As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition second to his parents’ homelessness, felt the poisonous effects of multiple substance abuse, and was the victim of the subsequent, injurious, powerful negative stress hormones pulsing through his mother’s veins.

The Origin Of A New Trauma-related Diagnosis

Addiction and overdose result in deep shame, guilt, and fear for persons suffering from addiction.

Most addicts report a heavy burden of anger and disgust for themselves for their addicted state. Subsequently, they acknowledge an absence of self-worth, which perpetuates hopelessness, low initiative for self-care, and an outward disregard for their lives and health as a way to offset dealing with the deep trauma roots of addiction.

A drug-addicted lifestyle is harder on the soul and body of an addict than on the people who love them, although family and friends suffer inexplicably living with and observing a loved one’s addiction.

However, there is a significant other victim of addiction who is most often never even acknowledged until the damage done to them is permanent. This person receives every spiritual, psychological, and physical impairment that the person in addiction experiences in active addiction and overdoses, but is incapable of processing or recovering from the events.

These lives helplessly experience repetitive, excessive drug use, and very often, overdose, in their body and mind. They can not escape the experiences or the source of those experiences and are unable to tell anyone or ask for protection from the effects of another’s drug abuse.

This is because they are not yet born.

How Excessive Prenatal Exposure To Drugs and Overdose Physiologically Affect A Newborn:

An addict’s excessive drug use is an overt sign of self-rejection. The user may not perceive initially that this is an originating factor of their addiction because there are many other valid facets to addiction.

However, a tragic consequence of addiction-related self-rejection is the destruction of innocence, both of the using individual and of any child growing in the womb of a pregnant addict.

A fetus has every capability to perceive love, affection, and its hopeful birth as it does to receive the innate rejection, disregard, and neglectful abuse occurring in substance abuse overdoses and drug abuse during its womb experience.

What transpires physically to the child through the onslaught of poisonous substances in-utero creates the intrinsic knowledge or perception that it is unwanted, alienable, and dismissible as being worthy of concern and love.

This is how addictive drug use causes any addict to feel. This deep trauma belief is transferred to the unborn through brain synapses, hormones, and the connective spirituality between mother and child.

My own grandson has been born from a severely multi-substance exposed pregnancy. Once home from the NICU, this tiny human being wore the look of the sadness and devastation of his intra-uterine experience in his countenance. I had never seen anything like it. It scared me to the core.

My experience with the result of a loved one’s addiction leads me to educate readers on the tragedies of prenatal opioid and substance abuse.

In my work as a NICU nurse, what always struck me about our “drug babies” was their direct inability to readily accept the human touch. I recognized that although sensory and neurological issues were a major component of that born trait, the inability to want or accept human touch was also resultant of the prenatal rejection occurring through pregnancy drug use and overdose.

They would grimace from touch first, as it appeared to hurt. Watching a new child recoil from another human being’s affection is heartbreaking.

An initial diagnosis of NAS or NOWS is not the separative long-term condition that these children go home with. Most NAS symptoms, some of which initially coincide with PORS symptoms, dissipate after several few weeks.

Most times, these babies were discharged home screaming, red-faced, uncomfortable, and heavily medicated. Their parent(s) would never have the patience and wherewithal to care for them, while still in active addiction or early recovery.

These children begin their fragile lives with both a biological and physical understanding/belief that life is pain, an intrinsic search to end that pain (which becomes a future central focus of existence), an inability to independently stop the physical and emotional pain of rejection (which creates a subhuman existence) and a disconnect from intimacy and self that permanently alters their perspective on self-worth, purpose, and trust for humanity.

Why Medical Intervention is Imperative in PORS and Active Parental Addiction

There are now new trauma classes for foster families accepting children from homes of drug use and other abuses, but few are well versed, if at all, on the subject of prenatal exposure to excessive substance use and overdose-related PTSD or the resultant rejection component in the newborn.

This is because the conditions in this delicate population are not yet medically recognized, documented, and treatable pediatric diagnoses.

It is especially not yet widely recognized that these brand new lives have severe PTSD.

Few professionals have or seek research on this.

Even with today’s recent increased trauma research, both the medical community and society seem to pull a sheet over both the inevitable and unexplainable realities occurring to a human being from prenatal drug exposure.

