Drug Testing: Technologies and Global Markets (2008)
The U.S. testing market segment generated the largest share of revenues with $1.4 billion in 2007. This is expected to reach $1.5 billion in 2008 and $2.0 billion in 2014…
10/23/2012, Third-party drug-test providers continue to grow nationwide
According to laboratory testing giant LabCare, the market for clinical, anatomic, and genetic testing is $55 billion in the US and Canada alone.1 Within that market, the revenue associated with drugs-of-abuse testing is set to jump from about $2.0 billion today to $2.7 billion by 2015—an increase of 26 percent—according to a recent TriMark Publications study.2
The demand for drug and alcohol testing program management enjoys a 20 percent annual growth rate, says the Drug and Alcohol Testing Industry Association (DATIA).3 It, along with groups like the Substance Abuse Program Administrators Association (SAPAA), offers legal, technical, and training assistance to the 65 percent of US businesses that require drugs-of-abuse testing. Such testing began nearly 25 years ago when Congress passed the Drug Free Workplaces Act—a response to the recognition that substantial numbers of working Americans were abusing alcohol and substances.
An Overview of Present and Future Drug Testing (2006)
8/14/2014, Drug Testing Market: Alcohol/Breath Analyzer, Saliva Testers and Biosensor Industry Worth $7 Billion by 2020
1999, Drug Testing: A Bad Investment
Rather than searching for drugs, urine tests search for drug metabolites – inactive drug by-products that the body produces as it processes drugs for excretion.
BLS economist Howard Hayghe attributed this dramatic shift away from private sector drug testing to a confusing legal situation, higher-than anticipated costs, and the failure of drug testing’s promised benefits to materialize.
“I was led into a very small room with a toilet, sink and desk. I was given a container in which to urinate by the attendant. I waited for her to turn her back before pulling down my pants, but she told me she had to watch everything I did. I pulled down my pants, put the container in place
— as she bent down to watch — gave her a sample and even then she did not look away… I am a forty-year-old mother of three, and nothing I have ever done in my life equals or deserves the humiliation, degradation and mortification I felt.”
SOURCE: LETTER FROM FEMALE WORKER TO THE ACLU.
Drug overdose, violence, alcohol, or suicide accounted for nearly all deaths of which the causes were known. Despite the availability of treatment, including methadone maintenance, both heroin use and criminality continued at a high rate. Of the 428 known survivors, 48% were currently enrolled in a methadone program after 22 years… Our findings offer an insight into heroin addiction as a chronic lifelong relapsing disease with a high fatality rate.
Updated July 2014
According to research from the Centers for Disease Control and Prevention, more than 30 percent of prescription painkiller deaths involve methadone, even though only two percent of painkiller prescriptions are for this drug.
Drug Abuse Patterns and Trends in New Mexico (2004)
The DEA Diversion Division has a lead role in assessing and addressing problems associated with the diversion and abuse of pharmaceutical drugs, which have become more common in the State.
Alcoholism alone and marijuana alone were not significantly associated with recidivism.
Prevalence of cocaine use and inhalant use is relatively high among New Mexico students. Reported prevalence of heroin use is also relatively high.
In 2001, the Secretary of Health and Human Services delegated to SAMHSA the responsibility for regulation and oversight of the Nation’s opioid treatment programs (OTPs).
An agency focused on drug abuse and mental health is in charge of regulating one subsection of drugs: Opioids. Wow, if I was an opioid, I would feel flattered that so many federal agencies were working against me.
The Food and Drug Administration (FDA) purchases access to drug utilization data through
a number of commercial drug utilization data vendors. From these data sources, FDA can
track the amount of methadone sold by manufacturers.
Every entity that manufactures or distributes prescription drugs is required to report that
activity to the Drug Enforcement Administration (DEA).
In 2009, 98% of methadone in the 40 mg formulation (about 38 million units) was
distributed to OTPs (also known as Narcotic Treatment Programs or NTPs). The remaining
2% was distributed to hospital pharmacies (Figure 5). In contrast, ARCOS data show that a large majority (90%) of the 5 mg and 10 mg formulations of methadone (commonly used for pain treatment) were distributed to retail pharmacies. Of the rest, 9% was distributed to hospitals and 1 percent to OTPs/NTPs (Figure 7).
