pharmaceutical

Benzo Update 02.25.18

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Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67 percent, from 8.1 million to 13.5 million. Unlike opioid prescribing, which peaked in 2012 and has decreased nearly 20 percent since then, benzodiazepine prescribing continues to rise. The risk of overdose death goes up nearly fourfold when benzodiazepines are combined with opioids, yet rates of co-prescribing benzodiazepines and opioids nearly doubled between 2001 and 2013. Overdose deaths involving benzodiazepines increased more than sevenfold between 1999 and 2015.

Anna Lembke, M.D., is associate professor of psychiatry and behavioral sciences at the Stanford University School of Medicine, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and author of “Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop” (Johns Hopkins University Press, 2016).

You can read the full article here.

Gabapentin Misuse and Abuse

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Last December, Ohio’s Board of Pharmacy began reporting sales of gabapentin prescriptions in its regular monitoring of controlled substances. The drug, which is not an opioid nor designated a controlled substance by federal authorities, is used to treat nerve pain. But the board found that it was the most prescribed medication on its list that month, surpassing oxycodone by more than 9 million doses. In February, the Ohio Substance Abuse Monitoring Network issued an alert regarding increasing misuse across the state.

A literature review published in 2016 in the journal Addiction found about a fifth of those who abuse opiates misuse gabapentin. A separate 2015 study of adults in Appalachian Kentucky who abused opiates found 15 percent of participants also misused gabapentin in the past six months “to get high.”

In the same year, the drug was involved in 109 overdose deaths in West Virginia, the Charleston Gazette-Mail reported.

Read the article.

Now slowly focus on the following sentences:

Gabapentin can enhance the euphoria caused by an opioid and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery.

Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

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Conclusions: Treatment with rosuvastatin at a dose of 10 mg per day resulted in a significantly lower risk of cardiovascular events than placebo in an intermediate-risk, ethnically diverse population without cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; HOPE-3 ClinicalTrials.gov number, NCT00468923.)

Source: Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

Source: Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

Source: Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease — NEJM

FDA Stiffens Warning on NSAID Cardiovascular Risk | Medpage Today

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FDA Stiffens Warning on NSAID Cardiovascular Risk | Medpage Today.

Thought I would add a link to the actual FDA alert.

via Safety Alerts for Human Medical Products > Non-aspirin Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Drug Safety Communication – FDA Strengthens Warning of Increased Chance of Heart Attack or Stroke.

NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.

PCSK9 Inhibitors

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There’s also the issue of cost. The medicines are expected to come with a price tag of $7,000 to $12,000 per patient per year, according to the Wall Street Journal’s Pharmalot blog, costing the US health system as much as $23 billion a year. “These injectable drugs are already viewed by payers as potential budget busters along the lines of treatments for hepatitis C and some cancers,” Ed Silverman wrote.

via There’s still a lot we don’t know about the new cholesterol-lowering drugs – Vox.