When medical professionals happen to note both the discord in the addict’s parental dynamics and in how prenatal and postnatal drug addiction (at home) affects those babies conceived in addiction, it is common to see the multitudinous signs and symptoms in a child who is suffering from PORS, dismissed as non-related diagnoses.

CPS can and will not intervene in most cases where a mother does not show up positive for substances at birth or just before. Addicts know to circumvent the system. Who confirms that she is sober a few days prior to the test and several days or weeks after discharge?

For the most part, no one.

An addict traditionally does not get sober during pregnancy just because an innocent life is at stake during or after childbirth.

Overall, there is little intervention from the medical community to acknowledge the delicate situation these children are born into or to actually protect their vulnerable and damaged lives from further damage.

Many times, it seems that this lack of response may stem from willful and/or fearful ignorance to address addiction and an age-old stigma that since an “addict begats an addict,” why intervene?

Few medical providers understand the devastating and insidious nature of the addicted mind. Many do not comprehend the further and continuing damage that occurs to a child who goes home to addiction in a post-exposure crisis medically, emotionally, and physically.

As a result, the formation of special parenting techniques is not addressed through counseling/therapy and things such as specialist referrals are not made or followed through with, compromising the child’s health and safety further.

Persons with an addiction can get better and someday give good care to and parent their child well but, in my experience and opinion as a nurse and observant custodial grandmother, the formative years of the child should not be under the care of addicts (even “functioning” ones) or newly recovered ones.

When an addict is in recovery, they learn that they must focus on themselves and their sobriety first and always to keep themselves in check to stay sober. Decisions must be made that leave out other members of that addict’s family and other life priorities in lieu of the priority of sobriety.

Only time, maturity, and experience weaving the recovery program’s requirements into all aspects of the addict’s life will eventually allow for that addict to be able to properly care for others, and achieve the self-awareness and discipline to do so while maintaining sobriety.

My professional and personal experience so far is the observation of the passive omission of the medical community to take initiative to reach out and engage these parents in any appropriate discussion or intervention of the care of their PORS-affected newborn, or the desperate need for addiction services.

Addressing Latent Effects of PORS and An Addicted Parental Response

A healthy baby whose pregnancy is free of substance abuse requires full-time, attentive, round-the-clock care.

A newborn who is riddled with the physical, mental, and emotional after-effects of prenatal substance abuse requires scrutiny and intervention in every aspect of care and an intimate understanding that their responses to everything around them are woven with distrust, fear, and disconnect.

In most cases, the obvious emotional and physical problems cannot be handled safely or appropriately either by addicts who remain in their addiction or by recovering addicts who are less than 1–2 years stable into their sobriety.

Beginning in the early months after birth, it takes a gentle hand, a calm demeanor, an overly attentive approach, and an excess of undistracted care to settle and restructure these children’s spirit after their womb trauma.

Keep in mind, rejection is a foundational component of their physical, mental, and emotional makeup.

The latent effects of this condition pose further danger to a child as they grow and age as most parents in recovery or in active addiction, will not recognize or understand prevailing and insidious symptoms such as the presence of sensory deprivation/overload, general sensorial problems, neurological delays, night terrors, processing disorders, speech/choking swallowing disorders and other serious maladaptations resulting from prenatal drug use and overdose.

Some of these diagnoses could take months or a few years to become visibly evident, although many are present right after birth.

This places the child in yet another traumatic situation because the uneducated, (uneducated to the problems associated with the diagnosis) addicted or sober parent is again, not traditionally sought out by the baby’s or mother’s medical professionals as an interventional risk or for the teaching of the probable issues to come.

Addicted or recovering parents are prone to getting angry easily (which is a result of their complicated mental and emotional condition in addiction) at the distracting crying, incessant need to eat and be soothed, or the refusal to eat and be held, as well as frequent illnesses.

What commonly happens in the manifestation of symptoms, is the parent(s) will react to the “irrational,” confusing behavior and excessive needs of the child and not to the cause of either. Subsequently, several types of abuse are common to occur, as the baby or older child’s behavior is intrinsically misunderstood.

Parents in active addiction or early recovery will usually misunderstand telltale signs that the baby is in need of a different kind of intense and patient parenting. The parents also do not have the ability in their current state to process or act on the needs of their child.

In one particular NICU environment I was employed in, the staff would read the city’s newspaper weekly on the unit to note which of our discharged babies had died by abuse or neglect. It was that common.

