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Deaths related to fentanyl double in six months



The report analyzed overdose deaths that yielded positive results for fentanyl and similar compounds between July 2016 and June 2017 in 10 states: Kentucky, Maine, Massachusetts, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, West Virginia and Wisconsin. From July 2016 to December 2016, the CDC found 764 deaths related to fentanyl and fentanyl analogue in all 10 states. In the following six months, from January 2017 to June 2017, the CDC recorded 1,511 deaths from drug overdoses.

When legitimately prescribed, fentanyl helps patients control extreme pain, such as that caused by cancer. It is usually dosed in the form of tablets, patches or intravenously. However, illicit forms of the drug are commonly sold in the form of powder or compressed into pills. Fentanyl and chemically similar variations, known as analogues have been sold on the black market and can be extremely potent.

One of these analogues is the drug carfentanil. It is 10,000 times more potent than morphine and is used to calm the elephants. It was discovered that the drug was responsible for outbreaks of overdose in Ohio and West Virginia in 2016. The CDC discovered that deaths associated with carfentanil increased 94% from 421 to 815 in the 10 states studied during the 12-month period.
Nationwide, the numbers for 2017 are still preliminary, but the CDC expects deaths related to opioid overdoses to reach an all-time high of 49,000. It is expected that almost 60% of these victims are related to synthetic opioids such as fentanyl and carfentanil.

According to the CDC, there were 20,310 deaths from synthetic opioid overdoses in 2016, and that number is expected to increase 45% to 29,400 in 2017.

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The recent increase in the popularity of these synthetic products has been called the third wave of the opiate epidemic; The first wave was attributed to the overprescription of analgesics such as oxycodone and hydrocodone and the second to heroin. The drugs are chemically similar and act on the same receptors in the brain.

This increase in overdoses related to illicit fentanyl and its analogues reflects an increase in drugs sent to the Drug Enforcement Administration that tested positive for fentanyl. According to the DEA, the positive fentanyl samples evaluated by the agency went from 14,400 in 2015 to 34,119 in 2016. In the first six months of 2017, the DEA expects 25,460 requests to be positive for the drug. [19659000]

CDC Problem Alert

This report comes after a CDC alert this week directed at public health professionals, first aid personnel and forensic doctors about the increased availability of illicit synthetic opioids. The alert is an update to a health notice of October 2015.

The updated notice warned that fentanyl was detected in combination with medications such as benzodiazepines, counterfeit opioid pills, ketamine and methamphetamine.

Because of the potency of drugs now available, the alert warned healthcare providers that multiple doses of naloxone, the opioid antidote, may be needed to revive someone from an overdose.

SOS Operation

In an attempt to stem the tide of overdose linked to illicit fentanyl, US Attorney General Jeff Sessions announced Thursday an aggressive Justice Department campaign to "prosecute" each case involving the distribution of fentanyl, fentanyl analogs and other synthetic opioids, regardless of the amount of drug "in the 10 districts with the highest rates of overdose in the country. The effort known as Operation Synthetic Opioid Surge focuses on the districts of California, Kentucky, Maine, New Hampshire, Ohio, Pennsylvania, Tennessee and West Virginia.
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The effort to stop the drug overdose crisis has reached every corner of public health and government.

Also on Thursday, Democratic Sen. Claire McCaskill of Missouri published a report on the practices of pharmaceutical distributors. The research found that three of the largest distributors in the country – McKesson, AmerisourceBergen and Cardinal Health – shipped 1.6 billion pills to the state of Missouri between 2012 and 2017. Those are enough doses to average more than 260 pills per state resident during each one of those years.

Congressional research on distribution practices

McCaskill's research focused only on Missouri but identified lapses in the larger pharmaceutical distribution process.

The three distributors had inconsistencies in the report of suspicious orders in the last 10 years, according to the report. Under the Controlled Substances Act, distributors must monitor and report suspicious orders to the DEA, which requires distributors to report orders "of unusual size, orders that deviate substantially from a normal pattern and unusual frequency orders" to offices local of the agency. The distributors are wholesalers who work as intermediaries between manufacturers, hospitals and pharmacies.

The report found that the three distributors "systematically failed" in reporting.

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For example, McKesson and AmerisourceBergen sent about 650 million pills to Missouri between 2012 and 2017. In that time period, McKesson reported more than 16,700 suspicious orders to the DEA, while AmerisourceBergen made only 224 reports of suspicious orders in that period. Cardinal Health reported 5,125 questionable orders to the DEA.

Although the report indicated that the findings themselves did not detect anything illegal, it highlighted potential flaws in the system that could lead to legal drugs being diverted to the black market.

"The opiate crisis that these pills have fueled is a failure of policy and oversight by the government and a failure of basic human morals on the part of many pharmaceutical companies and distributors, a failure that has destroyed families and communities in our entire state, "McCaskill said in a statement.

Companies trusted in their practices

In response to the report, McKesson said that "we have invested significant resources in our antiescamo program and, since 2008, blocked and reported more than one million suspicious orders in the whole country ".

AmerisourceBergen echoed a commitment to help end the opiate crisis and track suspicious orders. In a statement, the company said: "The AmerisourceBergen order control program involves two key steps: marking orders for review using our complex computer algorithm and conducting a detailed investigation of each marked order. our suspicious orders inform the highly accurate and actionable DEA. "

Healthcare Distribution Alliance, a national trade association that represents distributors, criticized the senator's report. In a statement, he said the report was based on "discredited and inaccurate statements without acknowledging the need for broader reforms in the pharmaceutical supply chain" and noted a tendency for overprescription by physicians as a "leading" contributor to the crisis.

Potential drop in opioid addiction rates

Also on Thursday, a Blue Cross Blue Shield report showed possible progress in efforts to fight the opiate crisis. New numbers from the insurance giant found that the number of people with opioid addiction (also known as opioid use disorder) fell for the first time in the eight years that the company has been tracking it.

In 2016, diagnoses of opiate addiction reached a maximum of 6.2 cases per 1,000 Blue Cross Blue Shield members. In 2017, that rate decreased slightly, to 5.9 cases per 1,000 members.

According to the Mental Health and Substance Abuse Services Administration, about 2 million Americans suffer from opioid use disorder. However, only one in five receives some type of specialized treatment. Blue Cross Blue Shield says that about 40% of its clients diagnosed with opioid use disorder are accessing specialized treatment.

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