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NCADD Affiliate Executive Director Featured in TEDx Event

NCADD Affiliate Executive Director Featured in TEDx Event

 

In September of 2017, Oneonta, NY hosted its first TEDx event with the theme of "Tipping Point."

Among the inaugural group of TEDx speakers was Julie Dostal, Executive Director of the Otsego County Affiliate in Oneonta and an NCADD Board Member. The title of her talk was "Expendable People" as a way to bring light to the real human impact of policy decisions related to addictive substances. Her hope was to "tip" the culture toward an understanding of the public health implications of economic strategies built on the likes of alcohol, marijuana, and gambling.

In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience.

At a TEDx event, TED Talks video and live speakers combine to spark deep discussion and connection. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.

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Criminal Justice System Could Play Key Role in Better Treatment for Opioid Addiction

Criminal Justice System Could Play Key Role in Better Treatment for Opioid Addiction

A new study published in the December issue of Health Affairs, found that just 5 percent of people referred for opioid addiction treatment by the U.S. criminal justice system receive the best treatment, according to HealthDay.

In contrast, the study found that 40 percent of people referred for opioid addiction treatment by other sources – including health care providers, employers or themselves – were treated with medication.

Medications such as methadone and buprenorphine are considered the most effective way to treat opioid addiction, said researchers from the Johns Hopkins Bloomberg School of Public Health. They help control withdrawal symptoms and cravings that can lead to relapse and they reduce the risk for overdose.

The low rate of referrals for treatment medication among people in the criminal justice system highlights a missed opportunity to connect the people at the highest risk for opioid addiction with effective treatment, the researchers noted.

Their findings stem from an analysis of about 72,000 adults admitted for the first time to a treatment program for opioid abuse. This included more than 17,000 people referred by police, judges, prosecutors, probation officers or others in the local, state or federal criminal justice system.

Original linkOriginal author: Ezra
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Surgeons Try Prescribing Fewer Opioids to Combat Addiction Risks

Surgeons Try Prescribing Fewer Opioids to Combat Addiction Risks

NPR reports that a group of surgeons at the University of Michigan has devised an approach that could lead to significant changes in how opioids are prescribed and help curb the nation’s opioid epidemic – prescribing fewer opioids after surgery.

Their findings were published this week in the journal, JAMA Surgery.

The group of surgeons suggests that to lower the risk of opioid addiction, surgeons should prescribe patients fewer painkillers after surgery — a critical time when many people are first introduced to what can be highly addictive opioid medications. They should also talk with patients about proper use of opioids and the associated addiction risks.

The researchers identified 170 post-surgery patients and surveyed them within a year of their gallbladder operations, inquiring about how many pills they actually used. They employed the findings to create new hospital guidelines that cut back on the standard opioid prescription for gallbladder surgeries.

They then analyzed how patients fared under the new approach, tracking 200 surgery patients who received substantially fewer prescribed painkillers and found that despite getting less medication, patients didn’t report higher levels of pain.

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Deaths During Opioid-Related Hospital Stays in U.S. Quadrupled

Deaths During Opioid-Related Hospital Stays in U.S. Quadrupled

A new study released earlier this week confirms that deaths in opioid-related hospital stays in the U.S. have quadrupled between 1993 and 2014, PBS NewsHour reports.

Zirui Song, an assistant professor of health care policy at Harvard Medical School and a physician at Massachusetts General Hospital, launched the study in 2016 in an effort to gain a better understanding of the patients he treated.

Dr. Song analyzed nearly 385,000 hospital stays involving patients who were admitted for opioid use with data from the National Inpatient Sample of the Healthcare Cost and Utilization Project, a national database compiled by the Agency for Healthcare Research Quality.

His research confirmed that by 2014, four times as many patients died from opioid-related causes while staying in the hospital, rising from 0.43 percent before 2000 to 2.02 percent.

Over the same time period, the study also found that patients admitted to the hospital for opioid use skewed younger — the average age was 39 years old — and were more likely to be Caucasian. The number of black and Hispanic patients admitted to hospitals for opioid or heroin use remained relatively stable.

