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Opioid Summaries by State

Information & Facts About Opioids

OPIOID INFORMATION & FACTS

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CDC - Center for Disease Control - Opioids


CDC OPIOID PRESCRIBING GUIDELINES HERE

FDA  - Drug Safety Information

HHS - Department of Health and Human  Services - Opioids

NIH - National Institute of Health - Opioid Summary by State


MME CALCULATOR HERE:

(Morphine Milligram Equivalent)


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Federal Agency Information


U.S. Dept. of Health and Human Services (DHHS) is the United States government's principal agency for protecting the health of all Americans and providing essential human services.


Office of the Inspector General (OIG) of the DHHS includes information about programs to combat waste, fraud and abuse in the Medicare program.


OIG's Reading Room posts advisory opinions under the Medicare/Medicaid Anti-Kickback Law and lists of persons excluded from the Medicare/Medicaid Programs.


Centers for Medicare & Medicaid Services (CMS) is the federal agency that administers Medicare, Medicaid, and the State Children's Health Insurance Program.


The U.S. Food and Drug Administration (FDA) is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation's food supply, cosmetics, and products that emit radiation.


Drug Enforcement Administration (DEA) enforces the controlled substances laws and regulations of the United States.


Drug Enforcement Administration (DEA) Office of Administrative Law Judges conducts formal hearings in accordance with the Administrative Procedure Act in connection with enforcement and regulatory cases brought by the DEA under the Controlled Substances Act and its attendant regulations.


National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency.


The National Library of Medicine (NLM) is the world's largest medical library. The Library collects materials and provides information and research services in all areas of biomedicine and health care.



National Resources



National Safety Council  


Role in Procurement of CDC GUIDELINES 


The National Safety Council formally dedicated its resources to fighting prescription drug overdose in 2012, although an NSC study five years earlier laid the groundwork for this important initiative. The study revealed prescription drug overdose was the fastest-rising cause of unintentional death in the U.S.

Since then, NSC has positioned itself as the resource for employers, families and prescribers on the opioid crisis. NSC has taken key steps towards eradicating this epidemic.





How Did We Get Here? Timeline of Events (2012-Present)



HOW DID WE GET HERE.?

Oxycontin Investigation

May 27, 2016

August 26, 2016

August 29, 2016

Nov 17, 2016

Timeline of Events 

2018

2017

2016

  • December – Attended signing of the 21st Century CURES act, which NSC supported  
  • October – Partnered with American Academy of Family Physicians and American College of Physicians to sponsor systematic evidence review for acute pain treatment
  • September – Established NSC Physician Speakers bureau
  • September – Sponsored Fed Up Rally
  • August – Conducted second Overdose Awareness Day in Chicago's Federal Plaza
  • August – Participated in meeting with Surgeon General and ONDCP Director on efforts to fight the opioid overdose epidemic with other leading organizations
  • July – Supported passage of the Comprehensive Addiction and Recovery Act (CARA)
  • June – Published Prescription Nation 2016 report
  • March – Published results of the  national prescriber survey
  • March – Met with HHS Secretary staff about efforts to fight the opioid crisis
  • February—Testified at U.S. Senate Aging Committee hearing on Opioid Use and Abuse Among Older Americans
  • January – Testified in support of CDC Opioid Prescribing Guideline for Chronic Pain at meeting of the CDC Board of Scientific Advisors

2015

2014

2013

  • October – Released Prescription Nation report calling for state action to address the opioid crisis
  • March – Held prescription drug symposium "Preventing Prescription Drug Overdoses: A National Strategy"

2012

  • December – Convened prescription drug expert panel comprised of business leaders, medical and pharmacy professionals, insurance industry and government experts
  • June – Partnered with National Governor's Association to provide grants to seven states to develop statewide plan to address prescription drug misuse
  • May – Launched the NSC prescription drug overdose initiative



DEA/DOJ Pressure on Prescribers - Circa 2015/2016

Health Care Physicians in the Crosshairs: Criminal Prosecution

Alan J. Sobol
Connecticut Law Tribune
October 23, 2015



Recent changes to our health care system have been at the forefront of the American news cycle for several years.  But certain aspects have not received adequate attention.  One example is the scrutiny federal and state authorities place on medical practitioners who over-prescribe pain medication controlled substances.  As part of its efforts to combat the over prescription (diversion) of pain medication, the Department of Justice organized “Operation Footprint,” a nationwide law enforcement initiative led by the U.S. Attorney’s Offices, the IRS-Criminal Investigation, the DEA, and the U.S. Postal Inspection Service.  In a recent press release following one of the largest medical fraud sweeps in history, the Special Agent in Charge of the U.S. Department of Health and Human Services stated that “Physicians who overprescribe narcotics not only waste valuable taxpayer dollars and defraud Medicare and Medicaid, they also threaten the health and safety of their patients.”  And in 2014, while serving as the U.S. Attorney for the Eastern District of New York, Attorney General Loretta Lynch highlighted the Department of Justice’s focus on these cases: “We are committed to vigorous prosecution of doctors who abdicate their Hippocratic Oath, participate in the illegal distribution of prescription drugs and contribute to the rise of drug abuse and addiction in our communities.” 