Others ended up in our emergency room completely malnourished and in active severe dehydration. Some made it, some did not.

The medical community as a whole must urgently re-examine the entire and intricate phenom of addiction. We must seriously re-examine sending a drug and overdose-exposed infant home to the people who had damaged them in utero, despite their “cleaned up” appearance and promises, and even despite any recent positive recovery status.

The menace that is relapse is an overshadowing, lurking danger, historically, and must be monitored very closely for a newly sober parent.

Self-coined Prenatal Overdose Rejection Syndrome Diagnosis.

Separate from my extensive nursing experience, I have gathered an immense amount of professional and personal expertise in managing, caring for, and in raising a child born into a heroin and meth addiction.

I noticed the symptoms of PORS in my professional career, but it was not until Charlie, my own grandson, was born from severe addiction that I could pen an actual name for the postnatal (and beyond) symptoms that I was seeing.

I have had legal custody of him since his fifth month of life. Charlie grew in-utero in my home from 28 weeks, was born at 38 weeks, and subsequently endured a month-long NICU stay and then was discharged to my home under the care of his birth mother and my youngest son, his father.

Both Charlie’s parents continue to struggle today with their recovery from heroin and meth, but for all their positive efforts (five years later) neither are in any kind of emotional or physical condition to parent Charlie and will not be for a long time, if ever.

During the pregnancy, in a rescue attempt to get help for her and for Charlie, I insisted that my grandson’s birth mother inform all her doctors and prenatal specialists of her heroin and meth addiction.

However, her specialists were not concerned.

They did not intervene and did not question her or even address her obvious positive drug screens occurring before her 28th week.

Not only was she not flagged as a risk to the baby at and after the birth, but the delivering ob/gyn actually told her that heroin and meth were not known to hurt a baby, so he “should be fine.”

This ridiculous and irresponsible line of thinking and under-education on this doctor’s part is reprehensible and did prove to be tragically wrong. Charlie was born with Gastroschisis, requiring immediate surgery after birth, and was subsequently diagnosed with 12 independent diagnoses.

Now, Prenatal Overdose Rejection Syndrome is an additional, undocumented and unrecognized problem I manage in his care and a focal point of intervention in his life.

Symptoms:

Charlie displays a constant need for reassurance of each family member’s role and connection with each other and to secure the idea that he and everyone “go together.” He continually looks for his proper place in the family, as it is clear he feels “out of place,” in general.

He is now almost five years old. Until very recently, he was inconsolable if I was not within sight and behaved as though he believed I was gone for good. This fear of abandonment began at birth. The few months his parents cared for him only cemented his fears as they did not know how and were not focused on meeting his needs…and they had both secretly returned to using just after he came home.

Charlie additionally had sudden, unexplained fevers, frequent illnesses (every 3 weeks almost on the dot) including pneumonia, RSV, strep, and other general maladies. He woke six to seven times a night, screaming inconsolably much of the time.

When a little older, he would hit himself when even gently corrected or if any situation seemed to place him in the spotlight for any reason. These issues are still present but improved now.

Charlie screams and talks angrily in his sleep often, now and seems to have dreams in which he is being threatened or attacked, as evidenced by this sleep speech and cries.

I sincerely believe this has to do with his prenatal and post-birth experiences with substance abuse, overdose, and the irresponsible, incomplete care he received from his parents in the first few months of his life.

For all the physical, neurological, and emotional difficulties (there are many more diagnoses), the most noted after effect of his prenatal exposure and trauma is his noticeable sense of rejection.

I am very careful in my one on one handling of his body when he walks and moves, as any accidental brush, scrape, or slight knock (think of getting a child into a car seat, dressing, or just moving about in general in the home) to his person sends him into a screaming fit, hitting himself.

The expectation of rejection and mistreatment is in his eyes, despite all my expressed care and love for him. I have also seen the same look in the eyes of other special needs children, both in my pediatric career and presently in other children attending therapy appointments at our therapy clinic.

Many things in a human being’s life can cause the rooted belief of unworthiness. It is incomprehensible that a developing fetus can be so poorly treated in the womb that this kind of root would begin before a first breath in the world, but it is an unfortunate reality.

