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Vanda Pharmaceuticals, Inc. Message Board

pechstein.carl 21 posts  |  Last Activity: May 27, 2016 6:02 PM Member since: Oct 22, 2014
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  • Reply to

    Then, Now

    by stalyon52 May 27, 2016 3:41 PM
    pechstein.carl pechstein.carl May 27, 2016 6:02 PM Flag

    good place to cover for sure...alley-oop

  • pechstein.carl pechstein.carl May 9, 2016 6:17 PM Flag

    splits is that you?

  • Reply to

    The Truth is....

    by jttarbel May 9, 2016 4:20 PM
    pechstein.carl pechstein.carl May 9, 2016 4:27 PM Flag

    good job jt.

  • all you have to do is go 24 hours without making a pumper post, and I will never post here again.

  • Reply to

    NADCP opposition to buprenorphine

    by pechstein.carl May 7, 2016 2:58 PM
    pechstein.carl pechstein.carl May 9, 2016 2:22 PM Flag

    pretty influential person with 32 years experience. MAT = medication as treatment.

  • pechstein.carl pechstein.carl May 9, 2016 1:25 PM Flag

    where?

  • pechstein.carl pechstein.carl May 9, 2016 1:22 PM Flag

    They have a full-blown national epidemic of buprenorphine abuse in Finland.

  • Reply to

    Carl and Jodies' track record on TTNP

    by jenkinsatsac Apr 28, 2016 2:39 PM
    pechstein.carl pechstein.carl May 7, 2016 4:31 PM Flag

    "The number of exposures to buprenorphine/naloxone reported to poison control centers increased over 400%, rising from 765 in 2006 to 3212 in 2009. Over the same period of time, the number of emergency department visits due to abuse/misuse of buprenorphine rose even more dramatically, increasing from 5025 in 2006 to 70,637 in 2009. In addition, reported diversion in applicants to specialized substance abuse treatment programs increased from 27% in 2005 to 46% in 2009.34 According to hospital emergency department data from the Drug Abuse Warning Network, the misuse of buprenorphine increased from 4440 emergency department visits in 2006 to 21,483 in 2011, a 384% increase."

  • pechstein.carl pechstein.carl May 7, 2016 3:50 PM Flag

    it is from an article posted less than a week ago regarding the expansion of buprenorphine limits. i know that is old to you and 12 year studies don't hold much weight on fantasy island, but the facts are the facts.

  • Reply to

    NADCP opposition to buprenorphine

    by pechstein.carl May 7, 2016 2:58 PM
    pechstein.carl pechstein.carl May 7, 2016 3:36 PM Flag

    if you only took the time to educate yourself, you would know that they recently changed their stance on this. you are so hung up on me, that you are blinded by the facts. i posted this thread just for you, the longest of the longs.

  • pechstein.carl pechstein.carl May 7, 2016 3:29 PM Flag

    "The largest amount of literature on this topic concerns Finland due to its epidemic of buprenorphine abuse. A 12-year follow-up study in Finland demonstrated that the annual proportion of clients seeking treatment for buprenorphine abuse increased from 3.0% in 1998 to 38.4% in 2008.47 Daily abuse (73.8%) and IV administration (80.6%) were common. Buprenorphine clients in Finland resembled “street users” in other countries in terms of socioeconomic status.47 In another study, 25% of all lethal intoxications in people who abused drugs in Finland in 2007 involved buprenorphine.52 Lethal buprenorphine intoxications were typically associated with concurrent use of benzodiazepines and alcohol (82% and 58% of buprenorphine poisonings in Finland from 2000 to 2008, respectively).53 The mortality rate in clients seeking treatment for buprenorphine abuse was 3 times higher than the national average, a finding similar to that reported in clients seeking treatment for abuse of other substances. Of note, survival rates among clients who were dependent on heroin did not differ from rates among clients who abused buprenorphine, an observation ultimately attributed to the high proportion of IV use in both groups. Drug-related deaths were the most common cause of mortality among buprenorphine clients, although it is unknown whether these were related to use of buprenorphine or abuse of other drugs"

  • Reply to

    NADCP opposition to buprenorphine

    by pechstein.carl May 7, 2016 2:58 PM
    pechstein.carl pechstein.carl May 7, 2016 3:12 PM Flag

    blah, blah, blah...go read it and the accompanying letter from earl hightower it is on the samsha site.

