The NFL and Painkillers

When Necessity Turns into a Serious Habit

No one can deny that professional athletes put their health on the line every time they suit up to entertain us. But injuries on the field can cause chronic pain and a legitimate need to take prescription painkillers. If these injuries aren’t addressed and don’t have time to heal, they can progress to the point where painkillers are needed every day. Prescription opiates are often used to treat moderate to serious pain but can be habit-forming when taken for prolonged periods. The sad part is that sports-related injuries can cost professional athletes their jobs and their livelihoods. Some athletes, including the Minnesota Vikings’ Brett Favre, have chosen to continue playing after an injury but ultimately paid the price. During the 1990s when he played for the Green Bay Packers, Favre admitted to a prescription painkiller addiction that began after an injury threatened to sideline his career. He worked through it and went on to play many more seasons after doctors told him he suffered a serious seizure that likely stemmed from his painkiller abuse.

Favre’s story made the national news but there are countless other athletes who may be using these drugs but flying under the radar. The NFL currently tests players for substances of abuse (not including steroids) only during the offseason. The National Basketball Association and National Hockey League have a somewhat stricter set of rules. Their players can be tested during the regular season. Major League Baseball players aren’t tested for many substances of abuse without reasonable cause. For the most part, these guidelines have been worked out through the players’ unions and the NFL has said it’s doing what it has to in order to honor those contracts. Some officials have acknowledged that prescription painkiller abuse in the NFL is an issue, but say it’s indicative of a bigger problem that affects the broader population.

Statistics from the U.S. Substance Abuse and Mental Health Services Administration show that this may be true. From 1998 to 2008, the agency reported a serious increase in painkiller abuse among nearly all segments of society “regardless of age, gender, educational level and employment status.” These medications are so easily accessible nowadays that these statistics shouldn’t surprise anyone. Some doctors overprescribe painkillers. They can be purchased on the streets of just about any community. Drugs such as OxyContin, Vicodin, Percocet and Dilaudid are readily available online. There are plenty of shady websites out there offering potentially addicting prescription drugs without requiring a prescription. Professional sports, injuries and chronic pain go hand in hand. An athlete on pain medication for an injury can be numb to the point that more injuries are likely. Long-term use can lead to a lifetime of problems. The issue is not likely to be remedied anytime soon without action from Congress and more stringent testing by professional sports organizations.

Increase in the Number of Opiate-Dependent Newborns Being Treated For Withdrawal Symptoms

The Painkiller Epidemic’s Tiniest Victims

It’s no secret that prescription painkiller addiction has surged among young people, but the littlest victims have no say over their circumstances. More and more hospitals across the country are reporting an increase in the number of opiate-dependent newborns being treated for withdrawal symptoms. The withdrawal for babies born to addicted mothers can be agonizing. Babies who are dependent upon painkillers such as OxyContin and Vicodin can experience symptoms within hours of being born, including hypertonia, or stiff limbs. These vulnerable babies can also experience feeding difficulties and gastrointestinal problems including vomiting, diarrhea and cramps. Others may suffer from difficult breathing, irritability, tremors or insomnia and at times may be inconsolable. In serious cases, infants can experience seizures.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has found that the number of people seeking treatment for prescription drug abuse has more than quadrupled in the last 10 years. Women of childbearing age who take opiates are a significant health concern. Some babies who are born addicted to opiates have been exposed to heroin or prescription painkillers in the womb. Others can become dependent upon methadone if the mother is taking it as part of her addiction treatment. Opiate withdrawal in infants is referred to as neonatal abstinence syndrome. It can kick in shortly after birth and may last several days, even a few months. A typical treatment protocol is to administer morphine or sedatives to ease babies through this difficult time.

Babies exposed to opiates in the womb can be born prematurely, suffer low birth weight or have intrauterine growth retardation. The long-term effects may not be fully understood and can depend on the drug used, the dosage and the length and severity of the mother’s drug use. Just because many painkillers are prescribed by a doctor does not mean they are safe to take during pregnancy. Women should always be up front with their doctors about all legal and illicit drug use during this time. In addition to the health consequences of opiate use during pregnancy, this can also result in a poor bonding experience for mothers and their babies. What should be a magical time between a mother and her child can become quite frustrating and hard to deal with.