Despite these pronouncements, some health care practitioners, especially those who do not regularly practice pain management, are likely unaware of the criminal liability that can stem from the prescriptions they issue. Ignorance of the law, however, is not a defense.  Thus, it is crucial for attorneys who represent health care professionals to ensure that their clients properly understand their responsibilities with respect to prescribing pain killing controlled substances.



How hospitals can reduce opioid prescriptions—and cut millions in costs



As legislators grapple with the opioid epidemic, hospitals are also rethinking their prescription practices. We polled over 200 acute care pharmacy leaders to understand how they are making formulary decisions, and what's the impact on reducing opioid prescriptions and related complications.

Read the research brief to learn more about our analysis of more than 400 organizations to investigate the impact of multi-modal pain regimens, and how your organization may be able to save over $1 million by reducing opioid use during surgery.

Download the brief 



DOJ announces new effort to crack down on doctors overprescribing opioids


A memo detailing the plan is expected to be sent to all 94 U.S. attorney offices next week

 - September 16, 2016



The Department of Justice (DOJ) is planning to launch a new initiative to combat the U.S. opioid epidemic, Kevin Johnson writes for USA Today.


Attorney General Loretta Lynch (D) outlined the plan, which has yet to be released, in an interview with USA Today. A memo detailing the plan is expected to be sent to all 94 U.S. attorney offices next week.


How physicians can help curb the opioid epidemic 


Plan details

DOJ's new strategy will focus on identifying links between physician overprescribing and distribution networks across the United States.


Specifically, Lynch said prosecutors will be encouraged to share information across state lines about physicians' inappropriate prescribing practices, which could help to identify traffickers and trafficking routes more quickly. Lynch said prosecutors also will be urged to coordinate their enforcement efforts with public health officials in their districts.


"I'm not calling anybody out, because I think the people who look at this problem realize quickly how devastating it has been to families, to communities, to public health dollars, to law enforcement resources,'' Lynch said. "There is no one magic bullet for this.''


Obama signs bill to combat opioid misuse 


Michael Botticelli, director of National Drug Control Policy, on Thursday said the Obama administration also will call on Congress to approve funding for recent legislation that aims to curb opioid misuse. In addition, the effort will call on congressional lawmakers to approve $1.1 billion in grants to pay for treatment requested by the White House, which will host events next week to raise awareness about the issue.


"The biggest area where we have fallen short is filling the gap between people who need treatment and those able to get it,'' Botticelli said, adding, "We need more treatment capacity. ... This requires a response commensurate with the size of the epidemic."


Lynch said, "We've been looking at this for a long time with an awareness that you can't just have an enforcement strategy alone" (Johnson, USA Today, 9/16).

Abuse & Diversion Research

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Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System


For many years, Purdue has dedicated vast resources to combating drug abuse from a range of approaches. The RADARS System, just one example, was developed by Purdue in 2001 to collect and analyze data on drug abuse, diversion, and addiction.


In 2006, Purdue transferred ownership to the Denver Health and Hospital Authority (DHHA) to facilitate access to RADARS surveillance data by pharmaceutical firms and government agencies.


Today, the RADARS System is an independent, non-profit operation of the Rocky Mountain Poison and Drug Center (RMPDC), a division of DHHA.



Perdue Pharma

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Responsible Use of Opioids


For many years, Purdue has been an industry leader in the fight against opioid abuse and diversion. We are also committed to supporting healthcare professionals on the responsible use of our products.

For information on appropriate use and prescribing of opioid analgesics as well as the risks of opioids, prescription drug abuse, prescription drug monitoring programs, and the opioid analgesic Risk Evaluation and Mitigation Strategy (REMS), please visit Ask Purdue Medical.


Opioid Analgesic REMS
The U.S. Food and Drug Administration (FDA) has mandated that opioid analgesics have a Risk Evaluation and Mitigation Strategy (REMS) to help ensure that the benefits of the drug outweigh its risks. Learn more about REMS for opioid analgesics.


