US Tightens Controls Over Hydrocodone Pain Killers

Today's post from webmd.com (see link below) talks about yet more controls on strong painkillers containing hydrocone, by the US Drug enforcement administration. In the battle to combat addiction and the criminality associated with it, access to hydrocone-based pain killing drugs is about to get much harder. The problem is that many neuropathy and cancer patients (to name but two) are dependent on these drugs for a decent quality of life with reduced pain. They are the innocent victims of a media-led hype about prescription drug addiction and the criminal circuit that feeds it. Surely in the most advanced country in the world it should be possible to distinguish between genuine need and potential criminal behaviour, or addiction. It's true that too many opioids are too easily available and their value on the black market even leads people to buying heroine, which is cheaper but genuine chronic pain sufferers don't abuse - they realise both the power of the drugs and the effectiveness they have in controlling their pain. In conjunction with their doctors, they plan their usage and avoid addiction. These people should not be punished for the actions of a few. Work out a sensible system America - it must be possible but blanket controls lead to a great deal of unnecessary suffering for those in genuine need.

DEA to Tighten Access to Some Narcotic Painkillers
Drugs containing hydrocodone, which include Vicodin, would be affected
WebMD News from HealthDay By HealthDay staff THURSDAY, Aug. 21, 2014

The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

The new restrictions would cover prescription narcotic drugs such as Vicodin, Lortab and their generic equivalents, putting them in the same regulatory class as painkillers such as Oxycontin, Percocet and codeine. Patients will now only have access to a three-month supply of the drug and will have to see a doctor to get any refills.

The new rules, posted online by the DEA on Thursday, come more than 18 months after a U.S. Food and Drug Administration advisory panel met to discuss the fate of painkillers containing hydrocodone. That 2013 meeting followed the DEA's request for an FDA panel review on the issue. The painkillers were previously classified as Schedule III drugs, but the DEA wanted them placed under the more restrictive Schedule II designation.

"Almost seven million Americans abuse controlled-substance prescription medications, including opioid painkillers, resulting in more deaths from prescription drug overdoses than auto accidents," DEA Administrator Michele Leonhart said Thursday in a news release. "Today's action recognizes that these products are some of the most addictive and potentially dangerous prescription medications available."

One expert applauded the move toward stricter oversight.

"Moving hydrocodone-combination products into DEA Schedule II for controlled substances will have several important effects," said addiction psychiatrist Dr. Eric Collins, physician-in-chief at Silver Hill Hospital in New Canaan, Conn. "It will relatively rapidly reduce the now very easy availability of hydrocodone -- this will help mitigate the rapid growth we've seen in the last 20 years in addiction to opioid [narcotic] pain relievers and heroin."

Collins also believes the move will "reduce both the number of new initiates to opioid use and the number of accidental and intentional overdose deaths. This change is both most welcome and long overdue."

Janina Kean, president and CEO of High Watch Recovery Center in Kent, Conn., said she thinks the DEA's new regulations "will have more of an impact on the adult population or individuals inappropriately prescribed very strong narcotics for mild operative procedures, than it will for the nation's adolescents, a population where 96 percent of substance abuse starts."

The new regulations, Kean added, should reduce the availability of "prescription drugs developed for excruciating pain from being used to treat much less severe ailments like dental procedures or minor surgery."

But she foresees potential problems with the stricter regulations. "With access to drugs like Vicodin and Percocet limited by the regulations and harder to obtain, we may end up seeing a trend of [teens] skipping the pills and going straight to heroin," she said.

The regulation of prescription painkillers has been a contentious issue.

Supporters of a move to a more restrictive Schedule II status pointed to tragic deaths and suicides that have been the result of misuse of these prescription drugs.

But, opponents of the tougher classification fear that tightening access to the drugs would mean that people who really need them to ease pain would not be able to get them.

Few people dispute the fact that too many of these opioid drugs are too widely available, even though the pharmaceutical industry has recently developed "abuse-resistant" formulations to help fight misuse.

Overall, some 22 million Americans have misused prescription painkillers of one kind or another since 2002, according to a report released by the U.S. Substance Abuse and Mental Health Services Administration. The agency noted that prescription painkillers now rank only behind marijuana as a drug of abuse in the United States.

http://www.webmd.com/news/20140821/us-to-tighten-access-to-certain-narcotic-painkillers

LOOSING SLEEP OVER YOUR DIVORCE YOUR BLOOD PRESSURE COULD SUFFER

Those who experience persistent sleep problems after a divorce stand to suffer from more than just dark circles. They might also be at risk for potentially harmful increases in blood pressure, a new study finds

A growing body of research links divorce to significant negative health effects and even early death, yet few studies have looked at why that connection may exist.

Divorce-related sleep troubles may be partly to blame, suggest the authors of a new study to be published in a forthcoming issue of the journal Health Psychology.

"In the initial few months after a separation, sleep problems are probably pretty normal, and this is an adjustment process that people can typically cope with well," said UA associate professor of psychology David Sbarra, who co-authored the paper with two of his former students -- lead author Kendra Krietsh and Ashley Mason.

"But sleep problems that persist for an extended period may mean something different. It may mean that people are potentially becoming depressed, that they're struggling with getting their life going again, and it is these people that are particularly susceptible to health problems," Sbarra said.

The study looked at 138 people who had physically separated from or divorced their partner about 16 weeks before the start of the study.

Participants were asked to report on their quality of sleep during three lab visits over a seven-and-a-half-month period, using the Pittsburgh Sleep Quality Index, which takes into consideration sleep issues ranging from tossing and turning to snoring to difficulty falling and staying asleep. Participants' blood pressure also was measured at each of the three lab visits.

Although researchers did not observe a relationship between sleep complaints and blood pressure levels at the participants' first lab visits, they did observe a delayed effect, with participants showing increased systolic and diastolic blood pressure in later visits as a function of earlier sleep problems.

"We saw changes in resting blood pressure were associated with sleep problems three months earlier. Earlier sleep problems predicted increases in resting blood pressure over time," Sbarra said.

In addition, the researchers found that the longer peoples' sleep problems persisted after their separation, the more likely those problems were to have an adverse effect on blood pressure.

"What we found was if you're having sleep problems up to about 10 weeks after your separation, they don't appear to be associated with your future increase in blood pressure," Sbarra said. "However, after 10 or so weeks -- after some sustained period of time -- there seems to be a cumulative bad effect."

For people who have high blood pressure to begin with, the increase is not to be taken lightly, Sbarra noted.

"Each standard deviation increase in sleep complaints corresponded to a roughly six unit increase in subsequent systolic blood pressure," Sbarra said. "If you're starting at the high average or low hypertensive range, this is a nontrivial bump."

Systolic is the top blood pressure number and measures the pressure in the arteries when the heart beats; diastolic is the bottom number and measures the pressure in the arteries between heartbeats. Normal blood pressure is around 120/80.

Lead study author Krietsh -- who began exploring the link between divorce, sleep and blood pressure as part of her honors thesis as a UA undergraduate -- suggests that people who have persistent difficulties sleeping after a divorce address the issue by seeking out cognitive behavioral therapy, making daily schedule adjustments that promote healthy sleep, or finding new ways to relax at bedtime.

"If somebody is going through a divorce and unable to sleep, they really need to get some help or it could lead to problems," said Krietsh, who earned her bachelor's degree in psychology from the UA in 2012 and is now pursuing her doctorate in clinical psychology at the University of Florida.

"We are all going to go through something stressful in our lives, whether it's a divorce or something else, Krietsh said, "and this shows how important it is for all of to value sleep and take care of ourselves."