Over the past week, several states have settled lawsuits with Opioid drugmakers, distributors, and pharmacies, tallying up over $390 million in total. The states in question (Alabama, New York, West Virginia, and California), have been deeply impacted by the ramifications of the Opioid epidemic, which has led to over 500,000 overdose deaths nationally in the past 2 decades. Among others across the nation, these settlements are the first steps to providing the financial backbone that many states need to rebuild their communities affected by Opioids. 

The companies involved in these recent settlements, all of which have denied any wrongdoing, include Johnson & Johnson, McKesson Corp, Endo International Plc, and Janssen Pharmaceuticals Inc. (a subsidiary of Johnson & Johnson). The next section of this article will break down who each state settled with and for how much. 

State-By-State Breakdown Of Recent Opioid Lawsuits

Alabama

On Tuesday, Alabama reached $276 million in settlements with Johnson & Johnson, McKesson Corp, and Endo International Plc. According to the state attorney general, this settlement resolves the claim that these companies fueled an Opioid crisis in the state. Alabama had previously accused McKesson of failing to prevent the diversion of Opioids for illicit use and for downplaying the addictive risks of the prescription Painkillers. Johnson & Johnson stated that its past marketing efforts were “appropriate and responsible,” and the company no longer sells prescription Opioids in the US. 

Alabama was one of 4 states that declined to join a nationwide $26 billion settlement of Opioid litigation by McKesson, two other top US distributors, and Johnson & Johnson. If it had agreed to the national settlement, the state would have received $115 million from McKesson over 18 years and $70.3 million from Johnson & Johnson over 9 years. Under this new deal, McKesson will pay $141 million within 9 years, Johnson & Johnson will make full payment within a year, and Endo will pay $25 million. 

New York

On Tuesday, New York State Attorney General Letitia James announced that Central New York would receive over $6.3 million from several settlements negotiated in 2019. The settlements involved 6 Opioid manufacturers and 4 distributors, and the funds will be distributed to Onondaga County and the City of Syracuse, $3.7 million and $263,000, respectively. The money received from this settlement is only a part of the original $1.5 billion settlement finalized by the attorney general, who says more money will be coming.

Central New York City was impacted significantly by the Opioid crisis, specifically during the 2020 lockdown. Onondaga County paused most in-person activities related to Opioid use disorder (OUD) treatment, and a 7th of the economy was forced to shut down, which placed working individuals on the sidelines, said Onondaga County Executive McMahon. 

West Virginia

West Virginia is to receive $99 million in a settlement with Janssen Pharmaceuticals Inc., a subsidiary of Johnson & Johnson. In this Opioid lawsuit, Janssen was accused of overstating the benefits of their prescription drugs while downplaying, or failing to mention entirely, the potential risks of addiction. The drugmaker has faced multiple Opioid lawsuits throughout dozens of communities in the country, but State Attorney General Patrick Morrisey said during a news briefing that he believes West Virginia’s settlement is the largest in the country per capita. 

West Virginia has long held alarming rates of drug overdose deaths. The Centers for Disease Control and Prevention (CDC) states that the state’s number of fatal overdoses has nearly tripled over the past decade. Additionally, the state has one of the highest rates of non-medical use of prescription Painkillers in 19 to 25-year-olds, with experts testifying in the Janssen case that the rush of prescription Opioids into communities was the driving force behind West Virginia’s drug crisis.

California

On Wednesday, the city of San Francisco reached a $10 million settlement with Endo, who makes the Opioid Painkiller Percocet. According to City Attorney David Chiu, Endo settled with the city days before an upcoming trial, which claims the drugmaker fueled an Opioid epidemic. While Endo hasn’t marketed Percocet since 2016, a 2018 lawsuit filed by San Francisco claims that the company “flooded” the community with prescription Opioids without corrective measures to prevent the drugs from being diverted to illegal use.  

Along with the Endo company, the lawsuit filed by San Francisco also targeted Purdue Pharma LP, Johnson & Johnson, McKesson Corp, Cardinal Health Inc, and AmerisourceBergen Corp. To date, Endo has agreed to pay over $300 million in Opioid settlements to local and state governments, including San Francisco. 

Settlement Money To Be Used For Recovery And Prevention

The funds from these settlements provide financial support for states and cities to rebuild the communities that the Opioid epidemic has deeply impacted. The use of the millions will go well beyond sopping up the damage caused by over-prescription, questionable marketing practices, and illicit use of Opioids; communities hope to stop addiction before it starts. Beyond funding treatment programs for those with an OUD, many communities are planning to use the funds for Opioid prevention and education to reduce the risk of addiction for the youth and individuals throughout the community. 

For example, in Central New York, Onondaga County and the City of Syracuse will use the settlement money to treat individuals with an OUD, to reduce the number of people dying of overdoses, and to give young people additional resources to teach them about the dangers of drugs, specifically Opioids. The settlement money supplied to the states and communities across the US is a necessary step in healing and treating individuals who have suffered at the hands of the Opioid epidemic that has in part been fueled by Opioid drugmakers, distributors, and pharmacies.  

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As the world reels from the 6.13 million lives lost directly to COVID-19, new research reveals the extent that the pandemic’s toll has reached, and it goes well beyond the disease itself. In the pandemic’s first year, from 2019 to 2020, the number of Americans who died from alcohol-related causes increased by 25%, as most forms of normalcy, routine, treatment access, and coping skills were either disrupted or eradicated during this time. 

