Let’s take a quick trip back to the 1990s. That’s when it all started.

Opioid prescription numbers were beginning to climb. And they didn’t slow down. Over the next two decades more and more doctors filled their prescription pads with painkillers.

By 2012, opioids were being dispensed at a rate of 81.3 prescriptions per 100 people. That year, doctors wrote more than 225 million opioid prescriptions.

By then, we were seeing alarming numbers of overdose deaths. We were in the middle of an opioid epidemic. We realized something needed to change.

And something did.

Doctors and officials saw the numbers climbing. They increased awareness and put new policies in  place. The rate started to decline. From 2012 to 2020, it continued to drop. By 2020, the opioid dispensing rate was the lowest it had been during that time period, at 43.3 prescriptions per 100 persons. This made a total of 142 million prescriptions that year.

As opioid prescribing falls, where does that leave us?

So…Where Are We Now?

The latest numbers show the rate is still dropping – but not evenly. A recent study by RAND Corp. found that opioid prescriptions dispensed by pharmacies declined by 21 percent from 2008 to 2018.

And the American Medical Association (AMA) reports that opioid prescribing nationwide has dropped a total of 44.4 percent in the years 2011 to 2020. This includes a 6.9 percent drop from 2019 to 2020.

If we’re hoping to turn the tide on the opioid epidemic, this means we’re on the right track – right? Maybe so. But the RAND study also discovered that these decreases have some interesting trends.

The rates aren’t dropping evenly across the nation. They noticed variances based on:

• The types of prescribers
• The types of patients
• The geographic area

Bradley D. Stein, PhD, MD, MPH, a senior physician researcher, admitted:

“The findings do not provide concrete answers about how much of the unnecessary prescribing of opioids has been eliminated. But…there is a lot more nuance in the changes in opioid prescribing than we previously understood.”

Here are some of the nuances researchers discovered:

• The volume of MME (morphine milligram equivalents) prescribed per capita declined the most in metropolitan counties and in counties with higher rates of fatal opioid overdoses.
• In some states, MME volume increased in multiple counties.
• In other states, some counties saw increased prescribing while other counties had decreases – and sometimes these counties were right next to each other.
• The greatest reductions seen in clinical specialties were among adult primary care physicians (a 40 percent decline).
• The biggest drop in opioid prescriptions written was among emergency physicians (a whopping 71 percent).

The CDC also reports that the 2020 numbers show dispensing rates remain high in certain areas. They found that in 3.6 percent of US counties there were enough opioid prescriptions dispensed for every person to have one.

And, while the overall rate had dropped to 43.3 prescriptions per 100 people by 2020, some counties still had rates nine times higher than that.

The bottom line: Opioid dispensing rates haven’t dropped everywhere. The numbers vary widely across the country. And some hotspots don’t seem to be slowing down.

As Opioid Prescribing Falls, What Does All This Mean?

The overall decrease seems to suggest things are headed in a positive direction. But it’s clear that some areas and populations remain at higher risk. And the AMA makes an important point about this.

Even with the decreased prescription rate, the nation’s overdose and death epidemic continues to worsen. In the 12-month period ending April 2021, there were 75,673 overdose deaths from opioids – up roughly 35 percent from the year before.

AMA President Gerald E. Harmon, MD noted:

“The nation’s drug overdose and death epidemic has never just been about prescription opioids. Physicians have become more cautious about prescribing opioids, are trained to treat opioid use disorder and support evidence-based harm reduction strategies. We use Prescription Drug Monitoring Programs as a tool, but they are not a panacea. Patients need policymakers, health insurance plans, national pharmacy chains and other stakeholders to change their focus and help us remove barriers to evidence-based care.”

“The medical community will continue to play its part,” he added. “And overall, the focus of our national efforts must shift. Until further action is taken, we are doing a great injustice to our patients with pain, those with a mental illness, and those with a substance use disorder.”

As opioid prescribing falls, there’s still so much work to be done.

For information about treatment options for you or a loved one, call 800-934-1582(Sponsored) today.

Images Courtesy of Canva.

Did you know?

• IV drug use puts people at a much higher risk of overdose.
• People who inject drugs are at a higher risk of HIV, tuberculosis, and viral hepatitis.
• IV drug use increases the risk of addiction and the need for individualized treatment.

Why the danger? What makes IV drug use so hazardous? And why is it that—despite the researched dangers—an estimated 11 million people worldwide inject drugs?

Why is IV Drug Use Different?

During IV drug use, a syringe is used to inject a substance directly into the bloodstream. This method bypasses the body’s protective systems. The kidneys, liver, and digestive tract are all designed to dilute and metabolize substances as they pass through. But they can’t do their job if substances go around them.

While this might sound appealing to someone looking for a “bigger” high, it comes with an even bigger risk: overdose.

Which Drugs Are Commonly Injected?

Heroin is the most commonly injected drug. Others include:

• Amphetamines
• Buprenorphine
• Barbiturates
• Benzodiazepines
• Cocaine
• Methamphetamine
• Opioid painkillers

7 Common Dangers of IV Drug Use

All of the drugs mentioned above pose extreme danger when injected and can lead to fatal overdose. But the risks don’t end there.

