Addicts turning to pain patches

From the National Post:
Despite triggering a growing list of overdose deaths, powerful pain-control patches have become a rare but highly sought-after narcotic on some Canadian streets, a new study indicates.

Resourceful addicts have even devised ingenious ways to defeat safety features added recently to the Fentanyl patches, researchers discovered.

"This is bad news in many ways and ... I don't think anybody has a clear idea what to do about it," said Dr. Benedikt Fischer of the B.C. Centre for Addictions Research, one of the authors of the study. "This is a killer drug out there, in many ways."

Known by the brand-name Duragesic, the patches are prescribed primarily for treating chronic pain of cancer patients and others. More than 600,000 prescriptions were sold in Canada last year, according to IMS Health. ...more

Pharmaceutical drugs overshadowing heroin

From the National Post:
Heroin is fast being replaced by legal pharmaceutical drugs such as OxyContin and morphine among street users of opioids, suggests a national survey of addicts that underscores the challenges and opportunities of the changing drug trade.

Users of pharmaceutical opioids are less likely to inject their narcotics, which is good for curbing infectious disease, but they are also more likely to mix them dangerously with cocaine, crack and other street drugs, the newly published study indicates.

Meanwhile, experts are struggling to understand a supply system that includes retirees peddling painkiller prescriptions and pharmaceutical company employees selling purloined stock. With Canada one of the world's biggest medical consumers of opioids, which provide users with an anesthetizing release, the abundance of legal supplies has undoubtedly fed the illicit street market, researchers say.

There is an "urgent need" to more closely investigate and comprehend the new opioid scene, says the study published this month in the journal Drug and Alcohol Review by researchers in B.C. and Toronto. ...more

Scientists pop Ritalin to sharpen thinking

From the Calgary Herald:
One-fifth of the world's professional scientists and university science students have used "cognition-enhancing" prescription drugs to help them concentrate, according to a survey by a top research journal.

The most common of these "steroids for scientists" is the amphetamine Ritalin, says the journal Nature.

And while some officials at Canadian universities expressed surprise at the finding, others said the practice is well-known, usually using drugs to keep awake and alert.

A student diagnosed with attention deficit disorder, which is treated with Ritalin, can become very popular at exam time or when essays and lab work are due, they say. ...more

New prescription law to take effect

From the Charleston (SC) Post and Courier:
Prescription cheaters beware. As of April 1, all Medicaid prescriptions must be written on tamper-resistant pads.

The move could save taxpayers up to $355 million in the next decade, according to the Congressional Budget Office.

After a six-month delay of the initial enforcement date, Oct. 1 2007, most in the medical community seem well-prepared for the switch.

"There's no indication they're not ready for the change," said Jeff Stensland, director of public information for the state's Medicaid agency.

Judi Bucknam, manager of Medical University of South Carolina's 20 adult medical surgical clinics, said that the whole hospital will go over to the tamper-resistant prescription pads Tuesday.

Before, prescriptions were written on regular laser jet printer paper, she said. A ream of regular paper runs about $6, she said. The new paper costs $64 a ream. ...more

Database puts the squeeze on addicts who rob pharmacies

From the Seattle Post Intelligencer:
Just weeks before last Christmas, Nicholas A. Dent fed his addiction to painkillers through a relentless show of force. In 10 days, he robbed a dozen pharmacies for OxyContin pills before stepping in front a security camera that revealed his identity to police.

Dent, 28, is one of many drug addicts over the past few years behind a spike of violence against pharmacies.

Federal authorities went after the pharmaceutical company making the painkiller, Purdue Pharma, for misleading doctors about the drug's addictiveness. The company was made to pay more than $600 million in fines.

But Purdue has also joined police and crime-prevention groups to stop addicts with a heavy dose of information technology.

Early last month, police officers and pharmacists in the Seattle area were introduced to RxPatrol, a nationwide database of robberies, break-ins and forged prescriptions at pharmacies. ...more

New Brunswick to set up online drug-control program

From CBC News:
The New Brunswick government has awarded the contract for development of an online drug control program to Medavie Blue Cross of Moncton.