Opioids With Abuse-Deterrent Properties
Purdue was the first company to introduce opioids with labeling claims for abuse-deterrent properties through development of novel formulations and abuse deterrence studies.


National Academies of Science and Medicine

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Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use


Released:  July 13, 2017


REPORT AT A GLANCE


  • Report Highlights (HTML)
  • Interactive Guide (HTML)
  • Watch the report release webinar (HTML)
  • Action Guide: Strategies for health professional organizations (HTML)
  • Action Guide: Strategies for research sponsors (HTML)
  • Action Guide: Strategies for state agencies (HTML)
  • Action Guide: Strategies for federal agencies (HTML)
  • Public Release Slides (HTML)
  • Report Recommendations (HTML)
  • Social Media Toolkit (HTML
  • Press Release (HTML)


Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. 


The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. 


Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. 


As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the  science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA’s development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.


Information & Resources

Video Series by George Knapp

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#OURPAIN 

Informative Video Series About the True Cause of the Opioid Crisis. 


 #OurPain: Opioid crisis leaves legitimate pain patients struggling
When you hear the word "opioid" on the news, it is usually attached to other words, including "crisis" and "epidemic."
Read More »News


#OurPain: The other side of opioids
Millions of Americans who rely on opioid medications for pain relief are in anguish because of government pressure to reduce prescriptions across the board.
Read More »News


#OurPain: How money factors into the opioid debate
Pain doctors say they'd like to wean their patients off of opioids when feasible, but many of the alternative treatments are not covered by public or private insurance programs.
Read More »News



George Knapp

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The Other Side of Opioids:

From https://www.lasvegasnow.com/


How the DEA Changed the Overdose Numbers

#OurPain: Opioid crackdown leaves veterans in pain

The years of service and injuries take their toll and for many, the only relief comes from opioids. But navigating the VA system is far from easy and fewer prescriptions are being written. Read More »News


I-TEAM: Opioid addiction versus dependency.  Millions of chronic pain patients, already living in agony because of disease or injuries, now live in fear that their medicine will be taken away because they've been stigmatized as drug addicts. Read More »News



#OurPain: Pain doctor who defends opioids under investigation  

A prominent pain doctor who was part of the I-Team's special project about the war on opioids is now the focus of a DEA investigation. Read More »


WEBSITES:

Links & Resources

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Health Care and Medical Organizations


The American Society of Anesthesiologists is an educational, research and scientific association of physicians organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.  


American Medical Association promotes the art and science of medicine and the betterment of public health and continues to be the leading advocate for physicians and their patients.


American Health Care Association provides information on long-term care including  issue papers, links to U.S. Government reports and databases, and more.


American Academy of Family Physicians preserves and promotes the science and art of family medicine and ensures high-quality, cost-effective health care for patients of all ages.


American Health Information Management Association is the community of professionals engaged in health information management, providing support to members and strengthening the industry and profession.


Agency for Healthcare Research and Quality is a home to research centers that specialize in major areas of health care research such as quality improvement and patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care organization and delivery systems. It is also a major source of funding and technical assistance for health services research and research training at leading U.S. universities and other institutions


The American Academy of Medical Management serves as an educational resource in the U.S. for people working in the business side of health care.


The College of American Pathologists, the principal organization of board-certified pathologists, serves and represents the interest of patients, pathologists, and the public by fostering excellence in the practice of pathology and laboratory medicine.


Institute of Medicine is a nonprofit organization for science-based advice on matters of biomedical science, medicine, and health. The Institute provides a vital service by working outside the framework of government to ensure scientifically informed analysis and independent guidance.


Joint Commission on Accreditation of Health Care Organizations (JCAHO), an independent and not-for-profit organization, is the predominant standards-setting and accrediting body in health care.


National Committee for Quality Assurance is a private, not-for-profit organization dedicated to improving health care quality. The organization is frequently referred to as a watchdog for the managed care industry.


Health Law Organizations


The American Health Lawyers Association (AHLA) is an educational organization devoted to legal issues in the healthcare field.


Legislative Information


Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the security and privacy of health data and establishes national standards for electronic health care transactions.


State Legislative Database Search offers key-word searching of all Internet accessible state legislatures.


US Code of Federal Regulations is a consolidation and codification by subject matter of the general and permanent laws of the United States.


Telemedicine, Technology & Health Law is Alan S. Goldberg's site on telemedicine, health law, fraud and abuse and related issues.


THOMAS provides Congressional legislative information via the Internet.


