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InvisiblePassiveAgressive
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Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?]
    #14360632 - 04/27/11 11:22 AM (12 years, 9 months ago)

http://www.medscape.com/viewarticle/741611



Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up


April 27, 2011 — Several national organizations, including the American Psychiatric Association (APA), have released statements of strong support for the new collaborative action plan to fight prescription drug abuse developed by the White House Office of National Drug Control Policy (ONDCP) in conjunction with the Food and Drug Administration (FDA), the Drug Enforcement Administration (DEA), and the US Department of Health and Human Services (HHS).

As reported by Medscape Medical News, the new action plan calls for healthcare provider training and increased patient education on these medications, expanded monitoring of their use, better disposal of unwanted and/or unused drugs, the shut-down of so-called pill mills, and doctor shopping.

"I am very pleased to support the administration in addressing the problems related to the abuse of prescription medications," said John A. Renner, MD, chair of the APA's Council on Addiction Psychiatry, in a release.

"It is important for all clinicians to recognize that we share a major professional responsibility to ensure that prescriptions for opioids and other abuseable medications are prescribed only for appropriate indications, that patients are followed closely, and both patients and their families understand the risks associated with these drugs," he added.

Also applauding the new federal recommendations are representatives from the American Osteopathic Academy of Addiction Medicine (AOAAM) and the American Academy of Addiction Psychiatry (AAAP).

"The administration's action plan to address the growing problem of prescription drug abuse in our nation, especially among our youth, is an unprecedented step forward in helping to reduce the morbidity and mortality associated with addiction," Joseph Liberto, MD, president of the AAAP, said in the same release.

He noted that the plan's call for prescriber education "is consistent with the educational missions of the AAAP, APA, and AOAAM."

Much Needed Plan

Dr. Renner, who is also an associate professor of psychiatry at Boston School of Medicine in Massachusetts and runs the Addiction Psychiatry Residency at the Boston VA, told Medscape Medical News that the new action plan is "a very well-organized approach" and much needed right now.


Dr. John A. Renner
"The abuse of opioid pharmaceuticals has been growing steadily for 10 years and has gotten to a point where it now overshadows all the other drug problems in the United States, certainly more so than heroin and cocaine. So it's important and necessary that we address it for the type of problem it is, that it involves elements of medical practice. It's not going to be resolved unless we pay attention to that," said Dr. Renner.

"I think that for physicians, learning how to use new medications, what the risks are and what the benefits are, this is all an important part of ongoing medical training."

During the press conference announcing the new national action plan, Howard K. Koh, MD, MPH, assistant secretary for health at the HHS, said that, based on his experience, clinician training on this topic is sorely needed.

"As a physician who has spent over 30 years caring for patients, I am very aware that providers have had too little opportunity for education on proper prescribing and dispensing of opioid medication."

Meeting Expectations

Dr. Renner noted that the new plan tells physicians that they "can no longer take for granted" that they can get their license and their DEA registration and certificate automatically.

"I think the public, the professional societies, and the regulating groups expect that we are maintaining a level of competence in our practice. And I think there are a number of areas where physicians are going to be watched a little more carefully."

However, he added that clinicians should not be concerned that the new plan's recommendations will mean a much bigger time investment.

"In most circumstances, physicians are already required to do a number of hours of continuing medical education [CME] in order to renew their state licenses. And I suspect this type of training will count toward CME requirements that already exist."

Dr. Renner said that although drug manufacturers are now in charge of designing the initial training and education efforts, he is not concerned with their involvement. This is due to the FDA's plan for reviewing all content to make sure it meets their standards and covers the topics they want taught. "I'm confident that that will guarantee a quality product."

In addition, he opined that the ONDCP's call for new legislation to make physician training mandatory "is a good thing" — although he admits that some in the field might not agree.

"I suspect that there will be some physicians and some elements of organized medicine that will not be comfortable with that. But I think we live in an era where physicians are expected to demonstrate that they're keeping up with the state of medical practice."

However, he noted that the training does not guarantee that participants will become experts — especially because the number of hours that are going to be required have not yet been specified.

"I imagine that it would be anywhere from 2 to 8 hours," said Dr. Renner. "That would be very helpful, but it's not a medical school curriculum. It will improve people's level of knowledge, but I would hope that if someone is working in this area, is directing their practice towards the management of chronic pain, than participation in a whole range of ongoing training courses should be routine and expected."