Let’s take a look at some of the dangers often associated with IV drug use.

Addiction

IV drug use increases the risk of developing physical and psychological addiction.

• Physical Dependence: Tolerance occurs when the body becomes dependent on a drug; you have to take more and more of that substance to achieve the same effects.
• Psychological Dependence: Feeling like you can’t normally function without the use of a drug is a common symptom of psychological dependency. You experience withdrawal symptoms when you stop using it or use less.
• Addiction: While dependence and tolerance are both unique, they often contribute to the development of addiction.

Wound Botulism

The illness wound botulism is caused by a germ that can get into the skin during IV drug use. This toxin attacks the body’s nerves. It causes breathing difficulties and muscle weakness. If wound botulism isn’t treated properly, it can cause death.

This germ can contaminate drugs when they’re produced, transported, or cut with other substances. Drugs contaminated with botulism don’t look any different than non-contaminated ones. And cooking the drug won’t kill the germ.

Once it enters the body, botulism attacks multiple body systems, and the person must receive antitoxin medication to treat it. The antitoxin can stop further damage and prevent death, but it can’t reverse damage already caused by the toxin.

Injection Complications

IV drug use involves injecting a substance into the body through a syringe. If the injection is too deep, it can pierce a vein. If it is too shallow, the drug pools below the skin instead of entering the bloodstream. Either condition can cause serious infections and painful sores.

Collapsed Veins

Repeated IV drug use causes veins to malfunction and collapse. But by then, the user is addicted. So, to continue using the drug, the person often injects into other parts of the body. This is called injecting intramuscularly (in a muscle) or subcutaneously (under the skin). These types of injections can cause a host of other problems, including:

• Necrotizing fasciitis (flesh-eating disease): A severe skin infection that kills tissue. It can result in loss of limbs and death.
• Gas gangrene: An infection that can lead to tissue death and can be fatal.
• Tetanus: This infection can cause neck stiffness, rigidness in the abdomen, lockjaw, and difficulty swallowing.
• Track marks: Acidic drugs (like heroin) cause agitation when injected. The entry site often becomes inflamed, bruises develop, and veins collapse. These visible symptoms on the skin are called “track marks.”

Heart Damage

Any drug injection method can cause heart problems. Specifically, bacteria may find their way to the heart and cause endocarditis (a life-threatening inflammation of the heart). Endocarditis increases the risk of stroke.

Poor Circulation

Injecting drugs damages the veins, which makes blood flow more difficult. This can cause swelling of the legs and feet, painful cramping in the legs, leg weakness, and sores on the legs or feet.

Infectious Disease

IV drug users often use syringes that are not sterile. Examples include reusing needles, sharing needles, or using needles that aren’t intended for intravenous injection.

This can expose the user to infectious diseases, specifically those spread through contact with bodily fluids. This includes HIV, Hepatitis B and C, Tuberculosis, and other blood-borne infections.

In fact, people who inject drugs are “22 times more at risk of HIV compared with the general population.”

How Can You Protect Yourself?

While there is no safe IV drug use, many dangers associated with drug injection can be treated. Some can even be reversed. The best way to avoid these dangers or stop them from progressing is to address the underlying dependence or addiction that leads to chronic misuse of injectable drugs.

If you or someone you know is struggling with IV drug use, help is available. Call 800-934-1582(Sponsored) to learn more about your addiction treatment options.

– Albert W. Henley, Confederate army physician, 1879

In the 1990s, opioid prescriptions soared. Overdose deaths started climbing in 1999. In 2010, the second wave of the epidemic started, with alarming increases in heroin-related overdose deaths. The third wave began in 2013, with a rise in overdose deaths related to synthetic opioids.

And in a recent 12-month period, over 100,000 people died of opioid-related overdose.

These waves of the opioid epidemic take us back over 30 years. But our history of opioid addiction is much older. If we want to trace the history of opioid epidemics in the U.S., we need to go way back. To the Civil War era.

Finding Out Where Your Enemy Is

The Civil War (1861-1865) took the lives of over 700,000 Americans. Ulysses S. Grant, Commanding General of the United States, aptly said:

Those left behind after the war officially ended faced a new enemy that was harder to spot: opium addiction. The war marked the beginning of the history of opioid addiction in America.

At the time, medical treatment was a far cry from what it is today. And as the war broke out, opium was central to treatment for soldiers. Soldiers suffered horrible injuries. The softer bullets of the time left jagged wounds and often lodged in bones. Many solders underwent amputation. Tens of thousands were hurt and maimed.

In the unsanitary conditions of battlefield hospitals, many soldiers developed fevers, diarrhea, and bacterial infection.

And what did doctors turn to for the treatment of all of these maladies? Opium. They dispensed it first in powder or pill form.

Historian Jonathan S. Jones reports that opium was viewed as a valuable pharmaceutical “that does so many different things. It was used to kill pain, stop deadly diarrhea, and suppress coughs. Opium was a godsend.”

