Drug and Alcohol News (JoinTogether.com)
Almost one-quarter of pregnant women enrolled in Medicaid in 2007 filled a prescription for opioids, a new study finds. The risks of opioids to a developing fetus are largely unknown, The New York Times reports.
An estimated 1.1 million pregnant women were enrolled in Medicaid in 2007. The program covers medical expenses for 45 percent of births in the United States, according to the newspaper. The study, published in Obstetrics & Gynecology, found the rate of opioid prescribing is on the rise—18.5 percent of pregnant women enrolled in Medicaid in 2000 filled opioid prescriptions, compared with 23 percent in 2007.
“To hear that there’s such a high use of narcotics in pregnancy when I see so many women who worry about a cup of coffee seems incongruous,” Dr. Joshua A. Copel, a professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine, told The New York Times.
The reason for the increase in opioid prescribing for pregnant women is unclear, but may be partly due to back pain.
An article published earlier this year in Anesthesiology, which included 500,000 privately insured women, found 14 percent were given opioid painkillers at least once during their pregnancy. Both studies found codeine and hydrocodone were the most commonly prescribed opioids during pregnancy. Most of the women took the drugs for a week or less.
The Medicaid study found stark regional differences in opioid prescribing. Among pregnant women in Utah, 41.6 percent were prescribed opioids, compared with 35.6 percent in Idaho, 9.6 percent in New York and 9.5 percent in Oregon. “The regional variation really concerned me the most,” said Dr. Pamela Flood, a professor of anesthesiology and pain medicine at Stanford University. “It’s hard to imagine that pregnant women in the South have all that much more pain than pregnant women in the Northeast.”
A bipartisan group of senators has formed to fight prescription drug abuse, according to The Hill. The group will look for innovative solutions to opioid abuse.
The Prescription Drug Abuse Working Group, part of the Senate Health, Employment, Labor and Pensions (HELP) Committee, will convene a series of meetings about prescription drug abuse, involving local, state and federal officials, private coalitions, and companies developing novel technologies for combating abuse. The group will focus on hydrocodone, oxycodone and other narcotics that can be easily abused, according to HELP Committee Chairman Tom Harkin of Iowa.
Committee Ranking Member Lamar Alexander of Tennessee has been an outspoken critic of the Food and Drug Administration’s (FDA) approval of the pure hydrocodone drug Zohydro. In February, he and two other Republican senators wrote to FDA Commissioner Margaret Hamburg to protest the agency’s decision to approve the drug. They wrote, “We believe the approval of pure hydrocodone products without methods to prevent abuse, misuse, and diversion, including abuse-deterrent formulations, poses a significant danger to our constituents, as it could worsen the drug abuse epidemic in our country.”
In a news release announcing the new Senate working group, Alexander said, “Not a day goes by that we don’t hear news of how prescription drug abuse is harming Americans across the nation, including in Tennessee. We are launching this working group to look at the problem from all angles—particularly what the federal government is doing to enable the mayors, governors, and law enforcement and public health officials who are working hard to address the problem.”
E-cigarette makers are targeting young people with free samples distributed at music and sporting events, according to an investigation by 11 Democratic members of the U.S. House and Senate. The companies are also running radio and television ads during programs aimed at young people, the lawmakers said.
They hope their report will speed the release of e-cigarette regulations by the Food and Drug Administration (FDA), according to The New York Times. Some public health experts say e-cigarettes could help reduce the rate of regular cigarette smoking, while others are concerned the devices could encourage young people to try traditional cigarettes.
The report included results from a survey of eight major e-cigarette producers. All eight said they had given away free samples, and six said they had sponsored events. According to the report, 348 events featured free samples and sponsorship in 2012 and 2013, “many of which appeared geared toward youth.”
Lorillard, which makes the e-cigarette Blu, was responsible for the most free samples and sponsorships, the report found. The company sponsored Freedom Project, a national music tour. Ads for Blu ran in Sports Illustrated, and featured women in bikinis. A spokesman for the company said it does not advertise to youth.
Representative Henry Waxman of California, who led the inquiry into e-cigarettes with Senator Richard Durbin of Illinois, said in a news release, “E-cigarette makers are starting to prey on kids, just like the big tobacco companies. With over a million youth now using e-cigarettes, FDA needs to act without further delay to stop the companies from marketing their addictive products to children.”
A vending machine that dispenses marijuana will soon be open for business in Colorado, NPR reports. The machine is able to verify a customer’s age, according to its creators.
