The latest in health: battling opioid epidemic by fighting fake meds, treating struggling families

Apr 22, 2018

It’s not easy to keep up with the latest in health and wellness. Each day, new studies, research and developments in health make it difficult to pick out the most important information for you.

We’ll be sharing a few of the latest developments in health at the end of each episode of “Take Care” this year. As the year goes on, we may even revisit some earlier news to see where things stand months later.

Today we're taking a look at two approaches to addressing the current opioid epidemic: a doctor urging the Federal Drug Administration (FDA) to stop dietary supplements from masquerading as withdrawal treatment and a Tompkins County partnership focusing on a holistic, family approach to a generational problem.

Stopping fake miracle treatment meds

With much worry surrounding the opioid crisis, some companies have taken advantage of the epidemic to market dietary supplements as treatment for opioid withdrawal symptoms, even though the FDA has called these claims unsubstantiated and the products dangerous.

Dr. Peter Lurie is the executive director and president of The Center for Science in the Public Interest, a Washington D.C.-based non-profit watchdog and consumer advocacy group that supports fighting for safer and healthier foods. 

Unlike drugs, dietary supplements, Lurie said, are not regulated by the FDA. Therefore, their manufacturers do not have to provide evidence of safety and effectiveness before the supplements can be made available to consumers.

“[Dietary supplements] can come on the market [and], in effect, imply safety and effectiveness, and unless they make a claim that turns them into a drug, there’s very little that the FDA could do,” Lurie said.

The claims those companies typically make, Lurie said, are that the products help ease withdrawal symptoms associated with use of OxyContin and other opioids. Lurie said there are two major problems with these claims: there is no evidence to back them up, and they are encouraging consumers to use them in place of FDA-approved products.

“Potentially, they are diverting people from products that actually are effective and could benefit them in their efforts to treat a disease that could be life-threatening,” Lurie said.

Lurie said despite having no evidence to substantiate the healing effects they claim their products have, companies that produce these dietary supplements often insist that “the proof is in the pudding.” Sometimes, they instead acknowledge that they do not intend on ever conducting scientific studies because of the potential costs.

“In our view, if you’re going to be a company that markets a product with these kinds of important claims…you need to be able to conduct the studies to support a claim like that,” Lurie said.

The good news, Lurie said, is that the claims the companies have been making are more akin to those made about FDA-approved drugs, which could land them within the FDA’s regulatory jurisdiction.

“Since the companies never went to the drug division of FDA and asked for approval, what in effect they are doing is marketing a drug without approval, and that is just plain illegal,” Lurie said.

Lurie said he and his nonprofit spoke with FDA representatives to get the FDA to take action. The efforts achieved some success, with six of the eight troublesome products identified in the complaints being shut down or marketed as something other than an opioid withdrawal treatment.

Lurie said that as much as those measures will help consumers, the age of digital media means companies can put out new products with similar claims at a faster rate than the FDA can keep up with.

“Unfortunately, the agency is left, because of its limited regulatory authorities, to play whack-a-mole with these products,” Lurie said. “I expect it will continue to have problems with products making these claims for as long as we have an opioid epidemic, and that’s going to be a very long time.”

Institutional Challenge Grant provides resources for treating families with opioid addiction

The College of Human Ecology, in partnership with Cornell Cooperative Extension-Tompkins County (CCE-Tompkins), has been awarded the William T. Grant Foundation’s first Institutional Challenge Grant to respond to increasing rates of opioid abuse and child maltreatment in low income, rural communities in upstate New York.

The foundation supports research to improve the lives of young people. The award seeks to shift how research institutions value research and to encourage them to build sustained research-practice partnerships with public agencies or nonprofit organizations to reduce inequality in youth outcomes.

Rachel Dunifon and Laura Tach are researchers at the College of Human Ecology at Cornell University. Anna Steinkraus is the program coordinator of CCE-Tompkins.  Dunifon, Tach and Steinkraus work together under the grant to research how parental addiction is affecting the children and families in Tompkins County and surrounding areas.

Dunifon said the grant will aid in research to better understand the link between parental opioid use and child maltreatment, as well as implementing policies and programs to help families in which the parents are addicted to opioids.

A second goal, Dunifon said, is to change the way universities approach this kind of research in the future.

“Oftentimes, faculty members are very good at conducting research that makes important theoretical contributions…but what we’re not always good at is doing work that really makes a difference in the real world,” Dunifon said.

Tach said one uplifting response to the opioid epidemic is more resources and attention at national and local levels being dedicated to addressing the issue. Unfortunately, research is lagging behind, which is why Tach said they are hoping the grant can help them build a broader research evidence base.

"It's really important to keep a focus how the work we do extends beyond the walls of the university," Dunifon said.

The partnership is working to implement an evidence-based program in Tompkins County called Strengthening Families, which has been shown to improve parent-child relationships and ultimately reduce opioid use across generations in other counties.

Dunifon, Tach and Steinkraus have a long history of working on parenting and how parents can influence the development at their own children, and Dunifon said they hope to use that experience to apply their research to the opioid crisis.

“For all of us, the issue of opioids specifically is something new,” Dunifon said. “We’ll be taking our expertise on the issue of children and their development and what sort of predicts the well-being of disadvantaged children and applying it to this really important issue.”

Steinkraus said CCE-Tompkins has also worked for many years to provide parenting education for families who are involved in department of social services and child welfare. Since 2014, CCE-Tompkins has been involved with a court-related Strengthening Families program specific to families dealing with substance abuse.

“It’s been a long period that we’ve been working and listening to the voices of the community and identifying where we could be supportive and helpful,” Steinkraus said.

Ultimately, the goal is to create a sense of communication between the university and the community to apply theoretical research to real families that need it, Dunifon said.

“When we think about all the investments that are made in higher education and what the important that colleges and universities play in society, it’s really important to keep a focus how the work we do extends beyond the walls of the university,” Dunifon said.

Steinkraus said their work will also focus on fathering research-based material to keep information up to date and make sure their solutions remain relevant to present day. One way they accomplish this is through community evaluations, surveying people about the effectiveness of certain programs.

“Where we struggle is what we do with that…and seeing is what we’re doing as effective as we think it is?” Steinkraus said.

Dunifon said a partnership between CCE and Cornell allows the university’s institutions to implement their analytical abilities to discern the effectiveness of their programs. This partnership both enhances the quality of the research being done and strengthens the relationship the research team has with community members, Steinkraus said.

“It also enhances the quality of the work that we’re doing directly with community members, so it definitely can be…a win-win not just for the players that are involved directly with this particular project, but communities at large,” Steinkraus said.

The terms of the grant allow for a two-year extension, which Tach said is a possibility the team is keeping in mind. Tach said a good deal of the focus in the current grant is gathering information from the communities within the county.

“We’re hopeful with what we learn in the initial period of our grant that we’ll be able to establish some best practices and tools and recommendations that can be ideally shared throughout the state of New York beyond the confines of Tompkins County,” Tach said.