As the coronavirus pandemic grips the world, the opioid epidemic continues to affect millions of Americans. Several states are developing innovative ways to tackle this public health issue. In this episode, we speak with Beth Connolly, who leads Pew’s research on substance use disorders, and Louisiana Representative Paula Davis, who helped ensure effective treatment in her state.

The United States is grappling with two severe health crises: the COVID-19 pandemic and an opioid epidemic that appears to be worsening as more people deal with stress and isolation as they face increased barriers to medical care. Preliminary numbers for 2020 show that overdose deaths were outpacing the record-setting number of more than 71,000 fatalities in 2019.

Cuddle hormone, also known as oxytocin, produced naturally in the human body, is becoming a better alternative to long-term pain management in the middle of America's rising opioid issue.

Addressing opioid use disorder significantly decreases the high suicide rate, which is eight times greater than that of the general population, for those with opioid dependence.

Post-surgical opioid use in hip replacement patients can be reduced by half with aromatherapy, reveals a new study. The new preliminary was study

medlinkAcupuncture/medlink can treat methadone dose and opioid cravings in patients receiving methadone maintenance therapy (MMT), suggests a new study.

New York, NY : Oxford University Press , 2024.

Years of sustained and coordinated efforts will be required to contain and reverse the harmful societal effects of the prescription and illicit opioid epidemics, which are intertwined and getting worse, says a new report from the National Academies of Sciences, Engineering, and Medicine.

Halting the opioid epidemic requires aggressive action across multiple dimensions, including informed, active, and determined front-line leadership from health clinicians working in every setting throughout the nation, says a new National Academy of Medicine (NAM) special publication developed at the request of the National Governors Association to assist the nation’s governors as they work with clinicians to counter the opioid crisis.

In recognition of the need for a national coordinated and collective response to the epidemic of opioid addiction in the U.S., the National Academy of Medicine (NAM), in partnership with the Aspen Institute, launched a public-private partnership made up of more than 35 organizations representing federal, state, and local governments, health systems, associations and provider groups, health education and accrediting institutions, pharmacies, payers, industry, nonprofits, and academia.

Medications to Treat Opioid Addiction Are Effective and Save Lives, But Barriers Prevent Broad Access and Use, Says New Report

The National Academy of Medicine (NAM) announced today that more than 100 organizations across the U.S. — including community organizations, hospital and medical systems, academia, nonprofits, and health professional societies — have joined NAM in declaring their commitment to reversing national trends in opioid misuse and overdose.

For severe acute pain due to surgeries and medical conditions, there is a lack of guidance on the appropriate type, strength, and amount of opioid medication that clinicians should prescribe to patients, says a new report from the National Academies of Sciences, Engineering, and Medicine.

The opioid epidemic in the U.S. is driving a simultaneous epidemic of infectious diseases — including HIV, hepatitis C virus (HCV) and bacterial infections, and sexually transmitted infections — but workforce shortages, stigma, and financial and policy barriers are preventing the integration of opioid use disorder (OUD) and infectious disease services, says a new report from the National Academies of Sciences, Engineering, and Medicine.

Pro-IV Pledges FREE Treatments For Amputees

Speaker and author Jack Alan Levine says a 50% reduction in addiction is possible with preventative measures in place

Economic & Health Policy Implications

The marijuana presence is still less than alcohol at 0.08 BAC (which is at 27%), however, marijuana presence is up 41% in last 5 years. This is based on the 2017 NHTSA data of 17,326 drivers in fatal crashes with valid drug test performed.

The present invention relates to compounds of Formula I or II, or pharmaceutically acceptable salts, esters, or prodrugs thereof: which relates to mophinan compounds useful as μ, δ and/or κ receptor opioid compounds and pharmaceuticals containing same that may be useful for mediating analgesia, combating drug addiction, alcohol addiction, drug overdose, mental illness, bladder dysfunctions, neurogenic bladder, interstitial cystitis, urinary incontinence, premature ejaculation, inflammatory pain, peripherally mediated and neuropathic pain, cough, lung edema, diarrhea, cardiac disorders, cardioprotection, depression, and cognitive, respiratory, diarrhea, irritable bowel syndrome and gastro-intestinal disorders, immunomodulation, and anti-tumor agents.

Benzodiazepines are some of the most commonly prescribed medications in the country, often used to treat anxiety. But a new study warns that taking benzodiazepines can be both helpful and risky for those with opioid use disorder.

A pharmaceutical giant owned by the Sackler family in the United States is using flaws in regulation to push its latest product deep into regional Australia.

Australia's island state is known for its rich history and pristine environment it also provides 50 per cent of the raw materials that go into the powerful painkillers at the centre of the United States' opioid crisis.

