Here’s what happened when codeine was made prescription only. No, the sky didn’t fall in

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Here’s what happened when codeine was made prescription only. No, the sky didn’t fall in

Buy Codeine Online. Our research, in the journal Addiction, found the 2018 switch resulted in a 50% drop in codeine overdoses and sales. There was also no increase in overdoses with stronger opioids or high strength codeine, as some had feared.

Remind me again, how did we get here?

Australia has a love affair with codeine. It has historically been our most used opioid, and 2013 data showed we took more codeine as a country than the USA, despite having roughly 7% the population.

However, from February 2018, you could only buy codeine in Australia with a prescription. Higher-strength codeine has always required a prescription.

The 2018 change was not an overnight decision. Codeine has been on the government’s radar for over a decade; the Therapeutic Goods Administration (TGA) set up a codeine working party in 2008 in response to increasing misuse. Codeine is an opioid analgesic, meaning people can become dependent on it. and there is a risk of harm from overdose.

Unfortunately, our previous study showed this move to stocking codeine behind the counter had little impact. Other studies also showed that deaths from codeine continued to increase.

The 2016 National Drug Strategy Household Survey reported codeine available from behind the counter at a pharmacy was the most misused legal opioid in Australia and misuse was particularly common in adolescents. Buy Codeine Online

Not everyone was happy. Buy Codeine Online

The announcement divided community and health-care professional groupsPharmacy organisationsopposed the change, whereas GPs were in favour.

There were also fears the change would lead to a massive burden on GPs as patients came to request codeine.

Some people were concerned the move would drive people to use higher-strength codeine. This was because people wanting codeine would need to see their doctor, so they might request the stronger products that had always been prescription only. There was also concern the change would push people towards even stronger painkillers, like oxycodone and morphine.

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How long does Xanax last?

Buy Benzodiazepines Online. Alprazolam (Xanax) is a useful medication for certain mental health conditions. Xanax starts to work quickly, and it stays in the body long after the effects of one dose have worn off.

Doctors often prescribe Xanax for generalized anxiety disorder or panic disorder. It is one of the most widely used medications for these conditions, and it belongs to a class of drugs called benzodiazepines, or “benzos.”

Xanax works by increasing the effects of gamma-aminobutyric acid, a neurotransmitter in the brain that increases feelings of calmness.

This article looks at how long the effects of Xanax last, the timeline for withdrawal, and various factors that affect this timing. It also describes when Xanax expires and how to dispose of old medication.

When does Xanax start to work?

People usually feel the effects of Xanax within 1 hour.

The body absorbs Xanax quickly after a person takes it.

Peak levels in the blood occur 1–2 hours after taking a dose. However, the person feels effects before levels peak.

One study, which examined the effects of Xanax in 14 healthy people, found that participants felt the effects in under 1 hour, with an average onset time of 49 minutes.

How long does Xanax stay in the body? Buy Benzodiazepines Online

Like many drugs, Xanax stays in the body long after a person stops feeling its effects.

Experts use a measurement called half-life to determine how long a drug stays in the body. Half-life is the amount of time that it takes for the body to eliminate half of the medication.

The half-life for Xanax is 8–16 hours in a healthy person, with a mean half-life of 11 hours. This is shorter than that of many other benzodiazepines.

The term “half-life” can be misleading, however. This is because it takes four to five half-lives for the body to completely eliminate a drug. This means that it may take an average of 44–55 hours, or about 2 days, for Xanax to leave the body.

In one study, researchers reported that they could detect Xanax in a person’s saliva for up to 2.5 days after the last dose. Buy Benzodiazepines Online

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New data shows drug overdose deaths fell in 2018. But there’s a big catch.

Buy narcotic pills online. Preliminary data shows that drug overdose deaths may have fallen by 5 percent in 2018 — the first drop in overdose deaths since the country’s opioid epidemic began in the 1990s.

The data, first reported by the New York Times, seems like good news. A 5 percent drop would amount to hundreds or even thousands of lives saved each year: According to the preliminary data from the Centers for Disease Control and Prevention, there were more than 68,000 drug overdose deaths in 2018, compared to more than 72,000 overdose deaths reported in the preliminary data for 2017. (The final data for 2017 put overdose numbers slightly lower — at a bit more than 70,000.) If nothing else, the figures suggest the opioid crisis may be starting to level off.

But there are also several reasons to be cautious about the report: Buy narcotic pills online

1) The latest CDC data is preliminary and subject to change. Overdose deaths could end up higher or lower than the data says right now. We just won’t know until the final figures come out later this year, likely around December.