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Why is America Addicted to Opioid Pain Relievers?

Why is America Addicted to Opioid Pain Relievers?

Opioid medications, sometimes known as pain relievers, are the most widely prescribed class of drugs worldwide.

While the United States represents about five percent of the world’s population, it consumes 80 percent of the global opioid supply. Not surprisingly, the U.S. is also suffering from the most severe opioid addiction and overdose crisis it has ever experienced. But, this didn’t happen overnight. Several factors contributed to the unprecedented use – and misuse – of opioids in this country.

A Dramatic Increase In The Supply Of Prescription Pain RelieversIn 1998, state medical boards changed the laws governing opioid prescriptions. Instead of limiting the use of opioids to treat severe cancer-related pain – which had consistently been the case before – they began allowing the prescription of opioids to treat moderate, non-cancer pain. This meant that people with back injuries, broken bones, toothaches and other ailments could now receive powerful opioids, dramatically expanding the medication’s supply.

In the same year, the pharmaceutical company Purdue Pharma, received government approval to market OxyContin, a powerful opioid medication, as a “minimally addictive” prescription opioid. The company claimed that less than one percent of people would become addicted to the drug despite little evidence to support this claim.To promote OxyContin, Purdue Pharma pursued aggressive marketing strategies, spending over $200 million in 2001 alone. It also directly targeted doctors across the country with campaigns that misrepresented the safety of its product.

Between 1996 and 2000, sales of OxyContin increased from $48 million to $1.1 billion. From 1997 to 2002, OxyContin prescriptions increased tenfold. In 2003, approximately half of all OxyContin prescriptions came from primary care physicians, as opposed to oncologists, surgeons or other specialists who treat people with severe conditions. By 2004, OxyContin was the leading misused drug in the U.S.

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Alcohol: America’s #1 Addiction Problem

Alcohol: America’s #1 Addiction Problem

More than two million Americans are addicted to opioids, ranging from the illegal drugs heroin and fentanyl to the prescription medications OxyContin and Vicodin, yet eight times as many people misuse or are addicted to a substance that is more widely available and easier to access. This substance is alcohol. Despite the fact that it has largely retreated from public consciousness in the context of the current opioid epidemic, research shows that rates of alcohol misuse and addiction are on the rise.

The Rates Continue To ClimbRecent reports indicate that nearly 16 million people ages 12 and older have an alcohol use disorder (AUD), better known as alcohol addiction. This represents an almost 50 percent increase from figures reported just 10 years prior.Additionally, the number of people who engage in high-risk drinking (more than five drinks at a given time for men, four for women) increased by nearly 30 percent over this same 10 year period.

The Damaging EffectsAlcohol addiction and high-risk drinking have an immense impact on society, from both a financial and personal perspective. Alcohol-related problems, such as health care costs, lost productivity and car crashes, cost society an estimated $250 billion each year. Moreover, approximately 88,000 people die each year from alcohol-related causes. That is 55,000 more people than died from an opioid overdose in 2015.

The Sobering TruthWhile the opioid epidemic should not be ignored, it is important to remain aware of the tremendous toll alcohol misuse and addiction have on our society. Addiction in any form is a big problem in America, requiring a big solution. Furthermore, people with addiction are likely to misuse multiple addictive substances, such as alcohol and opioids, often resulting in even more destructive consequences such as a heightened risk for depression or overdose.

Ultimately, there are too many families affected by addiction, regardless of the drug involved, and each deserves support, attention and the allocation of sufficient resources to ensure that every person with addiction gets the help he or she needs.

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Millennials and Baby Boomers Hardest Hit by Opioid Epidemic

Millennials and Baby Boomers Hardest Hit by Opioid Epidemic

Millennials and Baby Boomers appear to be the age groups hardest hit by the opioid crisis, doctors at Columbia University conclude.

