Dr. Henry Paul, MD

Psychiatrist, Author and Educator

BLACK BOX WARNING ON PAINKILLERS

March 25th, 2016

“They’re the most powerful painkillers ever invented, and their creating the worst addiction crisis America has ever seen.” TIME Magazine Cover June 2015

6422127_sThe US Food and Drug Administration this week announced that painkillers, such as OxyContin and Fentanyl, will now have to carry a “black box” warning stating the dangers of abuse, addiction, overdose and death.

It is called a black box warning because that is how it appears – in a black box. According to the FDA website, “it appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks.”

The FDA hopes that this warning will help to slow a growing epidemic in this country of opioid addiction that is leading to heroin addiction, overdose and death. In 2015, TIME magazine reported in their cover story that “9.4 million Americans take opioids for long-term pain and 2.1 million are estimated by the NIH (National Institutes of Health) to be hooked.”

The article went on to say that the crisis is a “tragic combination of good intentions, criminal deception and feckless oversight to turn America’s desire to relieve its pain into such widespread suffering.”

Here’s what the FDA told CNN about how this warning will work. “When a patient gets his or her prescription filled, the bottle should have a notification indicating there is a black-box warning for the drug. The consumer would need to go to the manufacturer’s website for details. In addition, pharmacists are encouraged to provide patients with a medication guide — consumer-friendly language explaining the risks of the drug. Under this new effort from the FDA, all instant-release drugs will need to have such a guide. It is up to the pharmacist to dispense this information, something the FDA encourages.”

The FDA ruling is a long-overdue step toward fighting America’s drug epidemic. I’m not sure it is realistic to assume that consumers will go to the manufacturers website for details, but I do think that pharmacists taking the time to go over the risks of painkillers will help. I have to agree with Senator Markey in what he told CNN, “It’s too little, too late.” We have a long way to go to turn this epidemic around and educating the public and doctors is key.

LINKS
Time Magazine Releases Cover Story on Pain Killers
Physicians for Responsible Opioid Prescribing
FDA now requires ‘black box’ warning on painkillers

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

YES, IT CAN HAPPEN IN YOUR FAMILY!

March 9th, 2016

22616601_sThe hardest part about the heroin epidemic in this country is getting those who think “not in my family” to understand that it happens to ANY family. It happens to high school and college athletes – the “good kids” — and it occurs in higher numbers in our adult population over age 50. Why? Because painkillers are prescribed to injured athletes and adults with injuries and chronic pain, and painkillers are a gateway drug to heroin.

Let’s focus today on adolescent athletes and how an injury can lead to addiction. A 2013 study published in the American Journal of Public Health found that young athletes are 50 percent more likely to abuse painkillers. Just yesterday CBS News ran a story about college high school wrestler Robert King who was prescribed the painkiller Percocet for his broken foot and who just a few years later found himself addicted to heroin.

According to CBS, “King’s story is not an uncommon one. As the heroin epidemic continues to rage throughout the country, high school athletes are falling victim to addiction in alarming numbers.”

I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness, and I applaud families who are opening up about their loved one’s addiction. Now, even in obituaries families are candidly disclosing the cause of death as a drug addiction. Families are not trying to scare anyone. On the contrary, they are helping to promote awareness that just may save a life.

In the CBS story, Jack Riley, Deputy Administrator of the Drug Enforcement Administration (DEA), emphasized that addiction cuts across every demographic group. He told CBS, “Heroin never discriminates, and athletes are no different. This dangerous drug has become a powerful weapon of mass destruction for drug addicts, some of whom are athletes who first became addicted to painkillers while rehabilitating from sports injury.”

So what should parents do? Most important is to educate yourself about the growing painkiller and heroin epidemic. If your school or community is offering drug awareness education forums — go! Encourage your friends to go with you too. Learn about Narcan™ (naloxone) an opiate antidote. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. Many local communities are training first responders and school staff in the use of Narcan.

Trust your instincts. If you think something is off with your teen, you’re probably right. Ask questions and get answers. If you have a child on pain medication, ask the doctor about it. In the end, remember this is an epidemic in this country so do what you can do to prevent it from spreading to your family. Knowledge is power – always a good place to start!