Former Tennis Champ Agassi Admits Crystal Meth Use

Andre Kirk Agassi’s yet to be released tell-all book, “Open,” contains at least one bombshell – his crystal meth use and how he lied to the ATP about it after failing a drug test back in 1997.
Due to be released on November 9, a publicist for Random House confirmed the rumors. "Those excerpts contain revelations about Andre's use of crystal meth when he was a tennis player.” Random House describes the book like this: “From Andre Agassi, one of the most beloved athletes in history and one of the most gifted men ever to step onto a tennis court, a beautiful, haunting autobiography.”

According to an excerpt published in The Times of London, the eight-time Grand Slam champion sent a letter to the ATP tour to explain the positive test, saying he accidentally drank from a soda spiked with meth by his assistant "Slim."
"Then I come to the central lie of the letter," Agassi writes. "I say that recently I drank accidentally from one of Slim's spiked sodas, unwittingly ingesting his drugs. I ask for understanding and leniency and hastily sign it: Sincerely.
But in a candid People magazine interview, Agassi reveals, “I was worried for a moment, but not for long. ... I wore my heart on my sleeve and my emotions were always written on my face. I was actually excited about telling the world the whole story," Agassi said.
When the celeb mag asked Agassi if he was ever addicted to crystal meth, he didn’t label himself an addict, but he did tell People, “if you're using anything as an escape, you have a problem.”

Agassi had already been a three-time Grand Slam champion, reached four other major finals, achieved No. 1 status and collected an Olympic gold medal before experiencing a nosedive of all nosedives in 1997, the year he reportedly starting using meth "a lot." He had finished inside the Top 10 eight times before that forgettable '97 campaign.

Maybe crime does pay, as the book has an initial run of half a million copies, with an estimated $5 million as an advance.

Drug Addiction: Government Plot in Iran?

Who Knew? According to an article in the Tehran Times last week, there are presently 11.2 million drug addicts in the country. Drug addiction is on the top of the social problems that has caused so much concern in the society.
Unfortunately, a government leader reported, campaigns against drug addiction would not produce the same results as campaigns against thugs or drug trafficking. According to the official statistics, there are 1.2 million drug addicts in Iran while the unofficial sources show that the figure exceeds 11 million.
Not long ago, a report by the United Nations found that Iran has the highest drug addiction rate in the world. Iran has the highest proportion of opiate addicts in the world -- 2.8 percent of the population over age 15. The director of the Iranian National Centre for Addiction Studies estimates that 20 percent of Iran's adult population was "somehow involved in drug abuse". In Iran, about 14 tons of Afghan heroin and a staggering 450 tons of opium were consumed locally in 2008, the report said, making it the world’s biggest consumer of the drug.
Many Iranians describe high drug availability as evidence of a government plot, adding, “After students rioted at Tehran University in 1999, residents of a locked-down dormitory told of drug dealers being allowed in to distribute narcotics for free”. "I believe this is the policy of the state, to make all the youth addicted", said Hamid Motalebi, 22, a police officer on duty in a south Tehran park almost overrun by junkies sleeping on the grass or staggering like zombies. "It's the lack of policy and management. If they could create enough jobs, enough entertainment, why would people turn to drugs?"
Where do the drugs come from? Afghanistan is particularly generous with Iran, with some sources saying as much as 60% of Afghanistan’s opium is trafficked across Iran’s border.
The effect of Afghan’s drug trade is felt around the world, says the UN. Iran, Pakistan and Central Asian nations are among the most affected states but the negative impact of the multibillion-dollar Afghan narcotics flow is felt around the world as it continues to spread, the United Nations Office on Drugs and Crime said in a new report issued last week. Afghanistan produces 90 per cent of the world’s supply of opium, the raw ingredient used to make heroin.
Few people truly believe it is an Iranian government plot, as the consequences are severe. With a quarter of drug users now infected with HIV, Tehran also has spent millions of dollars and deployed thousands of troops to secure its porous 1,000-mile border with Afghanistan and Pakistan. Experts say a few hundred Iranian drug police die each year in battles with smugglers.

