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Published by Happenings Magazine, 2017-10-25 11:31:36

There_is_Hope_2017

F RE
The Opioid
Epidemic... THERE IS
HOPE!


The opioid epidemic is getting extensive press coverage including the recent segment on 60 Minutes detailing Washington’s myopic attempts at dealing with this most serious problem. Despite considerable news attention, medical journalist Scott Lafee recently shared a disturbing statistic, for every opioid fatality there’s an estimated 30 overdose cases. What is so troubling is that in most cases what follows is essentially nothing. According to Lafee, in a study of 6,000 Pennsylvanian Medicaid enrollees who had been tested for an overdose, the number of opioid prescriptions fell just 10% compared to the period before the overdose. Most everyone would agree it’s a daunting, complex problem that at this point appears to be short on solutions. It is our hope, our goal, to keep this problem in the forefront, to encourage engagement and dialogue. This includes a series of knowledgeable guests who will appear the week of October 30th on Happenings Q&A, AM1050 WLIP. We ask for your thoughts, your feedback, your stories in hopes of incorporating your input in our next special issue in 2018.
By Frank Carmichael Publisher
For More Information:
We at the Hope Council on Alcohol & Other Drug Abuse, Inc. are so grateful to Happenings Magazine for shedding light on the opioids epi- demic in our community. The Hope Council is doing what it can to edu- cate others on the prevention and treatment of the disease of addiction, and with the help of Happenings Magazine, that message reaches much farther.
The mission of the Hope Council on Alcohol & Other Drug Abuse is to reduce the impact of alcohol and other drug abuse in our community by providing education, prevention, intervention, and referral services. For more information about those services, please
contact us at (262) 658-8166, email us at [email protected], or visit our website at www.hopecouncil.org. Recovery is possible, that treatment truly does work, but we cannot treat our way out of this current epidemic. Education and prevention is key.
Happenings Magazine’s efforts to educate the community can go far in offering hope and help- ing to heal our community.
Sincerely,
Guida Brown Executive Director, Hope Council
Every ten minutes someone in America dies of an overdose, and sadly a large num- ber of these drug related fatalities are happening here in our community. We're in the midst of a heroin epidemic. During the week of October 30th, Happenings Q&A will be featurig several guests to speak about this issue. Find the show on your radio dial at AM1050 WLIP, streaming live online at www.wlip.com, or download the WLIP app on your smartphone to listen in.
• A former Deputy Medical Examiner for Kenosha County, Lou Denko is currently the Fire Chief of the Wheatland Volunteer Fire Department. Mr. Denko will join the show on Monday, October 30th at 2 p.m.
• Brad D. Schimel took office as the Wisconsin Attorney General in January 2015. A frontline prosecutor first elected Wakesha County District Attorney in 2006, Schimel has pledged as Attorney General to put public safety over politics and to continue the fight against heroin, human traffickers, domestic violence, and Internet predators. Attorney General Schimel earned his law degree from the University of Wisconsin-Madison and was awarded the 2006 Wisconsin Association of Victims Professionals "Wisconsin Professional of the Year" for his work on behalf of victims of sexual assault. Tune in to Happenings Q&A on Tuesday, October 31st at 1:30 p.m. when Schimel joins the program.
• Michael Gravely joined the Kenosha County district attorney's office in 1989, his first job after graduating from law school at the University of Wisconsin-Madison. In 2016, he was given the honor of Wisconsin's Prosecutor of the Year by the Department of Justice, where Judge Jason Rossell said Gravely's focus is "always about doing justice, about being fair." Mr. Gravely joins Happenings Q&A on Wednesday, November 1st at 1:30 p.m.
• Marinna Marotta is a Licensed Professional Counselor and Substance Abuse Counselor with Rogers Hospital. Marotta earned her Master's degree at La Salle University in Philadelphia. Marinna has been with Rogers Memorial Hospital since 2014 running their Dual Diagnosis Adult Intensive Outpatient Program. Ms. Marotta joins the show on Thursday, November 2nd at 2:30 p.m.
• Scott Carney has been working in the addiction field since 2013. As a survivor of multiple relapses, he knows what it is like to need treatment. His personal experience with addiction helps him understand the decision-making and recovery process. Scott is now help- ing others as a Client Services Representative with Lakeview Health. Mr. Carney joins the program on Friday, November 3rd at 1 p.m.