The pandemic has drastically disrupted work, home, and social life, and among these changes were America’s relationship with alcohol. The 25% increase in alcohol-related deaths was represented among all age groups, starting with age 16, ethnicities, genders, and races, but young adults ages 25 to 44 experienced the most significant increase. In fact, for adults younger than 65 years old, alcohol-related deaths outnumbered COVID-19 deaths, 74,408 to 74,075. Additionally, the study, conducted by researchers with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), found that the rate of alcohol-related deaths, including deaths from liver disease and accidents, outpaced the increase of death from all causes.

Changes In Alcohol Consumption During The Pandemic

To offset widespread fear, frustration, and social isolation rampant during the pandemic, many turned to alcohol to self-soothe. In the first month of the stay-at-home orders in March of 2020, national alcohol sales rose 54%, and some states even allowed restaurants and similar on-premises retailers to sell carry-out alcohol beverages. As more individuals found themselves stuck at home with amplified stressors, minimal coping strategies, and increased alcohol availability, the frequency of alcohol consumption increased by 14% compared to the previous year, according to a study by the Journal of the American Medical Association (JAMA). Increased alcohol consumption was a developing trend predating the pandemic, as were mental health struggles, but the conditions of the pandemic made individuals more susceptible to substance abuse. 

However, the pandemic particularly impacted women and parents with young children regarding alcohol consumption. Women have disproportionately taken on the responsibility of child care, home management, and children’s education since the pandemic, so it reasons that women have increased their use of alcohol disproportionately. What may have started as an additional glass of wine with dinner turned into a 41% increase in the number of days women are drinking heavily or consuming 4 or more drinks within a short time. Those without children faced their own struggles as many experienced increased rates of isolation and loneliness, which are factors related to increased alcohol consumption. 

Drug Overdoses Rise Alongside Alcohol-Related Deaths

In conjunction with rising alcohol-related deaths, the number of Opioid overdoses involving alcohol increased by 40.8% in 2020, and there was a 59.2% increase in overdoses involving alcohol and synthetic Opioids like Fentanyl. While rates of Opioid overdoses have been on the incline in recent years, the pandemic only exacerbated these trends due to several factors, including increased isolation, stress, and a lack of treatment and support resources due to lockdown stipulations. 

Additionally, drug overdose deaths reached a record high during the pandemic’s first year, with over 100,000 Americans dying from overdoses within 12 months. This increase, much like the increase in alcohol-related deaths, can be linked to the loss of access to treatment, increased mental health issues, and the availability of potentially lethal substances. The rise in overdose deaths was primarily due to the widespread use of Fentanyl, but stimulants like Methamphetamine, Cocaine, and natural and semi-synthetic Opioids, such as prescription pain medication, also factored into increased rates. 

Loss Of Access To Treatment

Not only were individuals unable to connect with loved ones during quarantine, those who were in recovery from a substance use disorder (SUD) suddenly found themselves without multiple resources as treatment facilities closed temporarily. Those who may have already been struggling with sobriety could not attend in-person support group meetings like Alcoholics Anonymous or receive addiction treatment medicine from clinics. Treatment facilities across the US shut their doors in compliance with COVID-19 safety regulations, and health care providers struggled to tend to the onslaught of coronavirus patients, potentially deterring individuals from pursuing treatment for substance abuse. This rapid severance of treatment left many individuals experiencing a SUD reeling and struggling to find support.

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This disruption of recovery treatment could lead individuals to resort back to old coping mechanisms, including using substances. “Stress is the primary factor in relapse, and there is no question there was a big increase in self-reported stress, and big increases in anxiety and depression,” said Aaron White, the senior scientific adviser at the NIAAA. These increased levels of stress, uncertainty, and anxiety that the pandemic has instilled in people only increases the risk of relapse in those struggling with substance abuse. 

Entering the third March of the pandemic, it is still unclear if alcohol-related deaths will decrease as the pandemic wanes. As COVID-19 restrictions continue to lax, many can physically access treatment centers, attend support group meetings, and connect with loved ones, so researchers are hopeful to see a reduction in alcohol-related deaths. 

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This week, the Centers for Disease Control and Prevention (CDC) presented a set of recommendations for Opioid prescriptions. These new guidelines are the first revisions made to the organization’s 2016 suggestions which stopped many with chronic pain from getting the relief they needed. 

The Opioid Epidemic And The CDC

For over 3 decades, the US has been experiencing a serious public health crisis known as the Opioid epidemic. In the 1990s, pharmaceutical companies, insurers, and pain specialists endorsed Opioid pain relievers as being less addictive and safe to use for common ailments. The marketing of drugs like OxyContin led to an increase in prescriptions being written for issues like backaches and arthritis. 

As a result, US overdose deaths rose drastically. From 1999 to 2017, Opioid-related overdose deaths increased almost sixfold. While local and federal governments attempted to restrict prescriptions, the crisis continued. Those who had already become addicted to Opioids turned to Heroin or Fentanyl when they couldn’t get a prescription. In fact, studies have shown that 80% of people who have used Heroin first used prescription Opioids. 

The CDC released a set of guidelines in 2016 aimed at decreasing the number of Opioids being prescribed. The organization urged physicians to explore other treatment options before turning to Opioids. Other medications and non-drug therapies were recommended as alternatives. If doctors chose to prescribe painkillers for acute pain, the CDC proposed a 3-day limit for prescriptions and that doctors prescribe the lowest possible effective dose. These guidelines also applied to treating chronic pain. Despite being voluntary, doctors and local governments implemented these recommendations. 