But then morphine was introduced, which could be given with a syringe, so it was even easier and faster to administer. And once the soldiers were back home, they could easily get opioids from the local store. (Until the early 1900s, opioids weren’t regulated.)

How Freedom Is Lost

-Abraham Lincoln

It is estimated that by 1890, several hundred thousand Americans—a majority of them Civil War veterans—were addicted to opioids. They had made it through the war, but now they faced the battle of addiction.

Jones says “It was epidemic both in scale, just the sheer number of people who got addicted, and also the fact that after the Civil War it becomes … front page news. It becomes a really major public health, and also kind of a cultural, crisis in the post-Civil War decades.”

Jones adds that doctors were previously aware of the risks of opioid use – tolerance with prolonged use and the potential for overdose. “But it was never…front page news…until the Civil War caused the number of cases to just go through the roof.”

While Jones is describing a crisis that happened over 130 years ago, much of his statements about opioid addiction ring as true in the 2020s as they did in the 1890s.

Personal Battles in the History of Opioid Addiction

Jones has studied the Civil War history of opioid addiction extensively and will be releasing a book on the topic, Opium Slavery: The Civil War Veterans and America’s First Opioid Crisis, in 2023. His research has uncovered many stories like that of Albert W. Henley, a physician in the Confederate army.

Henley was taken prisoner when Vicksburg surrendered to the Union in 1863. Previously, he had contracted typhoid fever, which left him with chronic diarrhea. Other physicians advised him to take opium. He did…and quickly became addicted to the drug.

He tried repeatedly to quit, with no success. “I at length gave up all hopes of emancipating myself [and] gloom and despair haunted my very soul,” he wrote. Henley’s addiction lasted for the next 15 years.

J.M. Richards was a Union doctor who started taking opium in 1867. He had been suffering from diarrhea since the war’s end. But he, too, became addicted to the drug and was unable to stop using it. “I grew wholly unfitted for business” he wrote. “Poverty stared me in the face. My life was a failure, and the gloom and despair I felt were constant and unrelieved.” Richards poured all his resources into morphine or cures for the addiction and eventually tried to take his own life twice.

Like today, the stories go on. So many addicted. So many fighting personal battles with opioids.

Jones noted “In a lot of ways this is the first example in U.S. history of the problem of opioid addiction becoming really epidemic in the true sense of the word.”

If you or a loved one has felt the effect of the current opioid epidemic, help is available today. Call 800-934-1582(Sponsored) now.

“We, the jury, find the defendants…guilty.”

In the first trial of its kind, a jury has found three major pharmacies guilty for their roles in fueling the opioid epidemic.

Pharmacies Take Their Chances With a Jury

The case is just one among more than 3,000 opioid lawsuits that have been filed across the country against various pharmacies, distributors, and manufacturers.

In many cases, the defendants have chosen to settle outside of court, paying significant settlements to counties and states.

But in this case, CVS, Walmart, and Walgreen’s pharmacies decided to take their chances with a jury. They took the case to trial, despite the fact they were urged by the judge to settle.

And they lost.

The amount all three pharmacies must pay has not yet been determined. U.S. District Judge Dan Polster will get to decide what the companies owe for posing a “public nuisance” in Ohio’s Trumbull and Lake counties.

Meanwhile, the case’s outcome may provide leverage for other local and state governments who filed cases against pharmacies or plan to file in the future.

What Crimes Did The Pharmacies Commit?

Between 2012 and 2016, around 80 million prescription painkillers were dispensed in Trumbull county. Another 61 million were distributed in Lake County during that same time. That’s enough to give each resident 400 pills.

Trumbull and Lake county attorneys claimed the three pharmacies should have done more to stop this flood of pills, which led to hundreds of overdose deaths and cost each county around $1 billion.

The attorneys pointed out that the companies should have hired more pharmacists and technicians or provided better training. They said the pharmacies failed “to implement systems that could flag suspicious orders.”

As a result, the attorneys argued, the pharmacies failed to confirm that each prescription was valid – which allowed an abundance of addictive drugs to flood their counties.

The jury sided with these arguments. After six days of deliberations, they returned with a guilty verdict, determining that the pharmacy chains did indeed create a public nuisance, and their actions resulted in “an oversupply of addictive pain pills and the diversion of those opioids to the black market.”

Pharmacies Claim “Not Guilty”

On the other side of the courtroom, attorneys for the pharmacies denied these allegations.

Pharmacy operators claimed they did take steps to prevent the diversion of pills. They pointed to policies designed to stop pill disbursement when a pharmacist has a concern.

Pharmacists are to notify the authorities when they receive suspicious orders from doctors.

The pharmacies pointed fingers at doctors, drug traffickers, and regulators. They pointed out that it was doctors who controlled the number of pills that were prescribed and whether they were prescribed for legitimate reasons.

Walgreens spokesperson Fraser Engerman noted:

“As we have said throughout this process, we never manufactured or marketed opioids nor did we distribute them to the ‘pill mills’ and internet pharmacies that fueled this crisis. The plaintiffs’ attempt to resolve the opioid crisis with an unprecedented expansion of public nuisance law is misguided and unsustainable.”

