Archive for August, 2012

Over Prescribing Antipsychotics For Every Day Problems

Friday, Aug. 31st 2012

Consequences Of Powerful Psychotropic Medications
It is happening more often than people would care to admit; people turning towards prescription medication for what traditionally would have been treated with rest, exercise, or making changes in one’s lifestyle. One of the most alarming trends is the use of atypical antipsychotics, a class that includes eleven different types of drugs. Up until a decade ago, these drugs were only used for the most disabling mental illnesses (primarily bipolar disorder and schizophrenia).

When they were used sparingly, only three percent of Americans were prescribed these drugs. Nowadays, primary-care doctors and psychiatrists prescribe these types of drugs for conditions that the drugs were never even approved for. These problems include dementia, behavioral problems in toddlers, problems sleeping, attention-deficit disorder, and anxiety.

These new drugs such as Abilify, Zyprexa, and Seroquel, make up approximately 90 percent of the atypical antipsychotics market. Recent reports found that adolescents and kids in foster care are taking more psychotropic drugs than other kids are – even more than children that have a severe form of mental illness. There are reports of children as young as 18-months of age that were prescribed medication for bipolar disorder, though this is a mental illness that rarely develops before adolescence. So why is it that as a society we appear to want to be medicated, what is causing these problems?

The Problem With Marketing

Part of the problem is the fact that pharmaceutical companies have changed their primary goal over the course of the last few decades. A few decades ago, their intent was to heal, provide medical breakthroughs and of course, money was an incentive. However, good medication would sell itself because it cures something that patients suffer from.

Nowadays, pharmaceutical companies have become more interested in marketing their product, trying to get people interested in their product before these patients even know they have a problem. Today these companies spend more on marketing their product than they do on research and development. The overall strategy has changed; these companies are using broad terms and symptoms that most people occasionally suffer from. Who doesn’t feel overwhelmed at times? Who doesn’t feel sad about something, who doesn’t suffer from an upset stomach once in a while? By targeting the consumer directly, these companies are generating a demand for a product and this is not how medicine should work.

There appears to be a pill or cream for just about every problem that you could possible think of. Anything ranging from overall unhappiness to having trouble sleeping, from restless leg syndrome to toenail fungus – everything now has an instant cure. It has become normal for people to reach for a pill that will take care of their problems as quickly as possible at the first hint that a problem might be present. People no longer want to put in the effort to fix problems the natural way. They don’t want to change their lifestyle, give up certain foods, exercise more, people want the quickest solution with the least amount of effort.

The Problem With Side Effects

When looking at some of the side effects of commonly prescribed drugs, they usually sound worse than the very symptoms that they are meant to treat. These possible adverse effects can include cancer, irreversible bone loss, kidney failure, stroke, and heart attack. When the Food and Drug Administration approved many of these drugs for use, these dangers were either underestimated or undetected entirely.

Even though many prescription medications can improve the quality of life for many people, even save their life, there is no such thing as a completely safe drug. Every type of medication comes with a risk, even those common, over-the-counter drugs such as aspirin and acetaminophen. Every single time that someone puts a pill in their mouth that they have never taken before, they are essentially taking part in an experiment.

The problem with people not recognizing the dangers of these side effects stems from the aggressive marketing as well. When certain side effects are read off as a list of things that “could potentially happen” it simply does not register anymore. Because of the constant repetition (you tend to see the same advertisements every commercial block), these warnings lose their luster over time.

Once these side effects do become problematic, people use new, additional drugs to address these new ailments instead of approaching them in a different way. This creates a dangerous cycle, especially considering that these new drugs are undoubtedly going to come with side effects of their own.

The Problem With Availability

Prescription drug abuse is on the rise in the United States. The latest numbers have shown that as many as one in five teenagers abuse prescription medication; that is approximately 20% of all American teenagers experimenting with prescription medication. This is a shocking statistic and not something you would see with narcotics such as heroin or cocaine. Part of the problem is the availability of these types of medication and the fact that they are constantly being normalized by showing these advertisements and prescribing them for even the most basic problems.

Especially considering that teenagers can get these prescriptions from home medicine cabinets or purchase them illegally through Internet pharmacies. These types of drugs are considered far less ‘dangerous’ because doctors prescribe them to people, even though addiction, injury, or even death can just as easily occur as it would with illicit drugs. If fewer drugs were prescribed, the access to prescription or over-the-counter drugs would be far less.

Our Overall Attitude Needs To Change

Of course, it would be unfair to put all the blame on pharmaceutical companies, or the FDA, or the doctors prescribing these medications. We must ask ourselves as a society why the rate of prescription drug use is constantly increasing; why we are clearly happy to keep swallowing those pills and tablets. For many of these ailments, we know the solution. We have grown complacent as a society. We want everything done for us instead of putting in the effort to solve it ourselves.

