Alert escalates on drug mix: 'Too many dying'

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Alert escalates on drug mix: 'Too many dying'

Postby palmspringsbum » Fri May 26, 2006 12:06 pm

The Detroit Free Press wrote:Michigan

Alert escalates on drug mix: 'Too many dying'


Detroit Free Press
May 26, 2006
FREE PRESS STAFF WRITERS


As metro Detroit officials braced for what could be a deadly Memorial Day weekend, a dozen drug abuse counselors fanned out across the city Thursday to warn users about a fatal mix of drugs laced with a pain medication that is suspected in the deaths of as many as 33 people in the past week.

With federal agents chasing down leads to the source of the drugs and investigators combing through autopsies and toxicology reports, the counselors deployed in hopes of alerting people to the dangers of the fentanyl-laced drugs suspected in more than 100 deaths in metro Detroit since September.

In recent days, that number has surged -- officials in Wayne County said Thursday 10 drug deaths occurred Tuesday, up from four reported a day before -- as health officials and police struggled to react to the distribution of a mix dealers are marketing as "drop dead" and "suicide packets."

"The idea that it is deadly potent could be a come-on for the dyed-in-the-wool drug addict," said Dr. Calvin Trent, director of Detroit's Bureau of Substance Abuse, which is part of the city's Health Department.

Another concern is whether less hard-core users of heroin and cocaine will try the fentanyl-added mix in search of a stronger high.

"This is not the time to be going to the streets and buying a recreational bag of drugs," Trent said. "This is one of the most serious issues we've dealt with and we're not sure if the community is taking it seriously."

On Thursday afternoon, Edward Aniapam, coordinator of special services for the substance abuse bureau, visited eight Detroit shelters as part of a coordinated effort to pass out information warning about the fatal mix.

"We need you to help us spread the word," Aniapam told a group of about 30 people at the Detroit Rescue Mission shelter on Third Street. "There are too many people dying. You may think: 'Gimme some of this bad stuff. I'll do just a little bit and it won't kill me.' Please, this is killing people."

Down the street, at the Neighborhood Services Organization shelter, people said word is out about the high-powered mix.

"We hear the drug is used for cancer," Robert Nesbitt, 56, said as he rolled homemade cigarettes in a tray. "It's genocide, in my opinion. Someone should have spoke up about this a long time ago."

Outside of the shelter, a group of men and women sipped from beer bottles and smoked marijuana before Aniapam approached them.

"Take these flyers, man," he said. "We've got something bad going on."

'We have some good leads'

As drug counselors tried to spread the word, U.S. Drug Enforcement Administration officials said Thursday they were tracking information that could lead to the sources of the heroin and cocaine that is mixed with the painkiller, typically given to terminally ill patients. The officials said their investigation could last at least two more weeks.

The source of the drug itself, however, is still unknown -- possibly a clandestine lab or a rogue pharmacist.

"We have some good leads," said Carolyn Gibson, a DEA spokeswoman. She did not elaborate.

The DEA has been working with its offices in Camden, N.J., Philadelphia and Chicago, where other cases of fentanyl-laced heroin have been identified, in hopes of figuring out whether those cities were supplied from the same source.

Although those cities have experienced problems with fentanyl, the number has paled in comparison with the death toll now being investigated in Detroit.

The DEA first identified fentanyl mixed with other drugs in Michigan last November when investigators bought heroin off the street to test it -- a practice aimed at monitoring the spread of the drug.

The recent surge has been so serious that investigators from the Atlanta-based U.S. Centers for Disease Control and Prevention have come to Detroit to try to re-create the events that led to the suspected fentanyl deaths, CDC spokeswoman Bernadette Burden said.

So far, they have not had anything to report.

Teresa Blossom, a Wayne County spokeswoman, said there have been 33 drug-related deaths in Wayne County since May 18. Although toxicology reports, which take weeks to complete, will be needed to determine how many are fentanyl-related, the majority of the 106 drug deaths in Wayne County from September through March were linked to fentanyl mixed with heroin or cocaine. That leads officials to believe the recent surge is related to fentanyl as well.

Blossom said the county would not release the names of the people who have died, because the investigation is ongoing.

Deaths from the drug are not just a Wayne County or Detroit issue, however.

Oakland County chief forensic toxicologist Gary Kunsman said Thursday the county has tentatively identified 28 fentanyl-related deaths since late September. In Macomb County, medical examiner Daniel Spitz said he has seen more fatal drug overdoses in recent weeks, but so far just one has been linked to fentanyl, and it wasn't mixed with either heroin or cocaine.

John Roach, a spokesman for the Wayne County Sheriff's Office, said the majority of the special operations unit is investigating the suspected fentanyl cases.

"Much of that is interviewing people we know or have contacted before that are known heroin users," he said. "It's a street-level approach we are taking."

Quick treatment is crucial

Officials said those who overdose can be saved if they get to an emergency room immediately.

"This can be treated: The key is looking for signs that include dizziness, trouble breathing or an inability to walk and talk," said Michele Reid, medical director of the Detroit-Wayne County Community Mental Health Agency and chairwoman of the newly created Wayne County fentanyl work group.

Asked why anyone would willingly take the more powerful drug, Dr. Michael Boyle, medical director of Henry Ford Health System's Maplegrove Center, a West Bloomfield drug treatment facility, said simply: "To feel good."

