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Parents Beware: The Link Between Prescription Drugs and Heroin

Parents Beware: The Link Between Prescription Drugs and Heroin

In recent years, drug abuse and addiction have skyrocketed as more and more people struggle with managing pain. Given the increased consumption of pain pills, it is important that you pay attention to the prescription, management, and use of drugs to protect your loved ones from potential abuses. Keep in mind that drug abuse does not discriminate according to age, race, or socioeconomic status. Further, drug abuse can be the result of various behaviors or experiences, as there is not one set factor that leads to misuse. In order to explore the signs of addiction, and explore solutions for drug abuse, keep reading for key information.

Know the Potential Sources for Drug Addiction and Misuse

When it comes to the abuse of drugs, the cause or catalyst of addiction can be difficult to pinpoint. If you are the parent of an addict or looking to protect your children from misusing drugs in the future, understanding the “why” is important. For example, if your child is struggling with drugs, you may be looking for a concrete answer as to what led your child to their troubling addiction. For this reason, it is important to start at the source.

First and foremost, most forms of addiction start with some type of injury. For example, if you break a bone and need a bone repair it can take anywhere from two to ten weeks to heal. During these weeks, the pain can be unbearable to handle. To help manage the condition, doctors may prescribe strong medication. Although the prescription is well-intended, the use of pain management drugs often leads to severe addiction. It is important to understand that the initial addiction may stem from legal sources but despite this, severe drug abuse can occur.

On a related note, consider that in 2015, more than 218 million people had driver’s licenses in the United States. Given the millions of people driving on the roads at any given time, the likelihood and risk of accidents are high. Much like a broken bone, a severe injury can lead to pill prescriptions. Keeping these potential exposures in mind is important as you need to be aware of the possible scenarios that could result in an opioid or drug addiction.

To protect your family members from these struggles, be sure to ask your doctors questions before any medications are prescribed. Further, consider how you will manage drugs if prescribed to you or a loved one. All in all, be aware of your surroundings and pay close attention to the use of strong medications in order to prevent addiction by all means possible.

Pill Use is Problematic, But Heroin is Worse

When addressing potential drug abuse in your family, it is important to understand that there are varying levels of drug abuse. For example, out of every five new heroin users, four of them start with the misuse of prescription pills. This information suggests that when drug addicts are prescribed pills and using them regularly, they run the risk of developing an addiction that spirals later on. Following the consistent use of one drug can lead to your body craving more intense, and addictive, drugs down the road. As a result, this can lead to a severe progression of drug abuse.

Considering this information, it is important that you manage any and all drugs prescribed to your family as exposure to pills can lead to worse outcomes. To assist with management, consider counting pills and keeping a clear record of any and all pills. Additionally, have a conversation with your loved ones about the dangers of drug use as well as a consultation with the prescribing doctor to understand the proper use and distribution of pills. Although this information can be overwhelming, taking the time to understand the misuse of drugs now can help protect your family long-term.

Pay Extra Attention To Youth

In considering the above information, it is important to note that a certain group of people are more susceptible to the dangers of addiction. Specifically, be sure to check in with your children as kids are the group most likely to face drug addiction. For example, research shows that youth commonly misuse prescription pain relievers. This can stem from experimentation, well-intentioned sharing of pills (passed around between friends and family), or intentional misuse. Considering these various opportunities, it is important that you check in with your children and look for possible signs of drug use.

Consider The Solution, Not Just The Problem

Now that you’re aware of the various dangers (and causes) associated with drug use, it is important to consider solutions. When it comes to addressing possible or known drug abuse, it is important that you research as much as possible. There are many drugs on the market and understanding the exact struggle your loved ones are facing is necessary to help them overcome drug-related issues.

First and foremost, consult a professional. If you believe your loved one is abusing medication in any form, it is important to reach out to someone familiar with the signs and treatment for drugs. Second, promote a healthy dialogue with your child or loved one. Letting your family members know that you are a safe space and anything is fair game to discuss can help open the floor for addressing scary issues. In turn, you are more likely to help your loved one overcome addiction. Lastly, pay attention to your surroundings. Drug abuse often starts in “normal” situations. Whether it be a prescription from a doctor or marijuana use with friends, people tend to use drugs in familiar circumstances. By paying attention to the signs, you are more likely to protect your family from long-term addiction.

