Hospitals are putting Native American patients at risk for opioid abuse, audit says

Associated Press Published 11:17 a.m. ET July 22, 2019 | Updated 3:53 p.m. ET July 22, 2019

FLAGSTAFF, Ariz. — U.S. government hospitals placed Native American patients at increased risk for opioid abuse and overdoses, failing to follow their own protocols for prescribing and dispensing the drugs, according to a federal audit made public Monday.

The report by the U.S. Department of Health and Human Services’ Office of Inspector General does not draw conclusions about actual abuse or overdoses. But it said all five Indian Health Service hospitals that were reviewed had patients who were given opioids in amounts exceeding federal guidelines.

“There are vulnerabilities with this particular population in the opioid prescribing and dispensing practices,” said Carla Lewis, one of the auditors.

The overdose epidemic that has killed more people than any other drug epidemic in U.S. history has hit indigenous communities hard. Native Americans and Alaska Natives had the second-highest rate of opioid overdose out of all U.S. racial and ethnic groups in 2017, according to the federal Centers for Disease Control and Prevention.

The report made more than a dozen recommendations to the Indian Health Service to better track patients’ health records and pain management, ensure opioids are stored under tighter security and update its information technology systems. The agency agreed on every point and said changes were coming.

The Indian Health Service, the federal agency that administers primary health care for Native Americans, has put an increased focus on opioids lately with a new website and the creation of a committee focused on decreasing overdose deaths, promoting culturally appropriate treatments and ensuring that communities know how to respond.

The audit covered five of the 25 hospitals directly run by the Indian Health Service: the Phoenix Indian Medical Center in Phoenix; Northern Navajo Medical Center on the Navajo Nation in Shiprock, New Mexico; the Lawton Indian Hospital in Lawton, Oklahoma; the Cass Lake Indian Hospital on the Leech Lake reservation in Cass Lake, Minnesota; and the Fort Yates Hospital on the Standing Rock Sioux reservation in Fort Yates, North Dakota.

Auditors considered the amount of opioids each hospital dispensed and the percentage increase over three years when deciding which ones to review. They looked at 30 patient records at each hospital, visited the facilities and interviewed staff.

The auditors found that the hospitals strayed from guidelines in the Indian Health Manual in reviewing treatment for patients and their causes of pain every three months. Patients also must sign a written consent form and an agreement to treat chronic pain with opioids so they know the risks and benefits, as well as the requirement for drug screenings. More than 100 patient records did not include evidence of informed consent, and dozens did not have evidence that providers adequately educated patients.

The Centers for Disease Control recommends that patients be prescribed no more than 90 morphine milligram equivalents per day, a measure used to compare an opioid dose with morphine.

The audit found that each hospital met or exceeded that amount at times. At the Shiprock hospital, the daily dosage was more than four times as high. The auditors also found some patients were prescribed opioids and benzodiazepines — commonly used to treat anxiety and insomnia —at the same time, which “puts patients at a greater risk of a potentially fatal overdose.”

The Centers for Disease Control recommends that patients be prescribed no more than 90 morphine milligram equivalents per day, a measure used to compare an opioid dose with morphine.

The audit found that each hospital met or exceeded that amount at times. At the Shiprock hospital, the daily dosage was more than four times as high. The auditors also found some patients were prescribed opioids and benzodiazepines — commonly used to treat anxiety and insomnia —at the same time, which “puts patients at a greater risk of a potentially fatal overdose.” (Click to Source)

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Costa Mesa files lawsuit against distributors and manufacturers of opioid pain medication

Costa Mesa is taking distributors and manufacturers of opioid pain medication to court in a bid to recoup tax dollars it alleges were spent as a result of the addiction epidemic that has afflicted communities coast to coast.

 

In a lawsuit filed March 29, the city argues that the businesses “intentionally flooded the market with opioids and pocketed billions of dollars in the process” while making “false statements designed to persuade both doctors and patients that prescription opioids posed a low risk of addiction.”