Signs of PORS: (some can be characterized under other diagnoses as well)

If the caregiver/parent/grandparent of a child who suffered prenatal drug abuse and overdoses recognizes some or any of the following signs, immediate PCP’s therapy and developmental delay referrals needs to be made:

• excessive separation anxiety
• frequent night terrors
• social distancing from peers (can be observed as early as 12–18 months)
• delayed or difficult speech and conversation
• frequent, unexplained illnesses
• any purposeful self-injury
• the appearance of being persistently sad, aloof, disengaged or if they appear overexcited, excessively talkative ie: like the Energizer bunny and they are in a noticeable state of stress)
• anything else that appears to be “odd” or out of sorts with their communication methods, thought processes, and reactions to everyday activities and stressors.
• subtle and overt signs of problems processing daily communication and information, discipline, and social expectations. *
• Congenital mobility problems: weaknesses in various parts of the body showing as imbalance, toe-walking, odd gait, frequent falls, weak extremities, etc.

As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition, felt the effects of multiple substance abuse, and was the victim of the negative stress hormones pulsing through his mother’s veins caused by the distinct chaos of another’s addiction.

Again, I continue to observe that the PORS phenomenon with all its nuances is not considered even when clinicians do work with addicts and their children. The effect of an addict’s life and abuse on the fetus is not addressed head-on.

Medical providers are bound to the search and research of best care and we are trained to unturn every stone for solutions and resolutions. If this is not accomplished, there are dire consequences for a patient who has experienced prenatal exposure to drugs, and especially, severe cases.

This type of unborn life, this type of prenatal rejection, affects the child’s whole physical, mental, emotional and spiritual makeup.

It is a permanent, invisible disfigurement.

Suggesting Further Solutions:

As with any health problem in our world, one effective and necessary solution is education, which is the purpose for my piece on this under-recognized and hugely epidemic medical and social problem.

Active and sober addicts, the parents and caregivers of the affected babies and children, and other involved (and medical) parties affected by Prenatal Overdose Rejection Syndrome need to be educated on the signs and symptoms of this not-yet-diagnosed condition.

Immediate, compassionate and consistent intervention should unequivocally begin at the positive test for pregnancy in an addict. As much as we, the medical community, can do to help that mother obtain permanent sobriety, we should do.

All parties affected by and involved in the care of Prenatal Overdose Rejection Syndrome also need a voice as a way to heal, educate, and be educated to implement treatments and cares and advocate for new research into this devastating issue. This begins by assessing, triaging, monitoring, and providing the utmost, loving and creative care are for these populations, as we are capable of.

This happens through the willful and purposeful engagement of physicians and other medical providers to swiftly address the symptoms of addiction in the parent and those of the child born out of that addiction. Researching and documenting these mental health and physical conditions and presentations is most imperative.

To summarize

Unborn babies in the womb of an active addict are the most at-risk type of patients in society and the medical community due to the inability of this type of patient to advocate for themselves and the inability of the addicted parent (s) to advocate appropriately for either of them.

The lives and health of these babies are severely compromised before birth. They are discarded and rejected prior to life outside the womb through the use and overdosing of substances, whether intentionally or neglectfully done.

Until research on the full psychosocial, psychological, and coinciding physical and emotional prenatal effects of drug use and overdose is addressed thoroughly, and protective measures for the unborn experiencing this abuse are put into effect, many an unborn child in the womb of an active addict will be plagued with a consciousness of intrinsic and lasting rejection before they are even seen or held.

This is unacceptable for our children and grandchildren and for any new human being.

The post Prenatal Overdose Rejection Syndrome appeared first on Medika Life.

One of the ways is to indicate that a patient required more pain medication than was administered or to collect any containers that have medication in them and that were to be carefully discarded.

As noted in a professional journal, “Too many of us have known of a colleague with substance use disorder (SUD) whose behaviour resulted in severe consequences to the person or to others. SUD is not specific to our specialty, but doctors are at the top of the occupational risk ranking and the anesthesiologist is at the top of these….”

In fact, “Anesthesiologists experience substance use disorders at a rate reported to be 2.7 times that of other physicians.”

How do we know that any health care personnel working on a unit is or isn’t addicted? Also, how do we know that all of the physicians caring for patients are not cognitively impaired? I knew of one physician who had to be guided by the nurses on the unit whenever he was prescribing a medication.

