According to this Drugs.com report, there may be an alternative. Remoxy has been suggested by Pain Therapeutics Inc. as a safe alternative. The company claims Remoxy is more difficult to abuse, even among those with a history of abusing pain medications.

Remoxy was reported as less enjoyable than OxyContin by those with a history of prescription drug addiction and abuse. These individuals did not like the drug as quickly and claimed they could not chew the drug for any length of time due to its unpleasant texture and taste.

Research results such as these could help the company receive approval for Remoxy. Regulators request data proving that new drugs to treat chronic pain are less likely to be abused than OxyContin, made by Purdue Pharma LP.

A trial to test the effectiveness and abuse potential of Remoxy included 45 adults, each of whom had used opioid drugs at least five times in the past year to achieve a high. The study also focused on a comparison between Remoxy, OxyContin and a placebo. Reportedly, none of the participants were able to chew on the Remoxy tablet longer than 90 seconds.

The active ingredient in these painkillers is oxycodone, a substance one can access all at once by simple crushing or dissolving the pill. To make it harder to abuse OxyContin, Purdue Pharma has reformulated the drug, while competitors continue to seek approval for pain medications more resistant to abuse.

The public’s perception of substance abuse addicts is demeaning. Addicts are called names like "junkie", "stoner" or "drunk". Very seldom do you see someone with depression degraded with such a hated label.

Society’s acceptance of mental illnesses has come a long way and openly talking about PTSD or anxiety is now more commonplace. But those suffering from other mental illnesses, like prescription-drug addiction, are thrown to the side and accused of deciding their own fate. Mental health experts are now arguing that there is not difference.

The recent financial crisis is suggested to be at the root of the problem for addiction. However, the article doesn’t recognize that the misuse of prescription drugs can be directly linked to complete disregard of mental illness.

Troubles with depression and anxiety are easily explained to be triggered by adverse affects of a person’s environment, and addiction works in much of the same way. Many individuals began self-medicating which is how they are introduced to prescription painkillers. They use these pills in stressful situations, called maladaptive coping mechanism. This is where the person can become hooked and so goes the story of the drug addict.

The problem is so persistent in Ohio that a story in the New York Times recently pointed out how bad the prescription drug epidemic has hit suburbia. The writings of Sabrina Tavernise illustrate the staggering number of young people who have lost their lives to addiction.

Scioto County sees nearly one in ten babies born testing positive for drugs. Overdoses in the entire state have surpassed car accident death totals. Across the country, addiction of prescription drugs is taking more lives than crack cocaine did in the 1980s and heroin in the 1970s combined.

A report from the Substance Abuse and Mental Health Services Administration (SAMHSA) says that visits to hospital emergency rooms due to misuse of carisoprodol have more than doubled from 15,830 visits in 2004 to 31,763 visits in 2009 (the most recent year for which statistics are available).

The federal report went on to say that during the time of its investigation, people making ER visits for misuse of carisoprodol had often combined it with other drugs. In fact, 77 percent of such visits involved at least one more drug besides carisoprodol. The figures were as follows:

• 18 percent of ER visits were for misuse of carisoprodol only
• 25 percent of ER visits involving carisoprodol included misuse of a second medication
• 33 percent of visits involved misuse of two additional drugs
• 12 percent of visits included four or more drugs besides carisoprodol
• 12 percent of hospital visits related to carisoprodol also involved misuse of alcohol

Prescription painkillers were the drugs most often taken in combination with carisoprodol (55 percent of visits), followed by benzodiazepines which includes tranquilizing drugs such as Valium and Xanax (47 percent of visits). Furthermore, 35 percent of all ER visits relating to carisoprodol ended up in patients being hospitalized.

Though the SAMHSA report records that carisoprodol-related ER visits were made by people of all ages, the worst offenders were those over age 50 whose visits were three times as many (2,100 in 2004 vs. 7,100 in 2009) while patients ages 35 to 49 doubled their trips to the hospital (6,300 in 2004 vs. 12,000 visits in 2009).

It may not be surprising that the demographic being prescribed carisoprodol is most heavily represented by those over age 35, since muscles are more injury-prone as we age. Some have suggested that patients who experience muscle injury and take carisoprodol to treat pain find the medication provides unforeseen fringe benefits. Passing through the liver, carisoprodol is broken down into chemicals useful in reducing anxiety. It is therefore likely that patients enjoy the calmness and restful sleep produced by the drug and continue taking it beyond the range of its intended prescription.

