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Weekly Postings
See something of interest? Please share our postings with colleagues in your institutions! Spotlight The MAR staff spent a day at the University of Pittsburgh Center for Creativity this week to talk about our goals for next year! Check out the photos and follow us on Twitter for live updates during the next #marRetreat @NNLMMAR. Check out the Fall 2017 issue of the MAReport! This quarter you can learn “Through the Eyes of a New MLIS Student,” how working in the library field adds perspective to entering the degree program, and take a moment to “Meet the New Health Professions Coordinator,” Erin! The...
Source: NN/LM Middle Atlantic Region Blog - December 15, 2017 Category: Databases & Libraries Authors: Hannah Sinemus Tags: Weekly Postings Source Type: news

Is there a better way to administer IV N-acetylcysteine?
3 out of 5 stars Fewer adverse effects with a modified two-bag acetylcysteine protocol in paracetamol overdose. McNulty R et al. Clin Toxicol 2017 Dec 8 [Epub ahead of print] Abstract Current recommendations for dosing intravenous N-acetylcysteine (Acetadote) for treating acute acetaminophen (paracetamol) poisoning involves a somewhat complex three-bag protocol, using 3 direct concentrations of the antidote given over a 21-hour period. Unfortunately, this protocol results in a high incidence of (usually mild) adverse events, including cutaneous effects, nausea and vomiting, and anaphylactoid reactions. Severe rea...
Source: The Poison Review - December 14, 2017 Category: Toxicology Authors: Leon Gussow Tags: Medical Acetadote acetaminophen antidote N-acetylcysteine paracetamol three-bag protocol toxicity two-bag protocol Source Type: news

Opioid overdose protection: an inevitable need to address an alarming epidemic - Setnik B.
[Abstract unavailable] Language: en... (Source: SafetyLit)
Source: SafetyLit - December 14, 2017 Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news

Housing and overdose: an opportunity for the scale-up of overdose prevention interventions? - Bardwell G, Collins AB, McNeil R, Boyd J.
North America is currently experiencing an overdose epidemic due to a significant increase of fentanyl-adulterated opioids and related analogs. Multiple jurisdictions have declared a public health emergency given the increasing number of overdose deaths. I... (Source: SafetyLit)
Source: SafetyLit - December 14, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Identifying gaps in the implementation of naloxone programs for laypersons in the United States - Lambdin BH, Zibbell J, Wheeler E, Kral AH.
BACKGROUND: The opioid epidemic in the United States (US) continues to generate significant increases in morbidity and mortality with no sign of decline. Overdose education and naloxone distribution (OEND) programs are highly effective at preventing opioid... (Source: SafetyLit)
Source: SafetyLit - December 14, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Can treatment during surgery reduce postoperative opioid use?
©iStock/windslegend With the current concerns related to opioid addiction and overdose, researchers from the National Institute on Drug Abuse (NIDA) are exploring ways to reduce the use of opioids for pain relief, while still effectively managing pain. In a randomized clinical trial, 422 patients. .. (Source: NIDA News)
Source: NIDA News - December 13, 2017 Category: Addiction Source Type: news

Front Lines of the Opioid Crisis: Perspectives from States, Communities, and Providers
U.S. Senate, Committee on Health, Education, Labor, and Pensions. 11/30/2017 This two-hour, 30-minute Congressional hearing discusses the current opioid crisis, with providers, public safety officials, and state health officials who are on the front lines fighting the epidemic, speak to what is happening on the ground, and what more Congress can do to help them address the crisis. Topics include Rhode Island's Strategic Plan to Address Opioid Addiction and Overdose, which recommended specific, evidence-based strategies in four areas: prevention, rescue, treatment, and recovery. (Video or Multimedia) (Source: Disaster Lit: ...
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 12, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news

Prescribing Policies: States Confront Opioid Overdose Epidemic
National Conference of State Legislatures. 08/2017 This nine-page document provides an overview of state legislation setting guidelines for, or limits on, opioid prescriptions. It discusses how state lawmakers are crafting innovative policies-engaging health, criminal justice, human services, and other sectors-to address this public health crisis, while also ensuring appropriate access to pain management. (PDF) (Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - December 12, 2017 Category: International Medicine & Public Health Authors: The U.S. National Library of Medicine Source Type: news

