At Least 28 People in Philadelphia Die From Fentanyl-Laced Heroin

At least 28 people in Philadelphia died after using heroin laced with the painkiller fentanyl between March 3 and April 20, the city announced Monday. Officials are awaiting test results on seven more people.

Last year, the city had 24 deaths due to illicit fentanyl use, The Philadelphia Inquirer reports. The drug was implicated in 269 deaths in 2006 in the city.

Earlier this year, law enforcement officials said heroin laced with fentanyl was suspected in at least 50 fatal overdoses in three states. In Pennsylvania, the drug combination was suspected in at least 17 deaths. Officials in Maryland and Michigan were also investigating deaths linked to the drug mix. In Flint, Michigan, fentanyl-laced heroin was suspected in four overdoses.

Fentanyl is often used during surgery, and is delivered primarily through a patch worn on the skin. Illicit fentanyl is added to heroin to create a stronger high. The article notes it can be a white powder like heroin but is 50 times stronger. The drug can interfere with breathing.

Officials don’t know whether people who purchased the fentanyl-laced heroin knew what they were getting. They also don’t know who is making or selling the product, or what it is being called.


NIDA’s updated Heroin Research Report now available online

Due to growing public concern about heroin and its potentially devastating effects, the National Institute on Drug Abuse (NIDA) has updated its online Heroin Research Report. This Report offers the most current data on heroin use and its consequences as well as treatment options for heroin use…


OxyContin Manufacturer Tests Tamper-Resistant Form of Hydrocodone

The maker of OxyContin announced promising results from a study of a tamper-resistant form of hydrocodone, The Washington Post reports. The Food and Drug Administration (FDA) has been criticized for approving Zohydro ER (extended release), a pure form of hydrocodone that is not tamper-resistant.

Purdue Pharma, which manufactures OxyContin, said it will soon seek FDA approval for its version of an extended-release form of hydrocodone. The company says its version is difficult for a person to crush, in order to inject or snort the drug. In 2010, the company reformulated OxyContin to make it harder to crush or dissolve.

The new study showed a majority of patients with chronic low back pain treated once daily with the hydrocodone drug experienced at least a 30 percent improvement in pain intensity, compared with a placebo. Almost half achieved a 50 percent improvement.

“This is another step forward in our efforts to develop therapeutic options for use by chronic pain patients that are designed to be unattractive to drug seekers,” Gary L. Stiles, the company’s Senior Vice President of Research and Development, said in a statement.

Last week, West Virginia Senator Joe Manchin called on Health and Human Services Secretary Kathleen Sebelius to overrule the FDA decision to approve Zohydro ER. Late last year, Manchin and three other senators wrote to the FDA, saying they disagreed with the agency’s decision to approve the drug. In October, the FDA approved Zohydro for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen.

In December, the attorneys general from 28 states asked the FDA to reassess its decision to approve Zohydro.


States Consider Synthetic Drug Bans, Opioid Education for Doctors and Marijuana Laws

A number of state legislatures are considering bills banning synthetic drugs, requiring education for doctors who prescribe opioids, and expanding the use of the drug overdose antidote naloxone this session.

Sherry Green, the CEO of the National Alliance for Model State Drug Laws (NAMSDL), says she is also seeing many state measures devoted to marijuana legislation, and bills that would require doctors and pharmacists to use state prescription monitoring databases.

“We’re seeing bills that ban synthetic marijuana, bath salts and other synthetic drugs by banning classes of substances, with specific examples of the chemical formulations of drugs that would fall into that category,” Green says. “In the past, states tried to ban specific chemical formulations, and drug makers would get around the ban simply by changing a molecule. Under these new measures, if something else in that class is created after the law takes effect, it would already be banned.”

Last fall, NAMSDL organized a meeting of health officials, law enforcement, doctors, state drug directors and others trying to stop the spread of synthetic drugs. NAMSDL has been working with the experts at the meeting to draft model legislation that will be part of a toolbox of legislative options states can use this year.

Some states are considering bills that would require education for opioid prescribers in pain management, addiction treatment and proper prescribing of controlled substances. In addition, some states want to limit the supply of certain controlled substances that doctors can prescribe for pain management. New Jersey and Pennsylvania are among the states that have established task forces on opioids, to take a closer look at how to deal with prescription drug abuse and diversion.

Other topics trending in statehouses around the nation include:

  • Prescription monitoring programs (PMPs): Some proposed measures require doctors and/or pharmacists to use the databases to spot patients who are “doctor shopping” for multiple prescriptions. Several states are considering bills that would allow a staff person in a doctor’s office to gather information about patients from the database, to save the doctor time.
  • Marijuana legalization: Green anticipates seeing many more bills that would legalize medical marijuana, as well as legislation that would legalize recreational marijuana.
  • Naloxone: States are introducing and refining legislation that would allow expanded use of the overdose antidote naloxone. “Some states want to expand who can administer naloxone beyond first responders, to include family members of people who abuse opioids. This requires rewriting laws to allow a prescription for naloxone to be written not for the patient, but for the patient’s parents, even if the patient is an adult,” Green says.
  • Good Samaritan laws: These laws grant limited immunity to people who seek help for someone who has overdosed. “States are looking at who should get immunity, and whether Good Samaritans should be shielded from both criminal and civil liability,” Green notes.