All in all, addiction is a serious issue that requires knowledge, persistence, and committed action in order to help prevent irreversible medical issues. Consider that taking the time to explore the signs of addiction, as well as the initial causes and solutions of drug misuse, may help save your loved ones in the long run. Be sure to keep the aforementioned facts in mind, as they are sure to help you protect your family members from the dangers and destruction of drug abuse.

IMAGE: A man injects himself with heroin using a needle obtained from the People’s Harm Reduction Alliance, the nation’s largest needle-exchange program, in Seattle, Washington April 30, 2015. REUTERS/David Ryder 

Tips For Navigating Medicare Open Enrollment

Tips For Navigating Medicare Open Enrollment

By Janet Kidd Stewart, Chicago Tribune (TNS)

Frustrated with your Medicare coverage? You have until Dec. 7 to look for new options.

That’s the last day of open enrollment for current beneficiaries. Changes made to your plan go into effect Jan. 1.

With speculation still swirling about possible changes to the program’s “hold harmless” provision — a rule that will stick people who are delaying Social Security and higher income beneficiaries with big premium hikes for 2016 — managing costs and benefits is more important than ever, experts said.

“It really takes an individualized assessment to find the right plan,” said Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center. “The one that’s right for your neighbor or even your spouse might not be the one for you.”

That’s certainly true for couples with different health profiles, where one very healthy spouse might choose a plan that’s low on premiums and higher on out-of-pocket costs, while the sicker spouse chooses a higher premium and lower out-of-pocket costs.

But it could also be true for couples in more comparable health situations, she said.

“I was speaking with someone the other day who uses a brand-name medication, and his wife takes a different one. There wasn’t a single plan in the lowest cost tier that had them both, so they chose separate plans,” she said.

Managing two plans in one household could be a hassle but potentially worth it if it means savings of hundreds or thousands of dollars a year.

Here are some other tips to keep in mind as you choose.

Look to the stars. Check out Medicare.gov for access to the health plans available to you. Plans carry a star rating of 1 to 5, with 5 being the best. The plans earn stars based on measures such as customer service, how many of their participants have well-managed blood sugar levels, how many got their flu shot, and the like. Schwarz said these measures are best used to help distinguish between two or more finalists you’ve already narrowed down according to coverage and cost.

Study up. Make sure you understand fully the final plans you are considering. One reader of this column shared some frustrating experiences as he transitioned from COBRA to Medicare this year. While the move ultimately meant his total costs were cut in about half, he spent many hours on the phone with his insurance provider, haggling over getting access to the right dosage of a prescribed medication.

“We always look for plans with the fewest quantity limits,” said Maura Carley, president of Healthcare Navigation LLC, a consulting service. In theory, doctors can write prescriptions for whatever amount of medication they feel is suitable for a patient, but insurers increasingly are scrutinizing those orders, requiring an additional administrative step to verify the prescription amount is medically necessary.

Watch your step. Some drug plans offer cost incentives for step therapy, the practice of starting a patient on the lowest-cost drug and moving to higher-cost alternatives if the first one doesn’t work. In practice, Carley said, patients view these rules as very heavy handed.

Wanderlust? If you spend part of the year in another state, make sure your plan can travel with you, experts said. Some plans, for example, only cover you in your home base.

The bottom line, experts said: Don’t leap for a low-premium plan just to save a few dollars of monthly cost. Look for a plan’s total out of pocket costs and deductibles, and find out about restrictions on drug dosing.

©2015 Chicago Tribune. Distributed by Tribune Content Agency, LLC.

Photo: Don Ariosto via Flickr

Sounding The Alarm As Prescription Drug Abusers Turn To Heroin

Sounding The Alarm As Prescription Drug Abusers Turn To Heroin

By Lisa Girion, Los Angeles Times (TNS)

LOS ANGELES — Standing in the pulpit above Austin Klimusko’s casket three years ago, his mother used his death to draw the connection between pills from a pharmacy and drugs from the street.

“When his prescriptions dried up, he turned to heroin,” Susan Klimusko said in a frank eulogy meant as a warning to the young mourners at Simi Valley’s Cornerstone Church.

Last week, the nation’s top public health official used the bully pulpit to sound the same alarm. The prescription drug epidemic is stoking the nation’s appetite for heroin with disastrous results, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters in a teleconference.

