How Abuse-Deterrent Opioids Give Doctors and Patients More Options

first_img October 11, 2016 How Abuse-Deterrent Opioids Give Doctors and Patients More Options By: Sarah Galbally, Secretary of Policy and Planning SHARE Email Facebook Twitter Public Health,  Substance Use Disorder,  The Blog While many people become addicted to opioids by simply swallowing pills, others crush pills to snort or smoke.Drug manufacturers, with encouragement and guidance from the U.S. Food and Drug Administration, are rapidly developing new technologies to prevent this kind of abuse. Some of these drugs are uncrushable, even with a hammer, while others are formulated with naloxone so the more an individual takes, the less effective it is in creating a high and limiting the potential for overdose. Others turn into a gel when they are crushed, making them impossible to put into a syringe to inject.Recently, Governor Wolf sent a letter to the FDA encouraging their expedited approval of generic forms of opioids with abuse-deterrent formulations which will ultimately make these drugs more affordable and more accessible for the people who need them.Governor Wolf believes that insurance companies should be required to cover abuse-deterrent opioids. HB1698, which has passed in the House and is sponsored by Rep. Heffley, would require health insurance plans and carriers to provide access to abuse-deterrent opioids. In no way would this bill require doctors to prescribe abuse-deterrent opioids. Rather, it would give doctors additional decision making tools and create more opportunities for doctors and patients to collaborate on the best clinical path forward in treating pain.In 2010, OxyContin (OC) was reformulated to be abuse-deterrent. Following this reformulation, rates of abuse, misuse, overdose, death, and drug diversion all decreased. By 2013, “abuse of OxyContin decreased 48% in national poison center surveillance systems, decreased 32% in a national drug treatment system, and decreased 27% among individuals prescribed OC in claims databases. Doctor-shopping for OC decreased 50%,” according to a study published in the summer of 2016. While this study was limited to analyzing the effects of reformulated OC on OC-specific abuse, it adds to a growing body of evidence that justifies expanding access to opioids with abuse-deterrent properties for doctors and patients.According to the American College of Preventive Medicine, almost 60% of prescription medications that are used for nonmedical purposes are obtained from family or friends. Imagine a mother of teen children who was prescribed opioids for pain management following a car accident. Why wouldn’t we want to give this mother the option of having opioids that cannot be snorted or injected in her home?The disease of addiction often begins with swallowing pills. However as the severity of abuse and an individual’s tolerance increases, people suffering from addiction can quickly move to injecting and snorting opioids in order to achieve a stronger high.Furthermore, many also believe that the risk of addiction increases substantially with snorting or injecting. By making abuse-deterrent opioids more widely available, we can help to curb the likelihood of accelerating the severity of a person’s addiction and instead connect them with treatment services earlier in their addiction.Abuse-deterrent opioids are not a cure-all for the opioid epidemic, but taking steps to ensure that pills cannot be altered into forms that make them more potent is a positive step forward and one we wholeheartedly endorse in Pennsylvania.HB1698 requires that insurance companies over which the state has regulatory oversight (typically large and small group plans) provide coverage for three opioids with abuse deterrent properties in the event they currently offer a non-abuse deterrent opioid on their formulary. Neither Pennsylvania’s Medicaid program, Medical Assistance, nor the Commonwealth’s employee benefits plan, PEBTF, are covered under the purview of this legislation and yet both currently cover multiple abuse-deterrent opioids on their formularies. Private insurance companies should do their part to fight the opioid epidemic and model this coverage to create a pathway for meaningful consumer choice.Abuse-deterrent opioids, if crafted properly, can be important tools to prevent against intentional or unintentional misuse, abuse, or overdoses. Like Governor Tom Wolf on Facebook:   SHARE  TWEETlast_img read more

