1. Treatment dilemma: No consensus on cure as demand for it explodes
2. The debate over Narcan 3. Watch: Video - Portugal's Approach to Fighting Drug Addiction 4. Collins Type 2 Writing Assignment
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1. 15 minutes to finish presentations
2. Opioid Addiction Treatment/Harm Reduction Presentations 3. What is Narcan? 4. The debate over Narcan
1. Opioids rewire – and take control of – the brain
2. Disease or bad behavior: Does addiction call for compassion or punishment? 3. Chris Christie Makes Emotional Plea To Rethink Drug Addiction Treatment 4. So what are our options for dealing with the heroin crisis beyond arrests and jail time? Below are five ways that communities are dealing with heroin addiction. Some are attempts to end the addiction, while others try to reduce the harm of heroin addiction. You will be working with the students at your table to create presentation that teaches the class about one of these approaches. Heroin Treatment and Harm Reduction Options Table 1. Abstinence Programs (Narcotics Anonymous) - treatment Table 2. Methadone Table 3. Suboxone Table 4. Needle Exchanges Table 5. Vancouver's Supervised Injection Site and proposed for Ithaca, NY A. Your group must present to the class about your assigned topic. For your presentation, you may use one of the following methods:
B. Your presentation must answer the following questions about your topic: - How does it work? - Does it work (how effective)? - Reasons for controversy? Pros/Cons? - How widely utilized in the United States (or Maine)? - What is the cost ($$$)? 1. Maine attorney general: Report on overdose deaths highlights need for more treatment
2. Finish "Prescription Thugs" 3. With a little help from your doctor: Speakers at hearing support limiting drug company gifts to Maine doctors 4. With a little help from your...friends and family (see first image above), or co-workers (Trapped by heroin: Lobster industry struggles with its deadly secret) 5. With a little help from your friendly pharmaceutical company: Oxycontin: Purdue Pharma's Painful Medicine Excerpts from link above: "FORTUNE -- We have become a nation of pill poppers. Pain tablets are the prime culprits -- more specifically, opioids. You may have never heard the word "opioid," which refers to a broad category of drugs derived from natural or synthetic forms of opium or morphine. You have, however, likely heard of many of the medications in the group, which includes everything from Percocet to Vicodin to Fentanyl. Their chemical composition is such that the U.S. is just a few carbon molecules from being a nation of heroin addicts... ...Consider these statistics, all for 2010: 254 million prescriptions for opioids were filled in the U.S., according to Wall Street analysts Cowen & Co. Enough painkillers were prescribed to "medicate every American adult around the clock for a month," the federal Centers for Disease Control reported on Nov. 1. It estimated that "nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs." Opioids generated $11 billion in revenues for pharmaceutical companies, says market research firm Frost & Sullivan... ...Two decades ago opioid sales were a small fraction of today's figures, as such drugs were reserved for the worst cancer pain. Why? Because drugs whose chemical composition resemble heroin's are nearly as addictive as heroin itself, and doctors generally wouldn't use such powerful meds on anybody but terminal cancer patients. But that changed years ago, and ever since, addiction to painkillers has become a staple of news headlines. There are periodic lurid crimes, such as the quadruple homicide in a Long Island pharmacy this summer committed by an addict desperate for hydrocodone. More often, there are the celebrities, such as Rush Limbaugh, who admitted on his radio show years ago that he was addicted to painkillers, or actor Heath Ledger, who was found dead with oxycodone in his system, or rapper Eminem, who entered rehab to address his reliance on Vicodin and other pills.... ...Among the sellers of opioids, none has been more successful -- or controversial -- than Purdue Pharma, maker of the No. 1 drug in the class: OxyContin, which generated $3.1 billion in revenue in 2010. Purdue and its marketing prowess are the biggest reasons such drugs are now widely prescribed for all sorts of pain, says Dhalla: "Purdue played a very large role in making physicians feel comfortable about opioids." And as we'll see, Purdue's past and present go a long way toward explaining how so many Americans came to be in the grip of potent painkillers... ...Purdue's breakthrough would be one of marketing rather than medicine. The painkiller in OxyContin was not remotely new. Its active ingredient was oxycodone, a strong, partly modified form of an opiate alkaloid called thebaine invented in Germany in 