"An addict will go to any lengths to feel good," he said.

And the knowledge that a drug has a potentially deadly ingredient will not stop addicts, particularly if that ingredient promises an even better high.

"There are two mechanisms in play," Boyle said. "One is denial: 'It will not happen to me.' The other is thinking: 'They took too much. I'm going to take less.' "

Getting the word out to users is not an issue, he said.

"Heroin addicts are aware better than you or I what's going on out there," Boyle said.

<font size=-1>For more information on drug abuse, visit www.drugfreedetroit.org or www.semca.org. A statewide substance abuse hotline is available at 888-736-0253. Contact BEN SCHMITT at 313-223-4296 or bcschmitt@freepress.com.</font>

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New heroin-fentanyl combination is a killer 'bomb'

Postby budman » Mon Jul 17, 2006 12:43 pm

The Middletown Journal wrote:Elmon Prier: New heroin-fentanyl combination is a killer 'bomb'

The Middletown Journal
By ELMON PRIER COLUMNIST
16 Jul 2006

Drug use and abuse continue to be a scourge and a plague on our American society. Ask a classroom full of students if they know someone who uses drugs and almost all of the hands are raised in the air.

Many people prefer to label themselves as recreational drug users, while others have crossed that imaginary line from recreation into full-blown addicts or alcoholics. There is an insanity about drug use because of the compulsion to use and the inability to stop on your own.

Underneath the radar screen — with the news being dominated by the Iraq and Afghanistan war, immigration reform and alien captives, the Korean missile scare, bird flu, and Barry Bonds’ bloated homeruns — drug addicts are dying in clusters from a strange mixture of heroin and the powerful painkiller fentanyl. The problem is the deceased addicts thought they were taking heroin alone. They can die just by the heroin alone, but add the fentanyl and it’s like death to the second power.

When addicts begin to die in this fashion — Wayne County, Mich. (70); Philadelphia (20); Chicago (30); New Jersey (20); and Delaware (5) — a feeling of dread and euphoria breaks out in the addiction community. According to a report by Sarah Karush of the Associated Press, one addict named Larry has a cardinal rule of getting high: “Never shoot up alone, and shoot up only one person at a time.” In Larry’s world, he reasons, “You need someone to bring you back.” That’s the insanity part of addiction I’m talking about.

And if that’s not enough about the cunning, baffling, powerful nature of drugs on a drug user, then read this. When “(the) bomb” — extremely high quality heroin — begins to kill fellow addicts, they still search for it. Even as they sometimes file past a deceased friend who died from a heroin or a heroin-plus-fentanyl mixture in a funeral home, their minds are filled with genuine remorse and sorrow — but these addicts also long to know where can they get some of “the bomb” which killed their friend. Is that insanity or what?

The Center for Disease Control and Prevention considers fentanyl to be 50 to 100 times more powerful than morphine. Fentanyl kills by inhibiting respiration, according to Detroit medical examiner Carl J. Schmidt. “It literally suppresses your natural impulse to breathe.”

No one seems to know why illegal heroin as a drug is diluted or “stepped down” with a powerful drug such as fentanyl. Normally heroin is cut or diluted with household substances such as starch, quinine or flour. But we cannot afford to exhibit the “Jaws Syndrome.” You remember how in the motion picture that the great white shark was really killing people but business persons wanted to be quiet about it. The heroin/fentanyl shark has killed 100 people thus far. At least one person died from a mixture of fentanyl and cocaine.

So far organizations are running needle exchanges and health programs for drug users to spread the word about “the bomb.” But that’s not enough. We must make a greater effort to deter our children from the throes of alcoholism and addiction. We must convince our youth that they cannot become addicts or alcoholics if they never smoke that joint of marijuana the first time never smoke that crack-cocaine pipe the first time never snort that line of cocaine the first time never use that methamphetamine the first time or never take that drink of alcohol the first time.

We may not be able to keep “the bomb” out of our community but we can keep it from exploding — through abstinence, education and spirituality.

Elmon W. Prier is a veteran educator and minister. His e-mail address is eprier@cinci.rr.com.




<span class=postbold>See Also</span>: Opiate related deaths soar

<span class=postbold>See Also</span>: Prescription Drug Abuse in Teens

<span class=postbold>See Also</span>: Las Vegas Prescription Drug Abuse Growing Problem

<span class=postbold>See Also</span>: West Virginia sees flood of prescription drug junkies

<span class=postbold>See Also</span>: Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach - Tod H. Mikuriya
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Philadelphia Deaths from Fentanyl-Laced Heroin Overdoses

Postby palmspringsbum » Thu Aug 31, 2006 3:45 pm

Genetic Engineering News wrote:Philadelphia Deaths from Fentanyl-Laced Heroin Overdoses Could be Reduced by Medical Treatment

8/31/2006 3:00:00 AM EST
PRNEWSWIRE


RICHMOND, Va., Aug. 31 /PRNewswire/ -- A recent string of opioid overdoses and deaths in Philadelphia and elsewhere in Pennsylvania highlight the devastation of a dangerous new illegal drug mixture: the combination of heroin with fentanyl, a powerful opioid painkiller used to treat cancer pain and in anesthesia. According to the Medical Examiner's office, so far there have been approximately 100 fatal overdoses in the Philadelphia area attributable to heroin laced with fentanyl, while several times this many have occurred nationwide.