Purple & Bold: Lakers have found their discomfort zone

first_img AD Quality Auto 360p 720p 1080p Top articles1/5READ MOREUCLA alum Kenny Clark signs four-year contract extension with PackersAnd yes, playing while sick impressed them, too.“He’s had reason to sit out, but he’s not sitting out of any games,” Green said. “Now he wants to fight through everything. And he’s letting not just us know that he has our back, but he’s letting the league know that he’s not sitting out for any reason.”Being under the weather is a temporary challenge, but it clicks with something the Lakers have talked about a lot this year: being comfortable with being uncomfortable. That can be an empty-calorie cliché in some contexts, but the Lakers have imbued that with real meaning with what Coach Frank Vogel calls their “growth mentality.” The players in the locker room have goals of expanding their games in particularly helpful ways.An example: Davis has made no secret that he prefers power forward over center. The Lakers made concessions and roster decisions to enable that for him. But Davis has had to do his part by guarding opposing power forwards, many of whom are smaller than him.In the modern NBA, this means Davis is often guarding ball-handlers rather than sticking near the rim and swatting at anyone who approaches. He pointed out that many teams pin down fours near the corner, and then give them the ball. Davis is used to guarding screeners rather than fighting his way through screens: It’s a completely different skill. Editor’s note: This is the Dec. 4 edition of the Purple & Bold newsletter. To receive the newsletter in your inbox, sign up here.DENVER — Here’s a Tuesday night twist on the Kawhi Leonard line: Sick man gets shade.As a red-nosed Anthony Davis swaddled himself in a towel in one corner of Pepsi Center’s visiting locker room, teammates playfully coddled him. Danny Green suggested he drink a ginger ale for his flu-like symptoms, while LeBron James called him “sick man.” Kyle Kuzma and Rajon Rondo noted they were both sick – implying that the media asking about Davis’ halftime IV drip might be a little too focused on the Lakers’ big man.But beyond all that was a genuine admiration from the Lakers for a night when Davis, who stonewalled the Denver Nuggets at the rim for the final three minutes of a 105-96 win on the road. A player whose stated goal since the beginning of the season has been winning NBA Defensive Player of the Year managed to make the crucial plays when it mattered. Also, if the Lakers switch (which they often do in crunch time), that means Davis could find himself, at 6-foot-10, trying to keep his feet in front of an opposing guard. He did this twice against Jamal Murray on Tuesday night in Denver. Neither is something he feels particularly great at, but he knows it’s his responsibility to improve in both areas.“So those two things are pretty different for me and I’m constantly just trying to get better at it,” he said. “But everything else, I take pride in what I can do – the other things – just as well as anybody in the NBA.”Remember: This is a veteran team. There are many players who have very well-defined roles in accomplished careers. But up and down the roster, you can see molds being broken and players redefining themselves.This is Dwight Howard, becoming an energy defender and roll man off the bench. This is Rajon Rondo, starting the season shooting 48 percent from 3-point range. This is LeBron James, leading the league in assists and leaving room on the stage for Davis as a co-star.This was something James alluded to as well, shouting out both Davis and Howard postgame for how they’ve worked on embracing the roles they’ve been given.“(A.D.) having to switch off on smalls, that’s being comfortable with being uncomfortable, and having growth mindset to be able to go out and do things that sometimes you wasn’t accustomed to doing in the past, because it’s for the better of the team or for the better of you individually,” he said. “We’re all trying to figure that out.”Many teams spout these kinds of sayings, but words only mean as much as the truth behind them. And so far, the Lakers have made growth a foundation of their 18-3 start. And if they keep it up, the rest of the league might need to be worried about what potential they still have.TOP QUOTABLEBless Danny Green. He’s nothing if not honest.Against the Nuggets, he wasn’t particularly on target, going just 2 for 12 overall and 1 for 7 from behind the arc. He admitted as much, saying that the bench (which had 42 points) had bailed out the non-LeBron-A.D. starters (who had 13 points).Lakers sideline reporter Mike Trudell pointed out that after his Lakers debut, when he scored 28 points, Green had said he wasn’t as concerned about whether his shots were falling as much as he was about getting good shots in rhythm. Green acknowledged that’s how he felt in the first game of the season, but now his priorities have shifted a little bit.“I do care. I would like to make shots. I did lie. I’m sorry I lied,” he said, with a bashful smile. “I would like to make shots. … Early in the season I don’t care as much, I just care about the process and how we look, what kind of shots we’re getting. If we’re getting good shots, good rhythm shots on offense, if they don’t get in, then I don’t care. Later they’ll be going in. That was early in the season. Now, we’re probably a third of the way through. I care a little bit more. A lot more. I would like to make some shots.”For the record, Green’s hitting 38 percent of his 3-point attempts this year. But as discussed above, we’ve all got room to improve.— Kyle GoonEditor’s note: Thanks for reading the Purple & Bold newsletter. To receive the newsletter in your inbox, sign up here.In Click-ness and in HealthMile-high manifest – Lakers show their aerial dominance against the No. 2 team in the West.“Who’s surprised?” – Not Denver coach Mike Malone, who has seen LeBron do this before.The slope gets steeper – How the Lakers look at a tough December schedule.The long-awaited Lakers – Mark Heisler gives perspective about the long drought for the NBA’s signature franchise.Dented by Dallas – Ending a 10-game winning streak, there were lessons to be learned Sunday.Injury updates – Avery Bradley is missing this road trip.Waxing the Wizards – Ouch.Mo’ Moe in Washington – The former Lakers pick has found his role after being traded over the summer.Bad habits could bite – Mirjam Swanson tried to warn y’all.center_img Newsroom GuidelinesNews TipsContact UsReport an Errorlast_img read more