Chronic pain outpatients should be monitored for early signs of abuse including “doctor shopping’ and the use of multiple medications.
Risk factors for drug overdose deaths
• History of substance abuse
• Using alone
• Previous drug overdose
• Injection drug users
• Mixing drugs (including the use of illicit and prescription drugs together)
• Chronic pain patients treated with prescription opioids
Opioid Replacement Therapy involves the use of methadone or buprenorphine to reduce the cravings for opioids. Individuals with chronic pain may also be placed on methadone. As the use of methadone has expanded, so has its misuse resulting in abuse and overdose. Consequently buprenorphine is viewed as a safer alternative with less potential for abuse. Traditionally methadone has only been dispensed at federally licensed methadone clinics, but buprenorphine may be dispensed by any trained physician expanding the availability of opioid replacement therapy.
These people just don’t seem to get it… The “craving” is not for opioids, but for pain relief.
Man, am I glad I didn’t try Suboxone…
“Every young person I’ve talked to that’s using heroin always started with pills,” said Jennifer Weiss, president of the Heroin Awareness Committee, formed in 2010 to curb opiate addiction in New Mexico.
Well, as long as you’ve done a scientific study, Ms. Weiss… And I bet the young people you’ve talked to are all in the middle class, right? I mean, you know the opioid “epidemic” is mostly found in the white population, don’t you? (Ms. Weiss is another parent who tragically lost a son to heroin abuse and addiction, and somehow, this makes her an addiction expert. These are the people whispering and crying in politicians’ ears…)
Ms. Weiss’s group recently received a $100,000 contract from the City of Albuquerque to plan an adolescent treatment center for opiate addiction.
Patients here are typically treated with dosages of Suboxone, a less stimulating opiate that helps quiet the craving for pain pills and heroin — along with acupuncture, reiki (which involves placing a practitioner’s hands on various body areas to cure ailments) and traditional Mexican healing practices.
Where can I sign up? I mean, I’m surprised there isn’t a line of people waiting outside this “treatment” center…
On a recent afternoon, three practitioners used reiki and acupuncture to treat a group of addicts, the patients’ feet and arms jerking as they tried to relax. Soon the addicts were fast asleep. Later in the week, there would be another session, a requirement here if patients want their dose of Suboxone.
With a success rate like that (all the addicts fell asleep?), maybe insurance companies should start covering acupuncture — although in the general population, it’s not as successful. And I don’t think the medical industry has fully embraced acupuncture (I think they call it something else). But for drug addicts who have no other choice, sure, let them try acupuncture. If they’re sleeping, they’re not taking drugs, right?
The Prescription Drug Abuse Reduction Policy Academy is a year-long exercise in strategic planning aimed at reducing prescription drug abuse. In addition to Alabama and Colorado, five states – Arkansas, Kentucky, New Mexico, Oregon and Virginia – will develop and implement comprehensive and coordinated strategies that take advantage of all available tools and resources to address this growing problem.
Under the governor’s directive, New Mexico started offering Medicaid reimbursement for Methadone and Suboxone in 2011 and 2012.
Sure, give the poor people methadone… and the state helps pay for it, too. I wonder if the state of New Mexico also pays the families of those who have died from methadone?
Vital Signs: Risk for Overdose from Methadone Used for Pain Relief — United States, 1999-2010
Vital statistics data suggest that the opioid pain reliever (OPR) methadone is involved in one third of OPR-related overdose deaths, but it accounts for only a few percent of OPR prescriptions… The overdose death rate for methadone was significantly greater than that for other OPR for multidrug and single-drug deaths.
[So, the cause of the problem wasn’t over-prescribing in at least one-third of opioid-related overdose deaths?]