The increase in hospital ER visits involving carisoprodol is another sign that the public is moving away from abuse of illicit drugs in favor of misuse of prescription medications. Prescription drugs may seem like "safe" drugs, but the emphasis should be on the word drugs rather than on the adjective safe. Drugs are a serious matter, even more so when taken in combination with alcohol or other drugs. The federal report has not named this an epidemic but does point out that the numbers of carisoprodol-involved hospital visits is a significant and increasing figure.

Federal agencies watching these trends have yet to make carisoprodol a controlled substance but are quick to point out that it is a drug and, as with all drugs, should be taken with careful attention to the parameters of its prescription use. Physician monitoring, proper storage and destruction of unused pills by patients, and warnings from ER staff regarding mixing medications are a few practical steps which can be taken to stem the tide of the drug’s misuse.

Zolpidem is the generic name for Ambien, a prescription-only sleep aid that is used to combat insomnia but is intended to be taken for no more than a few days to a couple of weeks. The drug is categorized as a nonbenzodiazepine hypnotic that is fast acting (i.e., can put you to sleep within 15 minutes) and typically lasts about four to six hours. Ambien does work much like a benzodiazepine, however, which is a type of drug used to treat anxiety and relax muscles or as a sedative, hypnotic, and anticonvulsant. The drug mimics GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter, by binding to the GABA receptors much like benzodiazepines. Although Ambien does not do a great job of keeping you asleep, it does do a great job of getting you there.

Although Ambien is meant to help the body get back on a regular sleep cycle, prolonged use of the drug can increase a patient’s tolerance, necessitating increasing amounts of Ambien to effectuate sleep. Further, drinking alcohol along with Ambien can multiply the drug’s effects. Those who are under the influence of Ambien may take more of the drug than is warranted because they do not remember that they have already had a dose.

When a patient is first prescribed Ambien, he may exhibit symptoms that resemble a drug-induced psychosis. This psychotic behavior may continue until his body becomes acclimated to the drug. If the symptoms are strong enough, antipsychotics may need to be prescribed in order to counter-act the psychotic behavior and effectuate sleep. However, because both Ambien and anti-psychotics can have hypnotic effects, doctors may prefer to prescribe a light sedative, such as an anti-depressant, to balance out the Ambien.

Patients who have taken Ambien also have reported walking, binge eating, driving, and performing routine daily tasks in their sleep, as though they were awake. Although sleep talking (incoherent babbling) is a common side effect, family members report that some Ambien users can hold full-blown conversations even though they are asleep. Because sleeping Ambien users can appear to be completely conscious and in control of their actions, safety issues abound. For instance, some Ambien users have gotten in their cars and driven while sleepwalking.

In addition to causing dependence and dangerous side effects in those patients who are using it get some sleep, Ambien has also become a very popular recreational drug. Recreational users report getting “high” from the very act of trying to fight off the effects of the drug (i.e., fighting the natural tendency to fall asleep). This self-imposed sleep deprivation can cause visual hallucinations, decreased anxiety, changes in perception, as well as euphoric feelings.

Once an Ambien abuser has successfully fought off the sleep-inducing effects of a particular dose of Ambien, he will eventually need to increase the amount he ingests in order to achieve the same “high.” The more Ambien that is needed, however, the more likely the patient will be to use other delivery mechanisms, such as snorting it or injecting it, for a quicker effect. This is true even though Ambien tablets are coated with a substance that is intended to thwart attempts to change the mode of delivery for the drug.

Although recreational drug users welcome some of the more serious side effects associated with Ambien, patients who take the drug as directed can also fall victim. Ambien’s most-common side effects include hallucinations (both auditory and visual), delusions, euphoria, dysphoria, impaired judgment, uninhibited social interactions, impulsivity, reduction in balance and libido, and an increase in appetite. Some users will even experience memory loss for things that happened immediately after a traumatic experience.

Treatment for Ambien Addiction

Prolonged use of Ambien can result in tolerance (needing more and more of the drug to get the same effect), dependence, rebound insomnia, and negative effects on the central nervous system. However, “cold-turkey” cessation of taking Ambien can also result in panic, nausea and vomiting, thoughts of suicide, and seizures. Someone seeking help for Ambien addiction should consider a medically supervised detoxification process, by which the frequency and dosages will be gradually reduced in order to avoid unpleasant, and potentially life-threatening, side effects.

