Senate panel seeks answers to prescription drug abuse - KansasCity.com

Senate panel seeks answers to prescription drug abuse - KansasCity.com

hatch sits on senate bill 507 committe

GOP senator Orrin Hatch's charity tied to massive pharmaceutical donations

Source: The Raw Story >>>>A charity founded by a senior Republican lawmaker who was a key ally to the pharmaceutical industry received more than $170,000 in 2007 from drugmakers, far in excess of campaign finance rules had the money been donated to him directly, leaked documents show. The senator, Orrin Hatch (R-UT), founded Utah Families Foundation, the recipient of the gifts, though he doesn't serve on the foundation's board. But his son is now the chief lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the industry's lobbying group. Hatch has received more money from the pharmaceutical industry than any other group, raking in $1.25 million since 1998. The latest sums, however, dwarf that of previous donations from individual corporations. In 2007, the foundation received $25,000 from Eli Lilly, $30,000 from Barr Pharmaceuticals, $25,000 from AstraZeneca and $40,000 from PhRMA.>>>> snip >>>>The same year Utah Families Foundation received massive gifts, Sen. Hatch voted on a bill relating to Medicare Part D. Hatch voted against a bill requiring that the government negotiate discounted prices from drugmakers, a measure the industry vehemently opposed. In 2005, Hatch also voted against a measure that would have allowed Medicare to negotiate bulk prices for prescription drugs. "And if that weren't enough political intrigue, the tax-exempt charitable foundation, which the senator from Utah helped start in the 1990s and still vigorously supports, has been delinquent for nearly a decade in filing its required annual reports with Utah state officials," a Washington Times review by Jim McElhatton and Jerry Seper found, the reporters who revealed the documents.>>>> Read more: http://rawstory.com/news/2008/GOP_senator_Orrin_Hatchs_.

Senate bill 507 failures /

Regarding S. 507, a Bill introduced “In The Senate Of The United States” on March 08, 2011 titled “Prescription Drug Abuse Prevention and Treatment Act of 2011”.

A Bill: “To provide for increased Federal oversight of prescription opioid treatment and assistance to States in reducing opioid abuse, diversion and deaths.”

This Bill is asking for increased Federal oversight of prescription opioid treatment and targets existing substance abuse treatment programs / clinics and their methadone dosing practices. 

The majority of legitimate Pain Management Treatment Centers and Prescription Drug Abuse Treatment Centers are the best educated, well informed and knowledgeable experts regarding addiction, treatment and safely prescribing of methadone. 

Why then is the United States Senate proposing spending 160 million dollars over four years to create a Controlled Substances Clinical Standard Commission to  increase oversight on these experts regarding substance abuse treatment, methadone dosing and doctor patient education?  Why is their no oversight on the majority of all other primary health care providers / family care doctors who are providing the majority of highly addictive and deadly prescription drugs to Americans?

Senate bill 507 fails to increase oversight on primary health care providers / family care doctors whose prescriptions cause the most overdosing regarding opioid abuse, diversion and deaths.  Primary health care providers / family care doctors have no oversight, are the least well trained or equipped to deal with prescription drug addiction yet they see millions of patients every year, writing hundreds of millions of deadly and addictive opioid prescriptions. 

The prescriptions written by primary health care providers / family doctors are the main reason for the epidemic of prescription drug addiction and death in America today, not methadone dosing by clinics and pain management experts.  Why does Senate bill 507 fail to address this well known fact?

The focus of increased Federal oversight should be on primary health care providers / family doctors.  These doctors are the main source for prescription drug deaths /addiction in America today; most of these doctors do so unknowingly other doctors do so unscrupulously.  

Currently in the United States a special federal waiver (which can be granted after the completion of an eight-hour course) is required in order to treat outpatients for opioid addiction with Subutex and Suboxone, the two forms of buprenorphine tablets currently available. However the number of patients each approved doctor could initially treat was capped at 30 the first year and 100 the thereafter . In no other area are physicians prevented from

providing care to patients in need - except for addiction treatment.  Why is this effective opioid addiction treatment capped at 10 patients?  Why is this treatment not mentioned in your bill?  Why are doctors who prescribe Suboxone having to put addicts on waiting lists in order to get drug treatment, but the same doctors can write thousands of prescriptions for extremely addictive and lethal drugs?

Senate bill 507 section 2 “Findings” state on page 4 lines 7 through 11, prescriptions for methadone increased by 700 percent from 1998 to 2006.   The number of poisoning deaths involving methadone increased nearly 7-fold from almost 790 in 1999 to almost 5,420 in 2006. The quotes seem to isolate methadone exclusively as the root cause of the prescription drug abuse epidemic in America. This is not true. 

Methadone Mortality

In the United States, deaths linked to methadone more than quadrupled in the five year period between 1999 and 2004. According to the U.S. National Center for Health Statistics,^[25] as well as a 2006 series in the Charleston (West Virginia) Gazette,^[26] medical examiners listed methadone as contributing to 3,849 deaths in 2004. That number was up from 790 in 1999. Approximately 82 percent of those deaths were listed as accidental, and most deaths involved combinations of methadone with other drugs (especially benzodiazepines).