Will the Guilty Verdict Stick?

The jury sided with the Ohio counties, but it remains to be seen if the verdict will stick. The three pharmacies said they plan to appeal the verdict. They argue that it’s a misapplication of the “public nuisance” law and doesn’t fit the facts.

California and Oklahoma recently decided in favor of pharmaceutical companies involved in similar cases. And, in November, Oklahoma overturned a $465 million judgment against Johnson & Johnson.

So it’s possible that CVS, Walgreens, and Walmart may succeed in appealing this ruling.

And Still the Opioid Epidemic Rages On

Meanwhile, the verdict doesn’t seem to be affecting business at the three pharmacies. Their stock prices fell briefly, but rebounded quickly after the jury’s decision.

CVS and Walgreens remain the top two pharmacies in the U.S. based on the number of stores (nearly 10,000 for CVS and nearly 9,000 for Walgreens).

And Walmart has the #1 slot on the list of top 100 retailers 2021 based on sales, which totaled over $543 billion in 2020.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

I was watching a crime drama on TV the other day. The cops were able to identify a drug user because she kept sniffing when they interviewed her.

But then I did a little digging. And as it turns out, drug use causes far more damage than a case of the sniffles. It can really wreak havoc on your nose.

If that woman really did snort drugs long-term, she would’ve had some serious symptoms that go way beyond a runny nose.

Here’s a breakdown of how drugs can damage your nose.

Membrane Damage: Stuffy Nose & Nosebleeds

Inside your nose, you’ll find a mucous membrane lining that covers the entire interior.

The point of this lining is to warm and humidify the air you inhale. The lining also helps to trap the debris and pathogens lingering around in that air, preventing them from entering your body and causing illness.

But snorting drugs (like OxyContin, heroin, cocaine, meth, etc.) damages the lining and decreases blood flow in the nose. The damage causes blockage in your airways, which results in a stuffy nose. The reduced blood flow also causes blood vessels to shrink and burst, which results in nosebleeds.

Deviated Septum: Breathing Problems & Infections

Over time, repeated damage to the mucous lining and the cartilage in your nose begins to affect the septum (the part that divides your nose into two nostrils). This damage causes the septum to become uneven or misaligned. This is referred to as a deviated septum.

A deviated septum can cause a host of problems. The most common issues are congestion and breathing problems. But this damage can also cause sleeping problems, headaches, pain in the face, snoring, and frequent sinus infections.

Perforated Septum: Nose Decay & Death

With long-term use, drugs that are snorted continue to eat away at the septum. Eventually, the damage goes beyond simply misshaping the septum to killing it. As the cells die off, a hole forms. This is called a perforated (punctured) septum.

A perforated septum can cause your nose to feel blocked, can cause whistling or wheezing in the nose, and can result in headaches, nosebleeds, nose pain, and scabbing inside your nose.

Palate Damage: Swallowing Issues

Here’s where the damage moves beyond your nose. With long-term drug abuse, the substances can start to damage the roof of your mouth (the hard palate).

Your palate is located right next to your nose, and the reduced blood flow and irritation of the nasal passages eventually spreads here. The damage eats away at the bone cells, causing a hole to form in the top of your mouth.

When this happens, you’ll have difficulty swallowing, food may come out of your nose when you eat or drink, and you may develop a nasally voice.

Saddle Nose: Permanent Disfiguring

And now we’ve come to the point where the damage has become very visible. Repeated damage to the septum can eventually weaken it so much that the nose collapses.

Your nose looks wider and flatter. The middle of your nose is no longer be supported by the septum, so it has a saddle-shaped depression in the middle (a “saddle nose”).

Warning Signs Your Nose is Damaged By Drugs 

The good news is that some of these issues will go away if drug use stops. Others are more severe and can cause permanent damage. Saddle nose, for instance, will require surgery to repair your nose.

But who wants to get to that point?

Watch for the following warning signs that drug use is causing damage to your nose. (Or look for these signs if you suspect a loved one is struggling with a drug addiction. Like the detectives in that crime show, you can use these clues to spot drug use.)

• Nasal pain
• Loss of smell
• Nose bleeds
• Frequent sinus infections
• Whistling noises in the nose when breathing

Don’t Let Drugs Damage Your Nose Permanently

Don’t wait around and let your nose damage become severe. It can happen quickly.

The hard truth is a stuffy nose can turn into a deviated septum in no time. And it will only get worse. The only way to stop this damage is to stop drug use. How? Learn more about treatment here.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

69,710.

That’s the number of people who died from opioid overdose in the U.S. in 2020. That’s up nearly 30 percent from the year before. And many expect those numbers to continue rising.

And why wouldn’t they? As we see more and more drugs laced with deadly doses of fentanyl, overdoses are becoming more and more likely. What’s the solution? Better interventions? More awareness? Fewer prescriptions? Policy makers, law enforcement, and health officials are looking into these options and many more.

Meanwhile, one group suggests going with a solution that’s less mainstream. In fact, it’s less…legal. (At least for now.) Enter the Safe Supply movement.