  • Reply to

    NADCP opposition to buprenorphine

    by pechstein.carl May 7, 2016 2:58 PM
    pechstein.carl pechstein.carl May 7, 2016 3:08 PM Flag

    Understandably, advocates purport that the Weiss et al. study is evidence thatpatients should stay on buprenorphine longer in order to achieve better benefits. However, only 7.2% of patients receiving buprenorphine-naloxone plus counseling and 6.1% of patients receiving buprenorphine-naloxone alone were abstinent from opiates (other than buprenorphine) during the full trial. The percentage of negative UDAs from
    alcohol or illicit drugs other than opiates was not reported. The best reported outcome in the Weiss study was that 49% of patients received a “successful outcome” while on buprenorphine in the first 12 weeks. “Successful outcome” was defined in the study as "no more than four days in a month with self-reported opioid use", plus “no more than one missing urine sample”, plus “absence of two consecutive opioid-positive UDS”. In phase two of the study, “successful outcome” was defined as “abstaining from opioids (other than buprenorphine) in week 12 and during at least two of the previous three weeks (weeks nine-eleven)” or “abstinence from opioids (other than buprenorphine) during week twenty-four and at least two of the past three weeks.” I know of no
    substance abuse treatment program that would consider this a successful outcome.

  • Reply to

    NADCP opposition to buprenorphine

    by pechstein.carl May 7, 2016 2:58 PM
    pechstein.carl pechstein.carl May 7, 2016 3:05 PM Flag

    The alarming reality is that MAT is no longer an acronym for Medication Assisted Treatment. Instead, as it relates to the manner in which buprenorphine is prescribed under DATA 2000, MAT now means Medicine as Treatment. That is a subtle but very dangerous shift in policy and practice; a practice that flies in the face of the
    federal government’s own standard of care for substance abuse treatment and which turns a blind eye to recent research findings regarding buprenorphine. For example, in 2011, the first large and randomized controlled multisite trial of patients dependent on prescription opioids assessed the consequences of terminating treatment with buprenorphine-naloxone.. This study reported near universal relapse(92%) to opioids after a 12-week treatment. The finding of near universal relapse after treatment discontinuation is particularly important in light of the fact that almost all patients who are being treated with buprenorphine will discontinue the medication eventually. In fact, once a patient has been inducted on to buprenorphine, the actual duration of treatment obtained in a retrospective pharmacy claims analysis is just 68 days.4
    In other words, for the vast majority of opioid-dependent individuals, treatment with buprenorphine alone is merely kicking the can of addiction down the road.

  • pechstein.carl by pechstein.carl May 7, 2016 2:58 PM Flag

    Dear Administrator Hyde:
    I write with grave concern regarding proposed changes to the SAMHSA
    buprenorphine regulations that would potentially lift the 100-patient limit of physicians,
    and/or allow nurse practitioners and physician assistants to prescribe buprenorphine in
    the treatment of opioid dependence.The National Association of Drug Court Professionals (NADCP) is the premiernational membership, training, and advocacy organization for the Drug Court model,
    representing over 28,000 multi-disciplinary justice professionals and community leaders.
    NADCP hosts the largest annual training conference on drugs and crime in the nation and
    provides 130 training and technical assistance events each year through its professional
    service branches, the National Drug Court Institute, the National Center for DWI Courts
    and Justice for Vets: The National Veterans Treatment Court Clearinghouse. NADCP
    publishes numerous scholastic and practitioner publications critical to the growth and
    fidelity of the Drug Court model and works tirelessly in the media, on Capitol Hill, and in
    state legislatures to improve the response of the American justice system to substanceabusing
    and mentally ill offenders through policy, legislation, and appropriations.
    In doing so, NADCP advocates for a comprehensive approach that includes the latest
    evidence-based treatments to address the problem of opioid dependence, including the
    appropriate use of addiction medication; also known as Medically Assisted Treatment
    (MAT).