An Unintended Consequence

Although these guidelines ultimately contributed to a decrease in Opioid prescriptions being written, they were largely opposed due to their effect on a specific group. Many doctors across the US feared there would be criminal or civil consequences if they did not follow them. Doctors became very hesitant to prescribe Opioids and quickly tapered patients off of their prescriptions. This greatly affected many chronic pain patients who rely on doses higher than the 90 milligram ceiling of Morphine listed in the 2016 guidelines. 

Studies have shown that rapid tapering patients off of Opioids can lead to harmful outcomes. One particular study of 100,00 chronic pain patients found there was 68% increase in overdose deaths for patients experiencing tapering compared to those who were not. For the tapered group, there was also a spike in mental health conditions. Chronic pain patients were also more likely to turn to substances like Heroin and Fentanyl to self-medicate their pain after being tapered off their medications. Suicide can also be an outcome of tapering. It has been reported that up to 30% of Opioid overdoses could be suicides. 

The rigid interpretation of the CDC’s 2016 guidelines also affected those who were struggling with a substance use disorder (SUD). Many doctors developed a one strike policy. This meant that if a patient tested positive for an illicit substance, they were not given further treatment. 

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CDC Proposes New Guidelines

Several organizations spoke out against the original 2016 guidelines. In 2019, the US Food and Drug Administration issued a warning about the dangers that can come from suddenly tapering patients off of Opioids. The American Medical Association recommended that doctors immediately suspend the CDC’s guidelines in 2020. In response, the CDC acknowledged that their suggestions had been misinterpreted and misused. Concerned about the reports of people with chronic pain being denied relief, the CDC began to work on revisions to their 2016 guidelines. This time, their recommendations were drafted with no input from drugmakers. 

The new guidelines, released on Thursday, are aimed at balancing the necessary use of Opioids for severe pain and protecting other patients against harmful risks. The 12 recommendations proposed in the 229 page document changes the “one-size fits all approach” to Opioid prescriptions. Doctors are being urged to look at each patient’s situation and assess the risk and benefits prescribing Opioids. Overall, the CDC still believes that non-Opioid therapies should be attempted before prescribing Opioids for pain. At the same time, they removed the 90 milligram ceiling of morphine for chronic pain patients and the 3 day limit for acute pain. 

While the document warns of addiction, depressed breathing, and effects to mental status, they have noted that they serve a very important medical purpose. Relieving pain from traumatic injuries, such as burns and crushed bones, were listed. In these cases, it is recommended that immediate release pills be used rather than long-acting. The CDC also stated that these guidelines do not apply to those with cancer, sickle cell, and end of life or palliative care. 

The CDC also noted that patients who come in and test positive for illicit substances could have untreated pain or a substance use disorder. The new guidelines recommend that doctors offer treatment, counseling, and careful tapering when necessary. In doing so, they can assist patients in improving their quality of life. 

These recommendations are currently available on the Federal register. For 60 days, the public can make comments on the proposed guidelines. The CDC will then review these comments and will likely release a final issue by the end of the year. 

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Macklemore, whose birth name is Ben Haggerty, has recently been candid about his struggles with substance use and relapse. The rapper has partnered with CLEAN Cause, a sparkling beverage company, in the hopes that being truthful about sobriety can help others who are struggling with a substance use disorder (SUD). 

Macklemore’s Early Drug And Alcohol Use

Last week, 38-year-old Macklemore shared his experience with addiction in an essay for TODAY. In his own words, he details his first time consuming alcohol. At age 14, Macklemore snuck alcohol from his parent’s liquor cabinet which was located above his refrigerator. After having 1 shot of vodka, he began to wonder what it would feel like to take 2 shots. This curiosity led the then 130-lb Macklemore to continue drinking 12 shots in one sitting. After this binge, he took a bus downtown, threw up in a trashcan, and ran from the cops. 

Macklemore recalls that he began rapping around the same age that his drug and alcohol use began. Despite many artists relating substance use to increased creativity, the rapper does not agree. In his essay, Macklemore said, “When I use drugs and alcohol, I shut off. I have a veil over my eyes. I can’t see the truth anymore. I sit on the couch and play PlayStation with my friends. Maybe I’ll go freestyling in a park, but in terms of making albums, it’s going to be impossible. When I’m sober, I’m prolific and productive.” 

After his first experience with alcohol, Macklemore continued down the path of addiction which caused his life to fall apart. At age 25, he started to find small, local success as a rapper; enough to pay his bills. When the momentum of this success came to a halt, Macklemore turned to drugs and alcohol to cope. He began recreationally using OxyContin, drinking excessively, and smoking Marijuana. These unhealthy habits caused him to feel as if he had lost the will to live. 

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Getting Treatment And Growing As An Artist

During this time, Macklemore’s father asked him if he was happy. When his honest answer was “no”, his father offered to help by paying for treatment. Macklemore agreed and entered a facility in 2008. The rapper claims that surrendering and admitting that he needed help was the most powerful thing he has ever done. 

Once out of treatment, Macklemore moved back in with his parents and began to contemplate if he could be a rapper while championing for sobriety. He remembers realizing that no one in hip hop had been openly sober before. Despite instinctually thinking he should hide this side of his life, he decided he wanted to be transparent and honest. 