Finally: 3 to stand Trial for Anna Nicole Smith’s Death

What took so long? Anna Nocole Smith, former Playboy model, turned reality star, died tragically of an accidental overdose of at least nine medications in February 2007. Three of the people in her life, have finally been ordered to stand trial. The charge?

In feeding her addiction to prescription drugs, her boyfriend lawyer Howard K. Stern, Dr. Sandeep Kapoor and psychiatrist Dr. Khristine Eroshevich stand accused of conspiring to illegally provide her with controlled substances and supplying drugs to an addict.

County Superior Court Judge Robert J. Perry ruled Friday, October 30 in Los Angelos after a 13-day preliminary hearing, that there was sufficient evidence to try the defendants on charges of conspiring to give Smith sedatives and opiates. Dr. Kapoor and Dr. Eroshevich are charged with prescribing controlled substances to an addict, writing opiate prescriptions in a false name and obtaining opiates by fraud.

Mr. Stern, Anna’s longtime companion and attorney, is charged with illegal prescribing under the theory that he aided and abetted the physicians.A friend of Smith’s, Gina Shelly, said Howard Stern would give Smith handfuls of drugs. "He poured them in her mouth like you would a bird." All three defendants pleaded not guilty.

If convicted they each could face more than five years in prison. NY Daily News reported that her longtime boyfriend, Howard K. Stern, is charged with 11 felony counts, including dispensing a controlled substance to an addict and obtaining a prescription for opiates by deceit.Doctors Kapor and Eroshevich each face six felony counts, including unlawfully prescribing a controlled substance to an addict. All three defendants face charges of conspiracy to commit a crime.

The sheer number of medications Smith was reported to have taken included Valium, methadone, Xanax, the anti-seizure medication Topamax, the muscle relaxant Soma, the sedative chloral hydrate and Dilaudid, a painkiller also known as "hospital heroin."

It was alleged during the hearing that while Smith was being weaned off methodone at a rehab hospital, Stern would sneak in extra doses for her.One expert witness testified that there was no legitimate medical reason for Kapoor and Eroshevich to provide Smith the amount of sedatives and painkillers they did.

Although, at one point, the judge pointed out that he was convinced that all three defendants cared deeply for Smith and tried to help her. Is it just me, or with friends like that, who needs enemies?

A Dec. 11 arraignment was set.

Prescription Drug Databases May Help States Curb Growing Misuse of Opiates

Many states are grappling with the grim realization that a rising number of cases of drug abuse and overdose are not related to street drugs such as heroin and cocaine. Instead, prescription pain killers or opiates are the alarming growing problem that government, health and law enforcement officials are trying to figure out how to stem. The statistics seem to mirror the trend in prescribing practices of many doctors and pain clinics across the country. It’s simple: as more prescriptions are written for opiates, and more of these drugs are illegally diverted, more people are becoming addicted and/or suffering fatal overdoses.

The Cleveland Plain Dealer reported in April 2009 that Ohio’s drug-related deaths increased 304 percent between 1999 and 2007, a problem attributed largely to abuse of prescription painkillers. The number of overdoses in this state surpasses the number of traffic-related fatalities. Ohio developed a Web database program three years ago to make it easier for police, doctors and pharmacists to check for all prescriptions filled in the state. Ohio and Kentucky recently agreed to share prescription information as many people go beyond state borders to “doctor shop” in an attempt to secure more than one source.

The Ohio Pharmacy Board has stated their hope to reach such agreements with other states. In similar moves, 38 other states are adopting a database program to help prevent people from obtaining multiple prescriptions for opiates such as OxyContin, Codeine, Fentanyl, Percocet and Darvocet. Sharing such information will give doctors and other officials the chance to flag those people who may be abusing prescription drugs.