The preliminary estimate for 2017 was off by roughly 2,000 overdose deaths. If the deviation is the same in 2018, but this time overdose deaths were undercounted, then 2018 could have been worse, not better, than 2017. We are just a margin of error from these numbers looking very different.

2) This isn’t the first time that it’s appeared the opioid epidemic has leveled off. Between 2011 and 2012, drug overdose deaths appeared to level off around 41,500. Then, dangerous synthetic opioids, particularly illicit fentanyl, seeped into the black market — and overdose deaths skyrocketed to 70,000 in 2017.

The fentanyl outbreak is still centered on parts of the Northeast and Midwest. If fentanyl starts to spread to other parts of the country in full force, overdose deaths could rise in other places too — and so would the overall death toll. Buy narcotic pills online

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Breaking the cycle: The opioid epidemic and ending addiction

Opioids pain meds for sale. The United States is in the middle of an opioid crisis that has killed hundreds of thousands of Americans.

The first wave in the modern opioid epidemic began in the 1990s because of an increased amount of opioid prescriptions, but the opioid epidemic is not new. 

“We talk about the opioid crisis all the time, but in reality, we’re in the midst of a drug epidemic that’s been going on for decades,” Community Medical Services CEO Nicholas Stavros said. “We’re in the midst of this drug crisis, it happens to be opioids, but the root cause of all of this is actually, I think, something very deep.” 

The history of opioid addiction

Opium has been used in medical and recreational drugs since ancient times.

In the early 1800s, a German pharmacist named Friedrich Wilhelm Adam Serturner was the first to successfully isolate and extract “alkaloid” from tarry poppy seed juice. 

He named the chemical morphine after the Greek God of Dreams, Morpheus.

After decades of an opium war between European powers and China, the Chinese brought the opium habit with them to California during the 1849 Gold Rush, according toHistory.com

On the other side of the country, the Civil War broke out and the country imported morphine for wounded soldiers. 

An estimated 400,000 soldiers became addicted and stayed addicted after the end of the war. However, moving farther into the 19th Century, women began to make up the majority of morphine addictions

In the 1890s, heroin as a morphine substitute started being used in medicine. In fact, German pharmaceutical company Bayer started using heroin as a cough suppressant for children suffering from coughs and colds. 

“This is not a new problem,” Dignity Health’s Arizona General Hospital Chief Medical Officer Frederick Johnson, M.D., said. “In 1896 or 98 it was legal to give heroin… how long do you think it took to eliminate heroin as a pharmaceutical agent? 25 years. Almost 100 years later…we get back to the same problem, the cycle repeats itself over again.” 

The modern opioid crisis 

According to the Centers for Disease Control and Prevention (CDC), the current opioid crisis began in the 1990s when overdose deaths involving prescription opioids increased; the second wave began in 2010 when there was a rapid increase in overdose deaths involving heroin; and the third wave began in 2013 with significant increases in overdose deaths involving synthetic opioids like fentanyl.

“Fentanyl, you see that 50 to 100 times more potent than the other medications. “You take that, and you start combining it with other drugs, other medications… and now things get really dicey for patients because the combinations of these medications actually cause death.” Opioids pain meds for sale

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How to Drink Your Lean With Slomocup

Buy Actavis Online. These days, there’s really no better place to feed your vices than on Instagram. Thankfully, back in July, the ‘gram enabled search on your desktop. This way, I can spend my time, like I did the other day, searching hashtags like #codeinecowboy, #promethazinekings, and #purplejelly.

I’d gotten interested in lean, aka sizzurp, otherwise known as purple drank, which is a way of consuming a prescription-strength cough syrup that contains codeine and promethazine. This method of getting high off cough syrup dates back to the 1960s blues scene in Houston, Texas, when musicians would mix Robitussin and beer.

Today, you may have heard of it because some high-profile rappers like Lil Wayne may or may not have had some problems with it. Three 6 Mafia isn’t afraid to boast, “I’m steady sipping on some sizzurp,” but the National Institute on Drug Abuse tells teens, “it is not cool,” mostly because it can kill you (see Wikipedia: notable deaths).

Purple drank isn’t hard to spot. But something caught my eye amidst all those ‘grams: a special double cup that you can use to — well, what you do with your Slomocup, that’s up to you.