Substance use patterns associated with recent exposure to fentanyl among people who inject drugs in Vancouver, Canada: a cross-sectional urine toxicology screening study - Hayashi K, Milloy MJ, Lysyshyn M, Debeck K, Nosova E, Wood E, Kerr T.
INTRODUCTION: Vancouver, Canada is experiencing an opioid overdose crisis where fentanyl, a potent, synthetic opioid contaminating the illicit drug supply, has been detected in the majority of fatal overdose cases. Despite its growing presence throughout N... (Source: SafetyLit)
Source: SafetyLit - December 11, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Prescribing Policies: State Confront Opioid Overdose Epidemic
Report provides an overview of state legislation setting guidelines for, or limits on, opioid prescriptions. (Source: HSR Information Central)
Source: HSR Information Central - December 11, 2017 Category: International Medicine & Public Health Source Type: news

Most Popular NEJM Group Feature This Week: Unintentional Opioid Overdose
Here's the most clicked-on item we featured from NEJM Group in the past week, in case you missed it the first time around: NEJM... (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - December 9, 2017 Category: Primary Care Source Type: news

Weekly Postings
See something of interest? Please share our postings with colleagues in your institutions! Spotlight The National Network of Libraries of Medicine (NNLM) is pleased to announce a partnership with the NIH All of Us Research Program (All of Us), part of the Precision Medicine Initiative. Through this collaboration, NNLM’s Regional Medical Libraries and National Offices will focus on improving consumer access to high quality health information in communities throughout the U.S., specifically, by working with public libraries. Check out the Fall 2017 issue of the MAReport! This quarter, Lydia Collins discusses “Rai...
Source: NN/LM Middle Atlantic Region Blog - December 8, 2017 Category: Databases & Libraries Authors: Hannah Sinemus Tags: Weekly Postings Source Type: news

Severe hypertriglyceridemia and colchicine intoxication following suicide attempt - Lev S, Snyder D, Azran C, Zolotarsky V, Dahan A.
We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg) of colchicine in a suicide att... (Source: SafetyLit)
Source: SafetyLit - December 8, 2017 Category: International Medicine & Public Health Tags: Suicide and Self-Harm Source Type: news

Overdose and adverse drug event experiences among adult patients in the emergency department - Bohnert ASB, Walton MA, Cunningham RM, Ilgen MA, Barry K, Chermack ST, Blow FC.
This study describes overdose/adverse drug event experiences among adult ED patients to inf... (Source: SafetyLit)
Source: SafetyLit - December 8, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Research progress of the death caused by insulin intoxication - Chen L, Lu YX.
In recent years, with the sustained increase of the incidence of diabetes in humans and the wider use of exogenous insulin, the cases of inappropriate use and overdose of insulin is growing, even the cases of suicide and homicide using insulin. Through sea... (Source: SafetyLit)
Source: SafetyLit - December 8, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Screening in Trauma for Opioid Misuse Prevention (STOMP): study protocol for the development of an opioid risk screening tool for victims of injury - Brown R, Deyo B, Riley C, Quanbeck A, Glass JE, Turpin R, Hetzel S, Nicholas C, Cruz M, Agarwal S.
BACKGROUND: Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population rem... (Source: SafetyLit)
Source: SafetyLit - December 8, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Viewpoint: Treat opioid epidemic like a crisis
We cannot afford to waste our time and money on small-scale efforts or other programs that are not evidence-based, not when we ’ve seen 300,000 Americans die from an opioid overdose since 2000. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - December 7, 2017 Category: Biotechnology Authors: David Offensend Source Type: news

Acetaminophen-induced acute liver failure is more common and more severe in women - Rubin JB, Hameed B, Gottfried M, Lee WM, Sarkar M.
BACKGROUND& AIMS: Acetaminophen overdose is the leading cause of acute liver injury (ALI) and acute liver failure (ALF) in the developed world. Sex differences in acetaminophen-induced hepatotoxicity have not been described. METHODS: We collected ... (Source: SafetyLit)
Source: SafetyLit - December 6, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Research finds new ways to fight the opioid crisis
(American College of Neuropsychopharmacology) In the US alone, more than 2 million people struggle with opioid use disorders. Opioids, often prescribed as pain medications, have now become the country's leading cause of drug overdose. But scientists are identifying ways to help combat the epidemic, which include getting people treatment faster, developing safer opioids, and helping patients choose appropriate treatment. A number of recent breakthroughs are being presented at the upcoming conference of the American College of Neuropsychopharmacology. (Source: EurekAlert! - Social and Behavioral Science)
Source: EurekAlert! - Social and Behavioral Science - December 6, 2017 Category: International Medicine & Public Health Source Type: news