Oxecta, formerly owned by King Pharmaceuticals under the name Acurox, is an addictive opioid and a form of oxycodone (the most infamous version of which is now Purdue Pharma’s OxyContin) and has been approved for acute and chronic moderate to severe pain treatment. Oxycodone has fallen out of favor with the FDA recently, as more and more scientific evidence suggests that millions of people have become addicted to a medication meant to give short-term relief to acute or chronic pain.

In its original form, oxycodone was subject to wide abuse as the “high” associated with the drug would increase the more that was ingested. In order to combat such abuse, OxyContin was developed as a time-release version of oxycodone, which had the negative affect of delaying pain relief for those who actually needed it. Oxecta has addressed this issue by associating too much of the drug with negative side effects. By doing so, it can now provide relief right away without having to worry about spreading out the effects over a period of time.

Pfizer’s other new pain management drug, Remoxy, is an alternative to OxyContin and is also up for approval and has been in development for almost a decade. Unlike Oxecta, which acts fast and should be taken only as needed, Remoxy is intended to treat moderate to severe pain that needs the presence of opioids on a continuous, 24-hour basis. Pfizer is currently trying to fix a problem with manufacturing the drug.

Remoxy is also a form of oxycodone, but it comes in a long-acting gelatin capsule. The pill has been formulated with the ORADUR technology, combining anti-tamper and abuse methods with twice-a-day dosing. Other extended release versions of OxyContin reached $3 billion in sales last year.

Remoxy’s pivotal FDA trial was a randomized, double-blind study using a placebo. Over 400 patients, each diagnosed with knee or hip arthritis and experiencing moderate-to-severe pain, were evaluated over a twelve week period using a Likert pain scale. Results showed that Remoxy was effective at reducing pain when given twice a day.

Whether Remoxy or Oxecta will be able to compete with OxyContin remains to be seen. Some commentators suggest that doctors will switch to Pfizer’s product simply as a way to punish Purdue for being so slow in developing a tamper resistant version of OxyContin (this version was not released until 2010). By sitting on the anti-tamper technology for so long, some medical professionals hold Purdue Pharma directly responsible for the OxyContin (aka “Hillbilly Heroin”) addiction outbreak in the US.
 

In Florida, anybody can open a pain clinic. One need not be a doctor or other such health professional. In fact, even those with a criminal past are not excluded. These so called, “pill mills” are basically just a front for legal drug trade. Instead of cocaine or heroin, addicts are seeking out prescription medications such as Vicodin and Oxycontin. And because there is no formal tracking system currently in place, there is nothing to stop someone from getting multiple prescriptions filled at pain clinics across the state.

The state of Florida is currently the leading supplier of the drug oxycodone, known to be as addictive as heroin. In 2009, it dispensed 523 million doses of the drug, an increase of 100 million from the previous year. The ease of access has been drawing those from the nearby states of Tennessee and Kentucky – even Ohio. Low entry-barriers for opening the pain clinics coupled with lucrative profits has exploded into a booming black market that even has authorities scratching their heads.

In Broward County, Florida, where the problem is exacerbated, there are approximately 115 pill mills. In a little over a year, the number of these establishments spiked from 66 to 176 in all of South Florida. Additionally, reports show that Florida is home to the top 25 oxcodone-prescribing doctors in the U.S.; 18 of those reside in Broward County.

Al Lamberti, Broward County sheriff says that he doesn’t understand what has been the big draw to his county besides the fact that they have beautiful beaches. What he can say, though, is that the issue has spiraled out of control. While legislators agree that something must be done, what isn’t known is how exactly reform will be funded.

The state has enacted legislation that would essentially start a tracking system monitoring and limiting the amount of pain management drugs being dispensed – a system that is already in place in 38 states. Other laws in the works include restricting those who are legally allowed to open pain clinics to doctors exclusively. Lawmakers are also seeking to ban any advertisements on the part of the clinics.

All of these measures are, of course, expensive and will require ongoing funding. State Senator Dave Aronberg, recognizes that securing funding will be a challenge for the recession-torn state. Fortunately, the state has grants that will get the ball rolling.