LINKS

The surprising path from student athlete to heroin addict  CBS

You can make a difference in the growing heroin epidemic. Blog by Dr. Henry Paul

He died of a Heroin overdose! Blog by Dr. Henry Paul

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription.

 

HE DIED OF A HEROIN OVERDOSE!

July 20th, 2015

A growing number of obituaries of people who have died of heroin overdoses refer to their addiction, The New York Times reports. In the past, these obituaries tended to say a person died “unexpectedly” or “at home.”  Partnership for Drug-Free KidsMore Obituaries Refer to Addiction as Heroin Overdoses Increase”

26559211_sHeroin again! I have written blogs about painkiller and heroin addiction for the past year and the need in this country for more awareness. Now I applaud families who are opening up about their loved one’s addiction, particularly in obituaries. In the past, obituaries referred to overdose deaths as an “undisclosed” or “sudden” illness. Now families are candidly disclosing the cause of death as a drug addiction. Families are not trying to scare anyone. On the contrary, they are helping to promote awareness that just may save a life.
“This is part of a trend toward a greater degree of acceptance and destigmatization about issues pertaining to mental illness, including addiction,” said Dr. Jeffrey A. Lieberman, Chairman of Psychiatry at the Columbia University College of Physicians and Surgeons, in the Partnership for Drug-Free Kids article.

He added, “If a family chooses to do this, they can have a cathartic experience that facilitates the grieving process. When the person was alive, they may have been enabling, and they couldn’t acknowledge it. But this allows them to begin that process of coming to terms with the fallibility of the family member and their own limitations in not having been able to deal with it while the person was alive.”

I found a comment posted by “Charlie” to the Partnership for Drug-Free Kids article said it best, “No one plans on being addicted. They think they are stronger than that. Heroin messes up how your brain processes things. It messes up your entire system. These are people that made a bad decision once or maybe twice and the addiction took hold of them.”

The news media is reminding us every day that we have a serious painkiller and heroin epidemic in this country. All teenagers will be exposed to drugs and alcohol at some point. Studies show that about 65 percent of teenagers try marijuana in high school, but for many children drug experimentation begins even earlier, in grade, middle or junior high school. Parents need to understand that alcohol and marijuana are gateway drugs. What I am concerned about is that there are still so many parents and teens that don’t understand the dangers. Teenagers are known for risky behavior. It is part of their development. Many teens don’t think about the cause and effect correlation of drugs and alcohol with the greater likelihood of becoming involved in criminal activity, suffering from suicidal tendencies, or facing other life-threatening dangers such as death from overdose.

We need to work together to do a better job at keeping our at-risk population safe from drug addiction. It really is a matter of life and death. For more information on addiction you can visit:

YOU CAN MAKE A DIFFERENCE IN THE GROWING HEROIN EPIDEMIC

HEROIN AGAIN!

Why heroin is spreading in America’s suburbs — The drug has followed prescription painkillers into new neighborhoods, forcing police and parents to confront an unexpected problem. By Kristina Lindborg, March 2014, cover story.

Nice coalition.  Look for coalitions in your area.  Powertotheparent.org

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

HEROIN AGAIN!

March 19th, 2015

“New York City is now the “nation’s most significant” heroin hub,” according to city Special Narcotics Prosecutor Bridget Brennan. NY Post, 3/16/15, NY is now heroin central: narcotics prosecutor

35442181_sI have been writing about heroin now for over a year in my blog, and the heroin situation just continues to get worse. Heroin is an epidemic that has taken America by storm. I cannot impress enough on parents that they need to educate themselves about the dangers of prescription painkillers and the rising use of heroin. These threats are particularly dangerous to our teenagers and young adults.