New hope for waitlisted patients addicted to opioids
(American College of Neuropsychopharmacology) As the opioid crisis continues to escalate, the number of people who need treatment for their dependency on heroin or prescription pain killers far exceeds the capacity of available treatment programs. People seeking treatment can wait months or even years for spots in clinics or with certified doctors -- and while they wait, they risk becoming infected with HIV or hepatitis, as well as dying from an overdose. (Source: EurekAlert! - Social and Behavioral Science)
Source: EurekAlert! - Social and Behavioral Science - December 6, 2017 Category: International Medicine & Public Health Source Type: news

Sausage sandwiches 'saltier than cheeseburger and chips'
Sausage manufacturers have been accused of failing to cut salt levels to meet public health targets. Campaigners say as a result some brands are putting customers at risk of overdosing on salt. (Source: the Mail online | Health)
Source: the Mail online | Health - December 6, 2017 Category: Consumer Health News Source Type: news

Upcoming NNLM Webinars for Public Health
The National Network of Libraries of Medicine (NNLM) website offers free professional development opportunities each month for public health professionals and librarians. During December 2017, attend free NNLM webinars related to high reliability in healthcare organizations, community response to substance misuse, apps related to consumer health, and how to search ClinicalTrials.gov: Today! Moving Towards High Reliability in Health Care – December 5, 2017, 2:00PM ET – In this session, characteristics of high reliability organizations will be discussed and the types of practical strategies that health ...
Source: NN/LM Middle Atlantic Region Blog - December 5, 2017 Category: Databases & Libraries Authors: Hannah Sinemus Tags: Consumer Health Education Health Professionals K-12 Outreach Public Health Source Type: news

Cocaine Accounts for Substantial Overdose Burden Among Black Adults
Cocaine is an important contributor to overdose deaths — in particular, among black adults — according to a research letter in the Annals of Internal Medicine. Analyzing... (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - December 5, 2017 Category: Primary Care Source Type: news

Cocaine death rate for blacks on par with opioids for whites
The American opioid crisis is only part of an overall drug abuse emergency. Cocaine-related overdose deaths among non-Hispanic blacks are on par with overdose deaths caused by heroin and prescription opioids among whites, according to a study published Monday in the medical journal Annals of Internal Medicine. (Source: CNN.com - Health)
Source: CNN.com - Health - December 5, 2017 Category: Consumer Health News Source Type: news

Cocaine kills as many blacks as opioids kill whites, study finds
The American opioid crisis is only part of an overall drug abuse emergency. Cocaine-related overdose deaths among non-Hispanic blacks are on par with overdose deaths caused by heroin and prescription opioids among whites, according to a study published Monday in the medical journal Annals of Internal Medicine. (Source: CNN.com - Health)
Source: CNN.com - Health - December 4, 2017 Category: Consumer Health News Source Type: news

New report recommends Georgia develop statewide plan for opioid epidemic
Nearly 1,000 Georgians died from opioid-related overdoses in 2016, an increase of 55 percent from 633 in 2012. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - December 4, 2017 Category: Pharmaceuticals Authors: David Allison Source Type: news

Naloxone Safely Reverses Opioid Overdoses in the Field
A systematic evidence review published online Nov. 28 inAnnals of Internal Medicine examined use of naloxone to treat opioid overdoses in the field. (Source: AAFP News)
Source: AAFP News - December 4, 2017 Category: Primary Care Source Type: news

Steep Rise in Deaths for People Hospitalized After Opioid OD
MONDAY, Dec. 4, 2017 -- The death rate has quadrupled among people whose opioid use lands them in a hospital, a new U.S. study finds. More opioid users are being sent to the hospital due to a life-threatening overdose than for treatment of drug... (Source: Drugs.com - Daily MedNews)
Source: Drugs.com - Daily MedNews - December 4, 2017 Category: General Medicine Source Type: news

Medication-assisted treatment for youth with opioid use disorder: current dilemmas and remaining questions - Chang DC, Klimas J, Wood E, Fairbairn N.
The prevalence of risky opioid use, opioid use disorder, and related harms continue to rise among youth (adolescents and young adults age 15-25) in North America. With an increasing number of opioid overdoses, there remain significant barriers to care for ... (Source: SafetyLit)
Source: SafetyLit - December 4, 2017 Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news

Management of Suspected Opioid Overdose with Naloxone by Emergency Medical Services Personnel
Systematic review determines optimal doses, routes of administration, and dosing strategies of naloxone for suspected opioid overdose in out-of-hospital settings, and whether transport to a hospital following successful opioid overdose reversal with naloxone is necessary. (Source: HSR Information Central)
Source: HSR Information Central - December 4, 2017 Category: International Medicine & Public Health Source Type: news