It was around this time that Macklemore formed a creative partnership with producer and songwriter Ryan Lewis. Together, the duo released an EP called VS. Redux in 2010. Macklemore says this EP, which focused on his struggles with drug and alcohol use, was the first time his music really connected with listeners. He noted that fans would specifically thank him for the song “Otherside.” 

Despite Macklemore’s doubts that sobriety could be marketable in the rap genre, he found there was power in sharing his story. He believes that being open and honest about your experience allows others to feel safe to share theirs. 

Macklemore’s Relapse And Views On Sobriety

In 2021, Macklemore did an interview on Dax Shepard’s Armchair Expert podcast. During this conversation, the artist confessed that he had experienced a relapse in the year prior. Macklemore has shared that the COVID-19 pandemic contributed to his relapse. He found that he was losing focus as his 12-step meeting became Zoom meetings. This caused him to become out of touch with his recovery community which he says is a big factor to staying sober. 

“Sobriety is not a daily struggle, but it’s a daily effort. I have to be proactive about my recovery. When I talk about it, I get a spiritual reprieve. If I’m not reaching out to others, being of service, going to meetings, working the steps, I will eventually forget how bad it gets. I will end up thinking that the drug is the best solution to take me out of whatever momentary pain I’m in,” Macklemore wrote in his TODAY essay. 

CLEAN Cause’s New Creative Director

Macklemore has recently teamed with CLEAN Cause, a beverage company with a mission. Founder Wes Hurt noticed that the sober living experience was crucial to the recovery process, especially when it comes to forming routines, finding employment, and preparing to re-enter the world. For this reason, CLEAN Cause donates 50% of their net profits, or 5% of net revenues, whichever is greater, to help fund sober living scholarships. Almost 3,000 scholarships, around $1.5 million, have been backed through CLEAN Cause. 

In this partnership, Macklemore has been named CLEAN Cause’s new Creative Director. Through his artistic vision and own personal experience, he hopes to raise awareness about addiction. Macklemore’s first project with CLEAN Cause will be a video series titled “Drink to This.” While the series is yet to be released, a short trailer can be found on YouTube. Individuals in the series are shown sharing their unique, yet universal stories about the benefits of sobriety. 

“To anyone in recovery… to anyone who loves someone in recovery… to anyone who needs recovery… to anyone, anywhere, on the road to recovery… to anyone who wants to help those in recovery… drink to this,” Macklemore can be heard saying while he plays the piano in the series’ trailer. 

The Importance Of CLEAN Cause’s Mission

It has been reported that 1 in 7 people in the US will develop a substance use disorder in their lifetime. Of these individuals, only 1 in 10 will receive the treatment they need. Additionally, the US saw the highest number of recorded overdose deaths, over 100,000, for any 12-month period last year. Macklemore hopes that being honest about his own story can help others to get the treatment they need. 

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New York City officials have proposed a new initiative that will feature the installation of “public health vending machines.” These vending machines will dispense free toiletries, safe sex kits, and harm reduction supplies, such as overdose reversal medications and sterile syringes.

What Is Harm Reduction?

Harm reduction programs are aimed at reducing overdose deaths and other adverse outcomes that can come from drug use. While most policies are focused on abstinence, harm reduction works to give agency to those who are struggling with a substance use disorder (SUD). This is done through a spectrum of approaches such as managed and safer use.

Because each program differs based on the community’s needs, there is no set definition for harm reduction. States in the US who take this approach typically provide medications to reverse overdose, resources on treatment, and needle exchange. The National Harm Reduction Coalition lists 8 principles that are essential for harm reduction programs. These principles include:

1. Accepts that licit and illicit drug use is part of our world and chooses to not ignore or condemn harmful effects. 
2. Recognizes that substance use is a complex situation and that some methods are safer than others. 
3. Uses the quality of individual and community life as the program’s criteria. 
4. Services and resources are provided without judgement or coercion. 
5. Program is created by routinely giving a voice to those who use substances or have a history of substance uses. 
6. Those who use substances are the primary agents in reducing harm. 
7. Acknowledges that social inequalities, like poverty, class, racism, past trauma, and discrimination can affect an individual’s vulnerability for substance use. 
8. Does not minimize or ignore the harms and dangers that are associated with substance use. 

New York City’s Vending Machine Plan

It has been reported that every 4 hours, a person in New York City dies of a drug overdose. Like the rest of the US, New York City has seen an increase in overdose related deaths over the past few years. In 2020, 2,062 overdose deaths were recorded for the city which is 500 more than the prior year.

This $730,000 pilot program is geared towards curbing overdoses by making harm reduction supplies easily accessible. In order to reach the areas that have been especially affected by overdose deaths, 10 public health vending machines will be placed in all 5 boroughs of the city. Central Harlem, Union Square, Far Rockaway, Stapleton, and East New York have been identified as top priority neighborhoods. 

While residents of New York state currently have access to clean syringes at pharmacies throughout the state, these vending machines may be a more appealing option. By eliminating face-to-face interactions and being available 24/7, harm reduction vending machines can get supplies to the people who need them most, where they need them, and on their schedule.

Needle Exchange Programs And Naloxone

Exchanging needles and providing Naloxone will be the main focus of New York’s harm reduction vending machines. 