There was no question that he should have retired, but he had a position of authority and was seen as an expert in his field, and no one wanted to step on his toes. I don’t know what happened to him, but I hope there were no serious mistakes because of his impairment.

Another physician at a nursing home, where he was the medical director, was a known alcoholic, and again the nurses always covered for him. He only left the position when the nursing home was acquired by a large corporation that cut back staff and brought in new management.

A third physician, a surgeon, was known to abuse alcohol and come into the operating room with alcohol on his breath. He was never reported. Once again, neither the nurses nor anyone else ever told anyone.

The Addicted Physician

I once worked at a hospital where a new psychiatrist came to one of the units where a colleague was working. His appearance was somewhat odd. He wore suits that were rumpled and outdated and were too flashy. We chalked it up to his not having done very well in the profession and let it go at that.

Imagine our shock when we discovered that another psychiatrist in the hospital was supervising him because he had previously been an anesthesiologist and was forced to change his specialty to psychiatry. However, the addicted physician found a way to continue his addiction, and it was simple. All he had to do was remove prescription sheets from the back of the pad of his supervisor. The supervisor had left the prescription pad in an unlocked office desk drawer.

How was his deception discovered? Foolishly, the addicted physician took the scripts, using patient names, to a local pharmacy to have them filled. In addition, the scripts were all for quaaludes. The pharmacist found this quite curious and called the director of medicine at the hospital to ask why this psychiatrist was handing in so many prescriptions. It was then that they discovered his ruse, and he was, once again, sent to an addictions rehab hospital. He had already been a patient at two prior addiction rehab facilities.

The cleverness of this deception was thwarted once the state in which he worked required all prescription pads to be printed on special paper and copies sent to a state database by pharmacists. This was not a unique instance, and other states quickly determined they needed to revise prescription pad production and recording databases to prevent misuse. But addiction isn’t the only challenge for medicine.

Setting Standards for Continued Practice

In the past few years, professional literature began discussing when a physician should retire or what types of evaluations should be put in place to maintain a license after a certain age. It doesn’t crop up often, and it is a tough call to make.

The state’s medical licensing board is one place where all physicians can be subjected to a review of their work or where complaints can be lodged. They examine both professional and consumer reports sent to them. If someone wishes to check on a specific physician’s credentials, there’s also a place for that, and it is here on Docinfo.

Unfortunately, another database, the National Practitioner Data Bank (NPBD), is accessible only to specific groups. It was created by federal law to protect consumers, and its site states, “Although these reports are not available to the general public, various entities (e.g., hospitals and other health care entities) may query the NPDB to obtain information on a specific licensee or entity.” I doubt that patients know the database exists or if it contains material on cognitively impaired physicians.

A “graying” of the physician workforce was noted before the 21st century, but there is a reluctance to report or to require evaluation of older physicians. How should this question(s) be resolved? “…the authors issue a call for an expert consensus panel to convene to make recommendations concerning aging physicians with cognitive impairment who are at risk for medical errors.”

We are awaiting such a panel and, in the meantime, let the patient be vigilant and keep good notes on their care and from whom they received it.

The post Are Lives Lost by Cognitively Impaired/Drug-Abusing Physicians? Who Reports Them? appeared first on Medika Life.

David Sarabia had already sold two startups by age 26 and was sitting on enough money to never have to work another day in his life. He moved from Southern California to New York City and began to indulge in all the luxuries his newly minted millionaire status conveyed. Then it all went sideways, and his life quickly unraveled.

“I became a massive cocaine addict,” Sarabia said. “It started off just casual partying, but that escalated to pretty much anything I could get my hands on.”

At one particularly low point, Sarabia was homeless for three months, sleeping on public transportation to stay warm. Even with plenty of money in the bank, Sarabia said, he’d lost the will to live. “I’d given up,” he said.

He got back on his feet, sort of, and for the next three years lived as a “functional cocaine addict” until his best friend, Jay Greenwald, died after a night of partying. Finally, Sarabia checked himself into a rehab in Southern California — ostensibly a luxurious one, although Sarabia didn’t find it to be so.

Still, the place saved his life. The clinicians really cared, he recalled, although their efforts were hampered by clunky technology and poor management. He had the feeling that the owners were more interested in profits than in helping people recover.

