US opioid scripts take a dive

A new study by IQVIA Institute for Human Data Science found that 12% fewer units of prescription opioids were dispensed in 2017 than in 2016. That’s the largest single-year decline since the drug peaked in 2011. On top of that, the largest declines were seen in the US states hit hardest by the scourge (New England region, West Virginia, Pennsylvania). Authors of the study attribute the decline to changing clinical guidelines, new legislation, altered reimbursement practices and broader public awareness of the addictive and destructive nature of the drug. That’s great news, of course, but overdoses from their follow-on illicit ancestors are still running rampant. Speaking of… here’s the Wikipedia page for fentanyl.  Nasty stuff. Just ask Michael Jackson, Prince, Tom Petty…

Unexpected life expectancy

For the 2nd straight year, life expectancy in the United States has declined. According to the National Center for Health Statistics data, the last time the US showed a multiyear decline in life expectancy was 1962-1963. And if 2017 completes the trend (remember from math class that it requires 3 data points to call it a trend), it will be the first time that’s happened since the Spanish flu did a number on the country over a hundred years ago—at least according to CNN. This writer wasn’t alive then. Much of the blame for the drop is being attributed to accidental overdose deaths—i.e., opioids. Accidental overdoses accounted for 63,600 deaths in 2016. Here’s wishing for a less-addicted new year.

1. Good or bad news first?

In an effort to combat the prescription drug abuse epidemic, several companies, like Purdue Pharma, have created reformulated opioids. These abuse-deterrent painkillers make it more difficult to snort, smoke or inject the drug—some estimates show that revised OxyContin has curtailed abuse by 40%. Well done, Purdue. Buuuuuut… a new study from the University of Pennsylvania and Rand Corp. shows that since the reformulation of OxyContin, heroin overdoses have surged and the increase in deaths can be attributed directly to the new-and-improved Oxys. One finding shows the number of heroin deaths tripled from 3,000 in 2010 (when reformulated Oxy was introduced) to 10,500 in 2014. InsightCity’s analysis? Addiction is painful and destructive, and the healthcare ecosystem plays too large of a role in the problem.

2. A vaccine for opioid addiction and overdose?

Strange but true. Using a molecule structurally similar to opioids, researchers at The Scripps Research Institute successfully blunted the effects of oxycodone and hydrocodone in mice. Specifically, the drug binds to the opioid molecule and prevents it from ever making its way to the brain, limiting the user’s pain and euphoria responses to the drug. Such an intervention may be beneficial over other forms of treatment because it does not chemically alter the brain. The study also found that mice that received the vaccine took longer to overdose from high levels of opioid ingestion, which could mean more time for users who overdose from opioids to seek treatment.

4. Compounding addictions

You know what sounds crazy? The FDA’s “2016 Naloxone App Competition.” The idea, to develop a location-based, social search service application (a la Tinder) that connects opioid users and first responders to someone nearby with a dose of naloxone, was presented as a challenge by the FDA to programmers, public health advocates, researchers and entrepreneurs in an attempt to slow the death rate from opioid overdoses. Naloxone is a prescription drug able to reverse the effects of an opioid overdose when administered quickly enough; the FDA believes this antidote is currently in too few hands to save all who might benefit. But an FDA sanctioned app that unites drug users with drugs? Just like opioids and smartphones, this app seems ripe for abuse.