The Independent • The Herald 5
September 8, 2016
FDA: Mixing opioids, sedatives can be a lethal combination Danger already known, but death toll has risen over recent years By Matthew Perrone Associated Press Health officials are strengthening warnings about the potentially fatal consequences of mixing prescription painkillers and sedatives like Xanax, saying the combination can lead to breathing problems, coma and death. The Food and Drug Administration said it will add a boxed warning — the strongest type — to nearly 400 medications about the interaction, including opioid
painkillers, opioid-containing cough medicines and benzodiazepines, which are used to treat anxiety, insomnia and seizure disorders. Painkillers and sedatives are among the most commonly prescribed medications in the U.S., but both drug types slow users’ heart rate and breathing. FDA officials said the number of opioid patients receiving sedatives increased by 41 percent, or roughly 2.5 million patients, between 2002 and 2014. Overdose deaths linked to nonmedical use of the drug combination tripled between 2004 and 2011, according to figures from the agency. The federal announcement
followed a petition from health directors in 16 states and 12 cities filed in February. “We said, ‘we cannot wait’ and called upon the FDA to save lives now,” said Baltimore City Health Commissioner Dr. Leana Wen, who spoke to reporters on an FDA call about the announcement. Wen, an emergency medicine specialist, cited federal figures estimating that nearly 1 in 3 accidental opioid overdose deaths in the U.S. also involve sedatives. While current drug labels and medical guidelines already caution against mixing the drugs, Wen said doctors still routinely prescribe them in combination. For instance, a patient injured in
a car accident might receive an opioid for pain and a benzodiazepine to control muscle spasms. FDA officials said they hoped the elevated warning would get the attention of doctors who have not heeded earlier notices. Along with the new drug labels, the FDA will require drug manufacturers to distribute pharmacy pamphlets to patients highlighting the risks of the combination. The FDA has come under fire for not doing more to stem to tide of fatal overdoses tied to prescription opioids, potentially addictive medications that include OxyContin, Vicodin, Percocet and numerous generic equivalents. The number
LIFT
ing not for the urban blight it was intended to fix, but for economic development, and to subsidize development that would have happened without it. “Everybody wants their piece of the pie,” Brzeczek said.
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Director Kevin Bommer said Windsor and Castle Pines are the only other municipalities in the state he knows of that have gotten rid of urban renewal authorities in similar fashion. Learning from the past? Urban renewal has a controversial history in Littleton. LIFT grew out of the Littleton Riverfront Authority, which was founded in 1980 to use tax-increment financing — in which the additional tax money anticipated is used to fund a project — to develop an area along the South Platte River. Its signature project was an ambitious shopping mall and mixed-use development, the Riverfront Festival Center, at the corner of Santa Fe Drive and Bowles Avenue. The center, anchored by an upscale grocery market, opened in 1985 and was a financial failure that never filled all of its retail spaces. A hotel and office buildings planned for the site were never built and the project could not raise enough taxincrement money to pay off its bonds. The site was vacant by 1989 and was eventually bought by Echostar to be used as corporate headquarters in 1997. The authority’s ability to collect tax-increment funds from the Riverfront project expired in 2008 and its outstanding debts were settled. The board continued to meet once a year to submit a budget. But in 2013, the LRA was given a new mission and four urban renewal plan areas — Columbine Square, Santa Fe, north Broadway and Littleton Boulevard — and a new name. Jim Taylor joined the LRA
of deaths linked to the medications has increased more than fourfold since 1999. FDA Commissioner Dr. Robert Califf has pledged to take a series of steps designed to reduce prescription opioid abuse. His confirmation by Senate lawmakers was held up earlier this year by lawmakers concerned about the FDA’s approach to tackling the issue, which has been termed an epidemic by public health authorities. In 2014, more than 17,000 people died from overdoses linked to opioid pain medications, including drugs like oxycodone, hydrocodone and fentanyl, according to the Centers for Disease Control and Prevention.
The Riverfront Festival Center, a failed upscale mall built using tax increment collected by the Littleton Riverfront Authority, was purchased by Echostar in 1997 and is now a Dish Network call center. Littleton Invests for Tomorrow, which grew from the LRA, may be abolished by the city council next month. Photo by Kyle Harding board in 1981 as a liaison from the city council and was the board’s chair from 1987 until he left the board in early 2015. He said the board had been looking for more opportunities, and discussions with city staff members led to its revival. But no projects are underway in any of the areas, which is a point opponents use to argue against LIFT. “The plans should have a project — none of them have a project,” said Carol Brzeczek, a Littleton resident and an outspoken critic of the authority. Because there are no projects, the LIFT board voted last month to terminate its executive director, Jim Rees. ‘Long-term planning’ Earlier this year, the Arapahoe
County District Court sided with the county and ruled that Littleton had improperly included more than 100 acres of agricultural land within the Santa Fe plan area, leading to much of the plan area being cut out. Brzeczek said she began studying the state’s urban renewal law in 2012 when she learned that the authority was looking for new plan areas, even spending money on a consultant to identify blighted areas. She said the LRA should have been disbanded once it was done collecting tax-increment money from the Riverfront project. But Hopping said not having projects doesn’t mean the authority should be disbanded. “It’s not about today — it’s about long-term planning,” he said, saying that most economi-
cally successful cities in the state have urban renewal authorities. Hopping said using urban renewal for smaller projects — and researching the viability of the projects ahead of time — could avoid failures like the Riverfront Festival Center. “It seems to me that they didn’t do their due diligence on economic feasibility,” he said. Former LRA and LIFT chair Taylor said that Littleton’s measures limiting how urban renewal is used — requiring voter approval of projects and barring eminent domain — render the approach harmless. “There’s absolutely no harm ever done to leave urban renewal in place,” Taylor said. But critics of urban renewal say authorities all over the state are using tax-increment financ-
Moving forward Councilmembers Jerry Valdes and Peggy Cole said at the last study session, on Aug. 23, that developers will still come to the city without an urban renewal authority. Beckman said Hopping’s example of The Streets at Southglenn is a roughly 15-acre site, while Littleton’s plan areas are larger. “We chose to apply urban renewal to hundreds of acres,” he said. Hopping said using tax-increment financing does not deprive other public entities of funding, as the increment would not be there if not for the project. “In reality, if the project is never developed, the taxes stay at the base level,” he said. Even while no plans are in place, increment is still collected from the plan areas. Abolishing the authority would include an agreement to return that money to the city. Hopping says most complaints about LIFT seem to be with how it has been administered, and that getting rid of it entirely would be an overreaction. Bommer said it is more common for authorities to not be renewed after 25 years, at which point their ability to collect increment expires, than to be shut down by a city council. But that may be what happens in Littleton soon, as the first reading of the ordinance to abolish it will be on the agenda for the Oct. 4 council meeting.
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