Better Balance Needed

"The abuse of [prescription] drugs, especially abuse of opioids, is a public health crisis that takes a tremendous toll on individuals, families, the healthcare system, and communities," said Margot L. Waitz, DO, president of the AOAAM, in a release.

Dr. Koh reported that prescription drug abuse now accounts for 1 million emergency department visits a year, matching the number of visits attributable to illegal drugs.

"These facts alarm me as a father, as a physician, and as the assistant secretary for health. All parents try to protect their children and create safe, healthy environments. So it's important they realize that prescription drugs are beneficial only when used appropriately."

In a recent survey reported by WebMD, the opioid hydrocodone combined with acetaminophen was currently ranked as the number one most prescribed medication in the United States. Dr. Renner said this finding does not surprise him.

"Initially, I think some of these meds were marketed aggressively. And I just think physicians need to realize you don't need a powerful opiate for every headache. Instead, we need to get a better understanding of the range of options for managing acute and chronic pain. Frankly, I don't think medical schools have or are currently doing a good job training physicians on how to do that effectively," he said.

"On the one hand, these medications have been wonderful additions to medical care. We're now able to control serious pain in ways we could not before. And I don't think anyone wants to interfere with the appropriate treatment of patients with legitimate pain. I think we just want to establish a better balance between guaranteeing that patients get the care they need and to make sure we don't generate secondary problems because of misuse of the medications," concluded Dr. Renner.

The new national action plan is located on the ONDCP's Web site.


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Offlineamilibertine
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: PassiveAgressive]
    #14360940 - 04/27/11 12:49 PM (12 years, 9 months ago)

The problem is that even patients who don't abuse their meds become addicts just like someone taking them to get high specifically.  It makes no difference, so many of the supposed "abusers" started out with an injury and were given opiates, realized how nice they feel, and then over the course of time they become addicts and soon they are buying them on the street. 

There's no going back to the way things were.


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InvisiblePassiveAgressive
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: amilibertine]
    #14360974 - 04/27/11 12:58 PM (12 years, 9 months ago)

Quote:

amilibertine said:
The problem is that even patients who don't abuse their meds become addicts just like someone taking them to get high specifically.  It makes no difference, so many of the supposed "abusers" started out with an injury and were given opiates, realized how nice they feel, and then over the course of time they become addicts and soon they are buying them on the street. 

There's no going back to the way things were.




You speak truth. Indeed.


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Invisiblebigmike7104
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: amilibertine]
    #14361102 - 04/27/11 01:29 PM (12 years, 9 months ago)

Quote:

amilibertine said:
The problem is that even patients who don't abuse their meds become addicts just like someone taking them to get high specifically.  It makes no difference, so many of the supposed "abusers" started out with an injury and were given opiates, realized how nice they feel, and then over the course of time they become addicts and soon they are buying them on the street. 

There's no going back to the way things were.




not true, theirs a difference between physical dependence and someone taking drugs to deal with their emotions. also the vast majority of people who try opiates don't become addicted.

The suprising truth about heroin and addiction
"More evidence that withdrawal has been overemphasized as a motivation for using opiates comes from patients who take narcotic painkillers over extended periods of time. Like heroin addicts, they develop "physical dependence" and experience withdrawal symptoms when they stop taking the drugs. But studies conducted during the last two decades have consistently found that patients in pain who receive opioids (opiates or synthetics with similar effects) rarely become addicted."

"A 1976 study by the drug researchers Leon G. Hunt and Carl D. Chambers estimated there were 3 or 4 million heroin users in the United States, perhaps 10 percent of them addicts. "Of all active heroin users," Hunt and Chambers wrote, "a large majority are not addicts: they are not physically or socially dysfunctional; they are not daily users and they do not seem to require treatment." A 1994 study based on data from the National Comorbidity Survey estimated that 23 percent of heroin users ever experience substance dependence."
http://reason.com/archives/2003/06/01/h

"Then there are the thousands of American soldiers who became heroin addicts during the Vietnam War. In an unrivalled demonstration of the effect of setting, a 1975 survey found that 88 percent of them simply stopped using the drug when they left the war zone. Their experience has been recreated by millions of hospital patients who have received (and become physically dependent on) morphine for severe pain"
http://www.walrusmagazine.com/articles/2007.12-health-rat-trap/2/


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Withering my intuition, missing opportunities and I must
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InvisiblePassiveAgressive
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: bigmike7104]
    #14361132 - 04/27/11 01:35 PM (12 years, 9 months ago)

Quote:

bigmike7104 said:
Quote:

amilibertine said:
The problem is that even patients who don't abuse their meds become addicts just like someone taking them to get high specifically.  It makes no difference, so many of the supposed "abusers" started out with an injury and were given opiates, realized how nice they feel, and then over the course of time they become addicts and soon they are buying them on the street. 

