ADAI News

UW Researcher Testifies at Federal Hearing on Heroin and Prescription Drug Abuse

On Thursday, March 26, 2015 the Subcommittee on Oversight and Investigations in the US House of Representatives held a hearing entitled “Examining the Growing Problems of Prescription Drug and Heroin Abuse: State and Local Perspectives.”  The purpose of the hearing was to review the recent prescription drug and heroin epidemic in the United States, with witnesses from states and local communities, including Dr. Caleb Banta-Green, Research Scientist at the University of Washington’s Alcohol & Drug Abuse Institute.  Witnesses gave a “boots on the ground” perspective of the trends they are observing and specific local impacts, why the problem is getting worse, how it is being handled by states and local communities, what works and what does not, and how to improve the federal public health efforts to prevent and treat prescription drug and heroin abuse.  The aim of the hearing was to identify “success stories” at the local level that could have national application, and to get feedback on the effectiveness of federal programs aimed at reducing prescription drug and heroin overdoses.

READ written testimony, or WATCH video of the hearing:  http://energycommerce.house.gov/hearing/examining-growing-problems-prescription-drug-and-heroin-abuse-state-and-local-perspectives

Drug Deaths in King County Up in 2013, Says Annual Drug Trends Report

Drug-caused deaths and heroin use among young adults increased in 2013, according to the annual King County Drug Trends report. The King County Drug Trends Workgroup releases an annual report on substance use trends each year. Findings for 2013 were presented at the National Institute on Drug Abuse’s Community Epidemiology Workgroup on June 5, 2013.

“Overall, drug-caused deaths were up in 2013,” says Caleb Banta-Green, PhD, MPH, MSW, research scientist at the UW Alcohol & Drug Abuse Institute, lead author on the report. “Pharmaceutical opiates (e.g. OxyContin, Vicodin, methadone), were the most common drugs detected, although down from their peak in 2009, and heroin deaths have doubled to 99 in 2013 compared to heroin deaths in 2009.”

Heroin use has increased in young adults, ages 18 to 29, and over the past four years treatment admissions are up substantially for heroin. Methamphetamine abuse persists as a major impetus for those entering treatment, and increased deaths in 2012 and 2013 may be linked to the increase in use coupled with heroin.

Major findings in the 2013 report include:

• Heroin use continues to increase in King County and statewide; young adults are a major population of concern. Heroin involved deaths among those under 30 has increased from 7 deaths (14%) in 2009 to 34 deaths (34%) in 2013, the numbers for all ages increased from 49 to 99 respectively.
• Methamphetamine indicators are up as are indicators of combined use with heroin. Methamphetamine in police evidence tests continued to increase for the third year in a row though the numbers were well below the level of 2001. Approximately one-third of those who reported any use of methamphetamine at treatment admission also mentioned heroin use, a substantial proportional and numerical increase since 2005. Deaths involving heroin and methamphetamine together increased substantially in 2012 and 2013.
• Pharmaceutical opioids remain the most common drugs identified in drug-caused deaths--125 in total in 2013--though for the past few years the level has been approximately 25% lower than the peak in 2009. Treatment admissions with pharmaceutical opioids indicated as the primary problem declined somewhat in 2013.
• While marijuana use is widespread, indicator data are down. Police evidence for people testing positive for marijuana is down substantially from the peak in 2009 and treatment admissions for marijuana have declined for the fourth year in a row.
• More police evidence tests were positive for methylone than MDMA (“Ecstasy”) in 2013 for the first time, with methylone first appearing in substantial numbers in 2011. Methylone is similar to MDMA in terms of its chemical structure and its physical and psychological effects. Users believe that “Molly” is pure MDMA, however when evidence has been tested it is often methamphetamine or methylone.
• Overdose prevention education and take-home naloxone (also known as Narcan, an opiate overdose antidote) distribution are increasing across Washington via syringe exchanges, clinician prescribing, pharmacist direct dispensing and jails. Among heroin injectors surveyed in King County in 2013 28% had take-home-naloxone in their possession in the prior 3 months. Overdose education and a naloxone locator are available at www.stopoverdose.org.

The King County Drug Trends Workgroup includes diverse local experts on substance use including people working in street outreach, law enforcement, public health, treatment and other service providers. A complete copy of the report is available online at http://adai.uw.edu/pubs/cewg/CEWG_Seattle_June2014.pdf.

Media coverage: KOMO TV, KPLU 88.5 FM, Capitol Hill Seattle Blog.

Is Naloxone 'Stigma' a Barrier to Prescribing for Overdose Prevention?

Although giving out naloxone to patients at high risk of overdose sounds like a good idea, researchers who work with the drug say the stigma surrounding its use may be a barrier to wider uptake among both patients and doctors, according to an article by Kristina Fiore in the online Medpage Today.

Patients may feel they're being treated like addicts and that their opioid prescriptions will be tempered, while doctors worry that just talking about naloxone may scare patients away, said Caleb Banta-Green, PhD, MPH, of the UW's Alcohol & Drug Abuse Institute.

"Both doctors and patients feel like they're under the microscope," Banta-Green told MedPage Today. "It's a very sensitive time."

Banta-Green and his colleagues are enrolling patients at high risk for opioid overdose -- both heroin users and patients on prescription opioids -- in a randomized trial to test whether providing naloxone, along with education and counseling, can reduce overdose.

Read more ...

