New York Tries To Tax Prescription Opioids Again

New York state has passed a measure to tax opioid prescriptions in an attempt to fund addiction-recovery efforts, despite the fact that a court ruled a similar measure unconstitutional last year. According to WXXI, the state said that the measure, part of the state budget, is intended to raise additional funds to pay for the response to the opioid crisis by taxing manufacturers.However, some people argue that the tax could have unintended effects, pushing people to use illegal substances if prescription opioids become more expensive. “While the language of the proposed law attempts to place the burden of the tax on drug manufacturers, in practice market forces determine how the burden of the tax is shared between producers and consumers,” Lewis Davis, professor of economics at Union College, wrote in a report.The report was prepared last year and paid for by a pharmaceutical lobbying group, but echoed concerns shared by other organizations including the American Cancer Society Action Network.Davis pointed out that the tax policy could have a number of negative side effects. “Most of the tax will be paid by non-consuming NY residents in the form of higher insurance premiums and higher taxes to cover public health programs. Second, to the extent that the cost of the tax is passed on to consumers, it will have a high cost to society in terms of reduced access to medically appropriate use of opioids,” he wrote. “Third, by increasing the cost of prescription opioids, the proposed tax will encourage NY residents suffering from opioid dependence to switch to cheaper illegal opioids, including heroin and fentanyl, with increased rates of accidental overdose.”He continued, “Because it fails to target opioid abuse, the proposed tax is poorly designed policy for addressing the opioid crisis.”Last year, a federal court struck down the tax because it would violate interstate commerce laws by treating New York residents differently from consumers in other states. The 2019 version of the bill works around that and should stand up in court, according to the state. Freeman Klopott, a spokesperson for the state budget office, said that New Yorkers who use prescription opioids won’t be affected by the measure, since most of the cost for the tax will be shouldered by insurance companies and drug manufacturers. “We expect no significant change in the availability of these pharmaceuticals or any diversion to illicit alternatives,” said Klopott.

Morning Roundup: Apr. 2, 2019

Taken for a Ride: How Ambulance Debt Afflicts the Extreme Poor [American Prospect]A report on how something as simple as a ride to the hospital can be financially crippling. This is true especially for people recovering from difficult situations.Two Ohio Mothers Open Up About Their Sons' Drug Addictions [NPR]A transcript of a conversation between two moms last year. Both of their young adult sons struggled with drug addiction. Now, they are both in treatment.HBO Interview: David Feherty Reveals He Suffered Relapse After Son's Death [Golf Digest]Former golfer and NBC commentator David Feherty lost his son to a drug overdose in 2017. "He was lost in so many ways. Reminded me a lot of me."The Challenge of Going Off Psychiatric Drugs [The New Yorker]A detailed account of one woman's experience with psychiatric drugs from a young age. She survived years of different diagnoses and medications, and a suicide attempt, to get where she is now. After Addiction Derailed His Hoop Dreams, He's Helping Others Through the Herren Project [South Coast Today]Much like his childhood friend and former NBA player Chris Herren, Kevin Mikolazyk struggled with substance abuse. Now, he's the executive director of the Herren Project, a non-profit recovery organization.Baltimore's Forgotten Opioid Epidemic [Vox]This report highlights the toll of the drug crisis on Baltimore's urban communities. Lack of funding makes it all the more difficult to provide the help that the city needs.After Losing Their Daughter, Family Tries to Fight Opioids in Their Community [VPR]A family that lost their daughter in February is helping people like her fight addiction by opening a community-based recovery center in her memory. "She was sober for 55 days and then made one call and four days later she was gone." Social Media Addiction Is Not Natural or Normal—But Is It Really a Disease? [Guardian]This columnist suggests that instead of demonizing and pathologizing social media use, we should "be focusing on living with it, rather than abandoning, restricting or censoring it."