Just days off cocaine, the tech entrepreneur was scribbling designs for his next startup idea: a digital platform that would make clinician paperwork easier, combined with a mobile app to guide patients through recovery. After he left treatment in 2017, Sarabia tapped his remaining wealth — about $400,000 — to fund an addiction tech company he named inRecovery.

With the nation’s opioid overdose epidemic hitting a record high of more than 100,000 deaths in 2021, effective ways to fight addiction and expand treatment access are desperately needed. Sarabia and other entrepreneurs in the realm they call addiction tech see a $42 billion U.S. market for their products and an addiction treatment field that is, in techspeak, ripe for disruption.

It has long been torn by opposing ideologies and approaches: medication-assisted treatment versus cold-turkey detox; residential treatment versus outpatient; abstinence versus harm reduction; peer support versus professional help. And most people who report struggling with substance use never manage to access treatment at all.

Tech is already offering help to some. Those who can pay out-of-pocket, or have treatment covered by an employer or insurer, can access one of a dozen addiction telemedicine startups that allow them to consult with a physician and have a medication like buprenorphine mailed directly to their home. Some of the virtual rehabs provide digital cognitive behavior treatment, with connected devices and even mail-in urine tests to monitor compliance with sobriety.

Plentiful apps offer peer support and coaching, and entrepreneurs are developing software for treatment centers that handle patient records, personalize the client’s time in rehab, and connect them to a network of peers.

But while the founders of for-profit companies may want to end suffering, said Fred Muench, clinical psychologist and president of the nonprofit Partnership to End Addiction, it all comes down to revenue.

Startup experts and clinicians working on the front lines of the drug and overdose epidemic doubt the flashy Silicon Valley technology will ever reach people in the throes of addiction who are unstably housed, financially challenged, and on the wrong side of the digital divide.

“The people who are really struggling, who really need access to substance use treatment, don’t have 5G and a smartphone,” said Dr. Aimee Moulin, a professor and behavioral health director for the Emergency Medicine Department at UC Davis Health. “I just worry that as we start to rely on these tech-heavy therapy options, we’re just creating a structure where we really leave behind the people who actually need the most help.”

The investors willing to feed millions of dollars on startups generally aren’t investing in efforts to expand treatment to the less privileged, Moulin said.

Besides, making money in the addiction tech business is tough, because addiction is a stubborn beast.

Conducting clinical trials to validate digital treatments is challenging because of users’ frequent lapses in medication adherence and follow-up, said Richard Hanbury, founder and CEO of Sana Health, a startup that uses audiovisual stimulation to relax the mind as an alternative to opioids.

There are thousands of private, nonprofit, and government-run programs and drug rehabilitation centers across the country. With so many bit players and disparate programs, startups face an uphill battle to land enough customers to generate significant revenue, he added.

After conducting a small study to ease anxiety for people detoxing off opioids, Hanbury postponed the next step, a larger study. To sell his product to the country’s sprawling array of addiction treatment providers, Hanbury decided, he would need to hire a much larger sales team than his budding company could afford.

Still, the immense need is feeding enthusiasm for addiction tech.

In San Francisco alone, more than twice as many people died from drug overdoses as from covid over the past two years. Employers, insurers, providers, families, and those suffering addiction themselves are all demanding better and affordable access to treatment, said Unity Stoakes, president and managing partner of StartUp Health.

The investment firm has launched a portfolio of seed-stage startups that aim to use technology to end addiction and the opioid epidemic. Stoakes hopes the wave of new treatment options will reduce the stigma of addiction and increase awareness and education. The emerging tools aren’t trying to remove human care for addiction, but rather “supercharge the doctor or the clinician,” he said.

While acknowledging that underserved populations are hard to reach, Stoakes said tech can expand access and enhance targeted efforts to help them. With enough startups experimenting with different types of treatment and delivery methods, hopefully one or more will succeed, he said.

Addiction telehealth startups have gained the most traction. Quit Genius, a virtual addiction treatment provider for alcohol, opioid, and nicotine dependence, raised $64 million from investors last summer, and in October, $118 million went to Workit Health, a virtual prescriber of medication-assisted treatment. Several other startups — Boulder Care, Groups Recover Together, Ophelia, Bicycle Health, and Wayspring, most of which have nearly identical telehealth and prescribing models — have landed sizable funding since the pandemic started.

