By Kara Fohner News-Topic
LENOIR, NC — A powerful new opiate approved just days ago by the U.S. Food and Drug Administration has sparked concerns, particularly among local law enforcement officials, that it could worsen the already serious problem of drug abuse.
The drug, Dsuvia, is intended to manage severe pain in hospitals and military combat, but Sgt. John Howard of the Lenoir Police Department said he fears that eventually addicts will find a way to get it.
“My personal opinion is that the state of North Carolina and the federal government have taken huge steps in trying to combat overprescribing prescription medication … however, the criminal element always finds a way,” he said. “My fear is they will find a way. They’re either going to make it themselves in a clandestine lab; they’ll steal it from the hospital; there will be a doctor that will administer it when it’s not needed.”
Dsuvia is a tablet form of sufentanil, a synthetic opioid that has been used intravenously and in regional anesthesia for decades. It can be dissolved under the tongue, and it is believed to be five to 10 times stronger than fentanyl, an opiate that has been linked to an increasing number of overdose deaths nationwide. Dsuvia was approved by the U.S. Food and Drug Administration Nov. 2, just weeks after the chairman of the advisory committee that reviewed it asked the FDA not to support the drug, the New York Times reported.
Nationwide, drug overdoses killed about 72,000 people last year, according to new preliminary estimates from the Centers for Disease Control and Prevention. The death toll is higher than the peak annual death totals from HIV, car crashes or gun deaths, the New York Times reported.
Lenoir Police Chief Brent Phelps said that there were 22 overdoses in the city of Lenoir from Jan. 1 to Nov. 6. Last year, from January to September, there were 28. Three of the overdoses last year and four this year were fatal, Phelps said.
Phelps recalled that in the early to mid-2000s, when he was a lieutenant in the investigations division, he began to see people who had overdosed and had fentanyl patches, which are used to manage chronic pain, in their mouths.
“People were obviously misusing that method that the pharmacies had developed for people’s pain to get high. Because it absorbed into their body so much quicker when they were chewing on the patch, it was killing them,” he said.
Howard said that while fentanyl was originally intended to treat extreme pain, abuse of the drug became “widespread and rampant.”
“We have really good intentions for things, and then as it goes on, it goes astray down the road. A lot of drugs were developed that way – to help people, and once the drug community figures out that they can abuse it and how to abuse it, then it becomes more of a problem then it does help anybody,” he said.
Unlike other opioid pain medications, however, tablets of Dsuvia will not be given to patients for home use, nor will they be available at retail pharmacies, and they will only be administered by health care providers through a single dose applicator, the New York Times reported, citing a statement from Dr. Scott Gottlieb, the FDA commissioner.
Dr. David Lowry, who is chief medical officer at Caldwell UNC Health Care and served as a physician in the Air Force 1988-1996, said that aside from military combat, he doesn’t believe Dsuvia is a necessary addition to a hospital’s pharmaceutical reservoir.
“In combat, it makes sense, but that’s the only role I can really see for it,” he said. “In my experience, there are so many other powerful opiate medications around. … I’ve never not been able to get good pain control with our current … medications.”
He said there are even other substances patients can put under their tongue that manage pain, such as Roxanol, a concentrated form of liquid morphine that is used frequently in hospices but is not practical for a battlefield.
“I don’t think it (Dsuvia) does really add anything, other than the addition of a super strong opiate that somehow, eventually, somewhere, somebody is going to divert,” he said.
He said that for Caldwell UNC Health Care doctors to prescribe Dsuvia, the drug first would have to be approved by its Pharmacy and Therapeutics Committee, of which Lowry is a part.
“My suspicion is we would not approve it,” he said. “Our hospital as well as the Chapel Hill system are all very aware of the opioid epidemic, and we’ve been trying to take measures to combat that epidemic.
“I can’t imagine that we would vote to bring this drug onto our formulary. It’s brand new on the market so it hasn’t even been addressed yet, but if it were … I would vote against it and I think everybody else probably would as well.”