"The current fentanyl crisis, while disastrous, highlights the need for more effective and aggressive treatment," said James Berman, M.D., addiction specialist and board certified internist affiliated with the University of Pennsylvania. "Opioid addiction is a chronic, progressive, primary disease, like diabetes or high blood pressure, which is an equal opportunity destroyer in that it can afflict anyone. Just as we treat other chronic conditions, this disease can now be treated in the privacy of your doctor's office. As the public health and medical communities struggle to contain this crisis and prevent more deaths, it is critical that in-office medical treatment for opioid addiction be made more widely available."

Opioid addiction is a growing public health problem that affects people from all walks of life. In Pennsylvania, misuse of prescription painkillers such as hydrocodone, oxycodone, and fentanyl is a major problem and heroin remains widely available in the Commonwealth, according to a report by the Office of National Drug Control Policy (ONDCP). And as evidenced by the current surge in fentanyl-heroin use, drug dealers are targeting this mixture in the Philadelphia area.

Pennsylvania's recent problems reflect a national public health crisis -- according to the most recent National Survey on Drug Use and Health (2005), published by the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 4.4 million teens and adults nationwide reported using prescription opioid painkillers for nonmedical purposes. In addition, in terms of new users, in 2004 more people abused opioid pain relievers for the first time than any other drug, including marijuana and cocaine, and opioid painkillers are the most heavily abused substance among teens and young adults. An estimated 1.5 million more Americans abuse heroin.

Many people do not fully understand the danger of misusing opioid painkillers such as fentanyl. A recent national survey on the public's perceptions of opioid addiction, Prescription Painkiller/Heroin Addiction and Treatment, revealed that nearly half of the US public does not know that misusing prescription opioid painkillers is as harmful to the body, and fully as addictive, as heroin abuse.

Upcoming Training Will Alleviate Shortage of Certified Doctors

Any doctor may take the training to become certified to treat opioid dependence in his or her private office using an FDA-approved medicine called buprenorphine. Many patients prefer the privacy, convenience, and discretion that office-based treatment offers. According to Dr. Berman, greater patient access to doctors who can prescribe buprenorphine is critical to reducing the area's high levels of opioid dependence.

Interested physicians are invited to attend a buprenorphine training session in Harrisburg, sponsored by the American Psychiatric Association:
<blockquote>
Saturday, September 9
7:00 AM - 5:30 PM
Harrisburg Hilton
One North Second St.
Harrisburg, PA
</blockquote>
For those unable to attend, more information on training may be found at docoptin.com. Additionally, information about online and CD-ROM training options may be obtained from 1-877-782-6966.

"We have a crisis on our hands, and more doctors in Philadelphia and throughout Pennsylvania need to join the fight by becoming certified to treat opioid addiction," said Dr. Berman. "In my experience, patients place enough value on the confidentiality and convenience of office-based buprenorphine treatment that they are willing to come into treatment. However, I routinely have to turn away patients who are seeking treatment for this devastating disease. This is tragic, given the tremendous success I have seen in my practice with buprenorphine. I would urge every physician to learn about this treatment option and to consider becoming certified to treat the inordinately high number of patients in the Philadelphia area who remain untreated."

Resources for Opioid Dependence and Its Treatment

Addiction to opioids is defined as a long-term brain disease by the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA). It is a treatable medical condition that is caused by changes in the chemistry of the brain. This dependence can start with use of medicine that a doctor prescribes for serious pain but that a person continues to use after the medical need for pain relief has passed. Or it may begin as recreational drug use that spins out of control.

Individuals who need more information about opioid dependence and its treatment, either for themselves or for someone they are concerned about, have several options. Educational materials on opioid dependence are available to answer questions about this often-misunderstood disease and the treatments that are available for it. To receive a free educational Resource Kit on these topics, visit turntohelp.com or call 1-866-455-TURN, both provided by Reckitt Benckiser Pharmaceuticals.

Additionally, the non-profit patient advocacy group NAABT -- National Alliance of Advocates for Buprenorphine Treatment -- is dedicated to helping educate the public on opioid dependence and treatment in a private doctor's office. "Increasingly more people are contacting NAABT for information on opioid dependence and treatment," said Timothy Lepak, president of NAABT. "This is a disease that does not discriminate. It affects people from all walks of life and all socioeconomic and demographic levels."

For more information on Pennsylvania physicians who can prescribe medicine to treat opioid dependence in a private medical office, visit naabt.org. SAMHSA's Web site also provides a physician locator and other valuable information at buprenorphine.samhsa.gov.

In the United States, Suboxone(R) (buprenorphine HCl/naloxone HCl dihydrate) C-III Sublingual Tablets and Subutex(R) (buprenorphine HCl) C-III Sublingual Tablets are the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for treatment of opioid dependence in a doctor's office. Suboxone and Subutex are manufactured by Reckitt Benckiser Pharmaceuticals.

About Reckitt Benckiser Pharmaceuticals Inc.

Reckitt Benckiser Pharmaceuticals Inc. is a specialty pharmaceutical company that manufactures and markets Suboxone(R) (buprenorphine HCl/naloxone HCl dihydrate [2 mg/0.5 mg and 8 mg/2 mg]) C-III Sublingual Tablets and Subutex(R) (buprenorphine HCl [2 mg and 8 mg]) C-III Sublingual Tablets, formulations of buprenorphine used to treat opioid dependence. Suboxone and Subutex are the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for office-based treatment of opioid dependence. Reckitt Benckiser Pharmaceuticals Inc. is committed to expanding access to medical therapies for patients suffering from the chronic, relapsing brain disease of opioid dependence. For more information, visit suboxone.com or opioiddependence.com. Reckitt Benckiser Pharmaceuticals Inc. is a wholly-owned subsidiary of Reckitt Benckiser PLC, a publicly traded UK firm.

