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Opioid Epidemic

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https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#1
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#2
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#3
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28073819/the-opioid-epidemic-and-neonatal-abstinence-syndrome-in-the-usa-a-review-of-the-continuum-of-care
#4
Jason R Pryor, Faouzi I Maalouf, Elizabeth E Krans, Robert E Schumacher, William O Cooper, Stephen W Patrick
As the prescription opioid epidemic grew in the USA, its impact extended to pregnant women and their infants. This review summarises how increasing rates of neonatal abstinence syndrome resulted in a need to improve care to pregnant women and opioid-exposed infants. We discuss the variations in care delivery with particular emphasis on screening at-risk mothers, scoring systems for neonatal drug withdrawal, type and duration of pharmacotherapy, and discharge safety.
January 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28073688/state-legal-innovations-to-encourage-naloxone-dispensing
#5
Corey Davis, Derek Carr
OBJECTIVES: The opioid overdose epidemic continues to claim the lives of tens of thousands of Americans every year. Increased access to the opioid antagonist naloxone can reduce opioid-related morbidity and mortality. In this commentary, we describe several recent legal innovations designed to encourage pharmacists to ensure that naloxone is available when and where it is needed, and dispel some common misconceptions regarding potential legal risks associated with pharmacy naloxone dispensing...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#6
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28063773/the-implementation-of-a-naloxone-rescue-program-in-university-students
#7
Shannon G Panther, Brenda S Bray, John R White
OBJECTIVE: Responding to the nationwide opioid overdose epidemic, Washington State University initiated a naloxone safety net project intending to increase awareness of opioid overdose, increase the availability of naloxone, and examine university students' perceptions regarding the usefulness of a novel, large-group audience-training model. SETTING: A Washington State University campus. PRACTICE DESCRIPTION: In September 2014, university students were recruited to attended a large-group audience training event which included opioid overdose prevention, recognition, and first response...
January 4, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28062816/primary-care-clinic-re-design-for-prescription-opioid-management
#8
Michael L Parchman, Michael Von Korff, Laura-Mae Baldwin, Mark Stephens, Brooke Ike, DeAnn Cromp, Clarissa Hsu, Ed H Wagner
BACKGROUND: The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. METHODS: Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28059635/naloxone-administration-for-suspected-opioid-overdose-an-expanded-scope-of-practice-by-a-basic-life-support-collegiate-based-emergency-medical-services-agency
#9
Ryan M Jeffery, Laura Dickinson, Nicholas D Ng, Lindsey M DeGeorge, Jose V Nable
Opioid abuse is a growing and significant public health concern in the United States. Naloxone is an opioid antagonist that can rapidly reverse the respiratory depression associated with opioid toxicity. Georgetown University's collegiate-based emergency medical services (EMS) agency recently adopted a protocol allowing providers to administer intranasal naloxone for patients with suspected opioid overdose. While normally not within the scope of practice of basic life support prehospital agencies, the recognition of an increasing epidemic of opioid abuse has led many states, including the District of Columbia, to expand access to naloxone for prehospital providers of all levels of training...
January 6, 2017: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/28051841/a-review-of-a-national-training-initiative-to-increase-provider-use-of-mat-to-address-the-opioid-epidemic
#10
REVIEW
Frances R Levin, Adam Bisaga, Maria A Sullivan, Arthur Robin Williams, Kathryn Cates-Wessel
BACKGROUND AND OBJECTIVES: The Providers' Clinical Support System for Medication Assisted Treatment (PCSS-MAT) initiative focuses on training and mentoring health professionals in the treatment of opioid use disorders (OUD) using pharmacological strategies. Led by the American Academy of Addiction Psychiatry (AAAP), PCSS-MAT is a consortium representing four of the five national professional organizations authorized by DATA 2,000-AAAP, American Osteopathic Academy of Addiction Medicine, American Psychiatric Association, and American Society of Addiction Medicine...
December 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/28033313/increases-in-drug-and-opioid-involved-overdose-deaths-united-states-2010-2015
#11
Rose A Rudd, Puja Seth, Felicita David, Lawrence Scholl
The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone)...