Lou Denko Brad Schimel Michael Gravely Marinna Marotta Scott Carney
Page 2 HAPPENINGS EXTRA 2017


Warning signs of abuse:
• Neglecting responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children) because of drug use.
• Using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unpro- tected sex.
• Drug use is getting the person into legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.
• Drug use is causing problems in relationships, such as fights with family members or partner, an unhappy boss, or the loss of old friends.
Warning signs of addiction:
• Drug tolerance has increased. The person needs to use more of the drug to experience the same effects previously attained with smaller amounts.
• Taking drugs to avoid or relieve withdrawal symptoms. Going too long without drugs causes nausea, restlessness, insomnia, depres- sion, sweating, shaking, and anxiety.
• No control over drug use. Drugs are used more often or more than planned is used, even after promising no use or less use. Person may want to stop using, but feels powerless.
• Life revolves around drug use. Person spends a lot of time using and thinking about drugs, figuring out how to get them, and recov- ering from the effects.
• Person has abandoned activities previously enjoyed, such as hob- bies, sports, and socializing, because of drug use.
• Continues to use drugs, despite knowing the harm it’s causing. It’s causing major problems — blackouts, infections, mood swings, depression, paranoia — but person uses anyway.
Physical warning signs of drug abuse:
• Bloodshot eyes, pupils larger or smaller than usual
• Changes in appetite or sleep patterns
• Sudden weight loss or weight gain
• Deterioration of physical appearance, personal grooming habits • Unusual smells on breath, body, or clothing
• Tremors, slurred speech, or impaired coordination
Behavioral warning signs of drug abuse:
• Drop in attendance and performance at work or school
• Unexplained need for money or financial problems; may borrow or steal to get it.
• Engaging in secretive or suspicious behaviors
• Sudden change in friends, favorite hangouts, and hobbies
• Frequently getting into trouble (fights, accidents, illegal activities)
Psychological warning signs of drug abuse
• Unexplained change in personality or attitude
• Sudden mood swings, irritability, or angry outbursts
• Periods of unusual hyperactivity, agitation, or giddiness • Lack of motivation; appears lethargic or “spaced out”
• Appears fearful, anxious, or paranoid, with no reason
Warning signs of teen drug abuse:
While experimenting with drugs doesn’t automatically lead to drug abuse, early use is a risk factor for developing more serious drug abuse and addiction. Risk of drug abuse also increases greatly dur- ing times of transition, such as changing schools, moving, or divorce. The challenge for parents is to distinguish between the nor- mal, often volatile, ups and downs of the teen years and the red flags of substance abuse. These include:
• Having bloodshot eyes or dilated pupils; using eye drops to try to mask these signs
• Skipping class; declining grades; suddenly getting into trouble at school
• Missing money, valuables, or prescriptions
• Acting uncharacteristically isolated, withdrawn, angry, or depressed
• Dropping one group of friends for another; being secretive about the new peer group
• Loss of interest in old hobbies; lying about new interests and activ- ities
• Demanding more privacy; locking doors; avoiding eye contact; sneaking around
(Source: www.SaveLivesKenosha.org)
HAPPENINGS EXTRA 2017 Page 3


Drug Courts: A Win-Win for Individuals, Society and the Criminal Justice System
Plagued by a national opioid addiction problem, millions of indi- viduals continue to suffer from dependence in our country. The issue is even more pronounced in the criminal justice system. In fact, the lifetime incidence of substance abuse or dependence in the prison population is roughly 74 percent. In 2011, nearly half, or 48 percent, of inmates were serving time for non- violent, drug-related offenses.
There has been a 790 percent
increase in the federal prison popu-
lation since 1980, according to a
2012 Congressional Research Service report. Today, there are more than 214,000 inmates in federal prison, compared to 25,000 inmates in 1980. The rising inmate population has led to overcrowd- ing of cells, and thus a public priority to find solutions to the high incarceration numbers.
Historically, opioid dependence had been viewed as a failure of motivation, willpower or character. More recently, however, scien- tists have proven that addiction has a biological basis whereby the repeated use of opioids may lead to physical changes in the brain. Over time, science has shown a person’s brain can adapt to the reg- ular use of opioids, leading the individual to need these drugs to function.