Kaiser Family Foundation provides access to resources and information on major areas of health care policy, including narrated slide lectures, research, data, and policy analysis.


Health Care News and Current Events


America's Health Insurance Plans is the national trade association representing the health insurance industry. Their website provides information about health care news and policy updates.


FierceHealthcare provides healthcare management news for healthcare industry executives.


Modern Healthcare provides healthcare business and policy news, research and information.


Publications


AJPH American Journal of Public Health 


Journal of Health Politics, Policy and Law


NEJM

The New England Journal of Medicine 

PubMed/MEDLINE  


JAMA

Journal of the American Medical Association

American Journal of Public Health 

Journal of Health Politics, Policy and Law

PubMed/MEDLINE

THE US OPIOID epidemic

 

Introduction


What drugs are contributing to the crisis?


What is the scale of the epidemic?What are the demographics of the opioid crisis?


What have been the socioeconomic consequences?


Where are the heroin and fentanyl coming from?


What has the United States done to restrict foreign narcotics?


What are some efforts to restrict domestic supply?


What is the United States doing to reduce demand?


What are some efforts to restrict domestic supply?


Federal agencies, state governments, insurance providers, and physicians all influence the supply of opioid medications.


Federal regulators have introduced new limits on opioid prescriptions, reducing the total nationwide in 2017 by 25 percent from the peak in 2012, according to the CDC. The agency issued guidelines in 2016 advising physicians not to prescribe opioids as a first-line therapy. The DEA reduced production quotas for pharmaceutical manufacturers by at least 25 percent that year for opioids categorized as schedule II drugs, or those that are currently accepted for medical purposes but carry high risk of misuse; these include oxycodone, fentanyl, and morphine. The agency has since proposed additional cuts, in line with a call by Trump to reduce the number of filled prescriptions by one-third in three years. 


Reporting by the Washington Post and 60 Minutes, however, found that a law passed in 2016 after heavy lobbying by pharmaceutical companies has effectively stripped the DEA of its ability to freeze suspicious shipments of narcotics. A December 2018 congressional report on painkiller shipments to West Virginia found that lack of oversight by the DEA fueled the black market and worsened the epidemic in the state.


In 2018, the Justice Department ramped up efforts to prosecute those involved in overprescribing and trafficking. In April of that year, it partnered with nearly all state attorneys general to share opioid prescription information in order to investigate drug crimes and, in its largest-ever move to crack down on health-care fraud, it brought charges against more than 150 doctors, nurses, pharmacists, and others for their alleged roles in distributing opioids.


Additionally, many U.S. states have passed legislation limiting opioid prescriptions since the start of 2016. States including Mississippi, New Jersey, Ohio, and Oklahoma, as well as thousands of cities, are suing pharmaceutical companies, alleging they overstated the benefits of prescription opioids and concealed the risks. In a landmark case brought by Oklahoma, Johnson & Johnson was ordered to pay the state $572 million in August 2019 for its role in the epidemic. In another case, the Sackler family, the owners of Purdue Pharma, reached a $3 billion settlement with state and municipal governments that allowed the company to file for bankruptcy in order to thwart thousands of other lawsuits against it, though some states are challenging the move.

Everything you need to Know About ILLICIT Fentanyl

FENTANYL 101

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ILLICITLY MANUFACTURED FENTANYL (IMF) is the TRUE culprit causing the OVERDOSE EPIDEMIC.  


This deadly synthetic substance is being added to most street drugs like heroin, cocaine,  meth, and look alike counterfeit pills.   It's so potent, one pill can cause an overdose!   


Learn More about ILLICIT Fentanyl Below.0


Websites:


Partnership for Safe Medicines 


FENTANYL 101 INFOGRAPHIC


DEA CHRONICALS 


Pain Crisis in America 



More Information:


This is your brain on opioids 


How buprenorphine, or ‘bupe’, changed opioid addiction treatment


Abstinence vs. medication-assisted treatment: Traditional 12-step programs embrace a new model 


The menace in the medicine cabinet: The opioid epidemic’s pharmaceutical roots


The rise of Narcan, the life-saving opioid antidote that can stop an overdose in its tracks 


Why the new face of opioid addiction calls for a new approach to treatment


https://www.cfr.org/backgrounder/us-opioid-epidemic


Most fentanyl coming to the United States is produced in China, U.S. officials say, and commonly transited through Mexico. Chinese authorities “have struggled to adequately regulate thousands of chemical and pharmaceutical facilities operating legally and illegally in the country,” says a 2017 report [PDF] issued by a congressionally mandated commission.

Exponential Growth in Drug Overdose Epidemic