Customers can also purchase marijuana-infused snacks from the machine, which is called ZaZZZ. It is designed to be used by medical marijuana patients, and will be located in licensed stores.
Stephen Shearin of Tranzbyte, the parent company of American Green, which built the machine, said, “Your identity is confirmed against active biometrics.” The machine may help dispensary owners reduce employee theft, the article notes.
Several other companies, including MedBox, also have created marijuana vending machines, but so far they have been kept behind store counters, according to NPR.
Following the decision by Massachusetts Governor Deval Patrick to order a ban on prescribing and dispensing the pure hydrocodone painkiller Zohydro, Vermont’s governor announced an emergency order to make it more difficult for doctors to prescribe the drug.
Vermont Governor Peter Shumlin said he joins the many critics of the drug, who are wondering why the Food and Drug Administration (FDA) approved it, according to the Associated Press. “What puzzles all of us is the recent FDA action to approve a new opiate that’s stronger and likely to be even more addictive because of its strength,” he said.
In January, Shumlin spoke about Vermont’s “full-blown heroin crisis” during his State of the State address. He focused his entire speech on drug addiction and its consequences.
When Governor Patrick announced the Zohydro ban, he cited a public health emergency stemming from opioid abuse. Zohydro is designed to be released over time, and can be crushed and snorted by people seeking a strong, quick high. It was approved for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Other hydrocodone drugs on the market, such as Vicodin, also contain acetaminophen.
In December 2012, a panel of experts assembled by the FDA voted against recommending approval of Zohydro. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the company’s manufacturer, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone.
Zogenix announced it will assemble an oversight board designed to spot misuse of the drug.
The FDA’s decision to approve Zohydro has been criticized by some legislators and public health groups. FDA Commissioner Margaret Hamburg has received letters protesting the decision from 28 state attorneys general and four senators, among others.
A new government report finds twice as many adult men as women entered substance abuse treatment facilities in 2011. The report found 1.2 million men, and 609,000 females, entered such facilities that year.
Among teens 12 to 17, the rate of substance dependence for both males and females was about 7 percent, UPI reports. The findings come from the Substance Abuse and Mental Health Services Administration (SAMHSA). Teenage boys were more likely to abuse marijuana, while teenage girls were more likely to abuse alcohol.
Twenty-two percent of women ages 18 to 24 said marijuana was their primary substance of abuse, compared with 3 percent of men the same age. Women 65 and older were almost three times as likely to abuse prescription painkillers such as oxycodone, compared with men of the same age.
“This report provides insight into how age and gender relate to substance abuse, SAMHSA Chief Medical Officer Elinore McCance-Katz said in a news release. “SAMHSA believes that health care professionals can use this information in designing programs that are better tailored to effectively meet the treatment needs of both genders.”
No other major retailers have joined CVS in pledging to pull tobacco from store shelves, the Associated Press reports. CVS, the nation’s second largest drugstore chain, announced earlier this year it will stop selling tobacco products by October 1.
Major retailers want to see what happens after CVS stops selling tobacco, before deciding how to proceed, the article notes. The company has more than 7,600 retail stores. Public health advocates have pressured retailers for years to stop selling cigarettes and other tobacco products. CVS says its annual sales of tobacco products total about $2 billion, or about 1.6 percent of the company’s revenues in 2012.
The company’s announcement caught many people in the retail industry by surprise, the article notes. CVS stock has risen about 11 percent since it made the announcement. Many analysts predict it is unlikely other drugstore chains will make a similar decision to pull tobacco products. Walgreens CEO Greg Wasson last month said that instead of stopping sales of tobacco products, his company would focus on helping people quit.
Some discount chains, such as Family Dollar, have added tobacco to their stores in recent years.
There are several reasons retail chains may want to consider dropping tobacco sales, according to the AP. The cigarette business faces tax increases, smoking bans, health concerns and social stigma. The number of Americans who smoke continues to drop. In addition, selling tobacco products runs counter to the healthy image drug chains want to project.
In March, the attorneys general of 28 states and territories urged major retailers to follow the lead of CVS and stop selling tobacco products. They sent letters to Rite Aid, Walgreens, Kroger, Safeway and Walmart, which are among the nation’s biggest pharmacy retailers.
Advocates of medical marijuana came to Capitol Hill this week to urge legislators to pass a measure that would ban the federal government from restricting state medical marijuana laws.