Health Minister Mike Murphy made the announcement Tuesday afternoon in the provincial legislature in Fredericton.

The program will allow the province to track the use of prescribed narcotics like OxyContin, which is a group of drugs similar to morphine, and Dilaudid, a derivative of morphine.

The program will also monitor the prescribing patterns of doctors and drug patterns of patients, Murphy said.

Pharmacists will be taught how to use the new online program, Murphy said.

"All of the province's approximately 190 community pharmacies will be linked in the system, and pharmacists trained over a period of about one year," Murphy said. ...more

Bush urges new rules on online sales of addictive prescription drugs

From the Los Angeles Times:
President Bush called on Congress on Saturday to pass legislation restricting online sales of powerfully addictive prescription drugs, citing a growing number of overdoses.

Bush referred to San Diego teenager Ryan Haight as he unveiled the 2008 national drug control strategy in his weekly radio address. Haight overdosed on painkillers he bought over the Internet, prompting Sen. Dianne Feinstein (D-Calif.) to introduce the bill that Bush championed Saturday.

The president said his national drug policy had reduced youth drug consumption by 24% since 2001. That progress has been counterbalanced by the growing problem of prescription drug abuse.

"Unfortunately, many young Americans do not understand how dangerous abusing medication can be," Bush said. "In recent years, the number of Americans who have died from prescription drug overdoses has increased." ...more

Disgraced doctor jailed 5 years for dealing prescription drugs

From the Toronto Star:
A notorious former doctor, stripped of his licence for administering useless cancer treatments to terminal patients, has been sentenced to five years in prison for trafficking in prescription pills, including highly addictive OxyContin.

For this "serious breach of trust," Ravi Devgan, 60, deserves to have his 5-year-sentence added on to the three-year sentence he is already serving for fraud, Justice Todd Ducharme said Friday.

But because of his extreme ill-health and the likelihood that he has few years left to live, that would amount to a life sentence, Ducharme said. So the judge ruled that he is to serve both sentences concurrently. ...more

Painkiller use stokes death fears

While I agree that work needs to be done to prevent prescription narcotic abuse, I really hope this won't be at the expense of those who genuinely need these medications. I've seen people with abuse problems, but I've also seen a lot of patients who had poorly managed pain control.

From the National Post:
When it comes to consuming prescription opioids, Canadians are world leaders, taking twice as many of the powerful, addictive narcotics as Europeans and 20 times as many as the Japanese.

With some experts afraid the trend could also be exacting a rising death toll, Health Canada is moving to find out how many people succumb to fatal overdoses from the drugs, usually after the pills have ended up on the black market. Evidence from the United States -- one of only two countries that ingest more opioids such as Oxycontin and fentanyl than Canada -- suggests the numbers could be soaring.

Health Canada is hiring outside researchers to come up with a system for tracking the deaths. The results should help decide whether Canadian doctors' propensity for handing out the medicines is justified or not, said one of the addiction scientists commissioned to do the work.

"Part of the assessment of the pluses and minuses is that you have to know how many people die of this," said Dr. Jurgen Rehm, a drug policy expert at Ontario's Centre for Addiction and Mental Health. "No matter what opinion you have on the burning drug questions of the day, you need those data…. It's irrational not to have them."

One pain specialist, though, warns against using overdose statistics to curb legitimate use of the drugs since, if anything, they are not prescribed widely enough now for Canadians with genuine pain problems. Painkiller use stokes death fears

A dangerous cocktail

From the Globe and Mail:
The sudden death of 28-year-old actor Heath Ledger, whose body was found Tuesday with sleeping pills nearby, has highlighted the dangers surrounding a drug class prescribed to millions of Canadians each year: sedatives.

An autopsy was inconclusive and more tests are needed to determine how the Australian-born former Oscar nominee died in his SoHo apartment, the New York medical examiner's office said yesterday.