Some of the startups already sell to self-insured employers, providers, and payers. Some market directly to consumers, while others are conducting clinical trials to get FDA approval they hope to parlay into steadier reimbursement. But that route involves a lot of competition, regulatory hurdles, and the need to convince payers that adding another treatment will drive down costs.

Sarabia’s in Recovery plans to use its software to help treatment centers run more efficiently and improve their patient outcomes. The startup is piloting an aftercare program, aimed at keeping patients connected to prevent relapse after treatment, with Caron Treatment Centers, a high-end nonprofit treatment provider based in Pennsylvania.

His long-term goal is to drive down costs enough to offer his service to county-run treatment centers in hopes of expanding care to the neediest. But for now, implementing the tech doesn’t come cheap, with treatment providers paying anywhere from $50,000 to $100,000 a year to license the software.

“Bottom line, for the treatment centers that don’t have consistent revenue, those on the lower end, they will probably not be able to afford something like this,” he said.

The post Money Flows Into Addiction Tech, But Will It Curb Soaring Opioid Overdose Deaths? appeared first on Medika Life.

If you would like your local retailers to stop selling this drug to your children and other vulnerable members of the community, there is a link at the end of this article to report the drug and actions you can take to have the product removed from shelves.

What is Kratom?

According to a very detailed analysis of the plant on Wikipedia, Mitragyna speciosa (commonly known as kratom) is a tropical evergreen tree in the coffee family native to Southeast Asia. It is indigenous to Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where it has been used in herbal medicine since at least the nineteenth century. Kratom has opioid properties and some stimulant-like effects.

As of 2018, the efficacy and safety of kratom are unclear, and the drug was unapproved as a therapeutic agent due to the poor quality of the research. FDA and other investigations suggest that any applications for licensing would fail, based on the drug’s current safety profile and reported interactions with other medications and substances, reactions that are often fatal.

In 2019, the Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition. Some people take it for managing chronic pain, for treating opioid withdrawal symptoms (no shred of clinical evidence exists to support this), as a herbal cure-all sold on various websites as a treatment for pretty much everything, from the common cold to cancers, or for recreational purposes.

The onset of effects typically begins within five to ten minutes and lasts for two to five hours. It’s worth noting that most opioid users end up taking both opioids and Kratom (or cycling), clear evidence that Kratom is useless as a treatment against opioid addiction.

Common and more serious side effects include;

• nausea
• itching
• sweating
• dry mouth
• constipation
• increased urination
• loss of appetite
• seizures
• hallucinations
• respiratory depression (decreased breathing),
• seizure
• addiction
• psychosis

Other serious side effects may include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity. When use is stopped, withdrawal symptoms often occur. Deaths have occurred with kratom both by itself and mixed with other substances. Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.

Kratom is a controlled substance in 16 countries and, in 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use. In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts.

The real danger posed by Kratom

Availability is a key problem. Your child can stop in to shop at a gas station and buy the product off the shelf. A fact verified today by my colleague in Texas. It also doesn’t show up on regular drug tests, so many deaths associated with Kratom go unlisted.

If in some weird alternate universe Kratom is shown to possess any real medical benefits (none have been discovered or scientifically validated as yet) it would still require a lengthy regulation process for certification by the FDA. This process exists to protect consumers against products exactly like Kratom. In 2013, the US Drug Enforcement Agency (DEA) issued a warning about Kratom, stating that there was no proven medical use for the drug.

To be 100% clear on this. Kratom is considered highly dangerous by the FDA and many other countries’ drug licensing authorities. It can lead to death, dependency, and a host of other nasty conditions. It is a psychedelic, so please don’t feed me bullshit about pain management. Get stoned enough and your pain tends to magically evaporate for the duration of the high. The effects reduce with each usage, leading to increased dosages and almost guaranteed addition.

Kratom also won’t cure any diseases or conditions, no matter what the quacks and con-artists selling Kratom promise you.

New drugs often enjoy a honeymoon period with the public, a window where they can be freely distributed simply because legislation has not yet been enforced to protect the public. Cocaine was legally sold across the counter not so many years ago. The system isn’t perfect and it is slow to react. Sadly, death and addition are an all too common byproduct of this window.

There is a reason doctors don’t (or shouldn’t) keep their patients permanently stoned up the yazoo and there is a reason America has a MASSIVE problem with opioid addiction. Psychotropic and psychedelic drugs aren’t the answer for management of chronic pain. In fact, they aren’t a medical solution for just about anything.