 

Such actions, the city alleges, “have not only caused significant costs but have also created a palpable climate of fear, distress, dysfunction and chaos among Costa Mesa residents where opioid diversion, abuse and addiction are prevalent and where diverted opioids tend to be used frequently.”

 

Opioids include powerful legal prescription painkillers such as hydrocodone, morphine and oxycodone.

 

The lawsuit names about a dozen distributors and manufacturers as defendants, including Purdue Pharma, the maker of OxyContin, and certain members of the Sackler family that controls the company.

 

“This epidemic has personally touched the lives of many members of our community,” Mayor Katrina Foley said in a statement Thursday. “It’s time that we take action and put a halt to the lives being destroyed and the economic drain opioid addiction is placing on our community.”

 

Purdue Pharma spokesman Bob Josephson wrote in an emailed statement Thursday afternoon that the company “and the individual former directors of the company vigorously deny the allegations in the complaint and will continue to defend themselves against these misleading allegations.”

 

“The complaint is part of a continuing effort to try these cases in the court of public opinion rather than the justice system,” Josephson wrote. He added that he believes the complaint disregards or fails to note facts about Purdue’s prescription medications and pertinent federal regulations.

 

“Such serious allegations demand clear evidence linking the conduct alleged to the harm described, but we believe the city fails to show such causation and offers little evidence to support its sweeping legal claims,” he said.

 

In the suit, Costa Mesa alleges it has seen increased costs in myriad areas as a result of the opioid epidemic, including “medical and therapeutic care,” “counseling, treatment and rehabilitation services,” public safety and code enforcement.

 

A particularly pressing issue from the city’s perspective is the proliferation of local sober-living homes, which house recovering addicts, including those battling opioid dependence. Costa Mesa “has the largest concentration of sober-living homes in Orange County, creating a plethora of nuisance issues for residents, multiple calls for service by police and fire and millions of dollars in legal fees,” according to a city news release.

 

Also mentioned in the lawsuit is Costa Mesa fire Capt. Mike Kreza, who died in November after he was hit by a vehicle while riding his bicycle. The driver, Stephen Taylor Scarpa, 25, of Mission Viejo, was suspected of driving under the influence of drugs and has pleaded not guilty to one count of murder. Authorities allege he was in possession of pills prescribed by aTustin doctor who faces federal charges of illegally distributing opioids and other narcotics by writing prescriptions to people without medical examinations.

 

“Costa Mesa has been directly injured by the loss of Capt. Kreza, including costs for training and hiring a replacement, as well as pension and death benefits,” the lawsuit states. “These increased costs could have been — and should have been — prevented by the opioid industry.”

 

Lawsuits such as Costa Mesa’s have become increasingly common. Last month, Purdue and the Sackler family agreed to pay $270 million to the state of Oklahoma to settle claims that aggressive marketing of OxyContin helped create the addiction crisis, according to the

Associated Press. Nationwide, the company faces nearly 2,000 lawsuits, AP reported.

But Josephson said, “We believe that no pharmaceutical manufacturer has done more to address the opioid addiction crisis than Purdue, and we continue to work closely with governments and law enforcement agencies on this difficult social issue.” (Click to Source)

 

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Pfizer admits Big Pharma is profiting from addiction; its products support opioid epidemic

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(NaturalNews) Well, it only took two decades for Pfizer to admit that opioids are indeed addictive, even when they are used as prescribed. There is also no evidence that opioids are effective for long-term treatment of chronic pain, in spite of the clever and misleading marketing campaigns led by manufacturers.

Opioids cause up to 60 deaths per day in the United States. This shocking figure is part of what finally led to Pfizer’s concessions about their product’s lack of safety. The corporation has recently agreed to disclose that opioids “carry serious risk of addiction—even when used properly,” according to the Washington Post. The company has also agreed not to promote opioid use for off-label purposes that aren’t approved, such as for long-term back pain. Pfizer will also acknowledge that there is no good research on the effectiveness of opioids beyond 12 weeks of use. (Click to Article)