Deaths from prescription drug overdose in Florida have reached an all-time high – 3,750 lives were lost in 2008 as a result. That equates to about 10 deaths a day – more lives were claimed by prescription drugs than by heroin and cocaine combined. In Palm Beach County, due north of Broward county, 372 overdosed in 2009 alone. Unless, reform takes place quickly, these sobering trends promise to continue.
 

According to the study, about 20 percent of teens in middle and high school have abused prescription drugs. Vicodin, OxyContin, and Ritalin are just some of the medications that students used to get high. Cough medicines are also being abused. The Substance Abuse and Mental Health Services Administration states that prescription medications are the second largest drug abused by teens, second only to marijuana, and experts are concerned that this new trend is creating a slippery slope.

Kids get the false impression that these drugs are okay. First, many of their friends are doing it, so they buy into the peer pressure. Second, many of these drugs don’t have the bad reputation that street drugs like meth or cocaine do. In fact, many times these drugs are obtained from a trusted family member or friend. However, youngsters don’t realize that they can overdose on these medications, too, and that the results can be just as deadly.

There is also the risk of combining these medications with other drugs such as alcohol at parties. The newest craze is coined “pharming parties” where students exchange and share various types of prescription or household medications and create a medical cocktail of sorts. This is extremely dangerous because it can produce irreparable damage to the brain, heart and respiratory system, lead to addiction, or even cause death. Overall data for hospital emergency visits due to overdose of prescription drugs is also on the rise.

Unfortunately these bad habits are also popular beyond high school, spilling over into the college years. A study published in the journal Drug and Alcohol Dependence in 2009 affirmed that upwards of 20 percent of university students had abused prescription medications such as pain pills, sleeping aids, sedatives, and stimulants. This number is up from just 6 percent in 2001.

Not only are these drugs easily accessible through familiar circles, they are also being overly prescribed by college health clinics. At the University of Pittsburgh, a student was prescribed Vicodin for pain management due to an infection in her mouth without the root cause being properly diagnosed. She went on to see an outside doctor where it was determined that she needed antifungal medication, which cleared the infection in two days.

The main problem with campus health clinics is doctor/patient ratios. They simply don’t have the funds to support thorough care. Whereas the national average for doctor/patient ratio is about 26 doctors for every 10,000 people, university health clinics average about 1.5 doctors for every 20,000 students.

According to IMS Health, pharmacy sales of prescription pain pills represent an $8.5 billion market. Prescription drugs are being redistributed across college campuses and it’s very difficult to regulate. Students profit from the resale of these drugs with some potent pain pills like Roxycodone fetching $10 each.

To conquer this problem, there must first be awareness. Parents need to be involved and maintain open communication with their children. Youth services advocate, Jim Steinhagen, recommends they get educated as to the effects of prescription medication early on so they aren’t blind sighted. He says to watch for mood swings, changes in their child’s behavior, poor grades, lethargy and lack of interest. Parents should trust their instincts and seek professional help if needed. The Partnership for a Drug-Free America also provides great information on their website at www.drugfree.org.

In the US, it is estimated that approximately 35 million prescriptions are filled with bogus drugs each year. California patients obtain approximately 4 million of these prescriptions alone. Since the physical supply chain of products manufactured in the US is relatively secure, overseas pharmacies that are accessible to people in the US over the Internet are responsible for the majority of counterfeit prescriptions here. A 2007 study done in Europe estimated that over sixty percent of drugs ordered online without a prescription turn out to be counterfeit. It is important to note that countries such as Italy, Turkey, and Belgium already have pedigree requirements for the sale and transfer of prescription drugs.

Because online pharmacies tend to be part of non-US supply chains, the opportunities for counterfeit drugs to enter the chain are plentiful. For instance, there is often little government oversight of manufactures in developing countries, which leaves these companies with the opportunity to reduce costs dramatically by either faking the drug (using a placebo) or manufacturing a less-effective version. Inspection at foreign airports is cursory, if done at all, and many countries do not even require manufacturers to file applications or submit to safety and efficacy testing. Finally, many doses of medication manufactured abroad are sold out of their original packages in single lots or in significantly reduced quantities.

Under current law, whether or not a prescription drug is legitimate depends largely on the physical condition of the drug and its packaging. In order to test whether a product is truly what it appears to be, it must be subjected to testing in a laboratory. Because even single doses of a larger batch can be interfered with (i.e., half the pills in a large bottle), the testing that would need to be done to identify whether a drug is counterfeit would necessitate the destruction of the entire batch.