(JAMA Network) Death certificate data were used to compare the rate of opioid-related deaths in the US among cancer survivors with that of the general population from 2006 through 2016. Whether opioid-associated deaths in cancer survivors, who are often prescribed opioids for cancer-related pain, are rising at the same rate as in the general population is unknown.

The kappa opioid receptor (KOR) is implicated in various neuropsychiatric disorders. We previously evaluated an agonist tracer, ¹¹C-GR103545, for PET imaging of KOR in humans. Although ¹¹C-GR103545 showed high brain uptake, good binding specificity, and selectivity to KOR, it displayed slow kinetics and relatively large test-retest variability (TRV) of distribution volume (V_T) estimates (15%). Therefore we set out to develop two novel KOR agonist radiotracers, ¹¹C-EKAP and ¹¹C-FEKAP, and in nonhuman primates, both tracers exhibited faster kinetics and comparable binding parameters to ¹¹C-GR103545. The aim of this study was to assess their kinetic and binding properties in humans. Methods: Six healthy subjects underwent 120-min test-retest PET scans with both ¹¹C-EKAP and ¹¹C-FEKAP. Metabolite-corrected arterial input functions were measured. Regional time-activity curves (TACs) were generated for 14 regions of interest. One- and two-tissue compartment models (1TC, 2TC) and the multilinear analysis-1 (MA1) method were applied to the regional TACs to calculate V_T. Time-stability of V_T values and test-retest reproducibility were evaluated. Levels of specific binding, as measured by the non-displaceable binding potential (BP_ND) for the three tracers (¹¹C-EKAP, ¹¹C-FEKAP and ¹¹C-GR103545), were compared using a graphical method. Results: For both tracers, regional TACs were fitted well with the 2TC model and MA1 method (t*=20min), but not with the 1TC model. Given unreliably estimated parameters in several fits with the 2TC model and a good match between V_T values from MA1 and 2TC, MA1 was chosen as the appropriate model for both tracers. Mean MA1 V_T values were highest for ¹¹C-GR103545, followed by ¹¹C-EKAP, then ¹¹C-FEKAP. Minimum scan time for stable V_T measurement was 90 and 110min for ¹¹C-EKAP and ¹¹C-FEKAP, respectively, compared with 140min for ¹¹C-GR103545. The mean absolute TRV in MA1 V_T estimates was 7% and 18% for ¹¹C-EKAP and ¹¹C-FEKAP, respectively. BP_ND levels were similar for ¹¹C-FEKAP and ¹¹C-GR103545, but ~25% lower for ¹¹C-EKAP. Conclusion: The two novel KOR agonist tracers showed faster tissue kinetics than ¹¹C-GR103545. Even with slightly lower BP_ND, ¹¹C-EKAP is judged to be a better tracer for imaging and quantification of KOR in humans, based on the shorter minimum scan time and excellent test-retest.

When tackling societal problems - like the opioid epidemic in the US - there are two ways of approaching it. One is to reduce demand - by organising treatment programmes, or reducing the underlying reasons why people may become addicted in the first place - but that’s hard. So governments often turn to the other route - reducing supply - and...

There is very little guidance on withdrawing or tapering opioids in chronic pain (not caused by cancer). People can fear pain, withdrawal symptoms, a lack of social and healthcare support, and they may also distrust non-opioid methods of pain management. This can mean that patients receive repeat opioid prescriptions for extended periods of...

This edition of talk evidence was recorded before the big increase in covid-19 infections in the UK, and then delayed by some self isolation. We'll be back with more evidence on the pandemic very soon. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford...

Cancer survivors have a lower risk for a fatal opioid overdose -- from prescription pain medications or illegal drugs -- than those without the disease, an analysis published Thursday by JAMA Oncology shows.

Designer drugs -- Fentanyl.

Rockville, Maryland : National Institute on Drug Abuse, 1988.

Sandra Manninen
Jun 21, 2017; 37:6125-6131
BehavioralSystemsCognitive

In response to the growing impact of the current opioid public health crisis in the United States on adolescents and young adults, pediatricians have an expanding role in identifying opioid use early, preventing escalation of risky use, reducing opioid-related harms, and delivering effective therapies. Research and expert consensus suggest the use of brief interventions focused on reducing risks associated with ongoing opioid use and using motivational interviewing strategies to engage youth in treatment. Because fatal opioid overdose remains a major cause of opioid-related mortality among youth, delivering overdose education as part of any visit in which a youth endorses opioid use is one evidence-based strategy to decrease the burden of opioid-related mortality. For youth that are injecting opioids, safe injection practices and linkage to needle or syringe exchanges should be considered to reduce complications from injection drug use. It is crucial that youth be offered treatment at the time of diagnosis of an opioid use disorder (OUD), including medications, behavioral interventions, and/or referral to mutual support groups. The 2 medications commonly used for office-based OUD treatment in adolescents are extended-release naltrexone (opioid antagonist) and buprenorphine (partial opioid agonist), although there is a significant treatment gap in prescribing these medications to youth, especially adolescents <18 years of age. Addiction is a pediatric disease that pediatricians and adolescent medicine physicians are uniquely poised to manage, given their expertise in longitudinal, preventive, and family- and patient-centered care. Growing evidence supports the need for integration of OUD treatment into primary care.