Introducing the Safe Supply Movement 

The Drug User Liberation Front (DULF) took to the dark web and introduced their own solution: Safe Supply. DULF hopes policies change in the future and they can garner support off the dark web. For now, they’ll take what they can get.

DULF founders Jeremy Kalicum and Eris Nyx seek to provide drug users with the drugs they want – but with less risk of overdose. How? By purchasing the drugs and testing them before they are passed on.

With fentanyl showing up in opioids, cocaine, and meth these days, DULF founders hope to intercept these deadly drugs before they hit the streets and ultimately provide a “safe supply” for users.

With overdose numbers climbing, the founders upped their game over the past two years. Last year, they staged their first protest, demanding a “safe supply” of drugs.

And in April of this year, they distributed pre-tested heroin in downtown Vancouver. And this past July, in what was likely their boldest move yet, DULF distributed drugs in front of Vancouver police HQ.

What’s in the Bag?

Nyx and Kalicum point out that no one really knows what they’re getting their hands on when they buy drugs in unmarked bags. Dealers could be giving them anything – and they often are. With just a few surprise milligrams of fentanyl in the mix, the user easily becomes another overdose statistic.

So, DULF founders hope to follow the same model as alcohol and cigarette distributors. They want to test the ingredients and label the substances clearly. They’d test street drugs and distribute them in packaging that clearly states what’s inside. Clients and groups could get their supply from DULF at protest events.

Kalicum admits that purchasing the drugs is a lot like buying anything else online – but you’re not using eBay or Amazon. He buys drugs on the dark web, a virtually unregulated sector of the Internet that offers sites where people can buy drugs and even leave reviews for the vendors. If Kalicum gets fentanyl when he is supposed to get heroin, he can dispute the purchase and ask for a refund (and has done so).

Of course, Kalicum admits, he might be purchasing from a criminal organization and further funding their illicit efforts. “But, we’re forced to leverage the resources that we have access to,” Kalicum argues.

Kalicum uses an allegedly untraceable cryptocurrency for the purchases, then he tests the drugs using FTIR spectroscopy. This technology reveals what is in the substance using infrared light. Then, Nyx makes labels for the Safe Supply drugs and tracks data on the substances they distribute.

What’s Next for the Safe Supply Movement?

Kalicum notes they would prefer to use drugs provided by the government rather than illicit markets. He hopes other drugs become regulated, much like methadone is now. He and other DULF supporters are making efforts to implement a “safe supply” model and bring Canadian health officials onboard.

In August, DULF founders submitted a request for exemption to current policies so they could practice their “safe supply” model – due to the “health emergency” of the opioid crisis.

And the duo is actually gaining some official support. Vancouver Coastal Health, a regional health authority, gave DULF a letter of support for its plan. Some Canadian policy experts have also agreed to support DULF’s safe supply efforts.

In October, the Vancouver City Council voted to support DULF’s efforts, but only if they purchase the drugs legally. This will require cooperation from other organizations, such as Fair Price Pharma, to provide the supply.

Nyx and Kalicum see a long road ahead, but they continue to push the “safe supply” movement. Nyx noted in an interview, “We have a colossal amount of work to do. People are constantly dying, and there is no end in sight.”

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

Getting help for a loved one who’s struggling with addiction isn’t easy. You may be worried about their alcohol or drug use — or suffering from the consequences of their use — but you’re unsure what to do next. This is where an intervention can be helpful, but here’s the question: Do you need professional help planning an intervention?

Let’s talk about it.

What is an Intervention?

An intervention is a planned meeting where a family meets with a loved one of whom they are concerned about their drug or alcohol use. While interventions for addiction are most common, they can also be used for gambling addiction and eating disorders. 

Interventions can be held by facilitators or by family members, but it is usually recommended — given the emotional bonds you have with the family member — to seek professional help planning an intervention in this instance. Those professionals can include a social worker, doctor, therapist, or interventionist. 

Interventionists’ sole role is to facilitate a family discussion where everyone can share their concerns, provide potential solutions, and set boundaries should the person decide not to get help. They may also offer transportation to a facility after a successful intervention.

An intervention has a prescribed format, which starts before the actual meeting, and includes:

• Asking a professional for help with planning an intervention.
• Selecting a team of family members and loved ones who are concerned and can attend the intervention.
• Making a plan and setting a date.
• Conducting research about addiction and gathering information about the loved ones use pattern, the consequences, and how it has impacted the family.
• Writing statements to present to your loved one at the intervention.
• Discussing your boundaries with the intervention members should your loved one decide to reject treatment.
• Hosting a mock intervention to practice.
• Make a plan to follow up if your loved one rejects treatment and how you will support them.

In deciding whether you need professional help in planning an intervention, it’s important to consider a number of factors, including the type of substance your loved one is using harmfully. Each substance presents different risks.

Do I Need Help Planning for an Alcohol Intervention?

Alcohol addiction, also known as alcohol use disorder, can present a number of health risks from cardiovascular disease, cancer, and stroke in addition to the consequences of addictive use. According to the Centers for Disease Control and Prevention (CDC), 14.1 million Americans have alcohol use disorder. It’s a serious condition, killing 95,000 Americans every year.