Abuse of Prescription Painkillers Leaves Many Scrambling for a Solution

The Plain Dealer article, citing a report from the Centers for Disease Control and Prevention, reported that deaths from misuse of prescription narcotics had by 2004 outnumbered deaths in the U.S. from both heroin and cocaine. The number of prescriptions for opiates issued in the U.S. has skyrocketed in the last few years, and are now among the most commonly prescribed drugs in this country.

The fallout from this situation can be seen in just about every community. Police logs and newspapers reflect the societal scourge of painkiller addiction which can lead to theft, violence, overdoses, legal problems and personal and property crimes. In fact, the National Institute on Drug Abuse (NIDA) reports that “the cost to society of illicit drug abuse alone is $181 billion annually.” Many agencies are scrambling for the resources and time to deal with these issues, compounded by the fact that these same communities and agencies are tightening their belts and losing funding in a sour economy. While educational, prevention and treatment programs may put a dent in the opiate problem, these programs likely suffer from local, state and federal funding cuts.

There are many methods of drug treatment available, and in various settings, including residential treatment centers, outpatient programs, and inpatient care, and utilizing both behavioral approaches and pharmacological treatment. Often, however, the treatment programs used to address addiction last months, with a high incidence of relapse. As a result, the local, state, and federal agencies paying for these treatment programs end up paying for treatment for the same recipients multiple times, over a long period of time.

Obviously, a less costly and more effective method of drug addiction treatment is advisable. Medically-assisted withdrawal using the Waismann Method enables individuals to safely and comfortably reverse their dependence in days rather than months. The Waismann Method takes place in the hospital over 3-7 days, during which medications are administered to reverse physiological dependence and address the symptoms of withdrawal. Using this medical approach, the duration and severity of the withdrawal syndrome are reduced and, in fact, patients report feeling minimal to no withdrawal or physical cravings after one week of treatment. These patients are then able to start a therapeutical program of their choice to address their underlying social and psychological issues, which greatly aids in the success of the Waismann Method. The Waismann Method has been performing the highest level of opiate detoxification in the country for the last decade.

Instead of working with just the addiction (the symptom), we work with the patient. Opiates are numbing devices used to numb physical or mental pain. Unless the root of each individual patient’s physical or mental pain is assessed and treated properly, patients tend to relapse in order to mask the pain they cannot handle.

Suffering through withdrawal is physically and mentally traumatic and counter- productive to a patient’s well being. Not just are we able to safely and humanely detox patients under sedation, but we also created an after care Domus Retreat that, unlike most traditional rehabilitation centers, works with the patient’s chemical imbalance, depression, chronic pain or whatever issue each individual is diagnosed with.

Treating the patient as a whole both physically and mentally by being able to identify and assist each patient based on their specific medical and psychological needs allows us to maintain the highest success rate of any opiate treatment in the country.

Kelly Osbourne Addicted to Vicodin

Kelly Osbourne, daughter of Ozzy and Sharon Osbourne, has come clean about a problem that has plagued her for years. She recently opened up to People Magazine saying she got hooked on liquid Vicodin when it was prescribed for her following a surgery to remove her tonsils at age 13. Kelly is a few weeks out of rehab which was her third attempt at getting clean. The 24-year-old says that taking Vicodin made people like her, boosted her confidence and kept her from being teased. She had previously tried to get clean during rehab stays in 2004 and 2005.

Kelly told People she’s getting a second shot at her career and knows she would have died had she not sought help. She returned to the screen with her family in a variety show called Osbournes Reloaded that debuted March 31 on the Fox network. Kelly has said her month-long stay in rehab was voluntary and based on an “intense” relapse this year.

A Prolonged Vicodin Addiction Can Be Hard to Kick

Addiction to Vicodin and other opiate painkillers can be hard to kick, especially after prolonged use. Physical and psychological dependence can develop, making it especially important for users to seek out professional help in order to detox. In Kelly’s case, a decade-long addiction made the likelihood of relapse even greater.

This story is similar for many people going through opiate painkiller addiction. You are in pain from an injury, surgery or chronic illness. You get a prescription for pain medication. The next thing you know, you’re hooked. Prescription painkiller addiction is a chronic, progressive and relapsing condition that traps some users in a vicious cycle for years.