Here are some facts on Heroin from the DEA’s Prevention4teens:

  • Narcotics (such as heroin, morphine, OxyContin, etc.) are used to dull the senses and reduce pain. Narcotics can be made from opium (from the opium poppy) or created in a laboratory (synthetic and semi-synthetic narcotics).”
  • Heroin is a narcotic which can be injected, smoked or snorted. It comes from the opium poppy grown in Southeast Asia (Thailand, Laos and Myanmar— Burma); Southwest Asia (Afghanistan and Pakistan), Mexico and Colombia. It comes in several forms, the main ones being “black tar” from Mexico (found primarily in the western United States) and white heroin from Colombia (primarily sold on the East Coast). In the past, heroin was mainly injected. Because of the high purity of the Colombian heroin, many users now snort or smoke heroin. All of the methods of use can lead to addiction, and the use of intravenous needles can result in the transmission of HIV.
  • Heroin Effects: Euphoria, drowsiness, respiratory depression, constricted pupils, and nausea.
    • Overdose Effects: Slow and shallow breathing, clammy skin, convulsions, coma, and possible death.
    • CSA Schedule: Heroin has no legitimate medical use: Schedule I.
    • Street Names: Horse, Smack, Black Tar, Chiva, and Negra (black tar).
  • Denial Can Make the Problem Worse:  Some parents may be afraid to confront the realities of drug use, so they may deny the truth, even to themselves. You may have heard some adults say: “My kid doesn’t use drugs.” “It’s not a problem for our family.” “I used drugs and survived.” “Drug use is a normal part of growing up.” “We’ll never solve the drug problem.” “Alcohol is more dangerous than marijuana.”

I recommend that you attend a forum at your local high school or a community coalition awareness forum to learn more about the substance and heroin abuse in your community. Many local coalitions are forming around the country to educate the public, parents and teens about the dangers of heroin and the painkillers that often are the “gateway” drug to it.

Some of the latest newspaper stories about the heroin epidemic:
Schumer Moves to Reverse President’s Cut in Critical Drug Trafficking Program
Man accused of stashing heroin in daughter’s diaper
4-year-old hands out heroin at daycare
Cops seize $2.5M worth of heroin in Bronx raid
Schumer slams Obama’s proposed cuts to anti-drug program

Disclaimer

This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

NEW REGULATIONS ON DISPENSING HYDROCODONE. WILL IT MAKE A DIFFERENCE?

August 25th, 2014

In Move to Curb Drug Abuse, D.E.A. Tightens Rule on Widely Prescribed Painkiller — The stricter rule for hydrocodone, which is the most widely prescribed painkiller in the United States and which is an ingredient in drugs like Vicodin, is one of the most far-reaching efforts to stop the growing epidemic of prescription drug abuse. More than 20,000 Americans die every year because of prescription drug abuse, according to federal data.  The New York Times

 

On Friday, the federal government tightened the regulations on the most prescribed painkiller in America, hydrocodone. The reason? Hydrocodone is an ingredient in drugs like Vicodin and a leader in the growing epidemic of prescription drug abuse here in the United States.

As a psychiatrist treating adults and teens for over 30 years, I know that painkillers like Vicodin are highly addictive and are adding to a growing heroin addiction in this country.

As far as hydrocodone, the changes that the government requires are sweeping, making it much more difficult to prescribe the drug. For this drug, doctors will no longer be able to call in prescriptions, and patients will no longer be able to get refills on the same prescription without returning to their doctor for a visit. The DEA (Drug Enforcement Administration) published a rule on Thursday, August 21, 2014, which also requires pharmacies to keep the drug in a vault.

The problem is that the abuse of painkillers claims more lives than any other drug including heroin and cocaine combined, and hydrocodone and other painkillers are the leading cause of heroin addiction. The heroin addiction is out of control, and I have written several blogs about it and the need for more education about the epidemic. See my blogs on heroin Governor Cuomo Recognizes Heroin Epidemic and The Growing Heroin Problem in America.

These new restrictions are not a solution to the problem, but they do acknowledge the need to do something. Oxycodone, the main ingredient in OxyContin, which I am sure many of you have heard about, is highly addictive and has been restricted for years.

The downside of restricting all of these drugs is that it will most likely lead to an increase in heroin abuse. Why? Because synthetic heroin is cheap. The reality is that it is good to be aware of the need for restricting medications like hydrocodone, but we need to also be vigilant about educating our teens and young adults, the most affected population, about the dangers of these drugs and heroin.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.