December 30, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28027016/opioid-overdose-prevention-training-with-naloxone-an-adjunct-to-basic-life-support-training-for-first-year-medical-students
#12
Noah Berland, Aaron Fox, Babak Tofighi, Kathleen Hanley
BACKGROUND: Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Physicians play a role in prescribing opioids, recognizing risky use, and initiating prevention, including Opioid Overdose Prevention Training (OOPT). The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT...
December 27, 2016: Substance Abuse
https://www.readbyqxmd.com/read/28005123/addressing-the-opioid-epidemic-with-multimodal-pain-management
#13
Michael A Kelly
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27959718/ending-the-opioid-epidemic-a-call-to-action
#14
Vivek H Murthy
On August 24, 2016, I mailed a letter and pocket card (see figure) to 2.3 million doctors, nurses, dentists, and other clinicians asking them to help address America’s escalating opioid epidemic. It was the first time in the 145-year history of the Office of the Surgeon General that such a letter..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27926654/neonatal-abstinence-syndrome-and-ethical-approaches-to-the-identification-of-pregnant-women-who-use-drugs
#15
Mishka Terplan, Howard Minkoff
The United States is experiencing an epidemic of opioid use, addiction, and neonatal abstinence syndrome. Consequentially, a great deal of public, and public health, attention has turned toward the timely recognition of pregnant women who use drugs. We explore the clinical efficacy and ethical acceptability of different methods of identification-contrasting drug testing (using biologic samples such as urine) with screening (using an instrument or questionnaire) under both universal and selective approaches within the current legal and social landscape, which is fraught with potential adverse consequences for both the woman and her child...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27918880/racial-differences-in-hiv-and-hcv-risk-behaviors-transmission-and-prevention-knowledge-among-non-treatment-seeking-individuals-with-opioid-use-disorder
#16
Verena E Metz, Maria A Sullivan, Jermaine D Jones, Elizabeth Evans, Rachel Luba, Jonathan Vogelman, Sandra D Comer
In light of New York's recently reinforced strategy to end the AIDS epidemic by expanding testing, treatment, and access to pre-exposure prophylaxis (PrEP), we assessed drug use and sexual risk behaviors, along with HIV/Hepatitis C virus (HCV) transmission and prevention knowledge among non-treatment-seeking adults with opioid use disorder (OUD) in New York City. Over the course of 18 months, volunteers screening for research studies in the Opioid Laboratory at the New York State Psychiatric Institute completed a locally developed self-assessment questionnaire...
December 5, 2016: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/27917016/the-portapotty-experiment-neoliberal-approaches-to-the-intertwined-epidemics-of-opioid-related-overdose-and-hiv-hcv-and-why-we-need-cultural-anthropologists-in-the-south-bronx
#17
Brett Wolfson-Stofko, Ric Curtis, Faustino Fuentes, Ed Manchess, Alexis Del Rio-Cumba, Alex S Bennett
The following report from the field focuses on the authors' collective efforts to operate an ad hoc safer injection facility (SIF) out of portapotties (portable toilets) in an area of the South Bronx that has consistently experienced some of the highest overdose morbidity and mortality rates in New York City over the past decade (New York City Department of Health and Mental Hygiene, 2011, 2015, 2016). Safer injection facilities (also known as supervised injection facilities, drug consumption rooms, etc.) operating outside the US provide a legal, hygienic, and supervised environment for individuals to use drugs in order to minimize the likelihood of fatal overdose and the spread of blood-borne infections while reducing public injection...
December 2016: Dialectical Anthropology
https://www.readbyqxmd.com/read/27915497/current-and-future-development-of-extended-release-abuse-deterrent-opioid-formulations-in-the-united-states
#18
Lynn R Webster, John Markman, Edward J Cone, Gwendolyn Niebler
Prescription opioid misuse and abuse in the United States (US) is epidemic and is a major burden on health-care resources and costs to society. The need to significantly reduce the risks of prescription opioid misuse and abuse must be balanced with the important needs of patients with chronic pain who may benefit from treatment with opioids. The use of abuse-deterrent formulations (ADFs) of prescription opioids is one approach that could reduce the risk of prescription opioid abuse and misuse while maintaining access to opioids...
December 12, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27915490/challenges-and-opportunities-to-change-the-course-of-the-opioid-epidemic-a-surgeon-s-perspective
#19
Gregory J Mancini
No abstract text is available yet for this article.
December 22, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#20
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
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