While finding recovery is a positive step, stopping drinking carries risk factors for people with alcohol use disorder. It can be dangerous to suddenly stop drinking if the person is dependent. That means, if they stop abruptly, they will experience withdrawal symptoms that can include seizure and even death. So, it may be best to seek professional help.

An interventionist can help you fully prepare for the success of an intervention and support you in doing all of the intervention pre-work. This includes finding a detox facility as your loved one will likely need medical supervision and possibly medication to detox safely. You may also be asked to research a residential treatment facility that can give your loved one the best chance of sustaining their recovery.

Do I Need Help Planning for an Opioid Intervention?

Opioid addiction, or opioid use disorder, can involve addiction to any kind of opioid, including prescription painkillers, heroin, and fentanyl. Each of these drugs are powerful – particularly fentanyl, which is a synthetic opioid that’s 100 times stronger than morphine. Opioids also carry the very real risk of fatal overdose. 

According to CDC data, synthetic opioids (like fentanyl) are the primary drivers of overdose deaths in the United States. During 2020 and 2021, deaths due to opioids rose 38.1 percent.  It takes just two milligrams of fentanyl to cause an overdose.

Given the seriousness of opioid addiction and its risks, it may be more effective to have a professional facilitate an intervention. Here’s why. 

An interventionist:

• Knows the dangers of opioids
• Understands the risks and characteristics of opioid addiction
• Is equipped to help overcome rejection 
• Will keep the family on track with the intervention and toward a successful outcome
• Can provide a neutral voice and can rephrase the concerns of family members
• Are able to facilitate helpful discussion rather than blaming and punishing the person who is suffering
• Can provide transportation to a facility

Setting Up and Planning an Intervention

When in doubt, it’s perhaps best to speak to a professional who has expertise in addressing addiction and facilitating interventions.

Get help today. Call 800-934-1582(Sponsored) to learn about treatment programs for drug and alcohol addiction.
 

Setting up an intervention for a loved one is no easy task. You may be incredibly worried about their well-being and coming from a place of love, while also questioning if you’re making the right choice. You may also be asking yourself if an intervention might push them away from seeking treatment and deeper into their addiction. 

These are all valid concerns. It’s important to consider the situation individually and weigh a number of factors before setting up an intervention to ensure your loved one is successful in overcoming their battle with addiction.

What is an Intervention?

An intervention is a planned process whereby an addiction professional — interventionist, doctor, or addictions counsellor — facilitates a discussion between a person struggling with substances and their concerned family members.

The objective of the discussion is to raise concerns and confront the loved one about the effects of their substance use. 

Oftentimes an intervention is held by an intervention specialist who may draw on facilitation methods such as ARISE, SMART, or Johnson Model.

Whatever the method, the common steps involved in setting up an intervention include:

• Providing specific examples of how your loved one’s using is destructive and the effects it is having on them and the family
• Outlining boundaries that family members may set if the loved one refuses treatment
• A clearly defined treatment plan, such as a treatment center they can go to and who can accompany them there. 

Things to Consider Before Setting Up an Intervention

To ensure the success of any intervention, it’s important to consider a number of factors before setting one up, including:

1. Check your intentions: Ensure the motivation of the intervention is centered around supporting an individual struggling with an addictive behavior, not the opportunity to list the ways they have created harm. It is a loving and solution-oriented process not one that emotionally bashes or abuses the loved one.
2. Do your research: Before setting up an intervention, you need to be knowledgeable about substance use and the factors that may indicate your loved one has a problem. An intervention may be necessary if your loved one (and possibly the family) is experiencing negative effects of their substance use; remains unable to control their use, they are in denial of the negative effects of substance use, or if their use is having a negative impact on day-to-day life. 
3. Use a professional: Hosting an intervention can be overwhelming. There is a lot to organize and it is often a highly emotive situation. That’s why it’s often a smart decision to use a professional during an intervention, as they can guide you through the process, act as a neutral party, and keep all members focused on the goal of supporting the loved one. The other benefits of using a professional is that they’re not emotionally involved with the person struggling or under any kind of coercion to do what the family wants. They are simply there to facilitate the discussion toward a resolution.
4. Plan ahead: Never set up an intervention at the last minute. Take your time to plan the intervention and collect/arrange all of the people and material that the interventionist might think will support this process. You’ll also need to think about who is going to speak, when each person will arrive, where you’ll hold the intervention, what steps you’ll take if your loved one agrees to treatment, and what you’ll do if they don’t. This can take several weeks.
5. Share information: Once you have planned the intervention and selected family members to attend, share your concerns with each other and any other relevant information. This ensures that you’re a cohesive front when confronting your loved one.
6. Assign roles: When sharing information, this might be an opportunity to assign tasks to each family member. For example, tasks like: researching treatment centers and calling them to see where there is availability and if they take your loved ones insurance; figuring out childcare arrangements for the loved one’s children; and speaking to your loved one’s employer (anonymously) to find out their policy for an employee needing to attend treatment. 
7. Anticipate their objections: It is highly likely that your loved one may object to the intervention and the idea that they should go to treatment. Remember, denial is a common feature of addiction. This isn’t an opportunity to blame or ridicule, instead think of potential objections and have solid reasons to counter them. For example, your loved one might say: “But I only drink on weekends,” to which you could contend: “Yes, but this impacts your work the next day and you’ve had X days off this year, meaning you could lose your job. You’re also failing to help out with childcare when you promised you would, which means I’ve been late to work after taking the kids to school. The effect of this is a strain on our marriage and my employer’s patience. To make up for my tardiness, I often have to work late, putting me home even later.”