California is Latest State to Approve Naloxone to Prevent Overdose Deaths

On Thursday, California Gov. Jerry Brown signed into law Assembly Bill 635 which will expand the use of the drug naloxone across the state. Naloxone, also known by its brand name Narcan, can be administered to a person suffering from an opiate overdose to restore breathing.  Starting Jan. 1, drug users and their family and friends will be able to request a naloxone prescription from a doctor or addiction treatment program.

Naloxone is non-addictive, non-toxic, fairly cheap and is easy to administer through the nose or intravenously. It was approved by the FDA in 1971 and is stocked in thousands of emergency rooms, ambulances and post-surgery recovery rooms across the country. But frequently, opiate users don't make it to the hospital in time.

In 2008, California implemented a pilot program in seven counties that allowed drug users, their family and friends, health care professionals and addiction counselors to administer naloxone in an emergency -- and be protected from civil or criminal liability if anything goes wrong.  The new law expands the program to the whole state.

Drug overdoses kill more people each year than either cars or guns. In 2010, the Centers for Disease Control reported, 38,329 people died of drug overdoses -- mostly from opiates.

Between 1996 and 2010, overdose prevention programs resulted in reversing more than 10,000 overdoses using naloxone, and trained more than 50,000 laypersons to revive someone with the drug during an overdose, according to the CDC.

There are more than 52 programs in at least 17 states that distribute naloxone to those at risk of overdose and to laypeople who might be first responders in emergency overdose situations. The programs are expected to train recipients in overdose prevention; recognition and response, like calling 911; rescue breathing; and administering naloxone.

Read more in Huffington Post...

Opioid Overdose Toolkit: Facts for Community Members

To coincide with International Overdose Awareness Day, the federal Substance Abuse and Mental Health Services Adminstration published the Opioid Overdose Toolkit, aimed at equipping communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths.  The toolkit provides information on overdose prevention, treatment, and recovery for first responders, prescribers, and patients.

The Toolkit is available online from SAMHSA: http://store.samhsa.gov/product/SMA13-4742

International Overdose Awareness Day, August 31

Saturday, August 31 is International Overdose Awareness Day, observed each year to recognize victims of overdose. In Washington state, Gov. Jay Inslee issued a proclamation supporting the observance of the day, noting that most overdoses can be prevented and reversed before they become fatal.  The governor lauds the effectiveness of the Overdose Prevention and Response Law in saving lives.

A brief report about opioid overdose in Washington State can be found at http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2013-02.pdf

More information about overdose prevention efforts in Washington state is available on the StopOverdose.org website.

Heroin Use Spikes in Young Adults in Washington State

Heroin use is up across Washington State — particularly among 18- to 30-year-olds — as prescription-opioid use declines, according to a report from the University of Washington. The report Heroin Trends Across Washington State was released by Caleb Banta-Green from the UW's Alcohol & Drug Abuse Institute.

The report received extensive coverage in the Northwest and in national media: 

Seattle Times: Heroin use spikes in young adults, UW report says

The Oregonian: Washington heroin use, deaths increase, especially among young people

The Olympian: State’s heroin problem growing, study shows.

Yakima Herald:  Opioids figure in 18 deaths in Yakima County last year

US News & World Report: Study: Heroin Abuse Increase May Be Due to Prescription Painkiller Crackdown

The Partnership at Drugfree.org:  Heroin use on the rise in Washington State

KUOW Radio: extended interview about heroin trends; also discussed infectious disease/syringe exchange and primary prevention.  Listen 

KPLU Radio: Listen

KOMO TV: Watch 

Read the full report. 

Prescription Overdose Deaths Decline in Washington State

Drug overdose deaths from prescription painkillers are on the decline across Washington, as noted in a story on the KPLU website by Keith Seinfeld.  Deaths from drugs such as Vicodin and Oxycontin rose dramatically starting in 1998, reaching a peak in 2008, and killing more than 500 people that year.  Now, the deaths have dropped for three years in a row, with 407 deaths in 2011 attributed to overdoses of painkillers, called opiates, according to data released by the Washington Department of Health.

It appears the deaths might correlate with a drop in the number of pills prescribed, according to Caleb Banta-Green, a Research Scientist at the Alcohol and Drug Abuse Institute at the University of Washington. Read more...

What You Can Do to Prevent Fatal Overdoses from Heroin, Prescription Opiates

Doctors, patients, friends and family can take some specific steps to curb the risk of fatal overdoses from heroin and opiate use, say Caleb Banta-Green, Ron Jackson and Joseph Merrill in a guest column in the Seattle Times, published online on April 18, 2012.

In 2010, 570 people died from opiate-involved overdoses (heroin and/or prescription-type) in Washington state, up from 188 in 1995. This column lays out practical advice to patients, families, and professionals on how to prevent, recognize and intervene in an overdose. Read the full column ...

More information on the StopOverdose.org website.

 

Help Curb Overdose Deaths By Calling 911

The Seattle Police Department along with public health officials and researchers from the University of Washington are stepping up a campaign to educate the public about Washington State's 911 Good Samaritan Law, enacted in 2010 to help prevent deaths from overdose of heroin and other opiates.

The law provides legal immunity to people who call for medical assistance for drug users who overdose.  It also allows the prescribing of an opioid antidote medicine (Naloxone) to drug users and their partners. 

The Seattle Police Department released a new training video about naloxone and the importance of calling 911 when an overdose is suspected.

WATCH

 

For more information, visit the StopOverdose.org website.