The Untold Story of America’s Opioid Addiction

Slate, online
Author: Jeremy Samuel Faust
“We learned Thursday that Prince died of an opioid overdose—specifically from fentanyl, a synthetic opioid often prescribed to people who have built up a tolerance to oral opioids. (Fentanyl is more potent than powerful drugs like OxyContin and is most commonly administered via a patch.) While the toxicology report has not yet been made public—and may never be—it’s possible that Prince, who had a reputation for living substance-free but also suffered from debilitating hip and knee pain, got his drugs from his doctor, not a dealer. …Since the early 1990s, the annual number of opioid prescriptions has tripled. Opioid overdose deaths have quadrupled. Today, Americans consume 80 percent of the world’s (legal) opioids, despite accounting for less than 5 percent of the world population.  There’s no single villain in this story. Our dangerous embrace of opioids was the result of the entire medical establishment—including governmental, nonprofit, and pharmaceutical organizations—searching for an answer to the problem of pain.”
Find article here.

Reforming international drug policy

The Lancet, Volume 387, No. 10026, p1347, 2 April 2016
““Drugs have destroyed many people, but wrong policies have destroyed many more”, said Kofi Annan, the former UN Secretary-General. Indeed, international drug policy has been fraught with inconsistency and controversy. … For the first time in two decades, the UN General Assembly’s Special Session (UNGASS; April 19–21, 2016) will be about the world drug problem. It will be a crucial moment for revisiting and reforming international drug policy. To inform the Session’s discussions, the Johns Hopkins–Lancet Commission on Drug Policy and Health was launched in New York, USA, on March 24, and is published in today’s issue.”
Find editorial here.

Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline

New Eng J Med March 15, 2016DOI: 10.1056/NEJMp1515917
Authors: Thomas R. Frieden, M.D., M.P.H., and Debra Houry, M.D., M.P.H.
“Deaths from prescription-opioid overdose have increased dramatically in the United States, quadrupling in the past 15 years. Efforts to improve pain management resulted in quadrupled rates of opioid prescribing, which propelled a tightly correlated epidemic of addiction, overdose, and death from prescription opioids that is now further evolving to include increasing use and overdoses of heroin and illicitly produced fentanyl. … On March 15, 2016, the Centers for Disease Control and Prevention (CDC) released a “Guideline for Prescribing Opioids for Chronic Pain” to chart a safer, more effective course.2”
Find article here.

Historic medicinal cannabis legislation passes Parliament

Australian Government Minister for Health, statement 24 February 2016
“Parliament has passed the Australian Government’s historic legislation delivering the “missing piece” for Australian patients and their doctors to access a safe, legal and reliable supply of medicinal cannabis products for the management of painful and chronic conditions.”
Find statement here.

Senator questions pain panel’s ties to industry

BMJ 2016;352:i878
Author: Michael McCarthy
“A US senator has begun an inquiry into possible conflicts of interests among members of an expert committee that advises the US government on policy on pain treatment.  The Interagency Pain Research Coordinating Committee (IPRCC) is being consulted by the Department of Health and Human Services about changes to opioid prescribing guidelines that have been suggested by the US Centers for Disease Control and Prevention (CDC).”
Find extract here.

Landmark medicinal cannabis legislation introduced today

Australian Government Minister for Health, statement 10 February 2016
“The Australian Government will introduce landmark legislation providing the “missing piece” for Australian patients and their doctors to access a safe, legal and reliable supply of medicinal cannabis products for the management of painful and chronic conditions.”
Find statement here, including links to background and information papers.

US drug overdose deaths: a global challenge

The Lancet, Volume 387, No. 10017, p404, 30 January 2016
“Globally, the consumption of opiates has more than tripled in the past 20 years, yet access to drugs for medical purposes and pain relief is extremely low in countries such as India and China where strict laws or reduced market incentives exist regarding access to morphine and general use analgesics. As the global burden of non-communicable diseases increases (including late-stage cancers), the right to access pain management has never been more apparent. Doctors must be empowered to treat pain proactively, but also engage and be vocal in tailoring policy to address community gaps in pain and substance abuse management.”
Find editorial here.

Psychiatrist is charged after 12 patient deaths

BMJ 2016;352:i534
Author: Owen Dyer
“A psychiatrist from Atlanta, Georgia, has been charged with prescribing pain drugs outside the usual course of professional practice after 12 of his patients died from drug overdoses.”
Find extract here.  See also ‘Prescriptions for hydrocodone plummet after US tightens prescribing rules‘ (BMJ).

Germany considers legalising cannabis for medical use

BMJ 2015;351:h5952
Author: Ned Stafford
“Germany’s health ministry has drafted a proposed new law that would create a government operated “cannabis agency” to oversee production of marijuana and its distribution for use in cannabis based medicines to treat pain and other ailments.”
Find extract here.