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

The Attorney General in Alabama has designated a good chunk of its opioid crisis settlement money go towards an impressive cause. 

In a series of attempts to right the wrongs that opioids caused the state, Alabama will allocate $1.5 million of their McKinsey & Company settlement to the Department of Child Abuse and Neglect Prevention. Additional funding will be allotted to several more critical law enforcement departments.

Opioid Settlement Money From McKinsey & Company

Earlier this year, The New York Times reported the consulting firm McKinsey & Company agreed to pay nearly $600 million to settle investigations into their role in increasing opioid sales. One of the drug companies it gave sales advice to was Purdue Pharma, the manufacturer of the highly addictive drug OxyContin. 

McKinsey reportedly wrote a report for Purdue executives highlighting how their new marketing tactics could increase sales of highly addictive OxyContin by $200 to $400 million annually. The report included a suggestion that opioids are useful in reducing stress, making patients feel optimistic, and helping them feel less isolated. One might argue that’s the complete opposite of how opioid addiction presents – constant cravings, discontent, isolation, and symptoms of physical dependence.

Purdue Pharma was also found to be at serious fault in the opioid crisis by knowingly putting the well-being of millions of Americans at risk by marketing and selling opioids that it knew were dangerous. It was also alleged that the company had reason to believe some of the providers were diverting the drugs to people who were abusing them. In November last year, Purdue pleaded guilty to fraud and kickback conspiracies. 

Purdue agreed to an $8.3 billion settlement and plead guilty to criminal charges for its role in fueling the opioid crisis. McKinsey & Company agreed to a nearly $600 million settlement in order to end investigations into their role in helping Purdue “turbocharge” its opioid sales. 

Alabama Isn’t Wasting Its Opioid Settlement Money

Alabama sued McKinsey for their role in increasing opioid sales and were awarded $9 million, $7.6 million of which is due to be paid in 2021. (Alabama also has several other pending lawsuits against opioid manufacturers.) 

In a series of statements, the Alabama Attorney General announced the state would be awarding millions of dollars to the Alabama Department of Child Abuse and Prevention (ADCANP), their forensic lab, and specialty courts.

Here’s a breakdown of all three monetary awards:

#1 Opioids and Child Abuse

Official data suggests that a large percentage of children enter foster care in Alabama due to substance use. Child neglect accounts for 60 percent of child removal from their homes. 

Speaking about this intervention, the Marshall stated:

“The Alabama Department of Child Abuse Neglect and Prevention is a small state agency with a critical mission – strengthening families. I firmly believe that strong families are the answer to nearly every societal ill that our state is wrestling with, not the least of which is the opioid crisis.”

Marshall went on to say that he believes “…children are the invisible victims of the opioid epidemic.”

#2 Opioid Forensic Testing

The settlement awarded to Alabama’s forensic lab, which serves all 450 enforcement agencies in the state, is intended to improve the quality and turnaround of forensic services for opioid-related cases. 

“Our state forensics lab, like so many across the country, has been battling backlogs caused by the opioid epidemic. This investment in new technology will give ADFS the tools they need to quickly identify trends in increasingly complex synthetic opioids and to aid law enforcement in identifying opioid traffickers,” Marshall said.

#3 Specialty Courts

The Attorney General awarded the Office of Prosecution Services and officers from the Alabama District Attorneys Association $1.5 million to invest in specialty courts, including drug courts, veterans’ courts, and mental health courts.

Specialty courts, as they suggest, have a specific criminal justice reform role: treating offenders whose crime is related to substance use disorder and reducing recidivism. Attorney General Marshall believes that investing in drug courts is a way of relieving the strain of the opioid epidemic placed on their District Attorney’s offices and court systems.

Speaking about this investment on behalf of the District Attorney’s Association, DA Michael Jackson spoke of its potential value:

“Drug courts and pretrial diversion programs are an extremely valuable tool – not only can this type of intervention save the lives of addicted offenders, but these programs also help decrease victimization within communities.”

More Opioid Settlement Money on the Horizon?

And it isn’t over yet. Alabama is still set for trials with other pharmaceutical companies, including Endo Pharmaceuticals and McKesson Corporation. It also has pending litigation against opioid manufacturers Purdue Pharma, Mallinckrodt, and Insys.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.

A recent Biden administration proposal to crack down on opioids is causing quite a stir among criminal and civil justice reform groups.

The administration’s new drug policy proposal aims to reduce the supply and availability of illicitly manufactured fentanyl and related substances. However, civil rights groups warn this could have a significant impact on people of color and widen racial disparities in the U.S. 

