This sounded like a smoking gun on how opioids can often lead to addiction.

When I dug deeper, the data was a little surprising.

Of the total illegal drug users the study cited:

• 12.2% tested positive for marijuana;
• 2.0% tested positive for cocaine;
• 1.3% tested positive for heroin; and
• 125 samples tested positive for PCP and MDMA.

As it turns out, the majority of the people impacted were using marijuana.

In most cases, marijuana will clear a urine test within a month. I wanted to check on the overall adult US population usage of marijuana. Of the US population over 12,  used marijuana within the last month.  That is only a 0.8% difference.  If we remove the (under 16) population, who are likely not in the workers’ comp data, the margin is even narrower.  There may be a slight correlation between opioid usage and an increase in marijuana usage, but it is very small.

Regular heroin use in the US is between Ěý–Ěý based on the studies I have seen.  The 1.3% usage of the people in the study would be a 700 – 1300% increase over the general population.  This is still a small percentage of opioid users in general that use heroin, but an obvious statistical increase.  It stands to reason that a higher percentage of opioid users would seek out other types of opioids, such as heroin, so there is no real surprise in the data.

However, these numbers don’t even cover the main risk.  We can see a correlation in heroin usage between opioid users and non-opioid users.  What this study does not address is the greater threat posed for people who are cut off from their opioid prescription and their future illegal drug usage. These are the people that are far more likely to use heroin to continue to feed their addiction.

As always, the best solution is to manage and monitor treatment from early on so these people never become addicted.  Industry programs such as our own have a very strong correlation between decreased opioid usage, and a shorter duration of disability.  We all must continue to focus on finding better ways to get people healthy.

The post 10.4% of Chronic Pain Patients Prescribed Opioids Also Take Illegal Drugs appeared first on 911łÔąĎ.

“Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.?”

They reference the famous drug experiment where a rat living in isolation will consistently choose water laced with cocaine or heroin over clean water until it kills them. But when this same experiment is conducted in a virtual “rat heaven” (e.g. great food, tunnels, and multiple rats living together), the rats will mostly choose the pure water. None of these rats died.

Addiction is something our industry combats daily and it’s something that, like many of you, I have experienced with people close to me. These were people I loved and respected, but they shared a common pattern of drug use that arose during personal crises. Divorce, financial issues, or disconnection from family were always present at these troublesome times.

An illness or injury can be an isolating event, and can certainly trigger stress in a person’s life. They may have worries about health, finances, productivity—the list can be long and varied. It is vital to provide a patient not just with treatment, but also with the support system, empathy, and connection to help them manage pain and recovery responsibly.

For these reasons, 911łÔąĎ takes a holistic view of a patient’s health so that our interactions account for the physical/chemical, psychological, and social aspects of treatment and healing. For instance, with our early intervention program, we identify a patient’s psychological/social risk factors and we also employ a “medical concierge” approach that provides support and advocacy, assures appropriate treatment, and monitors risk throughout the continuum of care. What this article reinforces to me is that the social warning signs will often be more powerful than the physical. If a patient is unhappy at work or at home, it is a potent indicator that any addictive substance might pose a risk, particularly if used as a substitute for human bonding.

Humans are social animals. Relationships are critical—in work, in life, and yes—in recovery from injury/illness. We need to look beyond the physical and psycho-social red flags of addiction, and think of preventing addiction in terms of caring, compassion, and connectedness in our claims and medical management efforts.

The post Main Cause of Addiction: Loneliness appeared first on 911łÔąĎ.

We’ve heard that:

• Shark attacks are up in the US (53 in 2013, vs. 42 in 2012).
• Terrorism and mass shootings (or “multi-party shooting incidents”) are responsible for in the US in 2015.

These are, of course, terrible.

Yet, I recently wrote about how the US has over 440,000 deaths per year from hospital errors. These fatalities are 1,000 times worse than those from the mass shooting crisis our nation is facing, and yet I’ve not heard one mention about this in any presidential debate thus far.

Now, we have 47,000 people in a single year according to the CDC’s latest 2014 figures. This problem has an impact 100 times greater than the mass shootings. When you consider that the majority of mass shootings are drug-related (dealer infighting), the issue of drug usage becomes glaringly apparent. When you also consider that these shooting figures do not account for single-incident and police shootings – including the civil unrest caused by the “war on drugs” that is tearing apart the social fabric of areas of our nation – drugs become an even more critical issue.

The comparison to the gangsters and rampant violence in the US during Prohibition (a.k.a, “the war on alcohol”) is an obvious one to me.

If you think that regulations and stricter controls are the answer, consider this: over 50% of all drug overdose deaths result from highly regulated prescription drugs (16,235). That is nearly double those from street heroin (8,257). When you realize that most new heroin users began as prescription opioid abusers, the idea that regulations will assist in solving this problem seems a bit absurd.

I have thought long and hard on this issue.

I hate what addiction does to families and individuals. Just like alcohol, some people can take medications with no adverse impact on their lives, while others have a propensity to addiction. I have experienced addiction problems in my own family, and I would not wish them on anyone.

Still, I am a data guy. If something is not working, and something else would work better, the correct answer seems obvious. I believe our country’s drug problem is a health issue — not a criminal issue. Countries such as Belgium that have shifted focus from prosecution to treatment have seen a significant reduction in both crime and addiction. Likewise, when addressed their drug crisis by shifting their strategy from punishment to treatment, the country saw drug usage, addiction, health issues, and incarceration rates all decline.

Alex Stevens, a professor of criminal justice at the University of Kent states: “The main lesson to learn – decriminalizing drugs doesn’t necessarily lead to disaster, and it does free up resources for more effective responses to drug-related problems.”

We have seen positive results from the legalization of marijuana in some states in the US, similar to those in the countries mentioned above. This change has certainly not led to any “crisis.”

My conclusion? The best approaches to address and reduce these issues are exactly what 911łÔąĎ is doing today. For example, patients in 911łÔąĎ’s Ultimate early intervention program, whose treatment is overseen by nurse case managers, have experienced very significant decreases in drug and opioid usage.

Our pharmacy review program focuses on long-term usage/addiction and does not cut patients off. Instead, patients are guided through a weaning program to prevent them from moving to harder and even more dangerous drugs.

Our Pharmacy Benefit Manager (PBM) partners also have formularies to prevent unnecessary prescriptions and addiction. Such programs positively impact people’s lives without the need to criminalize behaviors that might lead to jail or violence.

We are having a substantial and lasting impact on society, and these are treatment efforts that we can – and should – be proud of.

The post CDC Reports a Record-Breaking Year for U.S. Overdose Deaths appeared first on 911łÔąĎ.