But police reports that sleeping pills and anti-anxiety medications were found in the apartment - combined with a recent interview in which Mr. Ledger said he was using Ambien, a brand of sedative - suggest prescription drugs may have played a role.

While sleeping pills used alone are "reasonably safe," mixing those pills with other sedatives is a dangerous cocktail, said Jack Uetrecht, who holds a Canada Research Chair in immunotoxicology and whose research looks at adverse drug reactions. ...more

Family of woman who died of overdose wants MD accountability

From CBC News:
The family of a Calgary woman who died of a toxic combination of prescription drugs wants physicians to be more vigilant in prescribing medication.

Jodie Bruketa, 28, died in January 2004 from an overdose of the painkiller Percocet — which contains a powerful narcotic called oxycodone — and Zopiclone, a sleeping pill. The amount of oxycodone in her blood was about five times the amount expected in someone taking a regular prescription.

Bruketa, who worked as a marketing assistant, was prescribed hundreds of pills in the two months before her death, primarily from one doctor. In total, she visited five different physicians in less than a year. ...more

Scientists testing vaccine for cocaine users

From the Globe and Mail:
Nothing says drug addiction more than a needle and syringe. But that's exactly what a team of U.S. researchers believes can help cocaine users kick their menacing habit.

Two Baylor College of Medicine scientists based in Houston have developed a cocaine vaccine that creates antibodies that bind to the drug and prevent it from travelling from the bloodstream to the brain.

Unable to penetrate the brain, the drug can produce no high.

If the vaccine makes it through regulatory hurdles, it would be the first medication approved to treat cocaine addiction.

“It certainly is a way of combining immunology that had not been used before,” Tom Kosten, a professor of psychiatry and neuroscience at Baylor, said in a telephone interview yesterday. “We had always thought of altering the brain as a way to prevent drug abuse. This way, the drug never gets into the brain to begin with.” ...more

Doctors warn of potential dangers of OxyContin

From CTV News:
Canadian physicians are warning of the potential dangers of the prescription painkiller OxyContin following a high-profile case in which a Newfoundland and Labrador doctor was convicted of trafficking the potentially addictive narcotic.

On Monday, Dr. Sean Buckingham was convicted of five counts of sexual assault, six counts of trafficking painkillers such as OxyContin and lorazepam (sold under the name Ativan), and one count of assault.

Witnesses testified during the two-month trial that Buckingham provided them with drugs in exchange for money and sexual favours over a two-year period. ...more

Pharmacists face dilemma over dispensing narcotics: provincial board

From the (Corner Brook, NF) Western Star:
Pharmacists in this province are finding themselves in a dilemma over dispensing narcotics like OxyContin, the Newfoundland and Labrador Pharmacy Board says.

"The dilemma is you don't want to be sucked in by people abusing it," said Don Rowe, secretary-registrar of the board. "You always have to be vigilant looking for potential abuse or signs of it, but at the same time not making a legitimate customer feel like some kind of a criminal just because they have been prescribed a drug like OxyContin or Percocet or whatever."

The "sucking in" hasn't always come from only patients, as the recent conviction of St. John's physician Dr. Sean Buckingham made evident. Last week, Buckingham was convicted of 12 counts of sexual assault, assault and drug trafficking in Newfoundland Supreme Court. Buckingham, who ran a practice on Queen's Road, was found guilty of having provided several former patients with prescription drugs, including OxyContin and Ativan, in return for sexual favours....more

Pharmacists worry about police requests

I applaud the actions of this Vermont pharmacist. The "War on Drugs" is much more aggressive in the States, but I could see a similar situation occuring in Canada. As pharmacists, we need to ensure that patient info is only released when appropriate.

From the Barre Montpelier (VT) Times Argus:
Law enforcement offices in Vermont are supposed to collect information about the purchase of prescription drugs only when they have a reason to believe a specific crime may have been committed.