What is Fentanyl and Why Does it Matter?

Fentanyl is a synthetic opioid similar to morphine, but it is 50-100 times more potent. It’s a prescription pain medication that’s typically used among patients who are unresponsive to other opioids. Those patients may be experiencing chronic pain from certain forms of cancer or pain from surgery. Medically prescribed fentanyl is available as a shot, lozenge, or skin patch. 

Fentanyl is also available on the black market. The illegal version of fentanyl is commonly sold in powder form and often “cut” (combined) with another substance, including methamphetamines, heroin, cocaine and other prescription pills. In fact, the United States Drug Enforcement Administration (DEA) recently reported an alarming increase in the amount of fake prescription pills containing fentanyl. 

According to the DEA, drug networks are now mass-producing fake pills and selling them as legitimate prescription pills. In 2021, the DEA seized 9.5 million counterfeit pills containing fentanyl, a number that jumped by 430 percent since 2019. As a result, unsuspecting Americans are overdosing in record numbers.

The DEA reports two out of every five fake pills sold on the black market now contain a potentially lethal dose of fentanyl.

Drug overdose deaths involving fentanyl are now the most common type of overdose in the United States, accounting for 59 percent of all fatal overdoses. This figure has risen drastically since 2010, when fentanyl was responsible for 14.3 percent of the drug overdose deaths.

While the COVID-19 pandemic has contributed to record high overdose deaths, the government also sees the importance of expanding the nation’s public health approach to substance use disorders in hopes of reducing overdose deaths. The new drug policy seeks to do that.

Key Points From Biden’s New Drug Policy

In September 2021, various government departments (Office National Drug Control Policy, Department of Health and Human Services, Department of Justice) presented recommendations to Congress in an effort by the Biden-Harris Administration to reduce the supply of fentanyl-related substances. This proposal also sought to protect civil rights and reduce barriers to scientific research for all schedule I substances.

Dr. Rachel Levine, Assistant Secretary for Health at the Department of Health and Human Services explained that expanding the nation’s public health approach to substance use disorders is essential. According to Levine, the proposal prioritizes comprehensive public health approaches that include expanding access to evidence-based treatment. The Biden administration’s recommendations “can help address the increasing rates of drug overdose deaths, primarily those related to synthetic opioids like fentanyl.”

The 2022 budget would provide a $41 billion investment in advancing a public-health approach to the overdose epidemic. The money would be invested in national drug program agencies, expansion of prevention, addiction treatment, harm reduction, and recovery support services. 

The key points of the proposal are:

• Permanently place all fentanyl and fentanyl-related substances (FRS) into schedule I of the Controlled Substances Act, giving law enforcement more tools to respond to illicit fentanyl manufacture and distribution
• Exclude FRS from all quantity-related mandatory minimum penalties
• Ensure courts can reduce the sentence of an individual involved in an offence related to FRS
• Expand research of scheduled substances to advance public policy
• Monitor the changes and their impact on research, civil rights, and illicit supply, and manufacturing of FRS

The Drug Policy and Racial Disparities

While this sounds like a noble undertaking on paper, the reality is that it is typically people of color who are treated unfairly when it comes to drugs.

Sakira Cook, who closely follows issues for the Leadership Conference on Civil and Human Rights, told NPR that this won’t bode well for people of color. “Since the inception of the war on drugs, African Americans and Latino people have borne the brunt of enforcement-first approaches,” said Cook. 

A staggering 70 percent of defendants charged with fentanyl-related crimes have been people of color, according to Cook. What’s even more troubling is that people of color have disproportionately been affected by overdose deaths, with non-Hispanic Blacks facing the highest increase in opioid-related deaths. Between 2014 and 2017 death rates among non-Hispanic Black people involving opioids increased  818 percent.

Leading this opposition is the Drug Policy Alliance (DPA), who stated in a letter to congress that they were deeply distressed by the Biden-Harris Administration proposal to combat the overdose crisis. They asked that Congress reject the proposal because it leans heavily on law enforcement and not on evidence-based public health solutions to solve the overdose epidemic.

They reminded Congress of the fact that FRS were classified back in 2018, yet overdoses continued to skyrocket. Despite the administration’s stated desire to use evidence-based public health interventions, the DPA pointed out that scheduling is not science-based and endorses criminalization of drug use instead of treatment.

According to the DPA, the administration’s proposal minimizes potential harms caused by scheduling. They say a public health approach grounded in expanding access to harm reduction instead of arrest and incarceration would be a more effective solution. The DPA’s letter urged the administration to let the scheduling expire and embrace public health solutions instead.

The DPA suggests a number of public health solutions to effectively combat the opioid overdose crisis, including:

• Provide individuals with access to life-saving tools (like naloxone) and related education
• Provide evidence-based treatment 
• Use medication assisted treatment
• Utilize syringe service programs
• Promote overdose prevention programs
• Provide drug checking tools so substances can be tested for fentanyl before use

Overall, opponents to Biden’s proposed opioid drug policy suggest the administration should turn to science instead of fear when combating this public health crisis.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Sponsored) today.