The Centers for Disease Control and Prevention (CDC) defines syringe services programs (SSP) as community based programs that provide access to sterile needles and syringes, facilitate safe disposal of used syringes, and link people to treatment programs. Studies have shown that those who participate in SSPs are 5 times more likely to enter treatment than those who do not. It has also been proven that these programs can be successful in preventing the spread of HIV, Hepatitis C, and other skin and other high risk infections.

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Naloxone is a medication that can reverse Opioid overdose by attaching to Opioid receptors to block the substance’s effects. This can be achieved through a nasal spray form of Naloxone or by injecting it into muscle. Being able to recognize an Opioid overdose is important when it comes to using Naloxone. Signs of of Opioid overdose include:

• Unconsciousness 
• Small pupils 
• Shallow breathing 
• Vomiting 
• Inability to speak 
• Faint heartbeat 
• Pale skin 
• Purple fingernails or lips 

Once Naloxone has been administered, it will only reverse effects for 30 to 90 minutes. For this reason, it is essential that emergency services be contacted immediately along with the use of Naloxone. 

Las Vegas’s Harm Reduction Vending Machines

Nevada was the first state to install vending machines similar to the ones included in New York’s plan. The state, which began using these vending machines in 2017, saw significant success within the first year, especially in the Las Vegas area. From 2017 to 2018, approximately 23,540 clean syringes were distributed. 1/4th of the transactions were for HIV and Hepatitis C tests and 5% of clients asked for referrals for treatment programs. Additionally, nearly half of those who used the vending machines requested Naloxone.

The 3 vending machines placed in southern Nevada have been deemed a success. Their harm reduction services have been able to keep people safe by providing supplies to otherwise hard to reach groups of people. These populations can receive the supplies they need in a discreet manner which has helped to lower the stigma that is associated with getting help for a SUD. 

Biden’s Push Towards Harm Reduction

The Biden Administration is the first to openly support harm reduction policies. While not everyone is in support of this approach, the need for reducing the harms caused by drug use is more important than ever. In 2021, the US reported its highest number of overdose deaths in a 12 month period at over 100,000. 

On December 8th, 2021, the Biden Administration announced that they will be making efforts to work towards implementing more harm reduction programs. To do so, they will be supplying over $30 million in grants. These grants will be used for harm reduction services such as syringe exchanges and Naloxone. 

Critics of harm reduction believe that these programs do not address the most critical issues of addiction. Additionally, it is often thought that needle exchange programs will create more litter in the area. Studies have found that this claim is not true. 

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The University of Washington (UW) has high hopes: to develop a vaccine that could be used to counteract the effects of addictive and illegal drugs, prevent overdoses, and save lives.

The work will occur at UW’s Center for Medication Development for Substance Use Disorders, which opened on January 3.

It will be spearheaded by Marco Pravetoni, a professor of pharmacology. Though The Seattle Times reported on January 5 that, at that time, Pravetoni was the only faculty member at UW’s new center, he will likely soon be joined by more allies and experts focused on the same goal. Pravetoni is optimistic about the progress to be made.

Said Pravetoni, “Every year, we’re going to start a new clinical trial.” The professor is eager to buckle down and get to the hard work of developing an inoculation against addiction that will save lives; the bill associated with such a venture will be large, however.

Pravetoni estimates it could cost as much as $300 million.

The center is off to a good start, however, and Pravetoni may have secured up to $50 million in funding so far. According to The Times, Pravetoni’s goal “is to get enough funding to get through at least Phase 1 and 2 — prove his vaccines are safe and likely work — and then get a pharmaceutical company to fund the rest.”

Addiction Vaccines Have A Long History

The thought of a vaccine for addiction could seem somewhat counterintuitive. Many vaccines function, ultimately, by increasing the amount of antibodies that might be used to fight off a particular virus. But how would a vaccine against addiction work?

As it turns out, much the same way.

According to The New York Times, which reported on the subject of so-called addiction vaccines in 2011, “Like shots against disease, these vaccines would work by spurring the immune system to produce antibodies that would shut down the narcotic before it could take root in the body, or in the brain.”

Unlike the COVID-19 vaccine, best practice for an addiction vaccine would not be to receive the immunization in advance of coming into contact with the thing being immunized against (in this case, illegal drugs). Rather, subjects would be given the vaccine after they’ve already used the drug and developed a dependency.

Animal trials have shown that the idea has legs: rats who were given an inoculation against Heroin no longer experienced the effects of the drug and stopped taking it after they were given a vaccine.

There has been great difficulty in making the jump from non-human animals to humans, however. In one trial of a Nicotine inoculation, the shot didn’t work to help people quit smoking any better than a placebo did.

Researchers have been trying to crack the code for a long time: the first study in a peer-reviewed journal on the subject was published in Nature in 1974. The test subject was a rhesus monkey; according to the study, “Results indicate that antibodies against morphine can block those effects of heroin on the central nervous system (CNS) that maintain self-administration behaviour.”

In other words, an anti-Heroin shot can make a subject stop shooting up. Now it’s up to scientists like Pravetoni, who stand on the shoulders of pioneers like Dr. Kim Janda (whose work involved both the rat experiment detailed above and the Nicotine vaccine trial, and who made advances in the addiction vaccine space for decades) to make those subjects human.

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An “Urgent Need For New Treatment Options”

Operation Warp Speed was the endeavor that brought the COVID vaccine, and it was a race against the clock unlike any other seen in the modern age. Now there is a different race against time occurring, perhaps just as important if not more so — the sprint to take an addiction vaccine to market before drugs like Fentanyl claim untold more lives.