Currently, 20 states have legalized medical marijuana, but the drug remains illegal under federal law. New York may become the next state to legalize medical marijuana, Time reports. The bill is unlikely to pass in the Republican-controlled House, the article notes. Democrats in the Senate do not want to champion the issue in a midterm election year. The Obama Administration seems willing to consider taking marijuana off the federal government’s list of the most dangerous drugs, according to the magazine.
“Once you use this medication and it works for you, or you see it work for a loved one, it really is crazy that we can’t even get a hearing at this point,” said Steph Sherer, Executive Director of Americans for Safe Access, a medical marijuana advocacy group. “We’re actually regulating this product from seed to consumption.” Her group brought 152 people to Washington to lobby Congress.
Every few years the media report an epidemic of heroin overdose deaths; often after a celebrity like Phillip Seymour Hoffman dies to set off the spark. This time the spike in deaths—which is real– is being attributed to heroin mixed with fentanyl. Attention will fade but the deaths will continue. We wring our hands about overdoses, but do little to make effective treatment widely available. Our continuing refusal to prevent and treat addiction is a medical and social scandal.
Here are the policy changes I believe we must make to end this scandal:
1) Complete the transition to individual health insurance with complete coverage for addiction treatment. The bulk of addiction treatment today is provided by small free standing programs that depend on contracts with public entities for treatment “slots” or individual out of pocket payment. The programs with contracts are responsive to their funders, not to the patients who may be filling a slot at the moment. The organization and funding of our treatment system works against developing a long term relationship between patient and provider that is key to successful long-term recovery. When a patient leaves, the treatment entity has no continuing contact with that person. Obamacare can cover almost all the people with addiction in the country if states, employers and insurers implement it properly. Sadly, some existing treatment programs are dragging their heels or opposed to getting their patients covered because they find it easier to bill the state or because they cannot meet the administrative and clinical requirements for accepting insurance payments.
2) Integrate addiction, mental illness and medical treatment around individuals with severe addiction. Telling a patient who is unemployed, homeless, addicted and mentally ill to go someplace different for each service or to wait weeks for an appointment is malpractice because the providers know it will not happen. We should force consolidation of addiction treatment, mental illness and medical care providers to coordinate and take care of the most severely ill patients in one place. The few places where this kind of care is provided now get much better results for their patients.
3) Increase insurance payment rates for addiction treatment to a level that meets providers’ costs, draws in new responsible providers, and pays for the required coordination. Very low Medicaid and private insurance payment rates create and perpetuate the shortage of quality treatment. Appropriate payment rates will attract higher quality providers.
4) Reward longer stays in treatment and stop using providers that are unable to successfully retain patients in treatment long enough for it to be effective. Longer time in treatment, inpatient or outpatient, improves outcomes. Research shows that drug treatment for less than 90 days is generally not effective, but very few public or private insurance programs authorize that much treatment now. It is shocking that some treatment programs still throw a patient out if he relapses during treatment. Relapse is part of the disease and a signal for more treatment, not a reason to end it.
5) Require hospitals, health centers, HMO’s and other primary providers, as a condition of their participation in Medicaid, Medicare, and public employee health programs, to demonstrate that they diagnose all patients with alcohol and drug disease and that they have a clinically sound program that gets individuals the care they need. Today, most hospitals refuse to provide addiction treatment at any appropriate scale even though many of their patients would have better clinical outcomes if they got brief interventions or treatment.
6) Stop the revolving door at detoxification programs. Current policy and reimbursement get the patient out the door as soon as he or she is “medically stable,” whether or not the person is connected or ready to enter real addiction treatment. The vast majority of people who leave detox without directly entering and staying in treatment quickly relapse. Many think they “failed” treatment but the truth is they never had any treatment, just detoxification.
7) Stop arresting people for non-violent drug offenses. And stop putting people back in jail or prison for non-violent addiction related probation violations. Our current policies ruin thousands of young lives. Addiction is a disease, not a crime. Drug court programs are fine, but they touch only a tiny proportion of the people in the criminal justice system who need treatment.
David L. Rosenbloom, PhD, is Professor, Boston University School of Public Health and former Director of Join Together.
This feature was originally published on the BU Today website.
Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, announced it has reduced prescriptions of narcotic painkillers by about 6.6 million pills in the past 18 months. The insurer limited the amount of opioids that members could obtain without prior approval of the company, WBUR reports.
Since the changes were implemented in July 2012, prescriptions for opioids including Percocet have declined by 20 percent, and those for long-lasting drugs such as OxyContin have declined by 50 percent, Blue Cross Blue Shield of Massachusetts President Andrew Dreyfus told The Boston Globe.