“We are priming people to addiction to heroin with overuse of prescription opiates, which are, after all, essentially the same chemical with the same impact on the brain,” he said.

Frieden made his comments as he announced that heroin use had increased 62 percent and related deaths had nearly quadrupled since 2002.

The biggest increases were among groups associated with a parallel rise in the use of prescription painkillers, such as OxyContin and Vicodin. Today’s heroin user is increasingly likely to be wealthy, privately insured and between the ages of 18 and 25, according to the study by researchers at the CDC and the U.S. Food and Drug Administration.

heroin use on the rise

Graphic showing the rise in heroin use and that overdose deaths have quadrupled from 2002-2013.

It is a phenomenon familiar to people on the front lines of the crisis from Simi Valley to San Diego.

“The face of the heroin addict has changed very much to that of an 18- to 25-year-old surfer kind of guy,” said Susan Bower, a San Diego County health official who noted the shift there a few years ago.

And the prescription painkiller has become the new gateway drug to heroin use, eclipsing marijuana, cocaine and alcohol, the study found. People addicted to narcotic painkillers are 40 times more likely to misuse heroin, it reported.

At the same time, Frieden said, the flow of cheap heroin from Mexico has surged, offering users a ready supply of an inexpensive substitute to prescription painkillers.

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“It’s really a one-two punch,” he said. “Those two factors are driving the increase and will drive the strategies we need to turn this around.”

Frieden called for a series of responses, including a crackdown on heroin, more treatment and more judicious prescribing. “For prescription opiates, the risks are very palpable,” he said. “A few doses and someone can have a life of addiction. A few pills too many and someone can die of an overdose.”

The findings offer a glimpse into the “real devastation the epidemic is causing to communities across the country,” Frieden said.

One affected area is Ventura County, where heroin-involved deaths more than doubled between 2009 and 2012 to 43. But in 2013, heroin deaths retreated, while deaths involving prescription painkillers jumped to 69. The shift coincided with a law enforcement push against heroin trafficking and may be further evidence of the interchangeability of legal and illegal drugs.

“You work one side of the problem, but then you see a ballooning on the other side,” said Patrick Zarate, who manages alcohol and drug programs for Ventura County. “We will probably continue to see a bit of back and forth over time.”

Simi Valley, on Ventura County’s eastern edge, is emblematic of the tandem crisis of pills and heroin. Austin Klimusko was one of several young overdose victims whose deaths brought the community to Cornerstone Church in 2012. Less than a week after his funeral, another family was planning a service for a daughter. And Austin, 23, was buried in the same cemetery as another victim who died at 21.

At his funeral, the Rev. Pat McCoy summed up the devastation.

“All of us, everyone sitting in this room has been affected by what happened,” McCoy said. “We don’t want that to keep happening. This is the fourth time I’ve done this in the last eight months. And I don’t want to do it anymore.”

Austin’s death illustrates heroin’s new reach. He grew up in a comfortable ranch home with a swimming pool and three dogs. He hung out with his older brother and the boys in the neighborhood. He liked to make them laugh. He loved Harry Potter books. He was enrolled in gifted classes. His mother is a hospital nurse; his father owned an electronics manufacturing plant. The family traveled to Mexico and Europe, and enjoyed skiing and fishing.

After high school, Austin moved to San Diego with friends. Susan Klimusko realized that her son had a serious drug problem when he accidentally “pocket dialed” her one night and she overheard him pressuring a friend to take drugs. She demanded he move back home in the belief that she could help him stop. Instead, he found a new supplier for his oxycodone habit, a medical clinic in Reseda.

“It just got worse and worse and worse,” she recalled. “He was a walking zombie.”

His parents convinced him to check into the Malibu Beach Recovery Center on his 21st birthday. He stayed sober, working in his father’s plant, for more than a year. But then, he slipped. Before long, Susan Klimusko said, he was spending his entire paycheck on prescriptions for oxycodone and other pills. At some point, he switched to heroin, pawning family valuables for cash. His parents locked their wallets in a safe when they went to bed.

His parents pleaded with Austin to give rehab another try. He agreed, driving himself to a facility in Bakersfield. “We were so hopeful,” Susan Klimusko said.

Sober for almost 90 days, Austin came home for Christmas, hung out and exchanged gifts. His parents gave him a purple and gold Lakers’ Snuggie. Austin headed back to Bakersfield, where he had a new job and a new girlfriend. It looked like a fresh start. But a few days later, he was dead of a heroin overdose.