In January 2008, on request of the Drug Enforcement Administration (DEA), manufacturers voluntarily limited distribution of the largest (40 mg) formulation of methadone to authorized opioid addiction treatment programs and hospitals only, because this formulation was not approved for the treatment of pain (6).
Data suggest that some of the current uses of methadone for pain might be inappropriate. According to an analysis conducted by FDA, the most common diagnoses associated with methadone use for pain in 2009 were musculoskeletal problems (such as back pain and arthritis) (46%), headaches (17%), cancer (11%), and trauma (5%). Most methadone prescriptions were written by primary care providers or mid-level practitioners (e.g., nurse practitioners) rather than pain specialists. Nearly a third of prescriptions appear to have been dispensed to patients with no opioid prescriptions in the previous month (i.e., opioid-naïve patients) (10).
The findings in this report are subject to at least five limitations…
Public and private insurers and health-care systems can ensure that prescribers of methadone follow dosage guidelines by requiring authorization for starting doses for pain that exceed the recommended upper limit of 30 mg per day (5). Insurance formularies should not list methadone as a preferred drug for the treatment of chronic noncancer pain. Pharmaceutical companies should introduce a 2.5-mg formulation of methadone to facilitate treatment with the lowest recommended dosage.
Well, it’s not bad enough that pain patients have the DEA acting as their doctors, but now also the allegedly bi-partisan CDC.
Chronic pain can greatly interfere with quality of life. Now a new initiative at the Murphy VA Medical Center in Albuquerque is helping women veterans learn to live with pain using several coping skills. The New Mexico VA Health Care System’s (NMVAHCS) Women Veterans Health Program (WVHP) launched “Living with Chronic Pain: Women Only Pain Management Group” in collaboration with Behavioral Medicine staff members. Women Veterans who have chronic pain now can meet for 90 minutes every other week in the new group. A Behavioral Medicine team including a female psychologist and a female intern conducts 10 group sessions. Patients share and learn coping techniques and tools for living with chronic pain. Typically, their pain is caused by fibromyalgia, migraines, back injuries, muscular skeletal problems or arthritis or other similar conditions.
The curriculum includes imaging tools to decrease focus on chronic pain and improve comfort levels, and discussions of values, acute versus chronic pain, depression, communicating with providers, confl ict management and a health self-evaluation. The goal is to normalize daily life activities. “We want to promote this non-invasive therapy and improve women’s quality of life, enabling them to engage in activities they may not have been able to manage before this unique group,” said Carole Donsbach, NMVAHCS Women Veterans Program Manager. Donsbach worked closely with psychologist Eric Levensky, Ph.D., to create and implement the program, a “National Best Practice.”
Women veterans interested in the chronic pain management group may call the clinic at (505) 265-1711, ext. 4621, or toll-free (800) 465-8262, ext. 4621 for more information.
My comment (which was put on hold):
So, the Medical Cannabis Program had nothing to do with it? Or the fact that most doctors refuse to prescribe pain medications any more? Even putting up signs in their offices to indicate same? And what have been the consequences?
As reported by KOB on 4/25/2014: “New Mexico has one of the highest drug overdose death rates in the nation, with heroin being among the top cause of death behind prescription drugs… In 2011, the New Mexico lifetime heroin rate was 4.7 percent, higher than the U.S. rate of 2.9 percent, the New Mexico Heath Department said.”
States like New York and Maine have reported a rise in heroin use and abuse, and as Forbes reported early this year: “The bottom line: Vermont’s stratospheric heroin increase is happening where the money is [high income professionals], and the national drug abuse trends suggest that the same thing is happening across the country.”
Maybe things are a little better with prescription drug overdoses, but isn’t alcohol a drug too?
As reported by NM DOH: “The consequences of excessive alcohol use are severe in New Mexico. New Mexico’s total alcohol-related death rate has ranked 1st, 2nd, or 3rd in the U.S. since 1981; and 1st for the period 1997 through 2007 (the most recent year for which state comparison data are available).”
I’m sorry, Governor Martinez, but what, exactly, are you crowing about?
(Stop the war against pain patients — because suffering is never pretty.)