Maximizing Texas’s Opioid Settlement: Investing in Treatment & Rehabilitation

The US has been experiencing an opioid crisis since the mid-90s. This was around the time when there was a shift in how doctors prescribed pain medication. Pharmaceutical companies downplayed the addictive potential of opioids, and doctors were encouraged to prescribe them more liberally for chronic pain. Sadly, this led to a significant increase in the number of people taking prescription opioids like Percocet and OxyContin.

As more people were exposed to opioids, rates of addiction and misuse skyrocketed. Many who became addicted to prescription drugs eventually turned to cheaper, more dangerous alternatives like heroin, further inflating overdose deaths. The rise in opioid overdose deaths paralleled the increase in opioid prescriptions, highlighting a clear link between the two. 

After the CDC survey that found over 10 million patients misused prescription opioids in 2018, it, along with states like Texas, declared an opioid epidemic and changed prescription standards. Texas and 13 other states took the drug companies to court, with both Democrat and Republican attorneys general teaming up to sue. 

In July 2021, a significant agreement was made: Johnson & Johnson and three drug distributors agreed to cough up $26 billion to settle the case. But other settlements, including with OcyContin manufacturer Purdue Pharma, are still pending. Texas is expected to get about $1.6 billion from six companies over 18 years as part of these settlement agreements.

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The Current State of Opioid Addiction in Texas

Texas is experiencing a drug poisoning epidemic. According to surveys, deaths from poisoning in the state increased by more than 75% in just five years. In 2017, the rate was 9.4 deaths per 100,000, and that nearly doubled to 15.8 deaths per 100,000 residents in 2021.

Although the prescription of opioids by doctors in Texas has reduced over the last few years, overdose deaths from illegally manufactured fentanyl continue to rise. A CDC report estimates 5,566 drug-related deaths occurred in Texas between August 2022 and August 2023. 45% of these deaths involved fentanyl.

The human cost of opioid addiction is immense. For every statistic, there’s a person and a story—a family member, a friend, or a neighbor whose life has been affected. Beyond that, the opioid epidemic is putting a strain on all levels of care. Hospitals and emergency services are overwhelmed by the number of overdose cases they handle daily.

This strain makes it harder for everyone to get the care they need. Local resources such as law enforcement and social services are also stretched thin trying to manage the wide-ranging consequences of the opioid crisis. 

The Potential Impact of Strategic Investments 

The $1.6 billion settlement presents a significant opportunity for Texas to combat the opioid crisis effectively through strategic investments. Proper allocation of these funds can profoundly impact the state's ability to support the people who are struggling with addiction, improve public health, and reduce the overall burden of the crisis.

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Let’s explore some key areas where strategic investments can make a difference:

Expansion of Treatment Facilities

There’s a need for more treatment facilities so more people can get the help they desperately need. With more money, we can build new treatment centers and improve upon the ones we already have. This means people won’t have to wait so long to get care. These centers can offer a variety of services like detox, inpatient and intensive outpatient treatments, and special treatments for mental health conditions. More facilities means increasing the number of beds, doctors, and nurses, which ultimately leads to saving more lives.

Enhancement of Recovery Support Services

The money can also go to recovery support to give people the tools they need to rebuild their lives. This includes access to counseling and therapy, which are crucial for long-term recovery. Programs that offer stable housing and job training can help people recover and stay sober.

We can also create peer support groups and mentorship programs where people who have been through recovery can offer support and advice. These services build a strong support network that can make a huge difference.

Implementation of Prevention Programs

Preventing addiction before it starts is key to tackling the opioid crisis. When we invest in prevention programs, we can educate communities about the dangers of opioid misuse and teach healthy coping strategies.

Schools, workplaces, and community centers can run educational programs to raise awareness. Early intervention programs can identify at-risk people and help them before things worsen. Strengthening prescription monitoring systems can also prevent misuse and diversion of opioids. Prevention efforts can stop the cycle of addiction before it starts, saving lives and reducing the impact of the crisis. 

Misallocation of Opioid Settlement Funds Raises Concerns

In the wake of the opioid crisis, states across the country have received significant settlement funds intended to combat addiction and support affected communities. However, there are growing concerns about how these funds are being used. Instead of directing the money towards prevention and treatment options, some states are spending it on things like new police cars and slush funds that don't directly help those struggling with substance use disorders.