If you’re a late-stage cancer patient or other, bedridden and on death’s door, that is a different issue. Don’t confuse chronic pain with end of life scenarios.

On overdose and related interactions

There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A 2019 paper analyzing data from the National Poison Data System found that between 2011–2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances.

In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances, including illicit drugs, opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications, such as cough syrup.

Also, there have been some reports of kratom packaged as dietary supplements or dietary ingredients that were laced with other compounds that caused deaths. The FDA also seized various Kratom products that were contaminated with Salmonella. Still think your local retailer should be selling this?

Figures above provided by the National Institute on Drug Abuse

The FDA and Kratom in the US

According to a 2019 statement on the FDA website the FDA stated the following regarding Kratom.

The U.S. Food and Drug Administration is warning consumers not to use Mitragyna speciosa, commonly known as kratom, a plant which grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea. FDA is concerned that kratom, which affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.

There are no FDA-approved uses for kratom, and the agency has received concerning reports about the safety of kratom. FDA is actively evaluating all available scientific information on this issue and continues to warn consumers not to use any products labeled as containing the botanical substance kratom or its psychoactive compounds, mitragynine and 7-hydroxymitragynine. FDA encourages more research to better understand kratom’s safety profile, including the use of kratom combined with other drugs.

To date, they have taken the following actions against the product’s import into the US.

• In September 2014, U.S. Marshals, at the FDA’s request, seized more than 25,000 pounds of raw kratom material worth more than $5 million from Rosefield Management, Inc. in Van Nuys, California.
• In January 2016, U.S. Marshals, at the FDA’s request, seized nearly 90,000 bottles of dietary supplements labeled as containing kratom and worth more than $400,000. The product, manufactured for and held by Dordoniz Natural Products LLC, located in South Beloit, Illinois, is marketed under the brand name RelaKzpro.
• In August 2016, U.S. Marshals, at the FDA’s request, seized more than 100 cases of products labeled as containing kratom and worth more than $150,000. The products are distributed by Nature Therapeutics LLC, which does business as Kratom Therapy and is located in Grover Beach, California. The seized products are marketed under the brand name Kratom Therapy.

The FDA has issued warnings to companies. The companies receiving warning letters use websites and social media to illegally market kratom products, making unproven claims about the ability of the kratom drug products they distribute to cure, treat, or prevent disease. Examples of claims being made by these companies include:

• “Kratom acts as a μ-opioid receptor-like morphine.”
• “In fact many people use kratom to overcome opiate addiction.”
• “Of course, people who are using kratom to overcome a preexisting opiate addiction may need to use kratom daily to avoid opiate withdrawal.”
• “Usage: It is for the management of chronic pain, as well as recreationally.”
• “Kratom is frequently used as a natural alternative to treat depression, anxiety, addiction, diabetes, chronic pain and fatigue…Kratom has been reported to have taken the place of brand name drugs like Hydrocodone or Oxycodone for individuals, all the way to weaning people off of Heroin.”
• “Some researchers have even claimed that kratom can protect you against cancer!”
• “Kratom is used for energy, to increase attention/focus, to relax, and also to treat pain and addiction. Here is just some of what our customers have used kratom to treat . . . Chronic Pain, Migraines, Opiate Addiction, ADHD/ADD, Anxiety, Depression, Arthritis, Insomnia, and much more!”

Health fraud scams like these can pose serious health risks. These products have not been demonstrated to be safe or effective for any use and may keep some patients from seeking appropriate, FDA-approved therapies. Selling these unapproved products with claims that they can treat opioid addiction and withdrawal and other serious medical conditions is a violation of the Federal Food, Drug, and Cosmetic Act.

There are a lot of advisories issued by the FDA on this drug, you can find an extensive list in the footer of the article linked to above.

Reporting This Drug

You can use this link provided by Medwatch to report the drug and any adverse interactions you, or someone you know, may experience.

MedWatch Online Voluntary Reporting Form

What can you do about retailers making these products freely available in your town or city? If they are large chains, reach out with a formal letter to their head office, notifying them of the dangers of Kratom, and copy in your local government and press. For smaller private retailers, try dropping off or sharing information on the dangers of the product and if they show disregard for your children’s safety and others within their community, consider boycotting the stores.

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