12 Nails to the Head: Picture

Blogged yesterday, picture today, courtesy of the Mumbai Times:

Docs seek access to Rx tracking

From the Boston Herald:

Pill-hungry “doctor shoppers” who gin the system to score multiple narcotics prescriptions are being tracked by regulators via mapping technology, but frustrated physicians and pharmacists on the front lines of the addiction battle say they are being pointlessly denied the vital information.

“I would like to know exactly who it is who is going doctor shopping,” said Dr. Srdjan Nedeljkovic, director of Pain Fellowship Education at Brigham and Women’s. “Sometimes you wonder about a patient. I wonder if I’m doing the right thing. How do you know?”

The $20,000 mapping software is used to pinpoint where patients are filling prescriptions for drugs such as OxyContin or Percocet. The new system uses data already collected by the state’s Prescription Monitoring Program.

The overall goal is to halt people from using scripts from numerous doctors to buy up large amounts of addictive painkillers for personal use or resale.

The program tracks patients’ prescription-filling trends through information given at the pharmacy counter, such as driver’s licenses.

While there is a proposal to notify doctors and pharmacists about patients who receive questionable prescriptions from multiple locations, for now only law enforcement, the DPH and regulators are allowed the data.The Public Health Council is likely to decide whether to let doctors and pharmacists access the data this summer. But that’s not soon enough for many of them.

Fentanyl Analog, Abuse and Overdose

From the Northwest (Chicago) Herald:

As far back as the early 1980s, a powerful narcotic painkiller called fentanyl began to be used illicitly. Subsequently, a legal loophole was found by developing an analog to the drug, a slight alteration of the compound that does not change its effect, but essentially makes it unregulated. These unregulated versions of fentanyl were called China White and sometimes “new heroin.” These compounds caused a number of overdose deaths on the West coast in the late 1980s and early 1990s.

Since the introduction of the fentanyl analogs and the use of fentanyl as a substitute for heroin, fentanyl-related overdose deaths have been on the increase, sometimes dramatically. According to emergency room statistics in the U.S., from 1994 to 2002, fentanyl overdose deaths have increased from 28 to 1,506. Pockets of overdose deaths have popped up in places from Salt Lake City to Philadelphia, from Los Angeles County, California, to Aiken County, South Carolina.

On Aug.15, NBC News reported police said fentanyl disguised as heroin had caused multiple overdoses on the west side of Chicago and had been given away by members of a street gang to acquire new customers. There was a rash of overdose deaths in Chicago in February, that according to the Chicago Sun Times, was initially suspected to have been caused by a bad batch of heroin. Upon further investigation, autopsy results showed the presence of fentanyl.

Fentanyl is available from drug companies in the form of a patch called Duragesic or a flavored lozenge with a handle called Actiq, known on the street as a “Percopop.”

Most of the illegal fentanyl on the street has been extracted from the patches. Even legal users of the long-acting patches have suffered mishaps and even fatalities when the patch accidentally releases its contents too quickly. Obviously fentanyl is an extremely hazardous drug and needs to be more closely monitored by the FDA. In the interim, however, let those who use heroin or other opiates or synthetics beware and be warned that an exceptionally dangerous heroin substitute is currently on the market.