Nice to Meet You, Will You Marry Me: Life as a Newcomer in Sobriety

One of the trickiest things to do in recovery is practicing mindfulness and awareness after putting the dope down and learning how to stay sober. Emotional sobriety is paramount when it comes to remaining sober. I believe that if I can grow in the areas of low self-esteem, codependency, anger management, and intimate relationships, then the act of not self-medicating becomes extremely easy.Those four areas are very important to address and work on while getting sober.I use because I am obsessed with the desired effect. When I put the drug in me I feel better. So when I'm not feeling good about my image or who I am as a person, I want to medicate. When I'm acting out in a codependent way, I want to medicate. When I'm struggling with anger, I want to medicate. I don't feel good; I want to feel good. Drugs help me feel great.If it weren't for all the consequences that come along with using, I'd be high right now.Love Is the DrugLet's talk about the fourth area: relationships.A wise man once told me that relationships would be the hardest thing I'll ever do in recovery. Those words never rang truer in my life than the day I finally got into one. It takes work, it takes patience, it takes a whole lot of faith and trust. It takes looking inward and being mindful of many things: who I am as a person, my morals, my ability to listen and show empathy, and making sure I’m living honestly with integrity. It takes courage and many other things that only come by living a holistic recovery lifestyle. When I do these things, my relationship is very rewarding for myself and for my partner. Even through conflict, we come out stronger.So factoring in all that, imagine being someone with low self-esteem; somebody that struggles with codependency and is quick to anger. Now imagine getting into a relationship when you haven't grown in those three areas. On top of all that you're still figuring out how to simply stay sober. What a beautiful recipe for disaster. It would be a miracle if you didn't use in the end.If I haven't grown in those three areas, it’s safe to say that I still don't feel good about myself. And if I don't feel good about myself, my knee-jerk reaction is to find something to make me feel better. And if the lifestyle of a person in active addiction is codependent in nature, imagine how potentially deadly it would be to engage in an intimate relationship.I mean, let's be honest. Relationships make us feel good. We feel wanted, we feel important, depending on the situation we feel attractive, the endorphins are flowing, the dopamine is at an all-time high, not to mention the sex is probably amazing! Relationships make us feel good. And if we haven't done the work to grow in the areas of emotional sobriety, we will quickly find that being in a relationship has become our new fix.It's intoxicating and obsessive. The desired effect is immediate. Almost sounds like using drugs. Now the term “drunk in love” isn’t such a stretch, is it?And that's why it's recommended to stay out of a relationship your first year in sobriety. It's not because sex is bad or being in love is wrong. It's because relationships make you feel good too soon, too often. I need to give myself an opportunity to recover in all areas of my life before I can think about anyone else.Essentially, I have replaced the drug with a person, most likely another person in recovery because those bonds are deep. And now there are two lives at stake. It's dangerous.I'm not trying to scare anyone away from pursuing a relationship, I'm simply saying to be mindful and aware. Assess where you're at in your personal recovery before you start messing with someone else. Especially if they are in recovery as well.That reminds me of a story.Falling in Love at a 12-Step MeetingI remember one of my first 12-step meetings. I was at an all-time low. I had just gotten out of jail, I looked like shit, my car had gotten repossessed, I was jobless, on probation, and coming off of painkillers, my real true love. When I got to the meeting there was a woman standing by the door greeting everyone. She made eye contact with me, smiled, gave me a hug and told me her name. She opened the door and pointed towards the coffee. I’d finally found her! The one I had been waiting for my whole life! I was in love!I sat through that whole meeting obsessing over her. I couldn't keep my eyes off her. When it was her turn to share, I thought I heard the voice of an angel. I imagined what it would be like to date her. I imagined the highs and the lows of being in a relationship with her. I thought about our wedding and how many kids we would have. I thought about the breakup and the make-up sex. I thought about her cheating on me and imagined what it would be like to win her heart back. I saw us growing old and dying together. The perfect couple, in love until the very end. I pictured all that in 60 minutes. The entire time I was at that meeting, that's all I thought about.I didn't hear about recovery that evening. I didn't hear a solution to my drug problem. I just sat there and crazily obsessed over this woman. She was the one. Perfect for me.I never saw her again after that. I couldn't even tell you her name.My first few months in early sobriety, that's kinda how it went. I would show up at a meeting, meet a woman, live an entire life with her in my head for 60 minutes, and go home. I did that dozens of times with dozens of women. I know none of their names and they have no idea who the hell I am.It was a miracle I never engaged or acted on the thoughts going through my sick unrecovered head. I can't imagine the damage I would've caused in those meetings.I'm blessed to have had sponsors who told me to leave the women alone; to give them a chance to recover too.They told me two dead batteries can't start a car.I'm grateful for the men in my life who instilled good values in me during early sobriety. I haven't lived a perfect life in recovery but I have been super mindful and aware of the fact that I don't want to hurt anyone.If I'm still creating chaos and causing as much damage in recovery that I used to cause while in active addiction, what's the fucking point in staying sober? I might as well use if I'm going to be a sober scumbag.How I Got Healthy Enough for an Intimate RelationshipToday I focus on myself, who I am as a person. I work on my self-esteem every day. Some days are better than others. I combat codependency whenever it rears its ugly head. I address the areas in my life where I may struggle with anger and find ways to work through them. I'm a better man for it.And because of that, I have the ability to practice being in a healthy relationship. Because I’ve gained so many tools while on this recovery journey and I’ve found all are indispensable, interchangeable, and useful within my intimate relationship.It's been a long time since I've walked into a meeting and asked a woman to marry me in my head.My hope for you if you've read up to this point, is that you find a place in your life where you have fallen in love with yourself; knowing all the good and all the bad that makes up who you are. I think when we can become our own best friend without all the false pride is when we finally become an awesome partner for someone else. I hope that happens for you (if that's what you're looking for).If nobody told you today that they love you, fuck it, there’s always tomorrow.