An initial review of prescription information, launched in 2011, revealed more than 30,000 of the company’s members received opioid prescriptions that lasted for more than 30 days. “What we found out is in looking at patients who deserved to get pain medications or needed pain medications, many of them were getting significantly more than they would need,” Dr. John Fallon, Senior Vice President and Chief Physician Executive, told WBUR.
Under the program, patients are initially given shorter-term prescriptions for opioids. Patients seeking long-term prescriptions must go through a review process. Before patients are given more medication beyond the new limits, they must be assessed for the risk of addiction, and must agree on a treatment plan with their doctor.
Patients with cancer or other terminal illnesses are exempt from the rules.
“In the past, physicians said that no one should be in pain, and people gave more prescription medication than they probably needed, and that led to supply sitting around, which was then used for inappropriate reasons,” Fallon said. “Now I think there’s an awareness in the physician community how hazardous these medications are.”
People seeking treatment for heroin addiction face a number of obstacles, including a lack of treatment beds, expensive care, and insurance companies that refuse to pay for inpatient rehab, according to ABC News.
Most insurance companies will not pay for inpatient heroin detoxification or rehab because withdrawal from the drug is generally not deadly, according to Anthony Rizzuto, a provider relations representative at Seafield Center, a rehabilitation clinic on Long Island, N.Y. He says insurance companies either claim the patient does not meet the “criteria for medical necessity” for inpatient care, or they require the patient to first try outpatient rehab and “fail” before being considered for inpatient treatment.
Most experts say inpatient care is often needed for a person addicted to heroin. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps, kicking movements and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose, and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health can be fatal.
The symptoms of withdrawal are so bad that many people go back to using heroin, often with deadly consequences. Even people who are able to stop using heroin without treatment often relapse. They may overdose because they use as much heroin as they did before, but their system can’t handle the same level of drug as before they went through withdrawal.
Even patients who do get some insurance coverage for heroin treatment generally don’t get 30 days in a residential center. The average duration is 11 to 14 days, according to Tom McLellan, CEO of the nonprofit Treatment Research Institute in Philadelphia. After insurance companies stop paying, facilities discharge patients, even if they are not done with treatment.
The average cost of a 30-day inpatient stay is about $30,000.
About 3.7 million Americans, who live in states that have not expanded their Medicaid programs under the Affordable Care Act, suffer from mental illness, psychological distress or a substance use disorder and don’t have health insurance, according to a recent report.
Twenty-four states have not expanded their Medicaid programs, according to USA Today. In the states that did expand Medicaid, about 3 million people with a mental health or substance use disorder, who were formerly uninsured, now are eligible for coverage. The findings come from the American Mental Health Counselors Association (AMHCA).
The Affordable Care Act originally required states to expand Medicaid benefits, but in 2012, the U.S. Supreme Court allowed states to opt out of participating in the expansion.
“It is really a tragedy,” said Joel Miller, Executive Director of AMHCA. “When uninsured people with mental health conditions, such as depression, gain Medicaid coverage, they become healthier and life expectancy increases, but in states that refuse to expand Medicaid, citizens will see their hopes dashed for a better life and better health.”
The report findings come from the National Survey on Drug Use and Health, which counted people with serious mental illness, serious psychological distress, and substance use disorders. The group found almost 75 percent (2.7 million adults) of all uninsured persons with a mental health condition or substance use disorder who are eligible for coverage in the non-expansion states live in 11 southern states that have rejected the Medicaid expansion: Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia.
More than 1.1 million uninsured people who have serious mental health and substance abuse conditions live in just two states — Texas (625,000) and Florida (535,000). These more than 1.1 million people are eligible for coverage under the new Medicaid expansion program, but won’t receive it, the report noted.
Employers in states where marijuana is legal for medicinal or recreational use must decide how to handle employees who use the drug when they are not on duty, USA Today reports.
Some workers in Colorado and Washington state, where recreational marijuana use is legal, say they are being punished for using the drug when they aren’t on the job. Employers say they are trying to maintain drug-free workplaces, the article notes.
“I imagine there will be a great deal of upheaval in the future. The law is going to be in flux for another 10 years,” said Curtis Graves, a staff attorney with the Mountain States Employers Council, which advises companies on workplace issues.
In the 20 states that allow medical marijuana, employers do not have to allow any kid of marijuana use in the workplace. In Colorado, workers cannot be fired for legal activities while they are off duty. However, the state’s courts have also ruled marijuana is not lawful, because the federal government still considers it illegal.