1916. The patent had run out decades before, and the generic form was sold by a number of companies. But with its new time-release mechanism, Purdue won FDA approval to sell OxyContin in late 1995. Purdue immediately set out to promote its new drug, following Arthur Sackler's template. The company pushed for its use in a broad range of chronic pain: everything from backaches to arthritis. Purdue knew it needed to overcome doctors' fears about addiction, so it treated the time-release formula as a magic bullet. It claimed the drug would give pain patients steadier 12-hour coverage, avoid withdrawal, and frustrate addicts seeking a euphoric rush. As one 1998 Purdue promotional video stated, the rate of addiction for opioid users treated by doctors is "much less than 1%. The pitch worked, and sales took off: from $45 million in 1996 to $1.5 billion in 2002 to nearly $3 billion by 2009. The key: Nearly half of those prescribing OxyContin were primary-care doctors rather than, say, cancer specialists, the General Accounting Office reported. Purdue had succeeded in vastly expanding the market for its drug. But evidence quickly emerged of OxyContin's dark side. Doctors discovered that the drug lasted around eight hours rather than 12, and that patients would crash, needing more and higher doses. Patients who took moderate amounts for backaches or arthritis could find themselves hooked. Addicts saw they could easily get high by crushing the pills and then snorting, chewing, or injecting them. In congressional testimony, Purdue's top executives would later say they first learned of problems with OxyContin in 2000, after the U.S. attorney in Maine warned of rampant abuse. But for at least three years prior, internal records show, company executives were aware of the abuse allegations. In October 1997, for example, a Purdue marketing executive e-mailed several people, including then-COO Michael Friedman, stating that references to OxyContin abuse on addiction chat sites were "enough to keep a person busy all day." He added, "We have three people that visit the site chat rooms." (A lawyer for Friedman and two other former Purdue executives says that "substantial levels of abuse did not begin until 2000 and 2001," and cites DEA data showing the numbers of cases reported to the government first spiked in those years.) Among the sellers of opioids, none has been more successful -- or controversial -- than Purdue Pharma, maker of the No. 1 drug in the class: OxyContin, which generated $3.1 billion in revenue in 2010. Purdue and its marketing prowess are the biggest reasons such drugs are now widely prescribed for all sorts of pain, says Dhalla: "Purdue played a very large role in making physicians feel comfortable about opioids." And as we'll see, Purdue's past and present go a long way toward explaining how so many Americans came to be in the grip of potent painkillers. When it was introduced in the late '90s, OxyContin was touted as nearly addiction-proof -- only to leave a trail of dependence and destruction. Its marketing was misleading enough that Purdue pleaded guilty in 2007 to a federal criminal count of misbranding the drug "with intent to defraud and mislead the public," paid $635 million in penalties, and today remains on the corporate equivalent of probation... ...Meanwhile an increasing number of physicians are wondering whether opioids are worth it. "I have come to question whether the long-term treatment of nonmalignant pain is causing more harm than good," wrote a San Francisco public health internist named Mitchell Katz in a journal article last year. He subtitled it "A Believer Loses His Faith." A little less faith in painkillers right now would do the country a lot of good." 6. With a little help from your members of Congress (see second image above) HW: Assignment #11 - Opioid Painkiller Crisis Reflection Apply your "sociological imagination" to opioid painkiller crisis. In a 1/2 page to 1 page reflection, analyze/explain what social/societal factors have influenced the surge in opioid prescriptions, addictions and overdoses. In your response, identify and explain at least three different contributing societal/social influences . When complete turn in to eBackpack Assignment #11 1. How the opioid epidemic became America’s worst drug crisis ever, in 15 maps and charts
2. Prescription Thugs 1. Drugs deaths by continent
2. Pew Research - Drug Opinion Survey 3. How the opioid epidemic became America’s worst drug crisis ever, in 15 maps and charts 4. Begin - Prescription Thugs HW - Assignment #10: Choose 5 charts/graphs from the article linked at #3 above that are the most surprising, shocking, or maddening to you. Explain/describe what each graph says about the American opioid epidemic and why it stuck out to you. Upload to eBackpack Assignment #10 |
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