"This American Life" Spotlights "Dopey," a Podcast on Addiction and Recovery

The NPR weekly radio/podcast series This American Life featured a segment on its February 1st broadcast about Dopey, a podcast about addiction and recovery heard by more than four million listeners.The podcast began as a forum for creators and hosts Dave and Chris—as well as guests ranging from Marc Maron and Dr. Drew Pinsky, to My Fair Junkie author and The Fix contributor Amy Dresner—to share "war stories" about their struggles without judgment and with a degree of humor. Dresner was a recent guest on the podcast (and will return as a rotating co-host) where she discussed how her experience trying to treat ringworm made her want to use again.  But with the overdose death of Chris in July 2018, Dave has shifted the focus of Dopey to promote recovery while continuing to address the stigma of addiction.As a result, the podcast has grown both in terms of the number of fans—also known as the "Dopey Nation," who have helped to boost downloads to more than 1.2 million to date—and as a community for listeners in all stages of recovery, as well as family and friends, to come together. As Vice noted, the roots of Dopey began in 2011, when hosts Dave and Chris—who do not give their surnames—met at Mountainside Treatment Center in Connecticut while undergoing treatment for substance use disorder.The pair became friends, and after acquiring and losing various periods of sobriety, they decided to launch a podcast about addiction that focused on what Dave called "the last bad thing"—tales from their past including "using stories, open-ended drug discussion and debate over addiction philosophy," as the pair wrote on the podcast's website. Dopey soon caught on with listeners, who submitted their own recollections. The result was a podcast where those in every stage of recovery could share their experiences and gain support.Then in 2018, Dopey Nation was rocked by the news that Chris had been found dead of an overdose. He had been sober for five years at the time of the incident, working as a manager at a sober living facility and studying to earn his doctorate in clinical psychology.In the wake of Chris's death, Dave was determined to carry on with Dopey, but as he told Vice, "It's apparent now more than ever that Dopey's main focus will be addicts living in recovery. Chris's legacy will live on through these episodes, and the lives he touched all around the world."The new approach has also brought a wealth of new guests, including Jamie Lee Curtis, Beautiful Boy author David Sheff, and musician and recovery advocate Bob Forrest.For Dave, continuing the podcast means giving individuals in the grip of addiction a place to go, to listen, and to share."[They] are not just showing up for Dopey, they're showing up to support one another," Dave said.