Important Safety Information

Intravenous use of buprenorphine, usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone(R) and Subutex(R) have potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted population receiving buprenorphine. There are no adequate and well-controlled studies of Suboxone or Subutex (a pregnancy category C medication) in pregnancy. Due caution should be exercised when driving cars or operating machinery. The most commonly reported adverse events with Suboxone have included headache (36%, placebo 22%), withdrawal syndrome (25%, placebo 37%), pain (22%, placebo 19%), nausea (15%, placebo 11%), insomnia (14%, placebo 16%), sweating (14%, placebo 10%). See full prescribing information for complete information.

Suboxone and Subutex are registered trademarks of Reckitt Benckiser Pharmaceuticals Inc.

CONTACT:
Cory Tromblee
1-617-761-6715
Cory.Tromblee@fkhealth.com
SOURCE Reckitt Benckiser Pharmaceuticals Inc.

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Chicago Deaths from Fentanyl-Laced Heroin

Postby palmspringsbum » Thu Sep 21, 2006 5:23 pm

PRNewsWire wrote:Press Release Source: Reckitt Benckiser Pharmaceuticals Inc.


Chicago Deaths from Fentanyl-Laced Heroin Overdoses Could Be Reduced by Medical Treatment

Thursday September 21, 8:30 am ET
<blockquote>
<b>-Physician training sessions will increase patient access to medical office-based treatment for opioid addiction- </b>
</blockquote>

CHICAGO, Sept. 21 /PRNewswire/ -- A recent string of opioid overdoses and deaths in Chicago and elsewhere in Cook County highlights the devastation of a dangerous new illegal drug mixture: the combination of heroin with fentanyl, a powerful opioid painkiller used to treat cancer pain and in anesthesia. According to the Medical Examiner's office, so far there have been nearly 200 fatal overdoses in the Chicago area attributable to heroin laced with fentanyl, while several times this many have occurred nationwide.

"The recent spike in fentanyl-related overdoses underscores the need for more aggressive treatment approaches and better access to new medical treatments," said Dr. Sarz Maxwell, Medical Director of Chicago Recovery Alliance. "Opioid addiction is a devastating chronic disease that needs to be treated much like we treat other chronic conditions such as diabetes and high blood pressure. Patients can now be treated, confidentially and conveniently, in the privacy of their doctors' offices. The problem is that there aren't enough doctors to handle the patient load. As we work to contain this crisis and prevent more overdoses, it is critical that access to medical treatment be made more widely available to patients throughout the greater metropolitan Chicago area."

Opioid addiction is a growing public health problem that affects people from all walks of life. In Illinois, misuse of prescription painkillers such as hydrocodone and oxycodone remains a major problem and, in Chicago, heroin use is at alarming levels, according to a report by the U.S. Drug Enforcement Administration (DEA). And as evidenced by the current surge in fentanyl-heroin use, drug dealers are targeting this mixture in the Chicago area.

The recent problems in Chicago and Illinois reflect a national public health crisis -- according to the most recent National Survey on Drug Use and Health (2006), published this month by the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 4.7 million people currently misuse prescription pain relievers, second only to marijuana use. Among young adults, nonmedical use of prescription drugs increased from 5.4 percent in 2002 to 6.3 percent in 2005. In addition, in terms of new users, in 2005 more people 12 years and older -- 2.2 million -- misused opioid painkillers for the first time than any other drug, including marijuana and cocaine.

Many people do not fully understand the danger of misusing opioid painkillers such as fentanyl. A recent national survey on the public's perceptions of opioid addiction, Prescription Painkiller/Heroin Addiction and Treatment, revealed that nearly half of the US public does not know that misusing prescription opioid painkillers is as harmful to the body, and fully as addictive, as heroin abuse.

Physician Certification Training Available at Sessions and Online

Any doctor may become certified to treat opioid dependence in his or her private office using an FDA-approved medicine called buprenorphine. Many patients prefer the privacy, convenience, and discretion that office-based treatment offers. According to Dr. Maxwell, it is critical that more doctors make themselves accessible to patients in need of treatment in order to reduce the area's high levels of opioid dependence and deaths.

Doctors will find information about becoming certified to treat with buprenorphine at http://www.docoptin.com. Additionally, information about online and CD-ROM training options may be obtained from 1-877-782-6966.

"The current crisis in Chicago and throughout Illinois serves as a reminder that treatment is essential in saving the lives of people suffering from addiction," said Dr. Maxwell. "It upsets me greatly to think that there are people out there seeking buprenorphine treatment who are unable to get it -- especially when I consider the success I have seen in my practice with buprenorphine. I would urge every physician to learn about this treatment option and to consider becoming certified to treat the extremely high number of patients in the Chicago area who remain in need of care."

Resources for Opioid Dependence and Its Treatment

Addiction to opioids is defined as a long-term brain disease by the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA). It is a treatable medical condition that is caused by changes in the chemistry of the brain. This dependence can start with use of medicine that a doctor prescribes for serious pain but that a person continues to use after the medical need for pain relief has passed. Or it may begin as recreational drug use that spins out of control.