Another problem is that it has become normal for us to want to put things off until we NEED to address them rather than dealing with them preemptively. The issue of procrastination is also at play. We need to take a step back and look at the fact that when negative symptoms arise, we do not deal with the elements of our lifestyle that might have caused these negative symptoms, but instead address the symptoms themselves.

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New Form Of OxyContin Introduced To Curb Abuse

Wednesday, Aug. 22nd 2012

Is OxyNEO Any Better?
In an attempt to reduce the problems with opiate addiction stemming from the abuse of OxyContin, Purdue Pharma (the manufacturer of the drug) is introducing a new version of the popular medication: OxyNEO. This new formulation is supposed to be tamper-resistant, unlike the previous version of OxyContin.

People struggling with an opiate addiction have been injecting or snorting OxyContin after crushing it up. This drug is normally a controlled-release tablet, but when the medication is injected or snorted, the effects of the drug are release in a single euphoric burst instead of providing controlled-release pain relief. The new formula transforms the pill to a gel-like substance when the pill is exposed to water, something that would hopefully ensure that people are unable to abuse the drug as easily. Why is Oxycodone abuse even a problem, and when did it start?

The Problem With Oxycodone

Even though the problems with Oxycodone have received increased media attention in the past few years, the potential dangers of the painkiller can be traced back as far as the 1960’s. This is when the Dangerous Drugs (Amendment) Ordinance classified Oxycodone as a dangerous drug. The chemical structure of Oxycodone is not unlike codeine – another pain reliever. Oxycodone alters the sense of pain or emotional response to pain in the central nervous system. Oxycodone ensures that the pain messages sent to the brain are altered, meaning that people suffering from such conditions as arthritis and cancer would be free of chronic or severe pain associated with their illness. That was supposed to be the new standard as it relates to pain relief.

How Oxycodone Is Abused

Oxycodone can be used orally through pills, rectally, through injection under the skin (subcutaneously), injected into the blood stream (intravenously), or through injection directly into the muscle (intramuscularly). The oral form of Oxycodone, OxyContin, can remain effective upwards off 12 hours after taking it. This makes it the longest lasting Oxycodone product on the market.

People abusing the painkiller tend to do so in one of three different ways:

  • Crushing and dissolving the tablets in water, then injecting the solution.
  • Chewing the drug.
  • Crushing the pill into a fine powder, and then snorting the powder.

These steps aim to circumvent the time-release mechanism of the drug. Upon ingestion, the active ingredients in the drug take effect almost immediately. Because the drug was never intended to be used this way, the chance of overdose or addiction increases dramatically when someone abuses the drug in such a way.

The Problems

There are many problems associated with the use of Oxycodone. Even though it would be next to impossible to detail all possible side effects, a few of them stand out more than others.

  • Dependence – Oftentimes, Oxycodone is only prescribed for a short period of time, generally, no more than 7 to 10 days. This is because it is quite easy to build up a tolerance and dependence on the drug. With prolonged use, the chance for physical and mental dependence on the medication increases. If dependence increases, the possibility for misuse or abuse increases as well. Even after the patient stops using Oxycodone, the pleasant side effects may be enough to make them want to keep using more or to just avoid the painful absence of the drug.
  • Withdrawal – When it is too difficult to stop using a drug, people use that as a reason to continue their drug abuse. If a person stops using the drug after having taken it for a while, it will bring on withdrawal symptoms. A number of withdrawal symptoms for this drug are tremors, sweating, insomnia, blurred vision, stomach cramps, nausea, and anxiety. Even though there is no significant danger of a fatality when someone withdraws from the drug, the symptoms of withdrawal are extremely uncomfortable. Besides being uncomfortable, they have also been equated to having flu-like symptoms. These include diarrhea, weakness, fever and chills, along with bodily aches and pains. Loss of appetite, sneezing, a runny nose, rapid breathing, and a rapid heartbeat are also amongst the possible symptoms.
  • Illegal use – After the patient no longer has a legal prescription for Oxycodone, they may try to reproduce the pleasant effects by using the drug through illegal means. The medication has a warning that says it has an “increased risk of misuse, abuse, or diversion” since 2001. When it comes to the most commonly abused prescription medication, Oxycodone consistently ranks at the top.

What We Can Do – Signs To Look For

Because the drug is habit-forming, addiction becomes quick and easy. Once addicted, it is important that appropriate steps be taken. However, for many people, trying to determine whether someone is struggling with addiction can be difficult. How do you know that someone has a problem with Oxycodone? These are a few warning signs that might indicate that you or someone you care about have a problem with addiction and should seek out treatment.

  • More is needed – When someone builds up a tolerance for the drug, they will need more of it to provide the same results that they seek. The body is merely reacting to the fact that a tolerance has been established. If you find that you or someone you care about needs more of the drug just to produce the same effects as before, it may indicate addiction.
  • Doctor shopping – The person goes from doctor to doctor in an attempt to find prescriptions for the drug. If one doctor turns them down or doesn’t want to renew the prescription, they try elsewhere.
  • Long-term use – Oxycodone was never meant to be taken more than a week, a week and a half at most. If someone uses Oxycodone for a longer period, chances of addiction increase greatly.
  • Changes – When the prescription runs out, you notice physical or psychological problems. These could include changes in personality, they isolate themselves from others or they suffer from intense mood swings.