A growing number of employers in Colorado are testing prospective employees before hiring, and are continuing to perform random drug testing, according to Tiffany Baker, co-owner of the Denver DNA and Drug Center, which provides drug-testing services to employers. “I think big companies were already testing anyway,” she said. “I think small companies are … now more likely to send their workers over.”
In Washington state, manufacturers and companies working in federally regulated areas, such as the aerospace industry, have long tested job applicants for drug use. Jennifer Lambert, a vice president of the employment agency Terra Staffing Group, says these employers are continuing to test job applicants for drugs. “It’s sort of a Wild West scenario. It’s very, very tricky,” she said. “I feel badly when someone comes to us and doesn’t understand the implication of their pot smoking.”
The Food and Drug Administration (FDA) has approved a handheld device that delivers a single dose of the opioid overdose antidote naloxone, The New York Times reports.
The device, called Evzio, is similar to an EpiPen used to stop allergic reactions to bee stings, the article notes. It can be used by friends or relatives of a person who has overdosed. When the device is turned on, it will give verbal instructions about how to use it. The medication blocks the ability of heroin or opioid painkillers to attach to brain cells. Evzio is expected to be available this summer.
“This is a big deal, and I hope gets wide attention,” said Dr. Carl R. Sullivan III, Director of the Addictions Program at West Virginia University. “It’s pretty simple: Having these things in the hands of people around drug addicts just makes sense because you’re going to prevent unnecessary mortality.”
According to a news release from the FDA, family members or caregivers should become familiar with the instructions for use before administering Evzio. “Family members or caregivers should also become familiar with the steps for using Evzio and practice with the trainer device, which is included along with the delivery device, before it is needed,” the FDA advises. The agency notes that because naloxone may not work as long as opioids, repeat doses may be needed. A person utilizing the device should seek immediate medical care for the patient.
Many states have begun to make naloxone more widely available. The FDA notes existing naloxone drugs require administration via syringe, and are most commonly used by trained medical personnel in emergency departments and ambulances.
Photo source: Medgadget.com
Major obstacles remain to expanded treatment for addiction through the Medicaid program, according to USA Today. Although the Affordable Care Act (ACA) requires treatment be offered to people who are newly insured through insurance exchanges or Medicaid, experts say a federal law is limiting available beds nationwide.
A federal restriction does not allow drug treatment centers with more than 16 beds to bill Medicaid for residential services provided to low-income adults. The law was meant to prevent Medicaid dollars from funding private mental institutions that warehoused patients, according to the article. The result is that addiction treatment centers are turning away new Medicaid patients who are entitled to treatment under the ACA.
“We don’t have enough capacity right now,” Becky Vaughn, Executive Director of State Associations of Addiction Services in Washington, told the newspaper. “The unintended consequence is that you are discriminating against an adult who needs help,” said Elizabeth Stanley-Salazar, a Vice President at the Phoenix House. “We don’t do that for any other illness or disease.”
Toby Douglas, Director of California’s Health Care Services Department, said only 10 percent of the available inpatient beds in the state are in facilities that meet the federal government’s restrictions. Most treatment for substance abuse in Colorado is provided in centers with more than 16 beds, according to Arthur Schut, Chief Executive Officer of Arapahoe House. “Everyone is in agreement about how dumb this is,” he said. “It doesn’t work economically, and it doesn’t work for the people seeking treatment.”
The federal government does not plan to change the law, according to Suzanne Fields, a senior adviser on health care financing for the Substance Abuse and Mental Health Services Administration. She said the federal government is looking at alternatives, such as treating patients under programs already paid for with other federal funds.
Democratic governors around the country are reluctant to support the legalization of marijuana, despite enthusiasm for the idea among voters in their party. The New York Times reports the governors are concerned about managing legalization, as well as being perceived as being soft on crime by Republicans.
In California, where voters strongly favor legalization and its Democratic Party adopted a platform urging the state to follow Colorado and Washington state in legalizing recreational marijuana, Governor Jerry Brown has said he wants to see what happens in those areas.
Some Democratic governors are supporting medical marijuana measures. This year, bills have been introduced in 17 states to legalize recreational marijuana. No sitting governor or member of the Senate has offered a full endorsement of those measures. Governor Peter Shumlin of Vermont, a Democrat, has said he is open to the idea.
“Quite frankly, I don’t think we are ready, or want to go down that road,” said Connecticut Governor Dannel P. Malloy, a Democrat. His state has legalized medical marijuana and decriminalized possession of small amounts of marijuana. “Perhaps the best way to handle this is to watch those experiments that are underway. I don’t think it’s necessary, and I don’t think it’s appropriate,” he told the newspaper.