The Slomocup was born from the mind of Cal Marshall, who is 25 and lives in San Francisco. Buy Actavis Online

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Xanax: the drug that defined the decade and changed rap

In the 2010s a crisis spread across America like wildfire, taking some of hip-hop’s brightest stars with it

Buy Benzos Online Text Thomas Hobbs 17 December 2019

Deep fakes, influencers, viral fashion – we live in a world unrecognisable from the one we stood in ten years ago. As a chaotic decade comes to a close, we’re speaking to the people who helped shape the last ten years and analysing the cultural shifts that have defined them. Explore the decade on our interactive timeline here, or head here to check out all our features.

Every decade has a drug that infiltrates music. In the 1960s and 1970s, LSD and heroin helped musicians break on through to the other side, while cocaine gave 1980s pop music its turbo charge. Fast-forward to the 2010s, and it’s opioids that now have a grip over some of music’s biggest stars. 

Their impact is particularly evident in the world of rap.

It isn’t uncommon to see rappers dribbling and falling asleep during interviews, or enthusiastically posting pictures with prescription pills on the tip of their tongue on Instagram (as Lil Peep did just hours before fatally overdosing on his tour bus). Meanwhile, Drake, still arguably the biggest rapper on the planet, nonchalantly referenced taking Xans to help him get to sleep on one of the biggest rap songs of the decade.

it’s a whole different flip,” says 25-year-old producer DJ Fu. He produces songs for Schoolboy Q, Meek Mill, and Lil Xan; It’s glorified. If LeBron wears Jordans then everyone wants to buy those sneakers, and it’s the same with rap. If Future is rapping about pissing codeine then people will want to imitate him as he’s the king.” Buy Benzos Online

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There are fewer suicides related to opioids than previously believed, research says

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(CNN)Since 1999, significant increases in US suicide rates have paralleled increases in drug overdoses from opioids. But a new analysis of numbers finds that the link between opioids and suicide might be much smaller than initially believed.

The percent of opioid-related suicides actually fell in recent years, dropping from 9% in 2000 to 4% in 2017, according to a research letter published Tuesday in the medical journal JAMA.”It gives you a very different picture of the role of opioids in the suicide epidemic,” said Dr. Mark Olfson, lead author of the analysis and a professor of psychiatry at Columbia University Medical Center. The conversation around “deaths of despair” — deaths related to suicide, drug overdose, liver disease and cirrhosis — has taken on a specific narrative, Olfson said, intertwining the opioid epidemic and suicide.Heading

Deaths of despair

They were among the first to note these deaths have increased significantly in the United States since the 1990s, particularly among white males.

Increases in these “deaths of despair” have been so significant in recent years, that they are major drivers in reducing American life expectancy. Deaton and Case noted that while the supply of opioids increasedsince 1999, it’s not the “fundamental factor”behind increased mortality, but rather, the prescription of opioids for chronic pain “added fuel to the flames” of overall mortality. A report issued in September from the US Congress Joint Economic Committee titled “Long-Term Trends in Deaths of Despair” noted, “Mortality from deaths of despair far surpasses anything seen in America since the dawn of the 20th century. .. Buy Legal Opioids Online

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Justin Bieber Reveals ‘Heavy Drug’ Use in Emotional Post

Buy painkillers pills Online. The post was probably in part a follow-up to a video Bieber posted on Instagram last week of an emotional performance he gave at his Los Angeles church. “God is pulling me through a hard season,” he wrote in that post. “Having trust in Jesus at your worst times is the absolute hardest.”

Jesus loves you,” he wrote Monday.

Bieber has not performed much this year or put out much music since his fraught last tour for his fourth studio album, “Purpose” (2015). In the summer of 2017, he canceled its final 14 shows. “I got really depressed on tour,” he told Vogue earlier this year. “I’m still processing so much stuff that I haven’t talked about. I was lonely.” Buy painkillers pills Online

Bieber has dealt with legal and other issues over the years. In 2014, he was arrested on charges of driving under the influence and with an expired driver’s license, and resisting arrest without violence. Police said that he had admitted to having beer, marijuana and prescription drugs in his system. He was able to avoid jail time. Around that time, videos emerged of him using racist language, which Bieber apologized for.

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Clinical Challenges: Benzodiazepine Prescribing

Beneficial effects on anxiety disorders must be weighed against the risk of abuse, injury

Buy Benzons Online. Benzodiazepines are effective in treating anxiety disorders, but balancing their benefits with the risk for dependence and injury can pose a challenge to prescribers.