Millennials (people in their 20s and 30s) have higher death rates from heroin than other age groups, while Baby Boomers (those born between 1946 and 1964) have higher rates of death from both prescription opioids and heroin, the researchers report in the American Journal of Public Health.

The study found Baby Boomers were up to 27 percent more likely to die of a prescription opioid overdose, compared with people born in the late 1970s, HealthDay reports. They were up to one-third more likely to die of a heroin overdose.

Millennials were 23 percent more likely to die of a heroin overdose compared with those born in the late 1970s.

Original linkOriginal author: Ezra
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Understanding the Difference between Physical Dependence and Addiction

Understanding the Difference between Physical Dependence and Addiction

In a recent hearing before Congress, the Food and Drug Administration (FDA) Commissioner Scott Gottlieb spoke about the devastating impact of the opioid epidemic and what his agency is doing to address it.

While Dr. Gottlieb is not the first to note the massive scale of this crisis, he did bring up one often-overlooked component of its much-needed solution – distinguishing between an opioid addiction and a physical dependence on opioids. Although frequently conflated, differentiating between these two conditions is essential to break the stigma associated with what has proven to be the most effective form of opioid addiction treatment: medication-assisted treatment (MAT) – a treatment approach that combines the use of medications such as methadone and buprenorphine with behavioral counseling.

To make progress in ending the opioid epidemic and help people with addiction, families, health professionals and policymakers must understand and appreciate the important difference between physical dependence and addiction, and acknowledge that medication is an essential part of the solution to this crisis.

But What Exactly Is The Difference Between Physical Dependence And Addiction?As Dr. Gottlieb pointed out, and as described in our report, Addiction Medicine: Closing the Gap between Science and Practice, physical dependence is not the same as addiction. Physical dependence occurs when the brain adapts to the effects of a drug and develops tolerance. In other words, an individual will require more and more of the drug to achieve the initial positive effect and will rely on continued use of the drug to prevent painful and uncomfortable withdrawal symptoms.

Opioids, even when used as directed, can cause physical dependence. This can also be the case for other medications that the body and brain adjust to and come to depend on in order to maintain normal function. However, if misused -- either by taking a larger amount than prescribed, for a longer time than prescribed, or for non-medical purposes – opioids, can lead to addiction, a disease that interferes with, rather than maintains, normal functioning.

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Over 1.6 Million Could Die From Drugs, Alcohol and Suicide Over Next Decade: Report

Over 1.6 Million Could Die From Drugs, Alcohol and Suicide Over Next Decade: Report

More than 1.6 million Americans could die from drugs, alcohol and suicide over the next decade, a new report concludes.

USA Today reports the findings come from the Trust for America’s Health and the Well Being Trust.

The nonprofit group found in 2015, there were 39.7 deaths per 100,000 U.S. residents due to drugs, alcohol and suicide, compared with 23.1 deaths per 100,000 in 1999—a 72 percent increase. That number could rise to 56 deaths per 100,000 by 2025, the group said.

“We see a connection among the three epidemics,” said John Auerbach, President and CEO of the Trust for America’s Health. “They are all behavioral health-related — that is, they have a substance abuse or mental health diagnosis associated with them.”

Original linkOriginal author: Ezra
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Are Teens with Opioid Addiction Getting the Treatment They Need?

Are Teens with Opioid Addiction Getting the Treatment They Need?

Today’s opioid crisis knows no boundaries, especially when it comes to age.

The National Institute on Drug Abuse found that “prescription and over the counter drugs [including prescription opioids] are among the most commonly abused drugs by 12th graders, after alcohol, marijuana, and tobacco.” Over the past 15 years, the number of children and teens hospitalized due to opioid poisoning has nearly doubled and it has been widely cited that most adults in treatment for opioid addiction started using illicit substances before the age of 18. These statistics make it clear that there is a need to effectively identify and treat addiction to opioids among young people in order to prevent the consequences of this disease from following them into adulthood, or worse — cutting their lives short.