There's no going back to the way things were.




not true, theirs a difference between physical dependence and someone taking drugs to deal with their emotions. also the vast majority of people who try opiates don't become addicted.

The suprising truth about heroin and addiction
"More evidence that withdrawal has been overemphasized as a motivation for using opiates comes from patients who take narcotic painkillers over extended periods of time. Like heroin addicts, they develop "physical dependence" and experience withdrawal symptoms when they stop taking the drugs. But studies conducted during the last two decades have consistently found that patients in pain who receive opioids (opiates or synthetics with similar effects) rarely become addicted."

"A 1976 study by the drug researchers Leon G. Hunt and Carl D. Chambers estimated there were 3 or 4 million heroin users in the United States, perhaps 10 percent of them addicts. "Of all active heroin users," Hunt and Chambers wrote, "a large majority are not addicts: they are not physically or socially dysfunctional; they are not daily users and they do not seem to require treatment." A 1994 study based on data from the National Comorbidity Survey estimated that 23 percent of heroin users ever experience substance dependence."
http://reason.com/archives/2003/06/01/h

"Then there are the thousands of American soldiers who became heroin addicts during the Vietnam War. In an unrivalled demonstration of the effect of setting, a 1975 survey found that 88 percent of them simply stopped using the drug when they left the war zone. Their experience has been recreated by millions of hospital patients who have received (and become physically dependent on) morphine for severe pain"
http://www.walrusmagazine.com/articles/2007.12-health-rat-trap/2/





This one hits close to home, I have to comment...

I realize that we all have our opinions, but opinion and quotes, no matter how scientifically based they are, often time do not align well with reality. How does my 87 year-old aunt have withdraw symptoms, and has to be HOSPITALIZED for opiate withdraw? I cannot prove to you now her character, but you'll have to take my word for it, he doctor overdid it and now she's a recovering addict.

Don't get me wrong, I DO NOT condone drug control, but I don't promote pill factories either.


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Thousands of candles can be lit from a single candle, and the life of the candle will not be shortened.
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Invisiblebigmike7104
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: PassiveAgressive]
    #14361592 - 04/27/11 03:02 PM (12 years, 9 months ago)

again physically dependent is not the same as addiction, otherwise millions of people that were patients around the world would be addicted to drugs looking to score. and assuming your aunt is not addicted, she probably won't crave the drug after withdrawals unlike a true addict would. unless she still needs it for medical reasons or she was in the minority that is. hope everything works out for her though

of course i don't promote pill mills, i was just responding to his comment.


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Over thinking, over analyzing separates the body from the mind
Withering my intuition, missing opportunities and I must
Feed my will to feel my moment drawing way outside the lines


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Offlinemetall
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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: bigmike7104]
    #14362923 - 04/27/11 06:50 PM (12 years, 9 months ago)

man this hits really close to home cus i got percs at liek 14 and boy did i love emm had surgury again at 19 and they gave my hydromorph shots and alot and i mean alot more perc needless to say i ended up gettign rid of about 100 pills and suffering bad for quite a few days buti felt it taking me and would not let it


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FUCK OFF FEDS PEOPLE NEED THEIR MEDS


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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: PassiveAgressive]
    #14363314 - 04/27/11 08:11 PM (12 years, 9 months ago)

Quote:

"In most circumstances, physicians are already required to do a number of hours of continuing medical education [CME] in order to renew their state licenses. And I suspect this type of training will count toward CME requirements that already exist."





CME is essentially a take-home-quiz with the answers included.  And since most is sponsored by pharmaceutical companies, it's more geared towards promoting certain drugs rather than continuing medical education.


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Re: Federal Crack Down on Prescription Drug Abuse Gets Thumbs Up [?] [Re: funkyjunky]
    #14363459 - 04/27/11 08:40 PM (12 years, 9 months ago)

Quote:

funkyjunky said:
Quote:

"In most circumstances, physicians are already required to do a number of hours of continuing medical education [CME] in order to renew their state licenses. And I suspect this type of training will count toward CME requirements that already exist."





CME is essentially a take-home-quiz with the answers included.  And since most is sponsored by pharmaceutical companies, it's more geared towards promoting certain drugs rather than continuing medical education.





So this lends one to wonder - where does the QUOTE "crackdown" END QUOTE come in?


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