone to overdosing on methadone because of the very quality that makes it useful in the treatment of heroin addicts. Users looking for a high tend to load up until they get it, and with methadone, that can easily prove fatal.

She said it is often mixed with other drugs as well, as addicts tend to take virtually any pills they can get. And because it lacks a pronounced high, it’s harder for them to tell how much they have ingested.

Just three years ago, Oregon logged 131 deaths by methadone overdose, so the 101 recorded last year actually represents an improvement, she said.

However, the legally prescribed painkiller still caused more deaths last year than heroin (90) or cocaine (20), and almost as many as methamphetamine (106, up from 87), according to records compiled by the state Medical Examiner’s Office.

Like heroin, falsely billed originally as a less addictive alternative to morphine, oxycodone, hydrocodone and methadone are all narcotic opiates.

While methamphetamine and cocaine are potent central nervous system stimulants, the opiates are powerful central nervous system depressants. That puts users at greater risk for a fatal overdose, particular when cutting and mixing in the street trade makes dosage determinations very difficult.

Methadone originally gained cachet for its use in helping heroin addicts kick the habit. The idea was for addicts to overcome the psychological craving first by switching to methadone, then begin to beat the physical craving gradually by tapering the dosage over time.

Some addicts succeed in achieving step one, but not step two. They continue taking methadone on a permanent basis, as a means of keeping off the more dangerous and expensive heroin and avoiding the criminal lifestyle typically accompanying it.

As a result, methadone clinics have sprung up in big cities across the country, including Portland. They dispense methadone as a pink liquid that must be drunk on the premises, in prescribed dosages and under direct supervision.

However, doctors around the state aren’t prescribing methadone in liquid form for people battling an addiction. They are prescribing it in pill form for people either suffering from chronic pain or successfully mimicking the symptoms.

Because it requires no natural ingredient, methadone is much cheaper than oxycodone. Gunson said that makes it popular with both patients and insurance companies, and thus with prescribing physicians.

According to DEA statistics, painkillers have become a popular prescription all-around. In 1997, Oregon’s pharmacies and hospitals received about 9,000 grams of methadone, 57,800 grams of oxycodone and 134,000 grams of hydrocodone.

Nine years later, in 2006, Oregon received about 218,000 grams of methadone, 616,000 grams of oxycodone and 387,000 grams of hydrocodone.

Although the state used less methadone than either oxycodone or hydrocodone, its distribution grew 23 times, compared to nine times and twice for the other two, respectively.

And in 2006, five years ago, methadone distribution had nearly caught up with hydrocodone. It could very well have passed hydrocodone in those five years, but the DEA doesn’t provide data that current.

Gunson said doctors often prescribe hundreds of methadone pills to a single patient on a single visit, expecting the supply to tide him over for months. But she said a goodly share of those pills get diverted into the street trade.

The trend toward higher rates of methadone overdose isn’t exclusive to Oregon. According to a 2006 study by the Centers for Disease Control and Prevention in Atlanta, methadone overdose have become a national problem.

The agency said the nation logged 3,849 methadone overdoses in 2004, representing a 390 percent increase in just five years.

In 1999, only 4 percent of poisoning deaths were attributed to methadone. By 2004, the figure had climbed to 13 percent.

Between 73 and 79 percent were determined to be accidental and 5 to 7 percent suicidal, the agency said. It said a determination could be made in most of the remaining cases, though a few were classified as homicidal.

According to the agency, Oregon experienced a 14-fold increase in methadone overdoses during the five-year study period. Only two state’s showed a higher rate – West Virginia and Kentucky.

Methadone’s two narcotic opiate cousins also exacted a significant toll last year in Oregon. Oxycodone was responsible for 59 deaths and hydrocodone for 30.

Together, oxycodone and hydrocodone killed almost as many people as heroin and far more than cocaine. Adding the methadone deaths gives the prescription opiates a combined death toll of 190. That almost matches the combined death toll of 200 for methamphetamine, heroin, cocaine and other drugs not available by prescription.

The medical examiner’s office didn’t break the prescription drug deaths down by county, only the street drug deaths. Yamhill County logged five of those last year, losing one resident to heroin, one to cocaine and three to methamphetamine.

Sheriff’s Sgt. Chris Ray, who heads the Yamhill County Interagency Narcotics Team, said the county has a thriving black market for prescription narcotics. However, he said relatively high prices – OxyContin can command as much a $100 a pill on the street – is fueling growing use of heroin as a cheaper alternative.

Gunson said the same market force is leading addicts to methadone. She said it sells legally for less than a $1 a pill, enabling a street selling to add a major markup and still undercut the price of OxyContin.

A change in the OxyContin manufacturing process is also fueling the trend toward heroin and methadone.