Police Cars and Equipment

In several states, portions of the opioid settlement funds have been used to buy new police cars and other law enforcement equipment. While law enforcement is crucial in addressing the crisis, these expenditures don’t provide the necessary treatment or support for individuals battling addiction.

Filling Budget Gaps

Some states use the funds to cover general budget shortfalls or unrelated projects. This means the money isn’t going to addiction treatment or prevention programs, which undermines efforts to combat the opioid epidemic.

Lack of Transparency

In some instances, funds have been placed into slush funds with little oversight or accountability. Without explicit tracking, it’s hard to ensure the money is being used to help those who need it most.

The Need for Transparency and Accountability

Unless the state and local governments put the funds to good use, they won’t help those affected. The state can ensure this happens by:

  1. Establishing robust oversight mechanisms. This includes transparent reporting, regular audits, and involving community stakeholders in decision-making processes.
  2. Learning from the missteps of other states, where funds have been diverted to unrelated expenses like new police cars and slush funds, Texas must commit to using the settlement money exclusively for addressing the opioid crisis.
  3. Strategically allocating funds to areas with the highest need and potential impact. This way, Texas can maximize the benefits of the settlement, supporting recovery, reducing overdose deaths, and ultimately diminishing the overall opioid crisis in the state.
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How to Track Fund Usage in Your Community

There are several resources available to help track the allocation and use of opioid settlement funds:

News Sites

While the information might not be readily available, some platforms, like KFF Health News, have made it public after negotiations.

Government Websites

Check state and local government websites for information on fund allocation and spending. Look for sections on budget reports, public health initiatives, or opioid response plans. BrownGeer, a court-appointed firm administering the settlements, also shares the information on a public website.

Public Records Requests

You can file public records requests to obtain detailed information about funds' use. Do this through state or local government offices handling public information requests.

Community Advocacy Groups

Local advocacy groups focused on addiction and public health, such as the Texas Harm Reduction Alliance and the Texas Overdose Naloxone Initiative (TONI), can be valuable resources for information and action.

Opioid Addiction Treatment at More Than Rehab

At More Than Rehab, we’re committed to making a real impact. We offer comprehensive care, from detox and therapy to long-term support and education. Our mission is to provide a safe, supportive environment where people can recover and thrive.

With the right investments and a commitment to transparency and effectiveness, we can make a significant difference in the fight against the opioid crisis in Texas. Let’s work together to ensure these funds are used to their fullest potential, helping those in need and building healthier communities across our state.

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The Emerging Trend of Synthetic Drugs & Designer Substances

Synthetic drugs and designer substances are increasingly easy to come by. With the rise of online markets and illicit distribution networks, people can easily obtain these substances with just a few clicks or a quick exchange on the street corner. This accessibility presents a significant challenge to public health and safety, as it increases the chances of people experimenting with and becoming addicted to these dangerous substances.

Adding to the challenge is the fact that synthetic drugs are often marketed deceptively. They are branded as "legal highs" or "safe alternatives" to traditional drugs, luring unsuspecting individuals into a false sense of security. Many people underestimate the dangers posed by these substances, believing them to be harmless or less risky than “illegal drugs.”

This misinformation exacerbates the problem, as young adults are more likely to experiment with synthetic drugs without fully understanding the potential consequences. Synthetic drugs and designer substances can have unpredictable effects on the body and mind, leading to a range of health complications, addiction, and even death.

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What are Synthetic Drugs and Designer Substances?

Synthetic drugs and designer substances are human-made chemicals that mimic the effects of natural or legal substances like marijuana, cocaine, or fentanyl. They are sometimes sold under fancy names research chemical or safe alternatives, but they can be just as dangerous, if not more so, than the drugs they're imitating. And just because they are made in a lab doesn't mean they’re safe.

In fact, it's often quite the opposite. They can cause all sorts of problems, like heart issues, seizures, hallucinations, and paranoia. Plus, because they're so strong, it's easy to overdose and end up in serious trouble, or even worse, you could lose your life.

Research Chemical Laws

The National Institute on Drug Abuse outlines chemicals that can be used for medical reasons. But, illicit drug manufacturers mostly copy publicly published research and replicate the chemical structures. They only use labels like “research chemicals” to mislead users and downplay how dangerous these illicit substances can be.

On top of that, they package the products with warnings like “not for human consumption” to bypass drug enforcement laws and regulatory scrutiny. And since most of these drugs have legal analogs under the Controlled Substances Act, manufacturers are able to circumvent existing laws that target specific chemical formulations.