Addiction in the Osbourne Family: Hereditary or Circumstantial?

Kelly’s family members are no strangers to addiction either. Her father Ozzy, Black Sabbath front man and reality show star, has notoriously and publicly battled drug and alcohol addiction. Her brother Jack has also struggled with drug addiction and alcoholism ¹ and has sought treatment in the past. Her mother Sharon has admitted in the past to suffering from bulimia ², an eating disorder viewed by some to be addictive in nature.

The cause of addiction is the subject of much research and debate. For some people addiction is hereditary and determined in part by the genes inherited from their parents. For others, it is the result of life experiences and circumstances. In the case of the Osbourne family, it could be a little bit of both.

1. http://www.thesun.co.uk/sol/homepage/news/article103118.ece
2. http://www.timesonline.co.uk/tol/news/uk/health/article566999.ece

Anna Nicole Smith: A Sad Story Gets Even Sadder

The recent arrest of Anna Nicole Smith’s doctor, psychiatrist and attorney has put the spotlight on the role the professional community can play in keeping an addict addicted. Smith died Feb. 8, 2007 in a Hollywood, Fl. hotel room after suffering an accidental overdose from a cocktail of prescription drugs, including highly-addictive opiates. She was 39 at the time of her death which came shortly after she gave birth to a daughter and lost her son to a drug overdose.

Arrested in connection with the case were Howard K. Stern, Smith’s boyfriend and attorney; Dr. Sandeep Kapoor, one of Smith’s doctors; and Khristine Eroshevich, Smith’s psychiatrist. Eroshevich faces charges that she repeatedly supplied Smith, a known addict, with addictive prescription drugs. Stern and Kapoor have been charged with unlawfully prescribing a controlled substance and conspiring to prescribe, administer and dispense a controlled substance to an addict.

Kapoor and Eroshevich were also charged with one count each of obtaining a prescription for opiates by using a fake name or address, and one count each of obtaining a prescription for opiates by “fraud, deceit or misrepresentation.” All three turned themselves in recently and are scheduled to be arraigned May 13 in the downtown Los Angeles courthouse. They each face a maximum of five years and eight months in a state prison if convicted, according to the district attorney’s office.

Dangerous Mix of Opiates and Benzodiazepines Prescribed “Excessively” for Smith

Los Angeles County Superior Court documents show a dangerous mix of opiates, benzodiazepines and other drugs that had been prescribed to Smith over a three-year period. These include: methadone, a synthetic opioid used to treat addiction; Dilaudid, the brand name for hydromorphone, an opioid analgesic; Xanax, used to treat anxiety and panic disorders; Valium, used to treat anxiety, insomnia, alcohol withdrawal and addiction; Vicodin, a narcotic pain reliever and cough suppressant; Ambien, a short-term sleeping aid; promethazine with codeine, an antihistamine and sedative; clonazepam, a muscle relaxant; chloral hydrate, a hypnotic sedative; and carisoprodol, a muscle relaxant.

California’s Attorney General has called Stern Smith’s “principal enabler” and said the doctors prescribed the drugs “excessively to a known addict.” All three have denied they did anything wrong and an attorney for Eroshevich has said the doctor needed to use a fictitious name on prescriptions to protect Smith’s privacy.

Alleged Abuse of Power Kept Smith Sedated and Incoherent

The case calls attention to the alleged abuse of power by the very people who were charged with taking care of Smith. If they are found guilty of the charges, it will show that all three flagrantly violated their ethical obligations to the star who often seemed unable to care for herself.

Smith, who was a Playboy pin-up and Guess Jeans model, became a kind of caricature of herself in the years leading up to her death. She wed billionaire oil tycoon J. Howard Marshall II when she was 26 and he was in his late 80s. After his death in 1995, she battled his family for control of his estate. She also starred in a reality TV show which often portrayed her as unstable and incoherent. Smith even made embarrassing TV appearances where she slurred her words and seemed heavily sedated and impaired.