Disparities are known to exist in the prescription of opioid analgesics among racial and ethnic groups in the management of postoperative, cancer, and emergency department pain in patients across all ages, including children.

Race is associated with an unequal burden of perioperative pain and opioid adverse effects in children. Relatively, African American children had higher postoperative pain, and Caucasian children had higher incidences of opioid related adverse effects. (Read the full article)

Unintentional overdose and emergency department visits secondary to nonmedical use of prescription drugs are on the rise with peak age of onset in midadolescence for these risk behaviors. Also, risk behaviors, such as substance use and violence, tend to cluster.

Approximately 1 in 10 adolescents or young adults using the emergency department endorse nonmedical prescription opioid or sedative use in the past year. Rates of current opioid or sedative prescriptions are low among this group. (Read the full article)

Patients with sickle cell disease frequently express dissatisfaction with emergency department treatment of painful crises. Time to opioid administration has been suggested as a quality of care measure for painful crises.

Although not associated with hospital admission, time to opioid administration in sickle cell disease painful crises was associated with secondary outcomes including improvement between the first 2 pain scores, decreased pain score area under the curve at 4 hours, decreased emergency department length of stay, and increased total opioids. (Read the full article)

Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is not well described. Further, factors associated with development of neonatal abstinence syndrome, a neonatal opioid withdrawal syndrome is inadequately understood.

Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of neonatal abstinence syndrome. (Read the full article)

Legitimate opioid is a risk factor for subsequent misuse of opioids among adults. This study provides the first population-based estimate of the risk of future opioid misuse associated with legitimate opioid use among adolescents.

Use of prescribed opioids before the 12th grade is independently associated with future opioid misuse among patients with little drug experience and who disapprove of illegal drug use. (Read the full article)

Complaint accuses family behind Purdue Pharma of consumer fraud, negligence, and nuisance  Attorney General Kathy Jennings Monday sued seven members of the Sackler family for their role in creating and sustaining the opioid crisis in Delaware. The individuals named in the Delaware Superior Court complaint controlled and directed opioid manufacturer Purdue Pharma’s two-decade course of falsely and deceptively marketing opioids, sowing the seeds […]

Statistics from the Division of Professional Regulation, which licenses controlled substance prescribers, show a 12-percent drop in opioid prescriptions statewide compared to the first quarter of 2017. The number of Delaware patients being treated with opioid medications has also declined by 8 percent over the same time period, the division reports.

An Indian-origin psychiatrist in the US has to pay USD 1,45,000 as settlement to resolve allegations that he overprescribed opioids to his patients outside the usual course of his professional...

The number of prescriptions for opioid medications in Delaware, as well as the total quantity of opioids dispensed, have dropped significantly in the 12 months since the Department of State enacted stricter prescribing regulations to help combat the opioid crisis statewide.

The Division of Public Health launched a new smartphone app that provides lifesaving step-by-step instructions on how to use naloxone during an opioid overdose.

The Delaware Division of Public Health (DPH) is engaging dental providers in the launch of a statewide campaign directed at increasing awareness about the addictive nature of opioid medications used after dental procedures.

Recommendations focus on systemic changes and expanding treatment options   New Castle, Del. – On Thursday, Lt. Governor Hall-Long joined members of Delaware’s Behavioral Health Consortium, community advocates, and elected officials to accept recommendations from The Pew Charitable Trusts aimed at reforming Delaware’s addiction treatment system. Pew Charitable Trusts has been working in partnership with […]

NEW CASTLE (July 11, 2019) – As a new support for individuals and families impacted by the effects of mental health and substance use issues, the Division of Substance Abuse and Mental Health (DSAMH) officially will open the Sussex County Bridge Clinic on July 15 at the Promise Access Center in Georgetown, providing screening and […]

I was recently honored to share the stage with government and medical leaders to discuss ways to impact the nation’s opioid epidemic. Hosted by The Washington Post, this event included often spirited conversations on ways to solve this national crisis. As the medical director for SAS US Government, I have [...]

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