Despite the clear intent of users to consume these substances for recreational purposes, the inclusion of such disclaimers creates ambiguity regarding the manufacturer's liability and the intended use of the product.

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Common Types of Synthetic and Designer Drugs

There are literally hundreds of synthetic and designer drugs on the market. Here are some common types:

Synthetic Cannabinoids

Examples: Spice, K2, 2C-B, Bliss, Blaze, Skunk and Yucatan Fire

Synthetic cannabinoids are designed to mimic the effects of THC, the psychoactive compound in marijuana. They are potentially 100 times stronger than plant-based marijuana and can produce effects such as euphoria, altered perception, relaxation, and heightened sensory experiences.

Synthetic Cathinones

Examples: Bath salts, MDPV, Alpha-PVP, Flaka, Gravel

Synthetic cathinones mimic the effects of stimulant drugs like MDMA or cocaine, producing feelings of euphoria, increased energy, alertness, and sociability. According to research, a single dose of bath salts is equivalent to 10 lines of cocaine. Bath salt causes agitation, anxiety, paranoia, hallucinations, chest pain, high blood pressure, rapid heartbeat, and, in extreme cases, aggression and self-harm.

Novel Psychoactive Substances (NPS)

Examples: 5-MeO-DMT (5-Methoxy-N, N-dimethyltryptamine), NBOMe (N-Benzylmethoxy), synthetic opioids, dissociatives, and hallucinogens.

NPS encompasses a wide range of synthetic drugs with diverse effects, including hallucinogenic, stimulant, sedative, and dissociative properties. Effects vary depending on the specific substance and dosage. For example, hallucinogens like 2C-I-NBOMe and 2C-C-NBOMe work similarly to LSD, and even a few salt-sized grains can cause a deadly high.

Molly

Molly, short for molecular, or molecule, is a street name for MDMA (3,4-methylenedioxymethamphetamine), also known as ecstasy. The drug produces feelings of euphoria, empathy, emotional openness, and increased sensory perception. Users may experience enhanced sociability, reduced anxiety, and heightened sensory experiences. But molly is often cut with other chemicals like MDPV and methylone.

DMT, AMT, Foxy, Nexus, and Blue Mystic:

These hallucinogens produce profound alterations in perception, consciousness, and mood. They are often used in clubs, music festivals, and rave scenes and cause users to experience visual and auditory hallucinations, distorted time perception, and spiritual or mystical experiences.

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Mental and Physical Effects of Designer and Synthetic Drugs

Synthetic drugs can have a range of adverse side effects due to their unpredictable nature and chemical composition. Some common side effects include:

Physical Health Effects

Psychological Effects

Long-Term Consequences

The exact side effects can vary depending on the specific synthetic drug, its potency, dosage, and individual factors such as age, health status, and any co-occurring mental health conditions. Due to the unpredictable nature of synthetic substances, there is also a risk of experiencing adverse reactions or overdose, which can be life-threatening.

What Needs to Be Done?

While drug manufacturers and dealers are adept at exploiting legal loopholes and evading 5-MeO-DMT measures, concerted efforts are needed to counter their activities. This includes strengthening regulatory frameworks to close existing gaps that enable the production and distribution of synthetic drugs.

Enhanced public education campaigns are also needed to raise awareness about the risks associated with these substances. These campaigns should mostly target the high-risk groups, which include young adults, mainly males in their mid- to late 20s, as well as college students who are likely to use due to peer pressure. The campaigns should provide accurate information about the deceptive marketing tactics used by manufacturers and emphasize the potential dangers of experimentation.

Lastly, healthcare professionals must be equipped to provide drug testing, support, and treatment to those struggling with addiction to synthetic drugs.

If you or someone you know experiences severe side effects or overdose symptoms after taking any drug, seeking immediate medical attention is crucial. At More Than Rehab, we understand the urgency of addressing substance abuse issues and are here to provide support and guidance.

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How Naltrexone Implants Work for Alcohol & Opioid Addiction

Opioid and alcohol use disorders are a growing concern in the United States, especially with the rise in overdose deaths. In 2021 alone, 107,622 drug-involved overdose deaths were reported in the country, and opioids accounted for 80,816. In the same year, there were over 52,000 alcohol-induced deaths in the US. 

The increase in substance abuse and overdose cases indicates the need for addiction maintenance treatments. While traditional treatments for opioid and alcohol use disorder do a great job of helping people get off of drugs, they do little to prevent overdose cases. Once a recovering addict leaves the treatment facility, they may face triggers that can result in relapse and overdose. 