Unfortunately, young people are not receiving the opioid use disorder (OUD) treatment path most strongly recommended by the American Academy of Pediatrics: medication-assisted treatment (MAT). While MAT, which relies on medications to regulate the body’s response to opioids, in combination with counseling and detoxification, has been shown more effective in helping young people sustain their addiction recovery than detoxification and counseling alone, it is highly underutilized due to stigma and barriers in the healthcare system.

Boston University Medical Center researchers found that, “only one in four [young adults ages 13 to 25 diagnosed with OUD]… are receiving potentially life-saving medications for addiction treatment.” These numbers become even more troubling when you take a deeper dive; fewer than 1 in 10 teens aged 16 – 17 and 1 in 50 teens aged 13 – 15 received the addiction treatment medications that could have a significant impact on the success of their recovery.

This disparity can be attributed, in part, to the fact that less than three percent of all U.S. physicians have obtained the waivers necessary to prescribe buprenorphine – one of the few medications used in MAT – and of those physicians, only one percent are pediatricians. Additionally, some physicians may refrain from offering MAT to their adolescent patients because there is a lack of data showing the long-term impact it has on this age group. A lack of data also explains why the Food and Drug Administration (FDA) has only approved buprenorphine for use by those aged 16 and older, despite a demonstrated need for effective, evidence-based addiction treatment options for younger teens.

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Kellyanne Conway Will Oversee White House Response to Opioid Epidemic

Kellyanne Conway Will Oversee White House Response to Opioid Epidemic

White House counselor Kellyanne Conway will lead the White House response to the opioid epidemic, U.S. Attorney Jeff Sessions announced.

Sessions said Conway will be charged with helping change the perception about opioids and reducing addictions and deaths, Newsweek reports.

Conway, a lawyer, has no formal experience in drug policy or law enforcement, the article notes.

Before working for the Trump Administration, she had her own polling company.

Conway has promoted prevention programs as a way to combat drug use. In October, Conway told Fox News, “The best way to stop people from dying from overdoses and drug abuse is by not starting in the first place. That’s a big core message for our youth.”

Original linkOriginal author: Ezra
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60 Percent of People Who Die From Opioid Overdose Suffer Chronic Pain

60 Percent of People Who Die From Opioid Overdose Suffer Chronic Pain

A study of people who die from opioid overdoses found just over 60 percent suffer from chronic pain, HealthDay reports.

Many also struggle with anxiety or depression, the researchers report in the American Journal of Psychiatry.

The study included medical records of more than 13,000 adults who died from an opioid overdose between 2001 and 2007.

“The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems,” said lead investigator Dr. Mark Olfson of Columbia University Medical Center.

Original linkOriginal author: Ezra
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Significant Inequalities Between Mental and Physical Health Payments Uncovered

Significant Inequalities Between  Mental and Physical Health Payments Uncovered

Medical and surgical healthcare providers are receiving significantly higher payments from insurers than addiction and mental health practitioners for the same types of services, finds a groundbreaking, independent report published by Milliman, Inc. and released by a coalition of America’s leading mental health and addiction advocacy organizations including the Legal Action Center.

In the Milliman report, commissioned by the Bowman Family Foundation, researchers found that along with payment disparities, which occur in 46 out of 50 states, “out-of-network” use of addiction and mental health treatment providers by consumers is extremely high when compared to medical and surgical providers.

This perfect storm of factors reveals that patients are being forced into more costly out-of-network care, and can mean that treatment is abandoned altogether.

When taken together, the analysis paints a stark picture of restricted access to affordable and much-needed addiction and mental health care in an era of escalating suicide rates and opioid overdose deaths. Further, these disparities point to potential violations of federal and state parity laws, which require insurance companies to treat diseases of the brain, such as clinical depression and opioid addiction, the same way they treat illnesses of the body, such as cancer and heart disease.

One of the most dramatic disparities outlined in the report is the low reimbursements paid to behavioral health providers when compared to physical health providers – a factor likely influencing network access and overall practitioner shortages.