But in at least one case last month, Vermont State Police asked for a list of all customers seeking powerful pain medicine, according to a pharmacist.

Fairfax Pharmacy owner Rick Hogle said he refused to hand over a list of his customers prescribed schedule-two drugs, which include medications such as oxycodone, when asked by a state police trooper who was investigating the spread of such drugs on the street.

Hogle, a pharmacist for 16 years, said he felt caught between protecting the privacy of his customers and assisting law enforcement in stopping the illegal sale and use of these medications.

"I'm not going to release patient information," Hogle said. "The woman from the state police was very polite and did not throw her weight around, but unless they get a court order, I'm not going to release this information." ...more

Teens turning to prescription painkillers, survey finds

From Canada.com:
While alcohol still remains the substance of choice among Canadian teens, a new study in Ontario released Tuesday shows use of prescription painkillers is a growing cause for concern.

According to the Centre for Addiction and Mental Health in Toronto, 21 per cent of students surveyed about their drug use revealed they had tried a prescription pain medication for non-medical purposes at least once in the past year.

More than 75 per cent of teens reported getting the pills from home.

Doug Beirness, manager of research and policy for the Canadian Centre on Substance Abuse said Ontario's youth opioid statistics are the first of their kind in Canada but should serve as a wake-up call across the country. An opioid is a chemical substance that has a morphine-like action in the body and is used for pain relief. ...more

Methadone alternative to hit Canadian market

From CBC News:
A new heroin-addiction treatment that many doctors say is safer than methadone can be prescribed in Canada starting this week.

The drug, sold under the names Subutex and Suboxone, contains buprenorphine, an opiate. Manufactured by Schering-Plough Corp., it was approved by Health Canada in 2005.

Dr. Mark Dubé, a private practitioner in Sudbury, Ont., has been prescribing methadone for years. He started prescribing Subutex and Suboxone in August to one of his methadone patients under a special access permit granted by Health Canada. ...more

Solutions to oxycodone addiction

From Canoe.ca:
A Wallaceburg man gets hooked on OxyContin and helps launch a $175-million lawsuit against Purdue Pharma Canada, the maker of the drug.

City hall calls for a $3.7-million, five-year strategy on substance abuse.

Pain specialists suggest more training for family doctors.

Pharmacists ask for tools to track patients.

Addiction experts ask all of us to stop blaming the addicts.

There seem to be dozens of possible solutions to halting widespread and growing abuse of oxycodone-based painkiller drugs in London. ...more

Feds 'paranoid' about pain drug, doctors say

From the Ottawa Sun:
Canadian pain doctors are calling for Health Canada to avoid "paranoid scheduling" of tramadol, a popular prescription drug that could end up being put on a list of controlled substances.

Dr. Roman Jovey said the Canadian Pain Society's aggressive opposition to Health Canada's proposal is "unique," but the association believes the feds are making a grave mistake by grouping tramadol with already restricted narcotics, such as morphine and codeine.

"The question is, where do you draw the line?" asked Jovey, past-president of the pain society.

However, Health Canada spokesman Paul Duchesne said the agency believes tramadol "may be abused" like other painkillers listed in the controlled substances list. ...more

Sex & drugs case hurts pain care: MDs

From the National Review of Medicine:
Whether St John's, NL, family physician Dr Sean Buckingham gave drug addicts opioid prescriptions in exchange for sex is for the jury in his ongoing trial to decide. But pain care physicians from across Newfoundland and Canada fear his alleged crimes have already done their damage by making MDs too afraid to prescribe strong pain meds.

Dr Buckingham was first arrested in May 2005 after a long-running investigation by police that involved wire-tapping, raids and 24-hour surveillance, called Operation Remedy. He is currently facing 23 charges, ranging from drug trafficking to sexual assault. During the last week of October, the jury heard shocking testimony from three women who allege they had sex with Dr Buckingham in exchange for prescriptions for opioids painkillers. ...more