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.