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SAVE THE DATE: Join us December 14 for a Twitter Chat about Women and Alcohol

SAVE THE DATE:  Join us December 14 for a Twitter Chat about Women and Alcohol

Why are drinking guidelines different for women than men? How do the health effects of heavy drinking differ? Where can women turn for help if they have an alcohol problem?

The National Council on Alcoholism and Drug Dependence (NCADD) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) are partnering for a Twitter Chat on women and alcohol. Bring your questions for NCADD and NIAAA experts as we discuss what women need to know about alcohol and their health.

Date: Thursday, December, 14, 1:00-2:00 pm ETHashtag: #FAQWomenDrinkingNCADD Expert: Julie Dostal, PhD, Executive Director, LEAF Council on Alcoholism and Addictions, Oneonta, NY and NCADD Board MemberNIAAA Expert: Deidra Roach, MD, NIAAA Medical Project OfficerOriginal linkOriginal author: Ezra
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SAMHSA Releases Resource on Preventing Opioid Overdose

SAMHSA Releases Resource on Preventing Opioid Overdose

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a resource titled “Preventing Opioid Overdose: Understanding Good Samaritan Laws”.

This resource provides an overview of this overdose prevention strategy, including the aims of these laws and types of protections they can offer.

Overdose Good Samaritan laws are policies that provide legal protections for individuals who call for emergency assistance (such as 9-1-1) in the event of a drug overdose. This may include protection from arrest and/or prosecution for crimes related to drug possession, drug paraphernalia possession, and other crimes. These laws are designed to encourage people to summon emergency assistance if they experience or witness a drug overdose.

As of July 2017, 40 states and the District of Columbia have instituted Good Samaritan laws. Yet, lack of awareness and understanding of the protections these laws provide, as well as concerns about their limitations, may be limiting their effectiveness in encouraging overdose bystanders to call for help. These barriers may also prevent the criminal justice system from fully observing them.

The resource further outlines some of the obstacles that prevent overdose bystanders and the criminal justice system from applying their state’s Good Samaritan laws, and steps prevention practitioners can take to raise awareness of these laws among various target populations.

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Cost of Opioid Crisis Estimated at $504 Billion by the Council of Economic Advisers

Cost of Opioid Crisis Estimated at $504 Billion by the Council of Economic Advisers

The Council of Economic Advisers (CEA) recently announced that the opioid drug problem has reached crisis levels in the United States—in 2015, over 33,000 Americans died of a drug overdose involving opioids.

CEA finds that previous estimates of the economic cost of the opioid crisis greatly understate it by undervaluing the most important component of the loss—fatalities resulting from overdoses.

The CEA report estimates the economic cost of these deaths using conventional economic estimates for valuing life routinely used by U.S. Federal agencies. It also adjusts for underreporting of opioids in overdose deaths, includes heroin-related fatalities, and incorporates nonfatal costs of opioid misuse.

CEA estimates that in 2015, the economic cost of the opioid crisis was $504.0 billion, or 2.8 percent of GDP that year. This is over six times larger than the most recently estimated economic cost of the epidemic.

Copy of the full report is available here.

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Separating Side Effects Could Hold Key for Safer Opioids

Separating Side Effects Could Hold Key for Safer Opioids

NIH-funded scientists may have revealed brain functions in pre-clinical research that widen the safety margin for opioid pain relief without overdose

Opioid pain relievers can be extremely effective in relieving pain, but can carry a high risk of addiction and ultimately overdose when breathing is suppressed and stops. Scientists have discovered a way to separate these two effects -- pain relief and breathing -- opening a window of opportunity to make effective pain medications without the risk of respiratory failure. The research, published today in Cell, was funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Opioid medications suppress pain by binding to specific receptors (proteins) in the brain; these same receptors also produce respiratory suppression. However, the way these receptors act to regulate pain and breathing may be fundamentally different. Studies using mouse genetic models suggest that avoiding one particular signaling pathway led to more favorable responses to morphine (pain relief without respiration effects). The investigators then explored if they could make drugs that would turn on the pathways associated with pain relief and avoid the pathways associated with respiratory suppression.