The Democratic governors of Colorado and Washington opposed legalization, but said they would follow through on voters’ wishes to set up recreational marijuana marketplaces. Washington Governor Jay Inslee said, “As a grandfather, I have the same concerns every grandfather has about misuse of any drug, including alcohol and marijuana. All of us want to see our kids make smart decisions and not allow any drug to become injurious in our life. I recognized the really rational decision that people made that criminalization efforts were not a successful public policy. But frankly, I really don’t want to send a message to our kids that this is a route that is without risk.”
Poison control centers are reporting an increase in the number of calls they are receiving for nicotine poisoning from e-cigarettes. This February, centers received 215 calls, compared with about one per month in 2010.
About half of calls related to nicotine poisoning from e-cigarettes involved children age 5 or younger, HealthDay reports. Dr. Tim McAfee, Director of the Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health, which published the findings, said many people don’t know liquid nicotine is toxic. “The time has come to start thinking about what we can do to keep this from turning into an even worse public health problem,” he said.
McAfee said the Food and Drug Administration is expected to propose regulations for e-cigarettes, and he hopes they include childproof caps and warning labels. “These things can be hardwired into these products, rather than being left to the whim of the manufacturer,” he said. McAfee urged e-cigarette users to keep the devices and their refills out of the reach of children. “These should be treated with the same caution one would use for bleach. In some ways, this is more toxic than bleach,” he said.
He explained liquid nicotine can be poisonous if it is swallowed, inhaled, or absorbed through the skin or membranes in the mouth, lips or eyes. It can cause nausea, vomiting or seizures.
In a CDC news release, Director Dr. Tom Frieden said, “E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”
A new survey finds 75 percent of Americans think it is inevitable that recreational marijuana will become legal across the country, ABC News reports. The survey also found a growing number of Americans support ending mandatory minimum prison sentences for non-violent drug offenders.
More Americans are in favor of overturning laws that require jail time for possessing small amounts of marijuana, according to the Pew Research Center survey. “Even people who don’t favor the legalization of marijuana think the possession of small amounts shouldn’t result in jail time,” said Carroll Doherty, Pew’s Director of Political Research.
The survey found increasing support for legalization. Four years ago, 52 percent of survey respondents said they thought marijuana should not be legal and 41 percent said it should. This year, 54 percent of respondents said they favor legalization and 42 percent oppose it.
Many people remain concerned about drug abuse, the survey indicates—32 percent of respondents called it a crisis, and 55 percent said it is a serious national problem. In addition, 54 percent said they thought marijuana legalization would lead to more underage people trying the drug.
The findings were released this week as legislators around the country are considering changes to drug policies, the article notes. At least 30 states have modified penalties for drug crimes since 2009. Many of these states have repealed or reduced mandatory minimum sentences for lower-level drug offenses.
The federal government is also changing its approach to low-level drug crimes. Earlier this month, U.S. Attorney General Eric Holder testified in favor of changing federal guidelines to reduce the average sentence for drug dealers. He told the United States Sentencing Commission the Obama Administration supports changing guidelines to reduce the average drug sentence by about one year, from 62 months to 51 months.
Contrary to the advice of many medical groups, more emergency departments are giving headache patients prescriptions for powerful narcotic painkillers, according to a new study. Between 2001 and 2010, there was a 65 percent increase in emergency department use of narcotic prescriptions for headaches. Hydromorphone and oxycodone were two of the most frequently prescribed narcotics.
A number of groups, including the American College of Emergency Physicians and the American Academy of Neurology, say narcotics should not be used as a first-line treatment for headaches, HealthDay reports.
During the same period, there was no increase in ER prescriptions for non-narcotic pain relievers such as acetaminophen, nonsteroidal anti-inflammatory medications, or triptans (drugs used to treat migraines).
The study authors, who presented their findings at the American College of Medical Toxicology annual meeting, said they are concerned about the findings, in part because of the increasing rates of abuse, overdose and deaths due to narcotics.
“These findings are particularly concerning given the magnitude of increase in [narcotic painkiller] prescribing compared to the other non-addictive medications, whose use remained the same or declined,” lead investigator Dr. Maryann Mazer-Amirshahi of George Washington University said in a news release.
Co-researcher Dr. Jeanmarie Perrone of the University of Pennsylvania said several factors could be contributing to the increased narcotic prescriptions for headaches, including an increased focus on pain management, patient satisfaction, and regulatory requirements.