The Dangers of Synthetic Drugs

For law enforcement and drug counselors, keeping up with the ever-evolving world of synthetic drugs is an endless game of cat and mouse. When one substance or ingredient is detected and outlawed, backroom chemists can tinker with a formulation, changing it slightly to make an analogue that is technically not illegal. (Although legislators are trying to catch up with wider blanket bans on psychoactive substances).Despite the gray area of legality, synthetic drugs are extremely dangerous. This has been shown clearly in the United States, where fentanyl and its analogues are responsible for tens of thousands of deaths each year. However, opioids aren’t the only drugs being made synthetically. Sometimes known as “legal highs” or “new psychoactive substances,” these synthetic drugs are still every bit as dangerous—if not more so—than drugs that are explicitly banned by the law.Although there are decades of research about the health effects of drugs like heroin, cocaine and amphetamines, there is little research on synthetic drugs. Still, these so-called legal highs can present the same symptoms as those of more traditional illicit drugs, and require treatment in a rehab clinic.Here are some of the common synthetic drug formulations, and the signs and symptoms that someone might be using them to get a “legal high.”Synthetic CannabinoidsStreet Names: Spice, K2, Black Mama, Annihilation, Herbal IncenseDescription: Until relatively recently, Spice was a common sight in some corner stores and smoke shops. Spice generally features a blend of tobacco or other dried plants sprayed with chemicals that cause psychoactive effects. Synthetic cannabinoids can also be sold as liquid to be used in vapes.Symptoms: Although it is sometimes marketed as all natural or safe, Spice is very dangerous, arguably more so than marijuana. According to the National Institute on Drug Abuse, testing shows that the chemicals used in Spice are made in labs and are not safe for human consumption. Like the active ingredients in marijuana, these chemicals act on the cannabinoid receptors in the brain, but some research indicates that they bind even more strongly. This can amplify the effects of the drug, including negative effects like psychosis, paranoia and hallucinations. Synthetic cannabinoids have also been linked to suicide, violence and cardiovascular effects.Synthetic CathinonesStreet Names: Bath salts, Flakka, Bliss, Cloud 9Description: Synthetic Cathinones are a class of synthetic stimulants. Just as synthetic cannabinoids are meant to mimic the effects of the marijuana plant, synthetic cathinones are meant to mimic the effects of khat, an African shrub used as a stimulant. And, just like synthetic cannabinoids, the effects of synthetic cathinones are much stronger—and more dangerous—than the plant they are meant to simulate.Synthetic cathinones are sometimes sold in smoke shops, disguised with the categorization of "not for human consumption." Instead, they’re labeled as bath salts, plant food, jewelry cleaner or phone screen cleaner.Symptoms: When ingested, smoked or injected, synthetic cathinones act on the body in ways that are similar to cocaine, amphetamines and other stimulants. However, they’re much more potent—up to ten times as powerful as cocaine, according to one study cited by the National Institute on Drug Abuse. People who have taken synthetic cathinones can experience paranoia, hallucinations, panic attacks and delirium.Synthetic HallucinogensStreet Names: N-bomb, legal acid, smilesDescription: Synthetic Hallucinogens act on the serotonin receptors in the brain. They mimic the effects of hallucinogenic drugs like LSD but are much more powerful. They are sold in a variety of forms, including powders, liquids, on blotter paper or as edibles.Symptoms: Like most synthetic drugs, the research around synthetic hallucinogens is limited; however, it suggests that they are very dangerous. According to the National Institute on Drug Abuse, people have died from taking synthetic hallucinogens, and one scientific paper documented a suicide attempt after someone took a synthetic hallucinogen. Severe hallucinations can lead to panic in users.Some people mistake synthetic drugs for being “designer drugs” that are safer than other illicit substances. However, this couldn’t be further from the truth. As the case study of a suicide attempt shows, even one-time use of synthetic drugs can have dire consequences. It is therefore important that people who are using these drugs connect with a rehab clinic that can help them stop their use.Get more information on Serenity Health on the website or on Twitter.