That's why many medical institutes worldwide are still trying to find innovative ways to enhance the convenience and chances of long-term sobriety. Naltrexone implants are one such innovative treatment option. These implants provide long-term maintenance from alcohol and opioids by reducing the risk of cravings and relapse.

What are Naltrexone Implants? 

Naltrexone implants are small pellets that contain the medication naltrexone. Naltrexone is an opioid antagonist medication that blocks the effects of opioids and alcohol on the brain, thus helping manage cravings. 

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The principle behind this medication-assisted treatment is that if someone can't feel the desired effect of drugs, they won't be motivated to use them. Over time, the positive association with opioids or alcohol will fade, and temptations won't be present.

When the implant is inserted under the skin, it slowly releases Naltrexone into the body over several weeks to months. This extended release can help reduce cravings for opioids or alcohol and prevent relapse. In some cases, it can also help curb opioid overdose cases.

Naltrexone implants have shown promising results in treating alcohol and opioid addiction, mainly when used in conjunction with other forms of evidence-based treatment, like medication, counseling, and support groups. This holistic approach addresses substance use disorders and the mental health aspect. 

How Naltrexone Implants Work for Alcohol and Opioid Addiction

Naltrexone is an opioid antagonist medication that works by blocking the opioid receptors in the brain. The implants provide a constant level of medication in the body, which can help to keep the opioid receptors blocked and reduce the risk of relapse.

Naltrexone implants have several advantages as they:

Weakness of Naltrexone Treatment

Despite the advantages of Naltrexone, there are some downsides as well. These include:

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How Are Naltrexone Implants Administered?

Naltrexone implants are small, sterile pellets implanted under the skin in a minor surgical procedure. The procedure is usually done in an outpatient setting, meaning you won't need to stay overnight in a hospital.

First, a healthcare professional will clean and numb the area where the implant will be inserted. This is done with a local anesthetic, so you'll be awake during the procedure but won't feel any pain.

Next, the healthcare professional will make a small incision in your lower abdomen skin. They'll then insert the naltrexone implant into the pocket they've created under the skin and close the incision using stitches or adhesive strips. They will also apply a sterile dressing to the area to protect it as it heals. 

The procedure usually takes about 20 minutes or less you can go home the same day. 

Side Effects of Naltrexone Implants

Naltrexone is generally safe. But like any medication, it can cause side effects. Here are some of the potential side effects of naltrexone implant:

  1. Pain, swelling, or redness at the implant site
  2. Infection at the implant site
  3. Bleeding or bruising at the implant site
  4. Itching or rash at the implant site
  5. Nausea or vomiting, headache or dizziness
  6. Diarrhea
  7. Anxiety or nervousness
  8. Fatigue or weakness
  9. Liver problems
  10. Allergic reactions

It's important to note that these side effects are usually mild and temporary, and most people tolerate the medication well. However, if you experience severe or persistent side effects, you should contact your healthcare provider immediately. 

If you have any medical conditions or take other medications, inform your healthcare provider before starting a naltrexone implant to ensure it's safe and effective for you.

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Starting Naltrexone Treatment

Before starting Naltrexone, you must undergo an assessment to ensure you're suited for treatment. A good candidate for Naltrexone treatment would typically meet the following criteria:

Naltrexone implants are a cutting-edge treatment for addiction to opioids, heroin, and alcohol. But the FDA has not approved the implantable version of Naltrexone for use in America. The treatment is only available in Europe and Australia. Still, many centers offer other forms of Naltrexone, which also offer long-term maintenance.

For more details about Naltrexone, reach out to More Than Rehab today.

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Do Harm Reduction Efforts Actually Lower Addiction Rates?

In recent years, there has been a growing movement in the United States to adopt harm reduction strategies when it comes to drug addiction and overdose. Harm reduction is a public health approach that focuses on reducing the negative consequences of risky behaviors rather than on eliminating the behaviors themselves. Proponents of harm reduction argue that this approach is more realistic and effective than traditional approaches that focus on abstinence.

There is some evidence to support this claim. For example, a study of needle exchange programs in the United States found that these programs were associated with lower rates of HIV/HSV infections among injection drug users. Another study by SAMHSA notes that these programs save lives by being accessible and available in a way that underlines the need for compassion and humility toward people who use drugs. 