According to a piece published in the Drugs academic journal, “Drug addiction is a chronically relapsing brain disorder. There is an urgent need for new treatment options for this disease.”

That was from 2003.

Since then, overdose deaths have skyrocketed.

Per the Centers for Disease Control and Prevention (CDC), drug overdose deaths annually went from roughly 27,000 in 2003 to over 40,000 in 2011; by 2019, they had climbed to exceed 70,000.

Annual numbers from 2021 were over 100,000.

The White House has backed an approach to the problem based around harm reduction as opposed to punishment; per the Office Of National Drug Control Policy, primary drugs of concern include “illicitly manufactured fentanyl and synthetic opioids other than methadone (SOOTM),” though other targets include “cocaine and other psychostimulants, like methamphetamine.”

Some of the best minds in the world are working tirelessly on solutions to problems that plague the nation. While their work won’t be easy, some solace can be taken in the words of professor Pravetoni; researchers like him, he says, “are trained to overcome adversity.”

The post A Vaccine Against Addiction appeared first on Addiction Center.

Avicii, born Tim Bergling, was a popular DJ, songwriter, and producer from Sweden. With chart topping songs like “Levels” and “Wake Me Up”, Avicii’s music was genre re-defining. Despite the quick success Avicii experienced, the artist’s lifelong struggles with anxiety and addiction led to his death by suicide in 2018.

A recently released biography, written by Mans Mosesson, details how mental health concerns and addiction were present in the life of the Grammy nominated musician. For Moseeson’s Tim – The Official Biography Of Avicii, the author was granted access to Avicii’s personal journals. These journal entries reveal the extent at which the DJ was struggling during the years leading up to his death. 

Avicii’s Early Substance Use And Dissociation

Avicii was in high school when he smoked Marijuana for the first time. This experience caused an episode of paranoia for Bergling which resulted in feelings of derealization. He began to no longer feel connected to the world around him. In this state, Avicii confessed his substance use to his parents and expressed concern that the Marijuana had triggered a psychosis. They took him to a child psychologist who eased their worries. 

What Avicii was likely experiencing after first using Marijuana was a period of dissociation. This can be defined as a disconnect between a person’s memories, feelings, behaviors, perceptions, or sense of self. While dissociation is often mild, it can also become a disorder which can interfere with an individual’s daily life. Studies have shown that derealization can occur after an individual has used Marijuana, not as a cause of use but rather can be triggered by the substance. These feelings can present themselves after using for the first time or after extended, repeated use. 

Lifelong Struggles With Anxiety

Disassociation can also accompany the majority of psychiatric conditions, such as anxiety and depression. Avicii, who has often been described as a shy person, struggled with both of these conditions throughout his life. As a teen, he was self-conscious of his appearance, specifically his nose and acne. 

Fame, success, and the DJ lifestyle only heightened Avicii’s anxiety and substance use. Being recognized by fans in public, performance nerves, and a grueling tour schedule caused him to turn to alcohol as a coping mechanism. 

“It feels like I’m going to faint every single day now. And not just today and this tour but from about the first time I mentioned that I felt worn-out. Pretty regularly but I push it back down and choose not to bring it up because there’s nothing I can do about it,” he told his manager in 2011.  

Health Issues Caused By Avicii’s Substance Use

In 2012, at age 22, Avicii was admitted to the hospital with extreme stomach pains. It was determined that he was experiencing acute pancreatitis due to excessive alcohol use. Doctors instructed him to heal his stomach’s inflammation by avoiding junk food and staying sober for at least 6 months. During his hospital stay, he was also prescribed Oxycodone, an Opioid, to deal with the pain.   

Once back on tour, Avicii added pill popping to his old habits of poor eating, drinking, and not sleeping. In the journal entries featured in Mosesson’s book, he wrote, “Of course, I didn’t listen to the majority of doctors. I listened to the couple who said it would be okay if I was careful. I was ignorant and naive and touring the world, still on the never-ending tour because once you’ve circled it once, guess what? You start right back over again.” 

When stomach pains returned in 2013, doctors recommended that Avicii have his gallbladder removed. He opted to not have the procedure done until he had more free time in his schedule. The following year, his appendix ruptured and his gallbladder was removed. Both hospital stays resulted in more painkillers being prescribed. 

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An Intervention In Ibiza

Following his cycle of hospital visits, those closest to Avicii began to notice his behavior changing. He was often irritable and acted erratically. In 2014, his parents tried to help him with his Opioid addiction. He resisted their help and flew to Los Angeles where a personal doctor would write him prescriptions whenever he wanted. 

After two incidences of needing his stomach pumped from a mix of pills and alcohol, his friends and family staged an intervention. This intervention took place in Ibiza where Avicii was performing a few shows. He agreed to enter a tranquil and pricey treatment program on the Spanish island. It was during this 1 month of intensive, inpatient rehab, that Avicii came to understand that his addiction was a coping mechanism for his mental health struggles. 

“It needed to be explained to me very logically and caveman-esque for me to truly understand its nature and how it was harming me. Ouch, pain. Why me pain now? Uncomfortable feeling. Future Time deal with pain. Future deal with pain better than present Tim because already there’s too many present pains more urgent to deal with,” he wrote in his journals during the Ibiza treatment program. 