Individuals who need more information about opioid dependence and its treatment, either for themselves or for someone they are concerned about, have several options. Educational materials on opioid dependence are available to answer questions about this often-misunderstood disease and the treatments that are available for it. To receive a free educational Resource Kit on these topics, visit http://www.turntohelp.com or call 1-866-455-TURN, both provided by Reckitt Benckiser Pharmaceuticals.

Additionally, the non-profit patient advocacy group NAABT -- National Alliance of Advocates for Buprenorphine Treatment -- is dedicated to helping educate the public on opioid dependence and treatment in a private doctor's office. NAABT now offers a nationwide confidential matching service to pair individuals seeking buprenorphine treatment with available doctors. "Increasingly more people are contacting NAABT for information on opioid dependence and treatment and for help finding doctors who can prescribe buprenorphine," said Timothy Lepak, president of NAABT. "This is a disease that does not discriminate. It affects people from all walks of life and all socioeconomic and demographic levels."

For more information on Chicago-area physicians who can prescribe medicine to treat opioid dependence in a private medical office, visit http://www.naabt.org. SAMHSA's Web site also provides a physician locator and other valuable information at http://www.buprenorphine.samhsa.gov.

In the United States, buprenorphine is marketed as Suboxone® (buprenorphine HCl/naloxone HCl dihydrate) C-III Sublingual Tablets and Subutex® (buprenorphine HCl) C-III Sublingual Tablets, the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for treatment of opioid dependence in a doctor's office. Suboxone and Subutex are manufactured by Reckitt Benckiser Pharmaceuticals.

About Reckitt Benckiser Pharmaceuticals Inc.

Reckitt Benckiser Pharmaceuticals Inc. is a specialty pharmaceutical company that manufactures and markets Suboxone® (buprenorphine HCl/naloxone HCl dihydrate [2 mg/0.5 mg and 8 mg/2 mg]) C-III Sublingual Tablets and Subutex® (buprenorphine HCl [2 mg and 8 mg]) C-III Sublingual Tablets, formulations of buprenorphine used to treat opioid dependence. Suboxone and Subutex are the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for office-based treatment of opioid dependence. Reckitt Benckiser Pharmaceuticals Inc. is committed to expanding access to medical therapies for patients suffering from the chronic, relapsing brain disease of opioid dependence. For more information, visit http://www.suboxone.com or http://www.opioiddependence.com. Reckitt Benckiser Pharmaceuticals Inc. is a wholly-owned subsidiary of Reckitt Benckiser PLC, a publicly traded UK firm.

Important Safety Information

Intravenous use of buprenorphine, usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone® and Subutex® have potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted population receiving buprenorphine. There are no adequate and well-controlled studies of Suboxone or Subutex (a pregnancy category C medication) in pregnancy. Due caution should be exercised when driving cars or operating machinery. The most commonly reported adverse events with Suboxone have included headache (36%, placebo 22%), withdrawal syndrome (25%, placebo 37%), pain (22%, placebo 19%), nausea (15%, placebo 11%), insomnia (14%, placebo 16%), sweating (14%, placebo 10%). See full prescribing information for complete information.

Suboxone and Subutex are registered trademarks of Reckitt Benckiser Pharmaceuticals Inc.

Media Contact: Cory Tromblee


617-761-6715
Cory.Tromblee@fkhealth.com





<hr class=postrule>
Source: Reckitt Benckiser Pharmaceuticals Inc.

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Detroit Deaths from Fentanyl-Laced Heroin Overdoses

Postby budman » Tue Oct 03, 2006 5:28 pm

Yahoo News wrote:<table width=100%><tr><td>Press Release</td><td align=right>Source: Reckitt Benckiser Pharmaceuticals Inc.</td></tr></table>


Detroit Deaths from Fentanyl-Laced Heroin Overdoses Could Be Reduced by Medical Treatment

Tuesday October 3, 7:30 am ET
<blockquote>
Physician training sessions will increase patient access to medical office-based treatment for opioid addiction
</blockquote>
DETROIT, Oct. 3 /PRNewswire/ -- A recent string of opioid overdoses and deaths in Detroit and elsewhere in Wayne County highlights the devastation of a dangerous new illegal drug mixture: the combination of heroin with fentanyl, a powerful opioid painkiller used in anesthesia and to treat cancer pain. According to the Medical Examiner's office, so far there have been at least 122 fatal overdoses in the Detroit area attributable to heroin laced with fentanyl, while several times this many have occurred nationwide.

"Fentanyl-related overdoses in the Detroit area serve as a tragic reminder that there is a need for better patient access to aggressive and effective medical treatment for opioid addiction," said Mark Menestrina, MD, addiction medicine physician at Brighton Hospital. "Opioid addiction is a chronic disease that can afflict anyone and needs to be treated much like we treat other chronic conditions. Medical treatment is oftentimes prescribed in the privacy of a doctor's office, creating a confidential, convenient, and respectful atmosphere. Currently, there are not enough certified doctors in Detroit available to handle the increasing number of people seeking help for opioid addiction. It is critical that office-based medical treatment become more widely available in order to contain this crisis and prevent more deaths throughout the greater metropolitan Detroit area."