As a result of this new per- spective, there is growing pub- lic support for managing addiction as a complex health issue in need of treatment options rather than punish- ment. In April 2014, the Pew Research Center found that 67 percent of people nation- wide favored treatment for users of drugs including cocaine and heroin, compared to 26 percent who favored prosecution and incarceration for these individuals.
The shift in public opinion combined with a need to reduce prison populations is resulting in a growing number of judges and correc- tions officials across the country that are establishing programs designed to offer some offenders treatment options and rehabilita- tion rather than jail time. These programs, commonly referred to as drug courts, divert approximately 120,000 non-violent, substance- abuse-involved offenders each year to treatment instead of jail or prison. Drug court programs have demonstrably better outcomes, including reduced recidivism and reduced costs, compared with tra- ditional courts.
See DRUG COURTS on page 15
What’s in your
medicine cabinet? Prescription drug abuse is on the rise
Page 4 HAPPENINGS EXTRA 2017


HAPPENINGS EXTRA 2017 Page 5


How the Opioid
Crisis is Trickling
Down to Kids
An excess of opioid painkillers across the nation has increased the likelihood that children and teenagers will accidentally poison themselves, according to a new study.
As families and communities around the country battle opioid addiction and overuse, children have found themselves caught in the epidemic as well, either by bearing witness to their parents over- dosing, accidentally ingesting the drugs themselves, or deliberately using them. From 1997 to 2012, the number of hospitals saw a 165 percent increase in the rate of children admitted for opioid poison- ing, bringing the number from 1.4 in every 100,000 children to 3.71 in just 15 years, a study from the Yale School of Public Health found.
"Opioids are ubiquitous now," Julie Gaither, a postdoctoral fellow at the school who led the study, told NPR. "Enough opioids are pre- scribed every year to put a bottle of painkillers in every household. They're everywhere, and kids are getting into them."
The Centers for Disease Control and Prevention has declared that the US is "in the midst of an opioid overdose epidemic" in regard to the extremely addictive painkillers. The United States has seen the number of opioid deaths nearly quadruple since 1999, leading to around 78 daily overdoses, according to the CDC.
The study, which examined discharge papers from 13,000 opioid poisonings and census data to extrapolate rates of overdoses over that time period, found that an increase in child overdoses has mir-
See KIDS on page 10
Drug Overdose Deaths Climb Dramatically Across US, Again
Rick Sotiropoulos was a freshman baseball player for Merrimack College in North Andover, Mass., when he underwent surgery for an injured elbow. The procedure was successful. But the recovery introduced him to opiates.
Like many Americans who find themselves hooked on prescrip- tion painkillers, Mr. Sotiropoulos began legally, with Oxycodone, as he recovered from the operation. At first he resisted the numbing high, ridding himself of his last prescription when he saw he had a problem. But within five years, he was using pills almost daily – then came heroin. At the time of this interview he had been clean for a full year, despite the ups and downs of prior relapse: "I've made almost every mistake in recovery that there is, and I'm blessed to still be here," he said.
Over the past five years, the United States has seen a dramatic rise in drug overdose deaths, driven largely by heroin and synthetic opioids other than methadone, according to a US Centers for Disease Control and Prevention report. In 2010, overdoses killed 38,329 people. That figure jumped 23 percent to 47,055 in 2014. In 2015, the figure jumped again to 52,404 – numbers that have sent health and law enforcement officials scrambling for solutions.
Those statistics are not mere numbers for Sotiropoulos. He's lost friends to the epidemic: six from the halfway house in East Boston where he's completed two stints, and two from his hometown in Ipswich.
while. He's had to uproot, physically relocate, to avoid certain social circles, steer clear of certain places, and keep connected with a support system that includes 12-step meetings and a sponsor to hold him accountable. Every single decision must point him toward that goal of keeping clean and sober, he says.
"I don’t think I’ve arrived in any way. I’ve made that mistake before," Sotiropoulos said. "I know my recovery is an ongoing day- to-day process. I mean, I can look back and feel good about what I’ve accomplished in a year and look forward to what I can accom- plish in the future by staying clean.
"But if I look too far ahead, then that’s where I could make a mis- take and fall back. I just have to keep things simple, keep working the program and just worry about one day at a time."
Gayle Saks, a substance abuse counselor who advised Sotiropoulos at an all-male halfway house, says his story is a prime example of the difficult road to recovery.