“In some patient populations they work, so we don’t want to throw the baby out with the bathwater so to speak,” said Saundra Jain, MA, PsyD, of the University of Texas at Austin, during a presentation at Psych Congress 2019. “But we want to use these medications cautiously and wisely, and to make those decisions based on each patient individually.”

Initially approved by the FDA in the 1960s, benzodiazepines are commonly used as sedatives, sleep aides, anticonvulsants, amnesics, and muscle relaxants. From 2002 to 2014, the number of benzodiazepines being prescribed rose by 2.5 million, an increase of 41%.

“Decades ago, physicians would prescribe benzodiazepines for almost anything, e.g., sleep issues, a divorce, anxiety at work, etc.,” Alan Kaye, MD, PhD, of Louisiana State University in Shreveport wrote to MedPage Today in an email. “Benzodiazepines for many decades have been the most common class of medications prescribed. Currently, there has been a shift to reduce these prescriptions.”

Side Effects

Many studies have linked benzodiazepine use with an increased risk for dementia, said Rakesh Jain, MD, MPH, of Texas Tech University, during the same Psych Congress presentation, citing a 2019 meta-analysis that found a 51% increased risk.

Another side effect is residual sedation, which can last up to 11 hours and has been linked with an increased risk for motor vehicle accidents.

The American Geriatrics Society recommends avoiding benzodiazepines in older adults, although the society’s 2015 Beers criteria notes the drugs can be appropriate for treating seizures, generalized anxiety disorder, or certain forms of withdrawal.

risk of abuse

For the elderly, these side effects, including increased risks of falls, ataxia, and confusion, can be particularly prevalent, said Donovan Maust, MD, of the University of Michigan in Ann Arbor.

Specifically, benzodiazepines have been associated with as high as a 40% increased risk for hip fracture in older adults. And the risk for fall-related injuries in geriatric patients is high regardless of whether they are on benzodiazepines for 2 weeks or more than 30 days, Maust said, going against the “fallacy” that short-term use of this drug class is safe whereas long-term use is not.

“Long-term use is ‘riskier’ in the sense that if you are exposed to something with risks for a long time, you have more opportunities for something bad to happen,” Maust told MedPage Today. “But it is not true that those risks are not present with short-term use.”

Drug-Drug Interactions

Use of benzodiazepines has been associated with an elevated risk of all-cause mortality, previously reported as high as 76%, compared with nonusers, Saundra Jain said.

“That increased risk should make us stop in our tracks,” she said.

Benzodiazepines have been associated with an increased risk for respiratory depression when used in combination with opioids, with more than 30% of fatal opioid overdoses involving benzodiazepines.

Prescribing

This data prompted the FDA to issue a black box warning to nearly 400 products in 2016, but many physicians still prescribe the two together. For other clinicians, this growing body of evidence has stopped them from prescribing them altogether.

“Pain doctors such as myself, we are monitored for every patient that we prescribe medications to and this includes benzodiazepines, which i[n] each state are looked upon as increasing overdose risk,” Kaye said. “So, I have stopped completely prescribing benzodiazepines and have advised patients that if they receive benzodiazepines that I will not be able to prescribe opioids in the future.”

Dependence and Withdrawal

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid and have a mechanism of action that is similar to other drugs of abuse, Rakesh Jain said.

As such, they are often misused with other drugs of abuse, and clinicians should be sure to screen for a history of substance abuse or related disorders before prescribing them, he added.

Prescribers can also check their state’s prescription drug monitoring program before prescribing benzodiazepines to avoid dangerous drug-drug combinations and detect potential drug abuse.

injury

In addition to the risk for abuse, many patients will develop a physical dependence to benzodiazepines even with short-term use as, like with alcohol, the brain essentially acclimates to benzodiazepine exposure, Maust said. In turn, this will lead to withdrawal when taken off the drugs.

Up to half of patients will develop dependency for every 1 month they are on benzodiazepines, and withdrawal symptoms can set in as early as 2 weeks of continued use, Saundra Jain said.

Dosing and Tapering

All things considered, benzodiazepines play an important role when used appropriately, such as when a patient has a severe depressive episode and needs them for stabilization, or in some cases for the treatment of generalized anxiety disorder, Rakesh Jain said.

“Benzodiazepines can be very helpful acutely, such as an unexpected loss such as a death of a loved one, or acute stressful situation such as a rape victim,” echoed Kaye. “If these medications are prescribed long-term, patients will develop physical dependence and it will be difficult to get off of benzodiazepines.”