Once the prescription drug leaves the custody of its manufacturer, it is vulnerable to replacement, dilution, re-labeling, repackaging, or re-manufacturing prior to reaching a pharmacy or other retail-level distributor.

Counterfeit drugs pose two main dangers to the health and safety of patients. First, the replacement substance itself could be harmful to the patient or could interact with other medications that the patient is taking. Since most counterfeits are inert, however, the more dangerous consequence of prescription drug counterfeiting is that the patient will not receive the treatment that he or she needs in order to get better. In extreme circumstances, ingesting counterfeit drugs could actually kill the patient.

Under the new law, an electronic record will also be needed to establish that the drug is legal. In 2004, the California legislature passed SB-1307 which was aimed at preventing counterfeit medication from entering California’s prescription drug supply chain. The law proposed new licensing restrictions for drug wholesalers and introduced the concept of an electronic pedigree to validate the distribution of drugs. Although portions of the law went into effect in subsequent years, SB 1476 was introduced in 2006 in order to plug the supply chain holes that remained; this new piece of legislation proposed a 2009 start date for the e-pedigree program. However, the start date has been pushed back so many times that it is now five years late. Manufacturers have largely been behind the delay, arguing a lack of funds or man power to meet the requirements of the law.

Beginning July 1, 2016, a wholesaler or repackager of prescription drugs in California must provide a pedigree when it sells, trades, or transfers a drug. It also needs to obtain a pedigree when it acquires a drug. By July 1, 2017, California pharmacies will also be held to the same standards.

The new law is aimed at controlling the prescription drug supply chain in California and protecting it from counterfeit drugs. Ultimately, regulators will be able to determine where a container of prescription drugs originated from and the path it took in order to get the retailer. This will aid investigations surrounding tampering and counterfeiting.

This new “e-pedigree” law (also known as “packaging serialization”) is codified in California Business and Professions Code, section 4163. An e-pedigree is a serial number-based record that is generated each time a drug is transferred or sold; the information pertains to the smallest unit of the drug as it passes through the supply chain. For instance, manufacturers create e-pedigrees for containers sold to wholesalers and wholesalers then create new e-pedigrees for smaller containers sold to pharmacies. However, the new e-pedigree will also contain information about the container the new unit originated from. As a result, a complete history of possession and ownership of any particular container of drugs in California will be available, to the pharmacy level. This is especially important in light of the fact that any given unit of drug (i.e. a single pill) that is manufactured can be sold and repackaged multiple times by multiple entities before reaching the consumer.

EPCglobal, the entity involved in normalizing the use of UPC bar codes world-wide, has been involved in developing the system by which information pertaining to each container is shared among supply chain participants. Each container’s historical information will be contained in either a bar code or RFID chip installed on the container.

One problem with e-pedigrees is, predictably, the cost of implementing and maintaining the technology. For example, an individual RFID chip costs upwards of $.15, and each and every package will need one. In addition to cost, however, manufacturers also worry about the affect that RF technology may have on the drug itself. Testing would need to be conducted on each and every type of drug, including over different dosages, to determine if contact with the RFID chip would change the way the drug acts once ingested. Finally, e-pedigrees will have zero effect at controlling counterfeit drugs where drugs are sold outside the original packaging. The main vulnerability here would be interference with the drug at the pharmacy level while it is being transferred into individual pill bottles.
 

A recent report from the United States Centers for Disease Control and Prevention (CDC) highlights the danger posed by the increased use of prescription painkillers. Many people who begin using the drugs for pain relief are not aware of their highly addictive nature and find themselves desperate to keep increasing the dosage of their medication.

The CDC’s report shows that in 2006, there were 295 deaths from accidental overdose. The majority of these deaths are traced to painkillers. 67.1 percent were men and 63.1 percent of them used painkillers such as methadone, OxyContin and Vicodin.

One of the most alarming aspects of the high number of painkiller-related deaths is that the victims seem to be going to great lengths to feed their addiction. The deaths largely resulted from individuals not having a prescription for the painkiller, and 21.5 percent had prescriptions from at least five separate doctors.

Aron Hall of the CDC reports that drug overdoses in the United States are second only to motor vehicle deaths when measuring unintended deaths.

The researchers chose West Virginia for the study because accidental drug deaths are especially high in that state—the highest in the country. West Virginia also has the country’s fastest rising overdose rate, according to the CDC. Death from overdose rose 550 percent between 1999 and 2004.