Avicii’s Life After Rehab

Once he completed his month in rehab, Avicii seemed to have a new outlook on life. He was meditating regularly, reading about the collective unconscious, and got a puppy. After not performing for a long period of time, he returned to the stage in 2016 at Miami’s Ultra Music Festival. It was announced a few days after this gig that he would not be performing live anymore. Avicii chose to not perform so that he could focus on bettering his mental health. 

Despite appearing to have new-found stability, Avicii still struggled to deal with his mental health issues. While continuing to suppress the anxiety and depression that he frequently felt, Avicii also started to become disinterested in his music career. During this time, he was smoking and drinking on occasion which may have resulted in a resurgence of his disassociation feelings. 

He told Tereza Kacerova, his girlfriend at the time, “What if everyone around me is just a projection in my mind? Sometimes I just think these things. About how nothing really matters.” 

Avicii started to focus heavily on meditation which he found to be helpful in clearing the “nonsense” from his mind. He believed that a deep form of meditation taught by Maharishi Mahesh Yogi was a way to exercise his brain which he had decided would lead to his happiness. Despite this form of meditation typically being done in 20 minute increments, Avicii would sometimes spend full days meditating in an attempt to reach enlightenment faster. 

While on a trip to Muscat, Oman, one of Avicii’s friends called his father to express concerns for the DJ’s well-being. The friend described Avicii’s intense meditation and shared that he was refusing to eat, speak, or take shade from the sun. Just one day later, on April 20th, 2018, Avicii took his own life. Avicii was 28 years old. 

Addiction And Suicide

For Americans at all ages, suicide is among one of the leading causes of death. Those, like Avicii, who struggle with a substance use disorder (SUD), are at a higher risk for death by suicide. In fact, those who drink heavily are 5 times more likely to die by suicide than those who drink socially. Over the past few years, suicides related to Opioid addiction have nearly doubled. 

It is common for those at risk for suicide to struggle with addiction and other mental health risk factors like depression, anxiety, chronic illness, and a history of abuse. With drugs and alcohol being able to worsen these conditions while increasing aggressive behavior and lowering inhibitions, suicidal thoughts can occur. 

It is important to be able to recognize behavioral changes that might indicate a loved one may be suicidal. Behavioral signs include: 

• Admitting to feeling trapped, hopeless, or having no purpose in life 
• Isolating oneself 
• Oversleeping or trouble sleeping 
• Struggling to control anger 
• Physically harming oneself 

Relapsing can also be an indicator that an individual is having suicidal thoughts.

The National Suicide Prevention Lifeline is available to you for free, all hours of the day and night, at 1-800-273-8255.

The post What Avicii’s Journals From Rehab Reveal About His Mental Health appeared first on Addiction Center.

Dr. Susan Thompson, weight loss expert and professor of brain science, declared in an op-ed published January 3 that, “we are literally eating ourselves to death.”

According to Dr. Thompson, “It isn’t real food, it is the packaged, highly refined, chemically laden products marketed to us as ‘food’ that are killing us, and will continue to do so until we reframe what is being perpetrated on consumers in terms of addiction.”

The evidence on whether Americans agree with the notion that obesity, which kills almost 3 million people a year globally, could be the byproduct of addiction, is mixed.

On one hand, research has shown that growing numbers of both everyday Americans and medical professionals view obesity as more of a societal problem than a personal one. On the other hand, one survey found that 75% of respondents attributed obesity to a failure of willpower; this is how, at one time, drug and alcohol use disorders were viewed as well.

That so many view such a massive and shared community health issue as obesity as a private moral failing may confirm that obesity is, in fact, the result of addiction (since the thinking is a paradigm that’s been applied to other addictions in the past).

But if it’s not one’s personal willpower that is to blame for unhealthy amounts of weight, what is — and what is the scope of the problem in today’s landscape?

Americans More Obese Than Ever

Half of the population is now obese, meaning they have a “Body Mass Index” (BMI) that is higher than 30. Per the Centers for Disease Control and Prevention (CDC), and though BMI empowers individuals to evaluate whether or not they are obese, BMI “does not diagnose body fatness.”

An individual, therefore, could conceivably be medically obese but still not be body-fat; for the vast majority of those who fall within the designation of obese, however, this is not the case.

Body-fat obesity does not necessarily have to be linked to shame or personal failing in the way that many Americans’ beliefs indicate it perhaps should be; corporations that have spent millions, if not billions, on advertising an idealized body image just to turn around and sell Americans the “cure” for embarrassment, shame, or body dysmorphia are likely at least somewhat responsible for this belief having taken root in the first place.

It can’t be denied, however, that the threat to America posed by obesity has ballooned. The rate of obesity was 20 points lower at the turn of the millennium; so-called “severe obesity” has more than doubled since that time. For the public health impact of that growth, one need merely turn on the news — although it’s probable that a close friend or family member, if not oneself, is as good an anecdotal example as any.

Statistics quantify the risks of ill health likely already observable in acquaintances; a study published in Obesity Reviews in August of last year found that obese people are 46% more likely to get COVID and 113% more likely to become hospitalized. Non-COVID health complications also apply; the Harvard T.H. Chan School Of Public Health has reported that obesity raises the risk of stroke by 64%, raises the risk of premature death from coronary artery disease in women by 62% (and by a comparable amount in men), and is correlated with a 42% higher risk of Alzheimer’s (among many other risks).

Media Linking Obesity To COVID

In accordance with the above statistics, CNN has now published a report linking obesity to COVID, stating that, “People who are overweight or obese are at a much higher risk of much more severe disease and even death from Covid-19,” and going on to identify obesity as “the second leading cause of preventable death, after smoking.”