"We are pleased to have uncovered a potential new mechanism to create safer alternatives to opioid medications, ones that would be far less likely to cause the side effects that lead to overdose deaths associated with the misuse of opioids," said NIDA Director Nora D. Volkow, M.D. "We are excited that basic research on how opioid drugs work in the brain has led to this novel approach, and that we continue to make critical progress in this area."

How the pathways split following receptor activation is referred to as biased signaling. The study showed that as the degree of bias (divergence) increased, so too did the ability of an opioid to reduce pain in mice without affecting breathing. Similarly, compounds that favor the breathing pathway produced more respiratory side effects at lower doses. Ultimately, opioids with a larger divergence (bias factor) had a larger margin of safety, or therapeutic window, opening up an opportunity for medication intervention.

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Some Experts Question Opioid Commission’s Marijuana Warning

Some Experts Question Opioid Commission’s Marijuana Warning

The chair of President Trump’s Opioid Commission warned about the dangers of marijuana, in a letter accompanying the release of the commission’s final report.

Some experts are questioning the commission’s view that marijuana could further fuel the opioid crisis.

New Jersey Governor Chris Christie, the chair of the commission, warned against legalizing marijuana in the midst of the opioid epidemic.

One researcher, Dr. Chinazo Cunningham, a professor of medicine at the Albert Einstein College of Medicine, told CNN she is surprised to see negative language about marijuana in the opioid report. “Research that examines pain and marijuana shows that marijuana use significantly reduces pain,” she said. “In addition, the majority of studies examining marijuana and opioids show that marijuana use is associated with less opioid use and less opioid-related deaths.”

Dr. Cunningham is conducting the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV.

Original linkOriginal author: Ezra
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Long-Acting and Daily Medications to Treat Opioid Addiction Found Equally Effective

Long-Acting and Daily Medications to Treat Opioid Addiction Found Equally Effective

A new study finds a long-acting medication and a short-term drug that must be taken daily are equally effective in treating opioid addiction.

Researchers at NYU Langone Health found extended-release naltrexone (Vivitrol) was as safe and effective as more commonly prescribed buprenorphine-naloxone (Suboxone) in curtailing opioid use, relapse, treatment drop-out, and overdose.

The study, which was sponsored by the National Institute on Drug Abuse, was published in The Lancet.

The study is the first major head-to-head comparison of the treatments, according to The Washington Post. Researchers found each treatment had disadvantages. Short-acting medicines must be taken daily for years or even a lifetime. Naltrexone, which is given as a monthly injection, cannot be started until a person is fully detoxified from opioids—which more than 25 percent of the study subjects failed to do.

More than half of the study subjects relapsed at least once, regardless of which treatment they received.

Original linkOriginal author: Ezra
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DEA Rule Allows Criminal Prosecution for Fentanyl Trafficking

DEA Rule Allows Criminal Prosecution for Fentanyl Trafficking

The Drug Enforcement Administration (DEA) will classify illicit versions of fentanyl at the same level as heroin, Reuters reports.

The action will make it easier for federal prosecutors and agents to prosecute traffickers of all forms of fentanyl-related substances, the agency said.

Legally prescribed fentanyl is classified as a Schedule II drug, which means it is highly addictive but has a medical purpose.

The new DEA order classifies illicit fentanyl as a Schedule I drug, along with heroin. Schedule I drugs are considered addictive, with no medicinal purpose.

The DEA order will last up to two years, with a possibility of a one-year extension if certain conditions are met. In a statement, Attorney General Jeff Sessions said, “By scheduling all fentanyls, we empower our law enforcement officers and prosecutors to take swift and necessary action against those spreading these deadly poisons. I also urge the many members of Congress who clearly share our concern and alarm over fentanyl’s role in our opioid overdose epidemic to do their part by permanently scheduling these lethal substances.”

Original linkOriginal author: Ezra
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