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Each day I interact with individuals, including teens, whose lives have been affected by heroin use. I bear witness to pain, loss, family disintegration, shame, and hopelessness. Yet I also see the miracle of change. Despite recent media attention and increasing public awareness, opiate addiction is not a new phenomenon. Over the past few years, articles about the increasing incidence of opiate overdoses have dominated the news. In fact, while reading The Seventh Wish, a headline announced that the risk of an opiate overdose has surpassed the risk of dying in a car accident in our country.
Source: Journal of the American Academy of Child and Adolescent Psychiatry - Category: Psychiatry Authors: Tags: Book forum Source Type: research

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A  letter to the editor in the August 14 New England Journal of Medicine by researchers at the University of Michigan proudly reported on the results of their effort, called the Michigan Surgical Quality Collaborative (MSQC), to reduce the volume of opioids prescribed for postoperative pain. The Collaborative developed a set of guidelines for its participating prescribers.As a result, they found that from January 2017 through May 2018, the mean number of pills prescribed for postoperative pain decreased from 26 (+/-2) pills pre-guideline to 18 (+/ – 3) pills post-guideline. Patient pill consumption also dec...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
Abstract Endogenous opioids are neuro-peptides with multifunctional properties. Historically, opioids are used to mediate pain; however, excess opiate consumption can lead to addiction. One endogenous opioid, methionine enkephalin (MENK), was reported to modulate cell growth, MENK was identified as an opioid growth factor (OGF) that interacts with the OGF receptor (OGFr) and regulates cell proliferation. Further, opioid antagonists, including naltrexone and naloxone are widely used to reverse drug and alcohol overdoses. Naltrexone (NTX) acts on all opioid receptors, blocking the interaction between OGF and OGFr, a...
Source: International Immunopharmacology - Category: Allergy & Immunology Authors: Tags: Int Immunopharmacol Source Type: research
AbstractThe primary goal of this work was to develop a computational tool to enable personalized prediction of pharmacological disposition and associated responses for opioids and antidotes. Here we present a computational framework for physiologically-based pharmacokinetic (PBPK) modeling of an opioid (morphine) and an antidote (naloxone). At present, the model is solely personalized according to an individual ’s mass. These PK models are integrated with a minimal pharmacodynamic model of respiratory depression induction (associated with opioid administration) and reversal (associated with antidote administration). ...
Source: Journal of Pharmacokinetics and Pharmacodynamics - Category: Drugs & Pharmacology Source Type: research
Depending on what you read, kratom is a dangerous, addictive drug with no medical utility and severe side effects, including overdose and death, or it is an accessible pathway out of undertreated chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), medical professionals, and millions of regular kratom users have such divergent views of the same plant? What is kratom? Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opiate-like, causing drowsiness and euphoria. Kratom has d...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Vitamins and supplements Source Type: blogs
In February of this year, I co-authored a  paper in the Journal of Pain Research  explaining why there is  no correlation  between the amount of opioids prescribed and the incidence of non-medical use or prescription pain-reliever use disorder. That same month my colleague Jeffrey Miron and co-authors revealed similar findings in this Cato Institute  Policy Analysis.Now researchers in Germany have provided  more evidence to pour cold water on the idea of any relationship between the volume of opioid prescribing and the incidence of opioid use disorder. Publishing in the German M...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
With  clear evidence that restricting the number of prescriptions increased the death rate by driving non-medical users to heroin and fentanyl, the last thing one wants to hear about is a politician planning to double down on this deadly policy by calling for further prescription limits for patients in pain.Yet Senator Robert Portman (R-OH) is  proposing legislation that would impose a national 3-day limit on opioid prescriptions following surgeries. He will be kind enough to allow exceptions for people dealing with cancer, chronic pain, and “other serious matters”—whatever that means....
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential. When does an opioid prescription make sense? It is simply impossib...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Source Type: blogs
Opioid addiction is an escalating problem in the United States, with 33,091 reported deaths due to opioid overdoses in 2015. Although opioids are often an integral part of postoperative pain control, they can have significant side effects including physical dependence, development of tolerance, respiratory depression, and death. Orthopaedic surgeons are the third highest prescribers of opioids among physicians in the United States. Properly identifying patients who are at greater risk for prolonged postoperative opioid use can help direct patients care towards ancillary treatments such as behavioral therapy, pain managemen...
Source: Journal of Shoulder and Elbow Surgery - Category: Orthopaedics Authors: Source Type: research
The current opioid crisis has raised awareness of the risks of misuse, addiction, and overdose with opioid prescribing for pain management in the perioperative and nonoperative care of surgical patients. Despite these risks, it is essential for surgical providers to provide safe and adequate functional pain control to enhance recovery. The purpose of this review is to outline the relevance of the US opioid crisis to surgical prescribing, describe strategies for opioid reduction using a stepwise therapy approach, and provide recommendations for improving the safety of opioid prescribing. Additional recommendations for risk ...
Source: Surgical Clinics of North America - Category: Surgery Authors: Source Type: research
The Washington Post recently received access to a database maintained by the Drug Enforcement Administration that tracks the manufacture and distribution of every prescription opioid in the country. It  reported that 76 billion pills were distributed throughout the US between 2006 and 2012, with higher volumes shipped to the areas that were most hard hit with opioid-related overdose deaths. This is being offered as proof that the overprescribing of prescription opioids caused the overdose crisis. But this flies in the face of other powerful evidence. Research reported in the  Journal of Pain Research&nb...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
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