Charts showing number of overdose deaths from various drugs. Tribune News Service

Charts showing number of overdose deaths from various drugs. Tribune News Service

Susan Klimusko viewed her son’s addiction as a battle that she lost. But she hasn’t stopped fighting a bigger war. Beginning with her son’s eulogy, she has been working to help other families struggling with addiction. She consoles grieving mothers and she counsels addicts who end up in the hospital where she works.

“Healing from heroin is a very long process,” she tells them. “I say, ‘I’m a mom. I lost my kid. I understand.'”

Photo: Susan Klimusko spent hours pouring through her son Austin’s phone logs and texts following his final moves before dying of a heroin overdose. This self-portrait is one of the last he took before passing away. He was 23. His opiate addiction began with prescription narcotics, according to his mother. Originally sent to his girlfriend, his mother says this picture now serves as a symbolic goodbye kiss to all his friends, family and loved ones.  (Liz O. Baylen/Los Angeles Times/TNS)

When Paying Cash For A Prescription Is Cheaper Than Using Insurance

When Paying Cash For A Prescription Is Cheaper Than Using Insurance

By Steve Twedt, Pittsburgh Post-Gazette (TNS)

PITTSBURGH — Charles Conn stopped in to see his pharmacist to fill a prescription for a cough that had persisted for a month. Once he saw how much the medication cost, he could have used a side order of blood pressure pills.

The price, under his insurance plan, was $91 for 30 nonnarcotic Benzonatate gel caps.

“I told him, ‘I’m not paying it,'” the Baldwin resident said.

Ninety-one dollars isn’t the most expensive prescription medication sold in a pharmacy, but for a retiree on a fixed income, it’s not a payout to be taken lightly.

Luckily, the pharmacist had flagged the prescription and was able to sell the medication for $26.10 in cash.

Conn, 66, happily paid the lower price but the episode left him wondering: Why would a prescription cost nearly four times more through his insurance plan than paying cash?

The answer may lie in the vagaries of pharmaceutical pricing, which include the wholesale prices that hardly anyone pays and the largely unseen influence of third-party pharmacy benefit managers.

In Conn’s case, there was an immediate hurdle he didn’t recognize at first: Medicare Part D, the prescription drug coverage for seniors, does not cover cough suppressants and Benzonatate was not in his plan’s formulary of covered medicines. That meant he could not take advantage of any discount negotiated by his insurer, UPMC for Life.

That still didn’t explain why the gel caps cost much more through his insurance.

Tom Tritinger, a pharmacist at Conn’s pharmacy, said it probably has to do with a price set by the wholesaler that is rarely charged to the patient.

“I can’t even tell you what goes into setting that price,” he said, adding that usually, the pharmacist “would have managed that down” to a lower price or, absent that, charged a lower price anyway.

“With most pharmacists, the price is a courtesy. There is some compassion,” he said.

His advice: Check ahead to see if a new medication is covered under your insurance; ask to speak to a pharmacist if the price seems high; and, if practical, shop around if you’re unhappy with a pharmacy’s price.

UPMC for Life literature also suggests checking with its staff to see if a similar drug is covered under its plan when the prescribed drug is not in its formulary.

The insurer’s members can request the plan to cover a drug not in its formulary “at a pre-determined cost-sharing level,” although such exceptions generally are not granted unless alternative medications would not be as effective or could cause adverse side effects.

Pat Eppel, executive director of the Pennsylvania Pharmacists Association in Harrisburg, said a pharmacy benefit manager — typically a third party that manages prescription benefits for an insurer — also may be telling a pharmacy what to charge for a medication.

“No one sees exactly how much the (Medicare) Part D plan is billing the government,” she said.”A lot of pharmacists believe that the government is paying far more than they need to.”

Looking back, Conn’s wife, Christine, said they are is still “flabbergasted” by the price difference and now wonder if they should ask for the cash price every time.

Tritinger said that’s probably not necessary. “Ninety-nine percent of the time they’re going to get a better price through the insurance company.”

Photo: Charles Conn, of Baldwin, Pa., was told a prescription for his cough medicine would cost $91 under his insurance plan, but paying out of pocket would only be $26. (Robin Rombach/Pittsburgh Post-Gazette/TNS)