"The real success stories are the guys who are working the pro- gram, who are going to meetings, who are working with sponsors, and those are the ones who are staying clean," Ms. Saks said.
"I have pictures from a year ago, from our last Christmas party. A picture of each guy. I have them on my phone," she says. "Three- quarters of them are either dead or out running the streets."
In response to the epidemic, US physicians began reducing pre-
Sotiropoulos says his recovery has been hard work but worth-
See DEATHS on page 10
Page 6 HAPPENINGS EXTRA 2017


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Kids
rored the national epidemic. While the num- ber of toddlers and young children who ingested the drug without knowing it more than doubled, the highest rate of overdose came among teens, with around 10 of every 100,000 ending up in the hospital – some- times from their own prescriptions.
While more children are growing up in the homes of substance abusers who obtain drugs illegally, these cases involving chil- dren and adolescents overdosing mostly occurred when drugs in the home were obtained by a prescription and meant for an adult’s health benefits.
Deaths
scriptions for opioid drugs. For the first time in two decades, opioid prescriptions have fallen during the past three years, and law enforcement leaders have collaborated with health professionals to meet the massive need for treatment. The CDC recommends systemic solutions that include improving access to prescription drug monitoring pro- grams and enhancing distribution of nalox- one, a drug that counteracts the effect of a heroin overdose. The crisis has elicited responses from federal, state, and local authorities alike, from major coastal cities to small Midwestern towns.
Massachusetts Gov. Charlie Baker has sought to improve treatment quality and availability, limit opioid prescriptions, and increase the use of overdose counteracting drugs, as The Boston Globe's Evan Horowitz reported earlier this year.
But there is work to be done interperson- ally as well, Saks says, suggesting that peo-
As addiction and opioid abuse awareness has risen in recent years, many have devel- oped a new image of the crisis: Rather than just impacting the more commonly known heroin users in urban areas, opioid abuse has become commonplace in suburban and rural areas, taking the lives of tens of thou- sands across all demographics each year. But the substance's effect on those under 18, especially younger than 10, hasn’t been widely acknowledged, experts say.
"This is largely seen as an adolescent problem or an adult problem," Sharon Levy, director of the adolescent substance abuse program at Boston Children's Hospital, who was not involved in the study, told NPR. "But this paper really highlights that this really knows no age boundaries."
Findings like this could spur a rethinking of how parents and doctors rethink opioid distribution and storage. But that dialogue hasn’t been a part of doctor-patient conver- sations traditionally, and getting physicians to think about how a prescription could affect not only a patient but also others in their home could take time.
"Our research, however, suggests that poisonings by prescription and illicit opioids are likely to remain a persistent and growing problem in the young unless greater atten- tion is directed toward the pediatric commu- nity, who make up nearly one-quarter of the U.S. population," the study said.
By Amanda Hoover
continued from page 6
continued from page 6
ple need to listen to those caught up in drugs, refrain from passing judgment, and encourage them to embrace whatever treat- ment program works.
"Absent a single solution, the multi- pronged approach seems to make the most sense, including a combination of height- ened anti-trafficking efforts, better treat- ment, and ongoing public education," Mr.
Horowitz wrote, suggesting that inter-state collaboration may be in order.
"And given that opioids have become a marked problem for our region as a whole, state policy alone may not suffice," he added. "This Massachusetts crisis may require a New England solution."
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The Opioid Epidemic May Have Started with a Doctor's Letter
Nearly 40 years ago, a respect- ed doctor wrote a letter to the New England Journal of Medicine with some very good news: Out of nearly 40,000 patients given pow- erful pain drugs in a Boston hospi- tal, only four addictions were doc- umented.
Doctors had been wary of opi- oids, fearing patients would get hooked. Reassured by the letter, which called this "rare" in those with no history of addiction, they pulled out their prescription pads and spread the good news in their own published reports.
And that is how a one-para-
graph letter with no supporting
information helped seed a nation-
wide epidemic of misuse of drugs
like Vicodin and OxyContin by convincing doctors that opioids were safer than we now know them to be.
The journal recently published an editor's note about the 1980 let- ter and an analysis from Canadian researchers of how often it has been cited – more than 600 times, often inaccurately. Most used it as evidence that addiction was rare, and most did not say it only concerned hospitalized patients, not outpatient or chronic pain situ-
ations such as bad backs and severe arthritis that opioids came to be used for.
