<html><body><div style="color:#000; background-color:#fff; font-family:arial, helvetica, sans-serif;font-size:10pt"><div style="RIGHT: auto"><SPAN style="RIGHT: auto">Part of my job is <SPAN style="RIGHT: auto" id=misspell-0><SPAN style="RIGHT: auto">assisting</SPAN></SPAN> patients with their medications. I dispense hydrocodone. The biggest problem with it that I see is that it causes constipation problems in many people. I think it is a good, effective and <SPAN style="RIGHT: auto" id=misspell-2>inexpensive </SPAN>solution when used properly. It can be additive, but I don't think it is anymore addictive than alcohol, which is very easily available. </SPAN></div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto"></SPAN> </div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto">Most these people that are hooked on the drug are in constant pain, over 75, retired and often bedridden. So they really aren't doing anyone harm. And the <SPAN style="RIGHT: auto" id=misspell-3><SPAN>addiction</SPAN></SPAN> doesn't seem to be very destructive to a person whose only <SPAN style="RIGHT: auto" id=misspell-4><SPAN>responsibility</SPAN></SPAN> is to stay alive. Pain management is often the ONLY thing health care providers can do for someone since doctors cannot operate on some people that would not survive an operation, don't have the insurance, or are not expected to live long enough to fully enjoy the benefits of a costly operation. </SPAN></div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto"></SPAN> </div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto">Without hydrocodone, or hydro what we call it for short, a nursing or assisted living facility would be a very <SPAN style="RIGHT: auto" id=misspell-6><SPAN>unpleasant</SPAN></SPAN> place to even visit with all the screams of pain and nobody being able to do anything for them. An <SPAN style="RIGHT: auto" id=misspell-7><SPAN>ibuprofen</SPAN></SPAN> for this level of pain is like throwing a glass of water on a national forest fire. </SPAN></div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto"></SPAN> </div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto">One big problem with drugs, of any kind, is giving people with dementia uncontrolled access to their medication because they forget they just took it, and take it again and again because they are still in pain<VAR id=yui-ie-cursor></VAR> until they consume lethal doses. Or they keep forgetting to take it, and it doesn't work effectively. </SPAN></div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto"></SPAN> </div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto">Marijuana, I think would be a good alternative to some narcotics for some people living at home. The biggest problem with smoking MJ in a nursing home is it would get the staff and other patients high too. Then everyone would want my job. And we just cannot have that happening. . . </SPAN></div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto"></SPAN> </div>
<div style="RIGHT: auto"><SPAN style="RIGHT: auto">Donovan Arnold</SPAN></div>
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<DIV style="BORDER-BOTTOM: #ccc 1px solid; BORDER-LEFT: #ccc 1px solid; PADDING-BOTTOM: 0px; LINE-HEIGHT: 0; MARGIN: 5px 0px; PADDING-LEFT: 0px; PADDING-RIGHT: 0px; HEIGHT: 0px; FONT-SIZE: 0px; BORDER-TOP: #ccc 1px solid; BORDER-RIGHT: #ccc 1px solid; PADDING-TOP: 0px" class=hr contentEditable=false readonly="true"></DIV><B><SPAN style="FONT-WEIGHT: bold">From:</SPAN></B> Art Deco <art.deco.studios@gmail.com><BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> vision2020@moscow.com <BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Friday, April 6, 2012 9:26 AM<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> [Vision2020] Narcotics = Good, Marijuana = Evil?<BR></FONT></DIV><BR>
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<H1>Painkiller sales spike, fueling addiction</H1>
<H5 class=yiv588778975subhead>Overdose death toll from opioids rising</H5>
<DIV class="yiv588778975details yiv588778975nested yiv588778975grid-8"><SPAN>Chris Hawley<BR>Associated Press </SPAN></DIV>
<DIV class="yiv588778975tag-details yiv588778975details-top"></DIV>
<DIV id=yiv588778975story-body>
<div>NEW YORK – Sales of the nation’s two most popular prescription painkillers have exploded in new parts of the country, an Associated Press analysis shows, worrying experts who say the push to relieve patients’ suffering is spawning an addiction epidemic. </div>
<div>From New York’s Staten Island to Santa Fe, N.M., Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold. </div>
<div>Meanwhile, the distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is rising in Appalachia, the original epicenter of the painkiller epidemic, as well as in the Midwest. </div>
<div>The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says. </div>
<div>Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States. The DEA data records shipments from distributors to pharmacies, hospitals, practitioners and teaching institutions. The drugs are eventually dispensed and sold to patients, but the DEA does not keep track of how much individual patients receive. </div>
<div>The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York’s Daytop Village chain of drug treatment clinics. </div>
<div>Sales are also being driven by addiction, as users become physically dependent on painkillers and begin “doctor shopping” to keep the prescriptions coming, he said. </div>
<div>Opioids like hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder. </div>
<div>The AP analysis used drug data collected quarterly by the DEA’s Automation of Reports and Consolidated Orders System. The DEA tracks shipments sent from distributors to pharmacies, hospitals, practitioners and teaching institutions and then compiles the data using three-digit ZIP codes. </div>
<div>The AP combined this data with census figures to determine effective sales per capita. </div>
<div>A few ZIP codes that include military bases or Veterans Affairs hospitals have seen large increases in painkiller use because of soldier patients injured in the Middle East, law enforcement officials say. In addition, small areas around St. Louis, Indianapolis, Las Vegas and Newark, N.J., have seen their totals affected because mail-order pharmacies have shipping centers there, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy. </div>
<div>In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky – places with high concentrations of people with back problems and other chronic pain. </div>
<div>But by 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, stretching as far north as Columbus, Ohio and as far south as Macon, Ga. </div>
<div>Per-capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade. </div>
<div>“We’ve got a problem. We’ve got to get a handle on it,” said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation. </div>
<div>Many buyers began crossing into Tennessee to fill prescriptions after border states began strengthening computer systems meant to monitor drug sales, Farmer said. </div>
<div>In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now 40 do, but many aren’t linked together, so abusers can simply go to another state when they’re flagged in one state’s system. There is no federal monitoring of prescription drugs at the patient level. </div>
<div>In Florida, the AP analysis underscores the difficulty of the state’s decade-long battle against “pill mills,” unscrupulous doctors who churn out dozens of prescriptions a day. </div>
<div>In 2000, Florida’s oxycodone sales were centered around West Palm Beach. By 2010, oxycodone was flowing to nearly every part of the state. </div>
<div>While still not as high as in Appalachia or Florida, oxycodone sales also increased dramatically in New York City and its suburbs. The borough of Staten Island saw sales leap 1,200 percent. </div>
<div>The American Southwest has emerged as another hot spot. </div>
<div>Parts of New Mexico have seen tenfold increases in oxycodone sales per capita and fivefold increases in hydrocodone. The state had the highest rate of opioid painkiller overdoses in 2008, with 27 per 100,000 population. </div>
<div>Many parts of eastern California received only modest amounts of oxycodone in 2010, but the increase from 2000 was dramatic – more than 500 percent around Modesto and Stockton. </div>
<div>Many California addicts are switching from methamphetamine to prescription pills, said John Harsany, medical director of Riverside County’s substance abuse program. </div></DIV>
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