The outlet has faced some criticism from others, like Fox News, who called the subject of the article “a connection already well-known from data compiled earlier in the pandemic,” and reported that there have been “recent pushes by some…outlets against the airing of negative views on the body image of those who are overweight.”

If negative body image perceptions result in shame, disempowerment, or otherwise unpleasant feelings that don’t serve their feeler, then those perceptions need not be made valid – it’s a scientific fact, however, that obesity is claiming lives.

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Obesity, Mental Health Conditions Co-Occur

Obesity can co-occur with a variety of other conditions. For one thing, sugar addiction (often viewed as a behavioral addiction, though sugar is in and of itself an addictive substance – per Dr. Thompson, “sugar can be more addictive than cocaine”) may coincide with obesity.

Anxiety and symptoms of depression can also co-occur with obesity; the latter may contribute to the former (though the inverse may also be true).

Those looking to manage their weight and/or cut back on sugar have many options available to them. Avoiding processed foods, eating more leafy greens, managing the calculus of calories consumed versus calories burned, and seeking out so-called “good fats” (like the kind that can be contained by fish, nuts, and avocado) can be a strong way to move to a healthier weight and increase longevity along with quality of life.

For those who see food as a valuable part of life and/or a means of expression, and many do, considering the fact that wealthy corporations deliberately make processed foods addictive and unhealthy as a way of keeping consumers dependent and malleable may be helpful in viewing more nutritious choices in a different and more empowering light.

Eating healthily in 2022 could provide a host of mental and physical benefits; eating as well as is within one’s means to do could be a powerful way to make the most of one’s own dietary privilege.

The post The Obesity Addiction appeared first on Addiction Center.

On Wednesday, the Centers for Disease Control and Prevention (CDC) released data showing that overdose deaths have hit a record-breaking high: more than 100,000 fatalities due to drug overdoses, many of them caused by Fentanyl, occurred in the 12-month span that concluded in April of this year.

CNN contextualized the scope of the statistic in its reporting; an article published by the outlet reveals that deaths increased “28.5% from the same period a year earlier…nearly doubling over the past five years.”

Almost 2 in every 3 deaths are due to Synthetic Opioids, and within that class Fentanyl is the most deadly.

There’s speculation that the pandemic has facilitated the spread of drugs like Fentanyl, and that potent and synthesizable substances are appealing to drug traffickers who must contend with lockdown measures and may only have so much physical storage space with which to move their product.

Experts tend to agree that the long-term solution to the overdose crisis involves making addiction treatment, like the kind offered by inpatient and outpatient rehab, available to more Americans. In the meantime, however, state governments and law enforcement agencies are taking steps to act against Fentanyl — and a new model law released by the current administration may lead to more access to lifesaving medications that can help prevent further tragedy.

The Fight Against Fentanyl Ramps Up

The same day that the CDC released the new data, Pennsylvania Department of Drug and Alcohol Programs Secretary Jen Smith stressed the importance of carrying Naloxone (also called Narcan), a medication that can save lives by undoing the effect Opioids have in the brain and reversing an overdose.

Secretary Smith stated, “You never know when you may come across an individual suffering from an overdose. There are numerous ways [to] access life-saving naloxone…we’re here today to encourage that people take advantage of those resources.”

Pennsylvania has County and Regional Centralized Coordinating Entities (CCEs) that work with first responders to distribute Naloxone. Many states may have similar programs; in all 50 states, Naloxone is available with no prescription and may be obtained at a local pharmacy.

The medication is safe to use and relatively easy to administer, does not generally cause any side effects, and doesn’t get the user high.

At the same time that everyday Americans are being asked to step up and learn how to use Naloxone to save lives, law enforcement agencies are coming down hard on Fentanyl suppliers.

A day before the CDC released their data, the Los Angeles Police Department (LAPD) declared that it would begin more thoroughly and systematically pursuing Fentanyl dealers, especially when 1 dealer or group of dealers is seen to be responsible for multiple instance of the drug being distributed.

Assistant Chief Bea Girmala said that it was important to not merely address the currently unfolding crisis but also ask “What does the supply chain look like…can we link it to any particular dealer or an establishment where maybe people had frequented prior to the overdose?”

The LAPD said it would work with the DEA to dismantle and bring justice to Fentanyl suppliers; many law enforcement agencies across the country are doing the same.

New Model Law Could Provide Solution

On Wednesday, the White House Office of National Drug Control Policy gave states a legal template that might be used to increase access to Naloxone across the nation. As Bloomberg Law reported, “The model law would promote educational initiatives on the benefits of drugs like Naloxone, create a pilot program for bystanders to access the drug, and grant legal protections for people who administer it.”

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It could be beneficial to open up access to Naloxone in more places around the country; though it is legal without a prescription in all states, laws are very different across different jurisdictions. Furthermore, in many states, individuals who administer Naloxone could potentially be criminally charged for their behavior. Legal shields that would prevent something like that from happening could go a long way toward saving lives that might otherwise be lost to Fentanyl or drugs like it.

According to the White House, the administration is committed to increasing “access to evidence-based prevention, treatment, harm reduction, and recovery support services…In addition to these actions, the President’s FY22 budget request calls for a $41.0 billion investment for national drug program agencies.”

The post Overdose Deaths Exceed 100K, Fentanyl To Blame appeared first on Addiction Center.