Addiction to opioids, which includes heroin as well as the prescription painkillers oxycodone, hydrocodone, fentanyl, and morphine, is a growing public health problem that affects people from all walks of life. In Michigan, misuse of prescription opioid painkillers continues to be a major problem and, in Detroit, heroin remains widely available, according to a report by the U.S. Drug Enforcement Administration (DEA). And as evidenced by the current surge in fentanyl-heroin use, drug dealers are targeting this mixture in the Detroit area.

The recent problems in Detroit and throughout Michigan reflect a national public health crisis -- according to the most recent National Survey on Drug Use and Health (2006), published last month by the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 4.7 million people currently misuse prescription pain relievers, second only to marijuana use. Among young adults, nonmedical use of prescription drugs increased from 5.4 percent in 2002 to 6.3 percent in 2005. In addition, in terms of new users, in 2005 more people 12 years and older -- 2.2 million -- misused opioid painkillers for the first time than any other drug, including marijuana and cocaine.

Many people do not fully understand the danger of misusing opioid painkillers such as fentanyl. A recent national survey on the public's perceptions of opioid addiction, Prescription Painkiller/Heroin Addiction and Treatment, revealed that nearly half of the U.S. public does not know that misusing prescription opioid painkillers is as harmful to the body, and fully as addictive, as heroin abuse.

Physician Certification Training Available at Sessions and Online

Any doctor may become certified to treat opioid dependence in his or her private office using an FDA-approved medicine called buprenorphine. Many patients prefer the privacy, convenience, and discretion that office-based treatment offers. According to Dr. Menestrina, access to buprenorphine treatment for patients addicted to opioids is vital to reduce the number of deaths due to drug overdoses.

Doctors will find information about becoming certified to treat with buprenorphine at http://www.docoptin.com. Additionally, information about online and CD-ROM training options may be obtained from 1-877-782-6966.

"An increase in the number of doctors certified to treat opioid addiction is an important step in the fight against the problem we're facing in Detroit," said Dr. Menestrina. "It is unfortunate that patients seeking buprenorphine treatment are turned away simply because not enough doctors are certified to prescribe this medication. This is especially upsetting considering the great success I have seen in my practice with buprenorphine. I strongly urge other physicians to learn about this treatment option and seriously consider becoming certified to treat the exceedingly high number of chemically dependent individuals in the Detroit area."

Resources for Opioid Dependence and Its Treatment

Addiction to opioids is defined as a long-term brain disease by the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA). It is a treatable medical condition that is caused by changes in the chemistry of the brain. This dependence can start with use of medicine that a doctor prescribes for serious pain but that a person continues to use after the medical need for pain relief has passed. Or it may begin as recreational drug use that spins out of control.

Individuals who need more information about opioid dependence and its treatment, either for themselves or for someone they are concerned about, have several options. Educational materials on opioid dependence are available to answer questions about this often-misunderstood disease and the treatments that are available for it. To receive a free educational Resource Kit on these topics, visit http://www.turntohelp.com or call 1-866-455-TURN, both provided by Reckitt Benckiser Pharmaceuticals.

Additionally, the non-profit patient advocacy group NAABT -- National Alliance of Advocates for Buprenorphine Treatment -- is dedicated to helping educate the public on opioid dependence and treatment in a private doctor's office. NAABT now offers a nationwide confidential matching service to pair individuals seeking buprenorphine treatment with available doctors. "Increasingly more people are contacting NAABT for information on opioid dependence and treatment and for help finding doctors who can prescribe buprenorphine," said Timothy Lepak, president of NAABT. "This is a disease that does not discriminate. It affects people from all walks of life and all socioeconomic and demographic levels."

For more information on Detroit-area physicians who can prescribe medicine to treat opioid dependence in a private medical office, visit http://naabt.org. SAMHSA's Web site also provides a physician locator and other valuable information at http://buprenorphine.samhsa.gov.

In the United States, buprenorphine is marketed as Suboxone® (buprenorphine HCl/naloxone HCl dihydrate) C-III Sublingual Tablets and Subutex® (buprenorphine HCl) C-III Sublingual Tablets, the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for treatment of opioid dependence in a doctor's office. Suboxone and Subutex are manufactured by Reckitt Benckiser Pharmaceuticals.

About Reckitt Benckiser Pharmaceuticals Inc.

Reckitt Benckiser Pharmaceuticals Inc. is a specialty pharmaceutical company that manufactures and markets Suboxone® (buprenorphine HCl/naloxone HCl dihydrate [2 mg/0.5 mg and 8 mg/2 mg]) C-III Sublingual Tablets and Subutex® (buprenorphine HCl [2 mg and 8 mg]) C-III Sublingual Tablets, formulations of buprenorphine used to treat opioid dependence. Suboxone and Subutex are the only controlled medications under the Drug Addiction Treatment Act of 2000 approved by the FDA for office-based treatment of opioid dependence. Reckitt Benckiser Pharmaceuticals Inc. is committed to expanding access to medical therapies for patients suffering from the chronic, relapsing brain disease of opioid dependence. For more information, visit http://www.suboxone.com or http://www.opioiddependence.com. Reckitt Benckiser Pharmaceuticals Inc. is a wholly-owned subsidiary of Reckitt Benckiser PLC, a publicly traded UK firm.