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SAMHSA adds that harm reduction programs provide access to treatment, social services, and health care. They reduce chronic diseases such as HIV/HCV, overdose deaths, and acute life-threatening infections related to unsterile drug injection.

However, it is important to note that harm reduction efforts alone are not enough to address the underlying causes of addiction; they must be part of a comprehensive strategy that includes prevention, treatment, and recovery services. Nevertheless, harm reduction programs can play an important role in saving lives and reducing the harms associated with drug use.

What is Harm Reduction, and what are its Goals?

Harm reduction is a public health approach that seeks to minimize the harms associated with harmful behaviors. It is rooted in the belief that people have the right to make their own choices about their health and well-being and that everyone has the potential to reduce the harms they experience.

Harm reduction approaches provide a non-judgmental way to connect people with services and support. By focusing on reducing harm rather than on eliminating risk, harm reduction provides a more realistic and achievable goal for many people. As a result, it has the potential to improve individual and population health outcomes. The principles of harm reduction include:

·       Respect for autonomy: People should be free to choose their health and well-being without coercion or judgment.

·       Meeting people where they are: Services and support should be tailored to meet the needs of each individual, based on their unique circumstances.

·       Harm reduction is not abstinence: The focus is on reducing harm, not eliminating all risk.

·       Harm reduction is pragmatic: It recognizes that people will engage in risky behaviors and seeks to minimize the associated harm.

·       Harm reduction is evidence-based: It is based on the best available evidence rather than ideology. Harm Reduction Programs and Services A variety of harm reduction strategies can be employed to achieve the goals.

Some common harm reduction strategies include:

Needle Exchange Programs

Needle exchange programs provide clean needles and syringes to people who inject drugs to reduce the risk of HIV, AIDS and other blood-borne diseases. These programs also provide other services such as counseling, referrals to addiction treatment and recovery services, and access to naloxone, a medication that can reverse an opioid overdose.

Nearly three-decade of research has shown that these programs were associated with lower rates of HIV, hepatitis, and other infections. The research also found that SSP users are 5x more likely to enter drug treatment and about 3x more likely to stop using drugs than those who don't use the programs.

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The Use of Federal Funding to Purchase Fentanyl Strips

Fentanyl strips test for the presence of fentanyl in drugs. Fentanyl is a powerful synthetic opioid that is up to 100 times more potent than heroin. It is often mixed with other drugs without the user's knowledge, which can lead to accidental overdoses.

Drug checking with fentanyl strips can reduce this. The US government has funded states and localities to purchase fentanyl strips as a harm reduction measure. The strips can be used to test drugs for the presence of fentanyl, which can help users make informed decisions about whether or not to use them.

Providing Safer Consumption Spaces

Safer consumption spaces are places where people can consume drugs under the supervision of trained staff. These spaces can provide various services, including access to clean needles and syringes, naloxone, counseling, and referrals to addiction treatment and recovery services. They also educate individuals on how to reduce substance use and drug-related harm and curb the spread of infectious diseases. Today, over 66 safe consumption spaces are operating with the approval of law enforcement worldwide, including in Europe, Canada, and Australia. 

Increasing Access to Opioid Overdose Reversal Treatments

Opioid overdose reversal treatments, such as Narcan® or naloxone, can save lives by reversing the effects of an opioid overdose. Naloxone is a medication that can be administered by injection or nasal spray, and it is available without a prescription in many states. Many states have implemented standing orders programs, which allow health care providers to prescribe naloxone to people who may be at risk of overdosing. The drugs can also be issued to friends and family members of people who use opioids.

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Naloxone used to block the effects of opioids medication Oxycodone Morphine to save life in emergency case

Know Your Source

Know Your Source is a harm reduction program in Vancouver, Canada, that provides information about the purity and potency of drugs to users. The program also encourages users to inject slowly, use in the presence of a sober friend and be aware of the early signs of overdose and how to use naloxone. 

Medication Assisted Treatment

Medication-assisted treatment (MAT) is a harm reduction approach that combines behavioral therapy with medications to treat substance use disorders. MAT is used to treat opioid addiction and effectively reduces the risk of overdose and death.

These are just a few examples of harm reduction programs and services that can be employed to reduce the risks associated with substance use. Many other harm reduction strategies can be used, and the best approach will vary depending on the community's needs. If you or someone you know is struggling with substance use, resources are available to help. Treatment and recovery services can provide the support you need to overcome addiction and build a healthier, happier life.

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