"This pain population with no abuse history is literally at no risk for addiction," one citation said. "There have been studies suggesting that addiction rarely evolves in the setting of painful condi- tions," said another.
"It's difficult to overstate the role of this letter," said David Juurlink of the University of Toronto, who led the analysis. "It was the key bit of literature that helped the opiate manufac- turers convince front-line doctors that addiction is not a
concern."
Hospital databases were so limited in 1980 that we can't be con- fident there weren't more problems, or cases discovered after patients were discharged, Dr. Juurlink said. The letter was written by Hershel Jick, a drug specialist at Boston University Medical Center, and a graduate student.
See DOCTOR’S LETTER on page 15
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The Unexpected Faces Of America’s Addiction Epidemic
Opioid abuse and dependence stories appear every day in the media. Fatal overdoses, crimes committed to feed a habit, home- less addicts—the headlines are endless. To begin to address the issue, it’s critical to understand the populations at risk for depend- ence as well as the available treatment options. Studies from the early 2000s found heroin rates were reported highest among young, white males living in low-income, urban areas—most with a history of non-medical use of prescription painkillersi. Surprisingly, the age- old face of a “drug addict” as described is not the demographic driv- ing the growth of the new epidemic.
The New Face of Opioid Addiction
Today, it’s nearly impossible to stereotype the so-called “drug addict”—people from all walks of life are abusing opioids. The gap between women and men is narrowing, as there are an increasing number of women who are becoming addicted to opioids. Women, from the suburban housewife to the career professional, are strug- gling with addiction. Between 2002 and 2013, the number of females with an addiction doubledii. Women were rarely associated with opioid addiction; in the 1960s, less than 20% of heroin users were womeniii.
The New Age of Opioid Addiction
Opioid addiction is also no longer limited to young adults or those without health insurance. Americans age 50-69 years old, with health insurance benefits, are the fastest growing population of opi- oid addicts. Of these Americans, almost half are high school gradu- ates and a third have completed some college. Women (and men) have mostly fallen into opioid addiction through the use of prescrip- tion painkillers.
The New Cause of Opioid Addiction
The story of Tai J., a 34-year-old woman living in Texas and work- ing as a registered nurse, is just one of the many accounts of addic- tion in the U.S. Tai was prescribed the painkiller Vicodin to treat a back injury, as many patients are, but unfortunately for Tai, routine use of the drug to ease her chronic pain led to a 15-year addiction to heroin and prescription pain medicine.
“We often see opioid addiction develop as a result of scenarios similar to Tai’s, which helps to explain the alarming rate at which opioid addiction is growing to include men and women of all ages, races and socioeconomic backgrounds,” said Dr. Harold Urschel, Medical Director, Enterhealth.
Prescription pills may appear more socially acceptable, particular- ly for women, and come with different risks compared to using drugs
intravenously. Taking pills helps to eliminate the negative “addict” connotation. Dependence fed by prescription drugs is an expensive habit though, and the access to these drugs has started to decline due to efforts aimed at deterring physicians from prescribing opioids for pain. Consequently, users may choose heroin because it costs less and is easier to accessvi.
The Evolving Treatment Landscape
As the opioid epidemic grows, U.S. federal and state govern- ments, along with the medical community, are making it a priority to provide increased access to treatment. Research indicates that medication-assisted treatment, in combination with psychological support, helps people get into and stay in recovery. Treatment should be tailored to patients and their needs by offering a menu of available treatment options, including naltrexone, buprenorphine and methadone, and psychological support such as cognitive or behavioral therapyvii.
In 2014, the Obama Administration implemented a National Drug Control Strategy to reduce illicit drug use in the U.S. The president’s plan to reform drug policy includes education on prevention, expan- sion of access to treatment and support for those in recovery by tak- ing actions to eliminate the negative stigma associated with addic- tionviii.
State governments are also taking action to fight the epidemic. In March 2015, Kentucky implemented better treatment options for those struggling with addiction and seeking help by allocating $10 million to make treatment widely availableix.
“While prevention is important, the most immediate need is pro- viding access to treatment for the millions of people addicted to opi- oids who are struggling to keep their lives together. Recovery is not easy to achieve, but may include a combination of medication- assisted treatments, psychosocial counseling and support, which together can help people treat their addiction,” said Dr. Urschel.
