Tag Archives: diversion

Suspected opioid drug thefts persist at VA centers

Suspected drug thefts persist at VA centers | WISH-TV  – Hope Yen, AP – May 2017

Federal authorities are investigating dozens of new cases of possible opioid and other drug theft by employees at Veterans Affairs hospitals, a sign the problem isn’t going away as more prescriptions disappear.

Data obtained by The Associated Press show 36 criminal investigations opened by the VA inspector general’s office from Oct. 1 through May 19. It brings the total number of open criminal cases to 108 involving theft or unauthorized drug use

The numbers are an increase from a similar period in the previous year.   Continue reading

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Abuse-Deterrent Opioids A Double-Edged Sword

Are Abuse-Deterrent Opioid Products A Double-Edged Sword? – Practical Pain Management – May 16, 2017 – By Jasmine Shah, PharmD and Ryan W Rodriguez, PharmD, BCPS

Solving the opioid epidemic is complex because of the multifactorial underlying causes. Complicating this issue is the need to maintain access to opioids for patients with chronic pain conditions for which prescription opioid analgesics are the only effective treatment.

Any attempts to mitigate opioid abuse must not have the unintended consequence of eliminating a viable treatment option for patients using opioid medications appropriately and experiencing meaningful clinical improvement.  Continue reading

Lyrica and Neurontin Linked to Opioid Overdoses

Lyrica and Neurontin Linked to Opioid Overdoses — Pain News Network – May 2017

“It is important that doctors and people dependent on opioids are aware that the number of overdose deaths involving the combination of opioids with gabapentin or pregabalin has increased substantially and that there is evidence now that their concomitant use – either through co-prescription or diversion of prescriptions – increases the risk of acute overdose deaths,” said Matthew Hickman, a Professor of Public Health and Epidemiology

The idea that Lyrica and Neurontin are being abused may be surprising to many patients and doctors, but the drugs are increasingly being used by addicts.   Continue reading

Rx Drug Diversion an Issue at VA Hospitals

Prescription Drug Diversion an Issue at VA Hospitals  – Mar  2017 – Jennifer Barrett, Assistant Editor

I’ve long believed that the quantities of illicit Rx opioids available on the black market cannot be accounted for by pills stolen from “grandma’s medicine cabinet”. I think opioids are/were being diverted at a much higher level and involve huge quantities. By now, however, pills have become much too expensive in comparison to cheap heroin and illicitly manufactured fentanyl additives.

Employees involved in manufacturing, distribution, and pharmacy stocking aren’t as carefully monitored as individual pain patients, and diversion of mass quantities is so profitable that some of the staff involved in the supply chain are undoubtedly corruptible.  Continue reading

‘Inhumane treatment’ of pain patients

Strict limits on opioid prescribing risks ‘inhumane treatment’ of pain patients – By @StefanKertesz – Feb 2017

Lately I’ve been seeing dire warnings on Twitter:

  • Its important to have some sense before we make CDC suggestions enforceable, punitive, and not patient centric. https://t.co/G512mieHAf
  • No trials have tested impact of involuntary, nonexpertly-managed Opioid discontinuations. Risk of harm is high https://t.co/G512mieHAf
  • The road to hell is paved with good intentions. Making CDC #opioid guideline mandatory is ill-advised https://t.co/G512mieHAf
  • Let’s hit pause before @CMSGov makes @CDCgov #opioid Guideline mandatory  https://t.co/G512mieHAf

Stefan Kertesz, MD, is one of our most powerful advocates because he is an addiction specialist who speaks up for the right of both pain patients and addicts to receive treatment that is scientifically valid and individualized to the patient.   Continue reading

Opioids, Addiction, and Pain: Briefing for Policy Leaders

This excellent summary of the points of our argument against the CDC Guidelines was created by Stefan G Kertesz, MD, who also wrote the thoroughly researched paper, The Changing Opioid Epidemic: Not from Rx, proving that our opioid prescriptions are NOT the problem.

Opioids, Addiction, and Pain:
Message Clarity to Prevent Harm and Save Lives

Briefing for Policy Leaders

Prepared by: Stefan G Kertesz, MD. Associate Professor, U. Alabama at Birmingham, with review by two physicians expert in opioid use disorders and pain.  Continue reading

Opioid Abuse in Chronic Pain by N. Volkow – repost

Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies — NEJM – N Engl J Med 2016;   Nora D. Volkow, M.D., and A. Thomas McLellan, Ph.D.

The urgency of patients’ needs, the demonstrated effectiveness of opioid analgesics for the management of acute pain, and the limited therapeutic alternatives for chronic pain have combined to produce an overreliance on opioid medications in the United States,

Given the lack of clinical consensus and research-supported guidance, physicians understandably have questions about whether, when, and how to prescribe opioid analgesics for chronic pain

Why Opioid Medications Are Diverted and Abused  

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Surge in Fake Painkillers as Prescribing Drops

DEA: Surge in Fake Painkillers as Prescribing – 12/6/16 – Pain News Network – by Pat Anson

A decline in the abuse and diversion of prescription pain medication is being offset by a “massive surge” in the use of heroin and counterfeit painkillers, according to a comprehensive new report by the U.S. Drug Enforcement Administration.

The DEA’s 2016 National Drug Threat Assessment paints a stark picture of the illicit drug trade in prescription medication, fentanyl, heroin, marijuana, methamphetamine and cocaine.  Interestingly, the 194-page report doesn’t even mention kratom, 

“Sadly, this report reconfirms that opioids such as heroin and fentanyl – and diverted prescription pain pills – are killing people in this country at a horrifying rate,” said DEA Acting Administrator Chuck Rosenberg.   Continue reading

The Swinging Pendulum of Opiate Prescribing

The Swinging Pendulum of Opiate Prescribing – June, 2016 – Cmdr John Burke

In the several decades I have been in the business of following the diversion of pharmaceuticals, I have noticed a pendulum effect regarding this issue.

In almost everything important in life, balance is usually paramount; extremes are rarely the answer

However, finding balance is difficult and requires work. Balance requires careful thought, weighing the pros and cons, and taking an action that can be accepted by most individuals because getting everyone to agree is virtually impossible.   Continue reading

Negative outcomes of unbalanced opioid policy

Negative outcomes of unbalanced opioid policy supported by clinicians, politicians, and the media – Journal of Pain & Palliative Care Pharmacotherapy – 18 Feb 2016

This article contains good facts to use in arguments against overly restrictive opioid limits.

Harmful and nonmedical use of prescription opioids has increased precipitously in the United States…  Addressing this problem requires attention to scientific data and to objective and balanced consideration of factors driving the problems

Unfortunately, the situation has been blurred by some politicians, health professionals, and the media by their using inadequate concepts, misrepresenting and exaggerating facts, and demonizing pain patients.
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