Of course, it would be foolish to assume that even if this new formula can no longer be abused, that it would somehow clear up all problems. Instead, those struggling with addiction may choose to self-medicate with other drugs or pay premium prices for tablets of the older formula that can be injected or snorted. An increase in heroin abuse, the street narcotic most similar to OxyContin, is even more likely. The only true way to provide long-term relief from an opiate addiction is to enter rehab.

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Overwhelming Evidence Available - Addiction Can Be Overcome

Wednesday, Aug. 8th 2012

True Recovery Is Possible
According to the traditional 12-step program, even at your best you are still an addict. When looking at the way that the traditional 12-step program views a person’s progress, even someone who has not had a drink or used drugs in years, is still considered at risk to relapse and still considered an addict. They are just someone who has not failed, YET. Because ultimately that is what these groups label someone as – you are considered an addict for life. Surely the vast majority of the 23.5 million Americans, or 1 in 10 adults, that have overcome problems with illegal drugs or alcohol, would disagree with that assessment.

Those numbers came from a recent phone survey funded by OASAS (New York State’s Office of Alcoholism and Substance Abuse Services). An earlier study done in 2007 showed that 2.7% of the population had struggled with addiction at some point in their lives, yet only 0.6% of the population had suffered from addiction in the last twelve months. This means that the number of people that once had a problem but no longer did, outweigh people still struggling with addiction three to one. This just further exemplifies that the methods used by the twelve step groups are dangerously outdated and inaccurate.

The Dogma Of The 12-Step Treatment

Imagine that you are diagnosed with a disease; you then receive treatment for the disease, only to find out that the disease has come back months later. At that point, your physician tells you that you must have done something wrong and you can only truly be helped by the treatment if you let it do its work – sounds ridiculous doesn’t it? However, replace the word ‘disease’ with ‘addiction’, and the word ‘treatment’ with ’12-step program’ and you have the BLANK Anonymous model (fill in your favorite vice at the BLANK. This is not something that we made up, this is described in the twelve step instructions – if you fail; it must be your fault because the program would like you to succeed.

“Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves… They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty.”

This is precisely where the twelve-step program loses all credibility. In the field of medicine, it is quite simple – if a treatment doesn’t work, you try another one, if that one fails, try another. Medical professionals do this until they run out of known options, and even then, they are willing to try experimental treatment options in order to help their patient, this is how medical science advances. People are not the same, different conditions require a different approach and even two 40-year-old males both with a heroin addiction that have struggled for two years might individually need a very different approach from one another. There is an entire medical field based around intervention research and there is one thing they can tell you right now, telling the patient that they failed because they are inherently dishonest is not a commonly used nor fruitful technique.

Dogma Stunts Progress

This is the problem with the twelve step programs, even if we ignore the religious nature of the program, it is important to know that its followers are clinging to a book that was written decades ago. We have already moved on from medical advances that were made just a few short years ago because we have better options available, but those that cling to the 12-step book still believes it to be valid and impervious to criticism of any kind. When you look at medical texts, you will see that these texts are constantly incorporating new knowledge, new editions are issued in order to stay current, it is important that these books remain relevant. Meanwhile, the core values of the twelve-step program have not changed since 1939.

Now granted, 1939 was a rather eventful year, the use of penicillin started emerging, the “Grapes of Wrath” by John Steinbeck was first published, and the Third Reich invaded Poland. However, most people would probably agree with the fact that since 1939, we have seen quite a few interesting advances, including advances in the field of genetics, neuroscience, and overall brain function. Some of the interesting advances include Contingency Management (CM), Cognitive Behavioral Therapy (CBT), and Motivational Interviewing (MI) – all of which can help a therapist when it comes to recovery. However, the unfortunate truth is that the 12-step community does not ascribe to these ideas, because their initial twelve steps supposedly provided all the help someone would ever need – that sounds quite depressing.

It’s Time To Move On

Now some would suggest that having a 12-step program should not be a problem, they should be allowed to do what they want to do and preach what they want to preach. However, the problem is that if someone is struggling with an addiction to drugs or alcohol and they only know the twelve-step method, chances are that they will try to change their life and then proceed to fail when trying to get their life back on track. When they do so, this person has missed an opportunity to make that change and may relapse.

Relapse is not without its dangers. Oftentimes, relapse can lead to an overdose because the person is using more than the body is accustomed to. For many people the twelve steps is what they know, it is what they see on television and they are unaware that better, more permanent methods have been around for years.

Anyone struggling with addiction deserves to have every possible treatment tool available so that they can live a life without addiction and without relapse. The 1939 types of programs take away someone’s ability to overcome their own problems. At their best, these programs are horribly inefficient and at their worst, they should be held liable for criminal negligence.

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