Important Safety Information

Intravenous use of buprenorphine, usually in combination with benzodiazepines or other CNS depressants has been associated with significant respiratory depression and death. Suboxone® and Subutex® have potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists. Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted population receiving buprenorphine. There are no adequate and well-controlled studies of Suboxone or Subutex (a pregnancy category C medication) in pregnancy. Due caution should be exercised when driving cars or operating machinery. The most commonly reported adverse events with Suboxone have included headache (36%, placebo 22%), withdrawal syndrome (25%, placebo 37%), pain (22%, placebo 19%), nausea (15%, placebo 11%), insomnia (14%, placebo 16%), sweating (14%, placebo 10%). See full prescribing information for complete information.

Suboxone and Subutex are registered trademarks of Reckitt Benckiser Pharmaceuticals Inc.

Media Contact: Cory Tromblee


617-761-6715
Cory.Tromblee@fkhealth.com





--------------------------------------------------------------------------------
Source: Reckitt Benckiser Pharmaceuticals Inc.
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Abused, fentanyl can be a 'drop dead' drug

Postby palmspringsbum » Mon Jan 21, 2008 9:00 pm

The Berkshire Eagle wrote:
Abused, fentanyl can be a 'drop dead' drug

The Berkshire Eagle
By Conor Berry, Berkshire Eagle Staff
Article Last Updated: 01/20/2008 09:55:08 AM EST


PITTSFIELD — When Carlen Robinson, a local drug treatment and mental health agency worker, overdosed on the powerful painkiller fentanyl in 2005, the 32-year-old North Adams woman joined a growing list of people who have died from a synthetic narcotic that is 80 times more powerful than morphine.

Dawn M. Cote, the 42-year-old North Adams woman accused of selling the potent drug to Robinson, was released on personal recognizance after pleading not guilty to manslaughter and drug distribution charges in Berkshire Superior Court earlier this month.

But the mere fact that prosecutors are attempting to pin Robinson's death on Cote — the alleged "drug dealer" in this case — is a first for Berkshire County, according to some law-enforcement officials, who are wary of the county's fentanyl problem.

"This is the first time that any of us are aware that this office has brought these charges," said Berkshire District Attorney David F. Capeless.

<span class=postbigbold>'An unusual case'</span>

Holding drug suppliers criminally responsible for overdose deaths is uncommon — but not unprecedented — in Massachusetts, according to Capeless.

Michael Trudeau, a prosecutor in the office of Cape & Islands District Attorney Michael O'Keefe, could recall only two such cases in the past dozen or so years in his jurisdiction, illustrating just how rarely district attorneys seek the charge.

Trudeau, first assistant district attorney, declined comment on whether commonwealth prosecutors won convictions in those cases. In general, manslaughter convictions against drug dealers are rare in Massachusetts.

Part of the reason prosecutors seldom pursue the charge stems from the inherent difficulty of overdose investigations, according to Capeless.

"I've been very frustrated that we have had overdose deaths (in the past), and that we have not been able to hold people accountable," Capeless said.

In the case of Robinson's death, however, the information and evidence gathered by Massachusetts State Police detectives assigned to the local district attorney's office warranted a manslaughter charge, according to Capeless, who declined to discuss details of the investigation.

"This was an unusual case," he said.

<span class=postbigbold>Declares her innocence</span>

Cote, the accused, says she is being unfairly targeted for prosecution. If convicted of manslaughter, she could receive up to 20 years in state prison.

"I am innocent," she said in a brief phone interview with The Eagle on Friday. "(Robinson) was my best friend. She lived (in the apartment) directly below me, so obviously I didn't want to hurt her."

Robinson was employed as a direct-care specialist in the rehabilitation and vocational services department at the Brien Center for Mental Health and Substance Abuse Services. She worked there from 2000 until the time of her death in November 2005, according to a spokesman for the Pittsfield-based center, which has satellite offices throughout the county.

Her death coincided with a nationwide spike in fentanyl-related overdoses, according to local and national data. Of the 74 fatal drug overdoses in Berkshire County from 2003 to 2007, 44 involved prescription medications, according to Capeless.

Of those 44 deaths, eight involved fentanyl, a member of the highly addictive opioid family. And of those eight fentanyl deaths, five occurred in 2005 — including Robinson's — with single overdose deaths occurring in 2003, 2006 and 2007.

Capeless said that two other fentanyl-related deaths, both of which occurred last year, remain under investigation.

<span class=postbigbold>A recent, deadly trend</span>

From 2004 to 2006, a national outbreak of fentanyl-related fatalities — mainly the result of a deadly cocktail of fentanyl and heroin — left public health officials from Philadelphia to Detroit scrambling to get the word out about the lethal mixture.

Heroin addicts, who apparently thought they were just using heroin, were dropping dead from the fatal cocktail, according to published Associated Press reports.

In 2005, in Detroit alone, there were more than 100 confirmed cases. A year earlier, in 2004, more than 100 deaths were reported in Florida, allegedly from abuse of the fentanyl patch, which is intended to provide a continuous delivery of pain reliever to a patient with ongoing pain. Although some fentanyl-related deaths stemmed from improper use of the patch, others were the direct result of fentanyl abuse, including ingesting the drug orally and injecting it like heroin.

On the criminal front, from 2001 to 2006, the federal Drug Enforcement Administration reported an eighteenfold increase in the number of fentanyl-related drug cases, from 37 to 1,472 cases.