Cocaine contributes to overdose deaths among some minorities
Photo by ©Thinkstock.com/John Panella Drug overdose deaths are a major public health concern across all racial/ethnic groups, and are often associated with opioid use. However, a new study shows that cocaine is also a consistent contributor to overdose deaths. The research suggests that rates of... (Source: NIDA News)
Source: NIDA News - December 4, 2017 Category: Addiction Tags: African Americans, Cocaine, Health and Medical Professionals, Heroin, Opioids, Prevention Research, Researchers Source Type: news

Could Marijuana Replace Opioids As A Painkiller? Experts Are Skeptical
The widespread availability – and heavy marketing – of sustained release opioid pills has sparked a national crisis. Last year, some 50,000 Americans died of opioid overdoses. How do we close this Pandora's box? (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - December 3, 2017 Category: Pharmaceuticals Authors: Michela Tindera, Forbes Staff Source Type: news

Squarticles as the nanoantidotes to sequester the overdosed antidepressant for detoxification - Chen CH, Huang TH, Elzoghby AO, Wang PW, Chang CW, Fang JY.
The increasing death rate caused by drug overdose points to an urgent demand for the development of novel detoxification therapy. In an attempt to detoxify tricyclic antidepressant overdose, we prepared a lipid nanoemulsion, called squarticles, as the nano... (Source: SafetyLit)
Source: SafetyLit - December 1, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

FDA Approves Monthly Injection for Opioid Addiction Treatment
WASHINGTON (AP) — U.S. health officials on Thursday approved the first injectable form of the leading medication to treat patients recovering from addiction to heroin, prescription painkillers and other opioids. The Food and Drug Administration approved once-a-month Sublocade for adults with opioid use disorder who are already stabilized on addiction medication. The monthly injection has the potential to reduce dangerous relapses that occur when patients stop taking the currently available daily medication. But that benefit has not yet been shown in studies and the new drug comes with a hefty price: $1,580 per monthl...
Source: JEMS Patient Care - December 1, 2017 Category: Emergency Medicine Authors: Matthew Perrone, Associated Press Tags: Patient Care News Source Type: news

FDA Approves Monthly Injection for Opioid Addiction Treatment
WASHINGTON (AP) — U.S. health officials on Thursday approved the first injectable form of the leading medication to treat patients recovering from addiction to heroin, prescription painkillers and other opioids. The Food and Drug Administration approved once-a-month Sublocade for adults with opioid use disorder who are already stabilized on addiction medication. The monthly injection has the potential to reduce dangerous relapses that occur when patients stop taking the currently available daily medication. But that benefit has not yet been shown in studies and the new drug comes with a hefty price: $1,580 per monthl...
Source: JEMS: Journal of Emergency Medical Services News - December 1, 2017 Category: Emergency Medicine Authors: Matthew Perrone, Associated Press Tags: Patient Care News Source Type: news

Your NEJM Group Today: Unintentional Overdose Case / Ceftriaxone-Resistant Gonorrhea in North America / Virginia Hospitalist Opportunity
Here's what we've chosen for you today: NEJM Clinical Practice Center: Case Record: A 36-year-old man was seen in the emergency department because... (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - December 1, 2017 Category: Primary Care Source Type: news

Grant Funding Available for Behavioral Interventions for Prevention of Opioid Use Disorder and as an Adjunct to Medication-Assisted Treatment
More than 90 Americans die every day after  overdosing on opioids. The misuse of and addiction to opioids—including prescription pain relievers, heroin, and fentanyl—is a public health epidemic in the U.S. Combatting the opioid crisis requires sustained efforts from researchers, health professionals, and community members to impleme nt evidence-based prevention and treatment strategies and to evaluate the effectiveness of new approaches. (Source: NCCAM Featured Content)
Source: NCCAM Featured Content - November 30, 2017 Category: Complementary Medicine Authors: Robin Boineau, M.D. Source Type: news

' Pill Mill' Docs Only Partly to Blame for Opioid Epidemic
THURSDAY, Nov. 30, 2017 -- All prescribers of opioid pain medications -- not just high-volume prescribers -- play a role in the U.S. epidemic of opioid abuse and overdoses, a new study says. Deaths from drug overdoses in the United States rose from... (Source: Drugs.com - Daily MedNews)
Source: Drugs.com - Daily MedNews - November 30, 2017 Category: General Medicine Source Type: news

Impact of Childhood Trauma Reaches Rural Wisconsin
Focuses on a rural county in Wisconsin where rates of opioid overdoses and hospitalizations are particularly high. This county also has high rates of adverse childhood experiences (ACEs). Addresses the impact both of these things can have on individuals and communities and how they are exacerbated by limited access to healthcare. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - November 30, 2017 Category: Rural Health Source Type: news