Before prescribing, clinicians should obtain written, informed consent to document they have educated the patient about the potential risks, Rakesh Jain added.

Beneficial effects

But physicians should also know how to deprescribe them appropriately to help patients navigate away from the harms associated with dependence and polypharmacy use, Saundra Jain said. This is a slow and gradual process, and tapering too quickly can lead to seizures or other adverse outcomes.

In some cases, switching to a longer half-life benzodiazepine like diazepam (Valium) may be appropriate when individuals are using preparations that don’t easily allow for small reductions in dose, like alprazolam (Xanax) or flurazepam (Dalmane).

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What Doctors Can Learn From the Dark Web

Buy PainKillers online. Opioid addicts are turning to online forums for advice about quitting. Their conversations have a lot to teach us about drug use and public health.Doug JohnsonUndark October 20, 2019

Ryan Le Blanc got his first dose of opioids at three months old, after surgery for a unilateral cleft palate. Now in his late 20s, the English-as-a-second-language teacher has gone through about 15 more surgeries of varying severity.

With each operation came new painkillers. At 14, while living in New England, Le Blanc started buying and using illegal opioids for fun. By 16, he was injecting heroin, a habit that he carried from high school through college graduation.

As a teenager, Le Blanc came across Bluelight.org, a drug forum now more than 20 years old. He read post after post—innumerable lines of text and images about the substances he was taking, how to take them safely, and how to quit.

Today these threads aren’t just of interest to the site’s users. As the opioid epidemic worsens, claiming about 130 lives a day in 2018 in the United States alone, a cadre of researchers is looking for solutions to addiction and overdoses in the sprawl of drug forums. The researchers say that drug forums on the dark web—a catchall term for internet hubs that are often encrypted or unavailable through regular search engines—along with more mainstream counterparts such as Bluelight and drug-related threads on the website Reddit, might be medical or research tools in their own right.

public health

For instance, in research published this spring, Stevie Chancellor, a postdoctoral fellow in computer science at Northwestern University, used computational linguistics and machine learning—a subset of artificial intelligence—to find out how forum-goers on Reddit attempt to get sober. “We wanted to unearth the things the doctors didn’t even know about,” Chancellor says.

Chancellor and other academics, as well as advocates of harm reduction (a philosophy that seeks to minimize the negative effects of drug use), believe that drug forums can also provide insight into a secretive subset of society. The forums could also provide a route to reach users with potentially life-saving information about drugs.

Therefore, Working with these communities has presented challenges. Some researchers in this relatively new field have trouble collecting data, particularly when law enforcement busts an illicit marketplace. But both researchers and people who use the forums to quit drugs believe that there’s value in the chatter.

Opioid addicts

In addition, the Chancellor’s machine-learning study, she and her colleagues also built a computer program to recognize distinct words and phrases in nearly 1.5 million posts on 63 subreddits where people discussed opioid-addiction recovery. The program found that many Redditors who were trying to quit heroin and fentanyl, a potent synthetic opioid, were using other drugs to do it.

More so, Chancellor was surprised, but the approach is common on the forums, though sometimes discouraged by moderators and other users: People may use alcohol, cannabis, or however heavier drugs to quell withdrawal symptoms. Le Blanc was no exception. At 22, he tried to quit opioids using other drugs, although three years later, after a family intervention, he entered a formal methadone program, which uses a lower-grade narcotic to wean users off harder drugs. As of a few months ago, he quit using maintenance drugs, working toward true sobriety to be free of opioids altogether.

conversations

Furthermore, Chancellor’s team found other examples of drugs that Redditors leaned on to quit opioids: benzodiazepines such as Valium or Xanax; the anti-diarrheal drug Imodium; ibogaine, a psychoactive plant substance with alleged anti-addiction properties; and kratom, a powdered preparation of a plant that, taken in large enough doses, can cause opioidlike sensations. Others used relatively weak opioids such as codeine to step back from heroin or fentanyl. And the forum-goers also developed elaborate dosing regimens to get through a workday relatively unscathed by withdrawal.

Any benefit from self-administered treatments would need to be verified or tweaked by medical professionals, Chancellor says. Mixing some of these drugs can be deadly. Even Imodium, when taken at recreational doses—more than 15 times the therapeutic dose—can cause severe heart problems.

The fact that people are using such an array of drugs to quit opioids is a clinical and medical blind spot, Chancellor says: “I think there’s a lot of potential for communities to back-inform what could be productive investigations for medical researchers.”