The Hills of Appalachia: A Desperate Situation

An epidemic of drug abuse has gripped a part of America so often forgotten. Living conditions in parts of central Appalachia are bad – so bad in fact that images mirror those you would see in a commercial for starving children in a third world country. Diane Sawyer of ABC News reported last week on the crisis people face in this part of the eastern United States. Problems she uncovered include a poverty rate three times that of the national rate, chronic depression, cancer and toothlessness. People living in the region Sawyer visited have the shortest life spans in the nation and a serious problem with prescription drug abuse.

Sawyer profiles an 11-year-old girl and her struggle to get her mom well. Her mother is addicted to alcohol and prescription medication. The two live in Cumberland, Ky., and Sawyer said that region has a rate of prescription drug abuse twice that of cities like New York and Miami. Some people try to make an honest living and many put in long hours in dangerous coal mines. But with few resources and fewer jobs, people are turning to dealing prescription drugs as a way to survive.

And many battle addictions, saying the drugs and alcohol help to numb the pain of their reality. In these parts, a Lortab or Xanax pill goes for between $5 and $15. To get your hands on a powerful OxyContin pill, you’ll have to shell out at least $20. Because of this illicit sale and trade, it’s no wonder this part of rural Appalachia also has a high crime rate. Robbery, theft and other types of personal crimes are soaring. It’s a desperate situation to say the least.

OxyContin, a powerful opioid drug, is a major concern for parts of Appalachia. Couple that with a limited availability of substance abuse treatment centers and it’s not hard to see why people are stuck in this way of life. In 2003, the Lexington Herald-Leader analyzed federal data and found that, per capita, Eastern Kentucky drugstores, hospitals and other legal institutions receive more prescription painkillers than anywhere else in the nation.

Prescription Drug Addiction Knows No Boundaries

Drug abuse, diversion and illicit sale are not a problem isolated to the hills of Appalachia. These issues have no borders. The abuse rate of prescription medication, especially opiates and benzodiazepines, is soaring globally. Related concerns have also plagued other regions of the United States. As prescription drugs become more available legally and otherwise, overdoses and related drug deaths are increasing everywhere.

It could be argued that any one of us is one injury away from potential prescription painkiller addiction. Because of their makeup and the way opiates attach to receptors in the brain and body, addiction can take hold quickly with regular use. Addiction knows no boundaries. People from every background are affected. Addiction also does not discriminate based on race, nationality, sex or socioeconomic background. It’s up to each one of us to know the facts and protect ourselves.

Tapentadol: FDA Approves New Opiate Painkiller

Many Americans dealing with pain will soon have a new option when it comes to managing it. The U.S. Food and Drug Administration approved a new immediate-release tablet for the management of moderate to severe pain. 

Tapentadol hydrochloride is a synthetic analgesic available in doses of 50 mg, 75 mg and 100 mg. An FDA press release from Nov. 24 says the drug “acts in two ways, opioid (narcotic) and non-opioid.” It reportedly activates opioid receptors in the brain, spinal cord and gastrointestinal tract, and inhibits the reuptake of the brain chemical norepinephrine which may have an analgesic effect. The FDA lists side effects for Tapentadol as nausea, vomiting, dizziness and sleepiness. 

Labeling on the packaging warns users of the risk of respiratory depression and its potential to be abused. It can also have addictive depressive effects on the central nervous system when taken with alcohol, other opiates or illicit drugs, the FDA said.

As with Other Opiates, New Drug has Potential for Abuse

Tapentadol is manufactured by Janssen Ortho, LLC, in Gurabo, PR., a subsidiary of Johnson & Johnson. It will be available once the U.S. Drug Enforcement Agency classifies the controlled substance in its drug schedule. The FDA says opiates are “safe and effective in selected patients but can cause dependence, abuse and addiction.” Approval was based on clinical studies of more than 2,100 patients presented earlier this year at the annual scientific meeting of the American Pain Society. The studies found Tapentadol to provide significant relief when compared to a placebo. A trade name for Tapentadol has not yet been established.