In the Berkshires, fentanyl has been on the radar of local drug officials for several years now, according to Massachusetts State Police Lt. Joseph P. McDyer, coordinator of the Berkshire County Drug Task Force.

Fentanyl overdoses, while increasingly common here, are nowhere near epidemic levels, however.

"We don't have an epidemic," said McDyer, "but it does happen."

<span class=postbigbold>An end-stage painkiller</span>

The drug is normally used by "people who are on their way out," said McDyer, citing as an example terminally ill cancer or AIDS patients.

"We've had a high incidence of fentanyl abuse," McDyer said. "It's a painkiller — it's like heroin — that basically suppresses your whole system."

In general, people who tend to abuse Oxycontin or heroin also tend to abuse fentanyl, McDyer said. But fentanyl is far more potent than heroin, he said, and its abuse can lead to heart failure and death.

Opioids such as fentanyl, which are typically used for pain relief, can consist of natural, manmade or semisynthetic substances. Common opioids include heroin, morphine, oxycodone and methadone, among numerous other varieties.

But fentanyl, released in the 1960s but made available in time-release patch form in the early 1990s, is among the most powerful class of opioids, and its abuse has been on the rise since then, according to local and national data.

With a potency level that is more than 80 times the strength of morphine, fentanyl is used to treat severe or chronic pain. The patch — a prescription-only product — is generally intended for cancer patients, the terminally ill or for those suffering from chronic pain, and its delivery system is designed to dispense the drug slowly through the skin.

Common street names for the drug include Apache, China Girl, China White, Goodfella, Murder 8 and TNT.

<span class=postbigbold>'Chew one, drop dead'</span>

According to McDyer, addicts typically will tear open a fentanyl patch and suck on the gel form of the drug contained inside the device.

"They'll go and chew on one, and they'll drop dead," he said. "They're playing with fire. It's such a dangerous drug."

"The biggest problem in Berkshire County is the abuse of prescription drugs," not the abuse of common street drugs such as cocaine or marijuana, he said.

Dr. Jennifer Michaels, a psychiatrist and substance-abuse expert who is also medical director for the Brien Center on East Street, said that fentanyl, when used therapeutically as prescribed by a medical doctor, can be quite effective in pain management. However, when the drug is used "recreationally to get high," the results are often deadly, she said.

<span class=postbigbold>Easily addictive</span>

Fentanyl has "a very low threshold for addiction," she explained, which means that people can become addicted to the drug quickly and easily.

Michaels said that, when a person sucks or chews on the patch, the experience is "a rapid delivery" of fentanyl, which can overwhelm the body's system.

"Think of it this way: If a patch is meant to last for 24 hours, and you're taking a 24-hour medication in literally minutes, there's a risk of overdosing and dying," she said.

The effects of the drug, when deliberately misused to get high, can include feelings of intense euphoria. But the effects also can lead to respiratory depression, coma or death, according to Michaels, who said she rarely encounters individuals who are exclusively addicted to fentanyl.

Fentanyl historically has been misused by people who work in the health care field, according to the Drug Enforcement Administration, primarily because the general public has limited access to the controlled substance.

Lorraine Robinson, Carlen Robinson's mother, declined to discuss her daughter's death until after the case has been resolved. The district attorney declined to speculate on when the manslaughter case might go to trial.

"Right now, the family, we don't really have anything to say at this time," Robinson said in a phone message to The Eagle. "But there is a story to be told after all is said and done in court."

Carlen Robinson's sister, Kristen Gordon, the principal of C.T. Plunkett Elementary School in Adams, said she misses her sister "every single hour of every single day."

In September, the school officially dedicated a section of its garden to Carlen Robinson, now known as "Carlen's Corner."

To reach Conor Berry: cberry@berkshireeagle.com, (413) 496-6249

<span class=postbigbold>Fentanyl at a glance ...</span>

Fentanyl, a powerful synthetic pain-relief medication, was introduced in the 1960s, but it was not until the early 1990s that it became available in patch form. Among the king of painkillers, this narcotic is more than 80 times more powerful than morphine. Abuse and misuse of fentanyl, particularly in patch form, is on the rise.

<span class=postbold>Facts</span>
<ul class=postlist>
<li> Misuse of fentanyl patches is killing people, according to the federal government, which last month issued its second warning in two years about the powerful narcotic.</li>

<li> In 2005, the Food and Drug Administration announced that it was investigating 120 fentanyl-related deaths.</li>

<li> The introduction of heat sources, such as heating pads, saunas or hot baths, while wearing a fentanyl patch can increase the drug's absorption and lead to an overdose.</li>

<li> Abuse of fentanyl patches, including sucking or chewing on the time-release devices, can cause a deadly overdose.</li>

<li> Nationwide emergency-room visits by people misusing fentanyl, a member of the opioid drug family, rose nearly fourteenfold to 8,000 between 2000 and 2004.</li>
</ul>
<span class=postbold>SOURCES</span>: The U.S. Department of Health and Human Services; the U.S. Drug Enforcement Administration; The Associated Press.

<span class=postbold>On the Web </span>

The Food & Drug Administration's safety warnings regarding the use of fentanyl transdermal patches:
www.fda.gov/CDER/drug/advisory/fentanyl_2007.htm

The American Society of Health-System Pharmacists' Web site on fentanyl:
www.nlm.nih.gov/medlineplus/druginfo/me ... 01202.html
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