The Hope for the Future
Continued funding by federal and state governments will provide more options to those struggling with addiction. Broader access to treatment and education on prevention and the dangers of prescrip- tion painkillers, regardless of socioeconomic class, group, location or medical insurance, could increase the likelihood that people with opioid addiction will get treatment and stay clean. All these efforts combined are increasing attention on opioid addiction.
For more information on opioid dependence and its treatment, visit www.recoveryispossible.com.
Page 14 HAPPENINGS EXTRA 2017


Drug Courts
continued from page 4
According to a multi-site study from the Department of Justice, drug
court participants reported
less criminal activity (40 per-
cent vs. 53 percent) and had fewer rearrests (52 percent vs. 62 percent) than compa- rable offenders not in drug court programs. Reducing recidivism also saved com- munities an average of $5,680 to $6,280 per offend- er overall. Reform efforts are underway at the federal level, including modifications to changing policies for low- level nonviolent offenders and sentencing reform.
For those diverted into
drug court programs, the
focus is on immediate treat-
ment for substance abuse
and dependence as well as working towards long-term goal of prevention of relapse. Prevention of relapse is important because many former inmates return to their commu- nities having been “detoxed,” but re-entry into previous environments may trigger the urge to use. Concurrently, their tolerance has been lowered significantly during the course of treatment, leaving them more vul- nerable to overdose. These circumstances fuel the need to bolster prevention and re- entry programs to help improve outcomes
Doctor’s Letter
continued from page 12
"I'm essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did," Dr. Jick told The Associated Press in an interview on Wednesday. "They used this letter to spread the word that these drugs were not very addictive."
Jick said his letter only referred to people getting opioids in the hospital for a short period of time and has no bearing on long- term outpatient use. He also said he testified as a government witness in a lawsuit years ago over the marketing of pain drugs.
for people returning to communities from incarceration as well as to address public safety.
Drug court programs that offer treatment may include intense monitoring, peer sup-
everyone. Treatment plans must be tailored to address each person’s drug addiction pat- terns and drug-related medical, psychiatric and social problems, and patients should discuss with their providers what’s best for
them.
Many drug court treatment pro- grams are showing promise. For example, a local Massachusetts sheriff, with support from communi- ty health officials, has started using medication-assisted treatment to assist individuals with criminal involvement in their return to the community.
According to the sheriff, “In my experience, many people who seek and receive treatment are able to remain opioid-free. It is a day-to- day struggle and the path is diffi- cult, but there are treatment options available that may help.”
Drug courts show promise in making drug policy more efficient and effective by providing alterna-
tives to incarceration for non-violent offend- ers suffering from substance abuse and dependence. The drug court model offers state and local governments a cost-effective way to increase the percentage of addicted offenders who achieve sustained recovery, thereby improving public safety and reduc- ing costs associated with re-arrest and addi- tional incarceration.
For more information on opioid depend- ence and its treatment, please visit www.recoveryispossible.com.
Institutes of Health, and Dr. Nora Volkow, head of the National Institute on Drug Abuse, pledging to work with industry to develop new ways to reverse and prevent overdoses, to treat addiction, and to find novel, non-addictive drugs for chronic pain.
"Industry's interest in this has been muted until recently," Collins said. Now, "they feel the responsibility and the opportunity to take part in this and they're not going to stand back and watch."
With the Food and Drug Administration wanting to speed work on new pain drugs, "the stars are aligning," Collins said. "I think we can make real progress now."
By Marilynn Marchione
port and medical treatment. Treatments increasingly being used by courts, prisons and jails across the United States to fight opioid dependence include naltrexone, oral or injection; buprenorphine; and methadone.
Research has shown that combining med- ication with psychosocial support is a com- prehensive way to help patients with addic- tion, and including medication with psy- chosocial support is now considered the optimal evidenced-based approach. Of course, treatments do not work the same for
Use grew in the 1990s when drugs like OxyContin came on the market, and more people using opioids for chronic pain devel- oped dependence. The new editor's note in the journal says: "For reasons of public health, readers should be aware that this let- ter has been 'heavily and uncritically cited' as evidence that addiction is rare with opioid therapy."
The journal's top editor, Jeffrey Drazen, said, "People have used the letter to sug- gest that you're not going to get addicted to opioids if you get them in a hospital setting. We know that not to be true."
The journal also published a report from Francis Collins, director of the National
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