The study’s findings show that victims of overdose are often being assisted in their addiction by loved ones. While the researchers did not trace where the drugs had originated from in the study, they were able to conclude that the majority of people using prescription painkillers as a means to get high are obtaining them from friends and family members.

Another factor affecting the high number of overdoses is simply the high number of prescriptions for painkillers. The CDC reports that legal methadone purchases have increased 13-fold over the past decade. OxyContin has seen similar skyrocketing sales, increasing nine-fold in the same time period.

The CDC encourages doctors to counsel their patients about the potential risks of addiction and overdose when painkillers are prescribed. Doctors should include in the discussion encouragement to share that information if pills are shared with a family member or friend. In addition, doctors may want to explore therapies and other pain-management options that avoid the use of prescription painkillers.
 

All too often, Americans are being prescribed highly potent opioid medications like Oxycontin or Vicodin for long-term treatment of non-cancer-related pain—most commonly for back pain—and end up becoming dependent upon their prescriptions. Some patients believe that these medications are the only solution to their chronic pain. Patients relying on prescription pain relievers for extended periods of time are at higher risk for opioid dependency, which can lead to prescription drug misuse, abuse, and addiction. This self-defeating cycle leaves millions of Americans impaired physically and mentally, all the while exacerbating their dependencies.

Recent national studies have shown an increase not only in prescription drug misuse but also in the proportion of prescription drug-related overdoses and deaths. Researcher Jennifer Brennan Braden, MD, and her colleagues from the University of Washington School of Medicine in Seattle conducted a study to investigate the relationships between opioid prescribing and the frequency of serious adverse effects of opioid use.

Using information from the medical records of adult patients who were registered under Arkansas’ Medicaid program or HealthCore program, the researchers identified patients who used prescription opioid medications for at least 90 continuous days within a six-month period between 2000 and 2005. The researchers identified almost 38,500 patients covered under the HealthCore program and 10,000 patients covered under the state Medicaid program who were administered long-term opioid therapy during this time frame. None of the study’s participants were prescribed opioid medication for cancer-related diagnoses, and the most prevalent reason for their prescriptions was chronic back pain. Then the researchers tracked the patients’ medical activity within the first year following their long-term opioid treatment to measure their frequencies in emergency department visits and alcohol- or drug-related incidents.

In their results, the researchers discovered that 24% of private insurance holders and 28% of the Medicaid patients had made visits to the emergency department within the first year following their long-term opioid treatment. Also, approximately 2% of private insurance holders and 3% of the Medicaid patients had required medical treatment for alcohol- or drug-related problems. Headaches, back pain, and preexisting substance abuse disorders were found to have a strong associations to patients’ likelihood of visiting the emergency department or having an alcohol- or drug-related problem. Private insurance holders who were diagnosed with a mental illness were significantly likely to later visit the emergency department, and both private insurance holders and Medicaid patients with a pre-diagnosed mental illness were more likely to later have a substance abuse problem.

Furthermore, the type of opioid prescription affected the patients’ risk of future emergency department visits or substance abuse problems. Taking over 120 mg of opioid medication (similar to morphine doses) on a day-to-day basis was related to a twofold risk of substance abuse problems. Being prescribed short-acting Schedule II opioids increased the likelihood of requiring a visit to the emergency department, while long-acting Schedule II opioids were related to a higher risk of future substance abuse problems compared to patients who were not prescribed Schedule II opioids.

The researchers also noticed that the group of individuals who were most likely to experience emergency department visits or alcohol- or drug-related problems, such as those younger than 60 years of age and those with a history of substance abuse disorders, were the most likely to be prescribed opioid medications, and were more likely to receive higher potency opioids, to be prescribed higher doses, and to be prescribed longer term opioid therapy. Those who were less likely to become addicted, such as those over the age of 60, were less likely to be prescribed the medications.

Overall, the researchers found that headache, back pain, Schedule II opioids, and preexisting substance abuse disorders were significantly associated with the long-term opioid-treated patients’ likelihood to make emergency department visits and have alcohol- or drug-related issues. The researchers advise that reducing the number of Schedule II opioid prescriptions among individuals with these high-risk factors could help improve their general health and safety.

Source: Reuters Health, Anne Harding,  Less-potent opiates may be safer for long-term use, September 13, 2010