Previously, the drug’s time-release control could be short-circuited by crushing the pills, giving the user the instant high he was seeking. But that’s no longer the case.

Gunson serves on the state Board of Medical Examiners, which has long urged doctors to dole narcotics out in smaller quantities, even though doing so forces the patient to make more trips to the pharmacy for re-fills.

But she said the board has seen little improvement, particularly in rural Oregon, where the problem is most prevalent.

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Painkiller Overuse: Addicted Newborns, Oregon’s High Rate of Abuse, Roots of the Epidemic, & Criminals Profiting

Posted by CoffeeX3 on 16th November 2011

By Joe Rojas-Burke, The Oregonian, Monday, November 14, 2011

The epidemic of prescription painkiller overuse has led to a rising number of infants born with an opioid drug dependence. Prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of almost 15,000 people in 2008, including actor Heath Ledger. That's more than three times the 4,000 deaths from the painkillers 1999. (AP Photo/Sue Ogrocki)

The epidemic of prescription painkiller overuse has led to a rising number of infants born with an opioid drug dependence. Prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of almost 15,000 people in 2008, including actor Heath Ledger. That's more than three times the 4,000 deaths from the painkillers 1999. (AP Photo/Sue Ogrocki)

The epidemic of prescription painkiller overuse has led to a rising number of infants born with an opioid drug dependence. USA Today reports:

“National statistics on the number of babies who go through withdrawal are not available, and states with the worst problems have only begun to collect data. Scattered reports show the number of addicted newborns has doubled, tripled or more over the past decade. In Florida, the epicenter of the illicit prescription drug trade, the number of babies with withdrawal syndrome soared from 354 in 2006 to 1,374 in 2010, according to the Florida Agency for Health Care Administration.”

Oregon’s rate of use of opiates without a prescription is the second highest in the U.S. after Oklahoma. A recent federal study suggests that Oregon doctors’ greater willingness to prescribe opioid pain relievers may partly explain the state’s exceptionally high rate of abuse. It found that rates of use without a prescription ranged from lows of 3.6 percent in Nebraska and Iowa, to highs of 6.8 percent in Oregon and 8.1 percent in Oklahoma. Legal sales ranged from less than 4 kilograms per 10,000 people in Illinois to more than 11 kilograms in Oregon, Tennessee, Nevada and Florida.

States where doctors prescribed the largest amounts of opioid drugs tended to have the highest rates of abuse and overdose deaths. Oregon, despite its high rate of abuse, defied the pattern for overdose deaths. The state’s rate of 11.7 opioid overdose deaths per 100,000 people is not significantly different from the national average. Researchers collected data from a national registry of death records, a national survey on drug use, and lawful sales of prescription opioids tracked by the Drug Enforcement Administration.

Several factors have contributed to the rise in opioid prescribing – including a justifiable desire to improve the lives of people struggling with severe pain problems, as explained in this 2009 news report by The Oregonian:

“After World War II, intense federal scrutiny made doctors wary of prescribing the narcotics. Probably too afraid: In the 1990s, a general sense grew that doctors didn’t pay enough attention to relieving their patients’ pain, which prevented many people from working or living normal lives. A pain-management movement encouraged wider opioid use.

“‘Five to 10 years ago, the thought was that the problem was really a lack of access to these drugs,’ said Dr. Brett Stacey of the Comprehensive Pain Center at Oregon Health & Science University.

“Meanwhile, new kinds of pain drugs were being made, such as OxyContin, a pill so powerful and so often abused it won the nickname ‘hillbilly heroin.’ Drug companies making these new pills encouraged the pain-management movement, fueling sales, Ballantyne said. The global production of oxycodone, the main drug in OxyContin, shot from 11.5 tons in 1998 to 75.2 tons in 2007, according to the International Narcotics Control Board. Four-fifths of those pills were consumed in the United States.”

Public health authorities say that medical caregivers have helped fuel the overuse and outright abuse of opioids by prescribing them too freely and with too little monitoring of patients. With great public demand for opioids, criminal drug dealers are getting in on the profits. Earlier this year, a former Multnomah County pharmacy technician was accused of tampering with drug records and fraudulently stealing up to 23,000 oxycodone pills from several county-run pharmacies. In March, fifteen men and women were charged in Portland’s U.S. District Court for their roles in the distribution of oxycodone since 2008. The indictment accused them of taking part in an interstate drug-trafficking conspiracy that laundered proceeds of more than $1.7 million through bank accounts in Oregon, Florida, Nevada and New York.

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Methadone – Boon or Menace?

Posted by CoffeeX3 on 3rd July 1949

From the Oregonian, July 3 1949. Not available elsewhere online.

READ – Methadone – Boon or Menace? (PDF); from The American Weekly and syndicated in The Oregonian.

Methadone - Boon or Menace?

Methadone - Boon or Menace?

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