Although deaths from methadone are on the rise, methadone-associated deaths are not being caused primarily by methadone intended for methadone treatment programs, according to a panel of experts convened by the Substance Abuse and Mental Health Services Administration, which released a report titled "Methadone-Associated Mortality, Report of a National Assessment". The consensus report concludes that "although the data remain incomplete, National Assessment meeting participants concurred that methadone tablets and/or diskettes distributed through channels other than opioid treatment programs most likely are the central factor in methadone-associated mortality."^[27]

In 2006, the U.S. Food and Drug Administration issued a caution about methadone, titled “Methadone Use for Pain Control May Result in Death.” The FDA also revised the drug's package insert. The change deleted previous information about the usual adult dosage. The Charleston Gazette reported, "The old language about the 'usual adult dose' was potentially deadly, according to pain specialists."

Attached below are the top 10 deadliest drugs in America, methadone is listed sixth behind Ocycodone, Fentanyl, Closapine, Morhine, and Acetaminophen.  Why do these drugs get a free pass in the Senate bill 507?  The F.D.A. is source for the table listed below.

Rank	Drug	Type	Deaths 1998-2005
1	Oxycodone	Prescription opioid painkiller*	5548
2	Fentanyl	Prescription opioid painkiller*	3545
3	Clozapine	Antipsychotic	3277
4	Morphine	Prescription opioid painkiller*	1616
5	Acetaminophen	Over-the-counter painkiller	1393
6	Methadone	Prescription opioid painkiller*/addiction medication	1258
7	Infliximab	Immune-system modulating drug	1228
8	Interferon beta	Immune-system modulating drug	1178
9	Risperidone	Antipsychotic	1093
10	Etanercept	Immune-system modulating drug	1034

Source: Moore TJ et al., Serious Adverse Drug Events Reported to the Food and Drug Administration, 1998-2005, Archives of Internal Medicine, Sept. 10., 2007; 167 (16): 1752-1759

Here is Leonard J. Paulozzi, M.D., M.P.H., Medical Epidemiologist, National Center for Injury Prevention and Control Centers for Disease Control and Prevention report to the US Senate on March 12, 2008.  Below is Dr. Leonard J. Paulozzi quote concerning the types of drugs that are the most problematic in America.

“Type of Drugs Involved, 1999-2005

We have the best information about the drugs involved for the seven years of the trend beginning with 1999.  In 1999, almost all drug overdose deaths fell into one of three categories.  The most common type was called “narcotics,” and it included prescription painkillers, called opioids, in addition to cocaine and heroin.  OxyContin® and Vicodin® are examples of opioid painkillers. Methadone is also now widely used as a painkiller in addition to its use for treatment of addiction. The second most common was “other and unspecified drugs.”  The third most common was a group containing sedatives like Valium® and other psychotherapeutic or psychotropic drugs.  All three of these categories increased after 1999.

One might assume that the increase in drug overdose deaths is due to an increased use of street drugs like heroin and cocaine, because we have in the past associated such drugs with overdoses.  However, in a paper published in 2006, the CDC drilled down to another level to look at the codes given to the specific drugs recorded on the death certificates through 2004.  When these more specific drugs were tabulated, we found that street drugs were not behind the increase.  The increase from 1999 to 2004 was driven largely by opioid analgesics, with a smaller contribution from cocaine, and essentially no contribution from heroin. The number of deaths in the narcotics category that involved prescription opioid analgesics increased from 2,900 in 1999 to at least 7,500 in 2004, an increase of 160% in just 5 years.[1] By 2004, opioid painkiller deaths numbered more than the total of deaths involving heroin and cocaine in this category.

With the latest, 2005 death data, we were able to drill down even further and look at the specific drugs causing the deaths.  For deaths with multiple drugs involved, we looked at only the first-listed drug, which is a method to assign responsibility when multiple drugs are involved. This analysis showed that opioid painkillers were still the most commonly found drugs, accounting for 38.2% of the first-listed drugs, with methadone by itself contributing to almost half of these deaths. Benzodiazepine sedatives such as Valium® and antidepressants accounted for 6.5%. Even without including the category of “other specified drugs,” which are mostly prescription, the total of prescription opioids, benzodiazepines, and antidepressants (about 45%), exceeds the total of cocaine, heroin, and methamphetamines/amphetamines (about 39%).”

If you are considering passing a multi-million dollar bill I strongly recommend looking a all the findings not a select few which support stringent oversight on methadone dosing, commission building and meager patient and doctor education.

“The most common type was called “narcotics,” and it included prescription painkillers, called opioids, in addition to cocaine and heroin.  OxyContin® and Vicodin® are examples of opioid painkillers.”  This is another quote from Dr. Leonard J. Paulozzi not found in the bills findings.

I wish the solution to this problem was a simple as a new 100 million dollars over four years commission, more federal oversight on methadone dosing, limited 60 million funding for patient /doctor education over four years for 50 states., but it is not. 

If you want a bill that prevents people from dieing or becoming addicted to prescription drugs you are going to need to address the real problems, not cherry pick the easiest ones.  

This bill in its current form should not be passed; it will not reduce prescription drug abuse, diversion, addiction or deaths in America. 

James C. Bettencourt
Chairperson: Not In Our Town Glenn County
327 N. Culver Ave
Willows, Ca. 95988
530-934-2542
www.end2meth.org
www.drugpreventioned.com