Morning Roundup: Mar. 20, 2019

Wendy Williams Reveals She's Been Staying in a Sober Living House [Washington Post]TV personality Wendy Williams revealed that she has been staying at a sober living home. Williams has been candid about battling a cocaine problem and promotes recovery support through her family's foundation.Maine Lawmakers Discuss Bill to Create Substance Abuse Cabinet [Maine Public]A new "substance abuse disorder cabinet" has been proposed in the Maine Legislature. The cabinet will include officials from all state departments.Mindfulness Could Be a Key to Recovering from Substance Use Disorder, USC Experts Say [USC News]Encouraged by the positive impact that mindfulness can have on people in recovery, USC is recruiting participants for a new study that will examine whether mindfulness can help young people who are in treatment for drug use and mental health issues. Harford County to Present Free Performances of Award-Winning Play 'Addicted' [Baltimore Sun]'Addicted,' a play that spotlights heroin's impact on a community, is showing in Harford County starting this Thursday. The community is invited to attend the free performances, written and directed by a school psychologist in memory of her late brother.Kristoff St. John Cause of Death Revealed:  Was Hospitalized at Mental Health Facility Days Before Death [TMZ]Alcohol was a contributing factor to the death of actor Kristoff St. John, according to a new autopsy report. The report also revealed that the actor spent time at a mental health hospital days before his death.Aspiring Doctors Seek Advanced Training in Addiction Medicine [NPR]Schools across the U.S. are now offering fellowship programs that train doctors in addiction medicine. These programs offer training on evidence-based approaches for treating addiction.NHL Player Austin Watson Reinstated After Completing Substance Abuse Program [CBS Sports]Austin Watson of the Nashville Predators has been reinstated by the NHL after violating the league's substance abuse policy. Watson admitted that he had been living with alcoholism, anxiety and depression since he was 18 years old.'The Assassination of Gianni Versace' Sued for False Representation of Anonymous Alcoholic [NY Daily News] An anonymous lawsuit has accused the FX/Netflix drama series 'The Assassination of Gianni Versace: American Crime Story' of presenting "a false implication that (they are) a chronic abuser of alcohol who consumes alcohol throughout the day."

Johnson & Johnson Called Opioid "Kingpin" In Oklahoma Lawsuit

Johnson & Johnson is being named as a “kingpin” of the opioid epidemic in the first big trial targeting opioid manufacturers, which is set to take place in May 2019.The lawsuit, brought by the state of Oklahoma, is naming the multinational company as a “top supplier, seller and lobbyist” for prescription opioids, according to a report by Axios.Although Purdue Pharma is the most commonly cited company associated with the opioid crisis, there are several other pharmaceutical companies being targeted by the many hundreds of lawsuits being brought to court by local governments as well as individuals.Johnson & Johnson, most often associated with baby powder and lotion products, is classified as a pharmaceutical company. Prior to the Axios report, Johnson & Johnson came under fire when it was discovered that the brand’s baby powder contained asbestos. The company was ordered by a California judge on Wednesday to pay $29 million to a woman who sued based on the claim that the powder was a “substantial contributing factor” in the development of her terminal cancer.In addition to everyday home products, Johnson & Johnson “produced raw narcotics in Tasmanian poppy fields, created other active opioid ingredients, and then supplied the products to other opioid makers—including Purdue Pharma,” according to the report.The company also allegedly boasted about the high morphine content of its poppies, targeted children and the elderly in its marketing, and funded multiple “pro-opioid groups.” A brochure made by one of the company’s subsidiaries even claimed that “opioids are rarely addictive.”The lawyers representing Oklahoma in the upcoming case have asked a court to release millions of pages of Johnson & Johnson’s confidential documents to the public, based on the fact that the company has divested from the opioid business and therefore shouldn’t have to worry about losing trade secrets.“The public interest in this information is urgent, enduring and overwhelming,” wrote Oklahoma Attorney General Mike Hunter.Johnson & Johnson provided Axios with a statement in the company’s defense, claiming that it “appropriately and responsibly met all laws and regulations on the manufacturing, sale and distribution of APIs (active pharmaceutical ingredients) and the raw materials that go into them” and that its “actions in the marketing and promotion of these important prescription pain medications were appropriate and responsible.”The company claims that it accounted for “less than one percent” of the total market share for opioid medications.However, the Axios report points out that Johnson & Johnson made $1 billion in 2015 by selling the opioid Nucynta and $2 billion from the fentanyl patch Duragesic, which it still sells to this day.