Retired Adm. Winnefeld on son's opioid-overdose death
In our ongoing series Issues That Matter, we take a closer look at the opioid epidemic. It has taken more than 500,000 lives since the year 2000. For retired Navy admiral and CBS News military and homeland security analyst Sandy Winnefeld, the epidemic is personal. He lost his 19-year-old son, Jonathan, in September to a fentanyl-laced batch of heroin. Winnefeld joins "CBS This Morning" to discuss how his family is dedicating themselves to studying the problem and saving other families from the same heartache. (Source: Health News: CBSNews.com)
Source: Health News: CBSNews.com - November 29, 2017 Category: Consumer Health News Source Type: news

Mixed Evidence on Best Non-hospital Use of Naloxone for Suspected Opioid Overdose Mixed Evidence on Best Non-hospital Use of Naloxone for Suspected Opioid Overdose
Although higher-concentration intranasal naloxone seems to be as effective as intramuscular naloxone for out-of-hospital reversal of opioid overdose, there is limited evidence to determine how best to use naloxone in this setting.Reuters Health Information (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - November 28, 2017 Category: Consumer Health News Tags: Medscape Today News Source Type: news

More than 60% of opioid overdoses linked to chronic pain
The Columbia University study - the largest ever on opioid deaths - said the data provide a clear picture of the American healthcare system: big on pills, vague on alternative methods. (Source: the Mail online | Health)
Source: the Mail online | Health - November 28, 2017 Category: Consumer Health News Source Type: news

Chronic Pain Common Among Those Who OD on Opioids
TUESDAY, Nov. 28, 2017 -- More than 60 percent of opioid overdose deaths involve people who suffer from chronic pain, a new analysis reveals. Many of them also struggled with depression or anxiety, the investigators found. The findings stem from a... (Source: Drugs.com - Daily MedNews)
Source: Drugs.com - Daily MedNews - November 28, 2017 Category: General Medicine Source Type: news

Rural America in Crisis: The Changing Opioid Overdose Epidemic
Post outlines how the CDC is responding differently to the opioid epidemic in rural areas. (Source: HSR Information Central)
Source: HSR Information Central - November 28, 2017 Category: International Medicine & Public Health Source Type: news

Largest study of opioid deaths reveals who is at most risk
(Columbia University Medical Center) A new study of 13,000 people who died of an opioid overdose found that more than half had been diagnosed with chronic pain; many had psychiatric disorders. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - November 28, 2017 Category: International Medicine & Public Health Source Type: news

Doctor Who Doesn't Use Computer Unable to Regain License
CONCORD, N.H. (AP) — A New Hampshire judge has denied an 84-year-old doctor's request to regain her license to practice, which she had surrendered partly over her inability to use a computer. The state challenged Dr. Anna Konopka's record keeping, prescribing practices and medical decision making. It said her limited computer skills prevent her from using the state's mandatory electronic drug monitoring program, which requires prescribers of opioids to register in an effort reduce overdoses. Konopka surrendered her license in October, but later requested permission to continue her practice. New Hampshire Public Radio...
Source: JEMS Administration and Leadership - November 28, 2017 Category: Emergency Medicine Authors: Michael Casey, Associated Press Tags: Documentation & Patient Care Reporting News Source Type: news

Doctor Who Doesn't Use Computer Unable to Regain License
CONCORD, N.H. (AP) — A New Hampshire judge has denied an 84-year-old doctor's request to regain her license to practice, which she had surrendered partly over her inability to use a computer. The state challenged Dr. Anna Konopka's record keeping, prescribing practices and medical decision making. It said her limited computer skills prevent her from using the state's mandatory electronic drug monitoring program, which requires prescribers of opioids to register in an effort reduce overdoses. Konopka surrendered her license in October, but later requested permission to continue her practice. New Hampshire Public Radio...
Source: JEMS: Journal of Emergency Medical Services News - November 28, 2017 Category: Emergency Medicine Authors: Michael Casey, Associated Press Tags: Documentation & Patient Care Reporting News Source Type: news

Out-of-Hospital Naloxone for Opioid Overdose: What's the Optimal Strategy?
Higher-concentration intranasal naloxone and intramuscular naloxone seem equally effective for the treatment of opioid overdose in out-of-hospital settings, according to a review... (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - November 27, 2017 Category: Primary Care Source Type: news

OHSU researchers identify gaps in knowledge about overdose reversal drug
Many first responders are administering a cheaper formulation, raising concerns about its efficacy against powerful opioids like fentanyl. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - November 27, 2017 Category: Pharmaceuticals Authors: Elizabeth Hayes Source Type: news