  • Reply to

    Carl, give it a rest man.

    by gomets167200 May 6, 2016 8:54 AM
    pechstein.carl pechstein.carl May 6, 2016 12:09 PM Flag

    "The largest amount of literature on this topic concerns Finland due to its epidemic of buprenorphine abuse. A 12-year follow-up study in Finland demonstrated that the annual proportion of clients seeking treatment for buprenorphine abuse increased from 3.0% in 1998 to 38.4% in 2008.47 Daily abuse (73.8%) and IV administration (80.6%) were common. Buprenorphine clients in Finland resembled “street users” in other countries in terms of socioeconomic status.47 In another study, 25% of all lethal intoxications in people who abused drugs in Finland in 2007 involved buprenorphine.52 Lethal buprenorphine intoxications were typically associated with concurrent use of benzodiazepines and alcohol (82% and 58% of buprenorphine poisonings in Finland from 2000 to 2008, respectively).53 The mortality rate in clients seeking treatment for buprenorphine abuse was 3 times higher than the national average, a finding similar to that reported in clients seeking treatment for abuse of other substances. Of note, survival rates among clients who were dependent on heroin did not differ from rates among clients who abused buprenorphine, an observation ultimately attributed to the high proportion of IV use in both groups. Drug-related deaths were the most common cause of mortality among buprenorphine clients, although it is unknown whether these were related to use of buprenorphine or abuse of other drugs."

  • pechstein.carl pechstein.carl May 6, 2016 9:04 AM Flag

    58% of deaths were from mixing bup with alcohol.

  • pechstein.carl pechstein.carl May 6, 2016 7:19 AM Flag

    "in a review by Larance et al41 focusing on the availability, diversion, and injection of pharmaceutical opioids in South Asia, low-dose buprenorphine was reported to be the most commonly misused opioid among a variety of prescription opioids."

  • pechstein.carl pechstein.carl May 6, 2016 6:51 AM Flag

    "The largest amount of literature on this topic concerns Finland due to its epidemic of buprenorphine abuse. A 12-year follow-up study in Finland demonstrated that the annual proportion of clients seeking treatment for buprenorphine abuse increased from 3.0% in 1998 to 38.4% in 2008.47 Daily abuse (73.8%) and IV administration (80.6%) were common. Buprenorphine clients in Finland resembled “street users” in other countries in terms of socioeconomic status.47 In another study, 25% of all lethal intoxications in people who abused drugs in Finland in 2007 involved buprenorphine.52 Lethal buprenorphine intoxications were typically associated with concurrent use of benzodiazepines and alcohol (82% and 58% of buprenorphine poisonings in Finland from 2000 to 2008, respectively).53 The mortality rate in clients seeking treatment for buprenorphine abuse was 3 times higher than the national average, a finding similar to that reported in clients seeking treatment for abuse of other substances. Of note, survival rates among clients who were dependent on heroin did not differ from rates among clients who abused buprenorphine, an observation ultimately attributed to the high proportion of IV use in both groups. Drug-related deaths were the most common cause of mortality among buprenorphine clients, although it is unknown whether these were related to use of buprenorphine or abuse of other drugs.54"

  • Reply to

    Carl and Jodies' track record on TTNP

    by jenkinsatsac Apr 28, 2016 2:39 PM
    pechstein.carl pechstein.carl Apr 29, 2016 2:08 PM Flag

    what's funny is your infatuation with a fictitious mb character. if i respond to you with my pumper post handle, you fawn all over me. too funny indeed.

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