Overdose education and naloxone distribution promote access to rescue medication and reduce opioid overdose fatalities. Opioid use disorder prevention and treatment must embrace evidence-based care and integrate with physical and mental health care.
Full Answer
What are the treatment options for opioid abuse?
Opioid antagonist therapy (i.e., extended-release naltrexone) may also inhibit return to use. Prevention efforts emphasize public and prescriber education, use of prescription drug monitoring programs, and safe medication disposal options.
How can we reduce opioid overdose fatalities?
Overdose education and naloxone distribution promote access to rescue medication and reduce opioid overdose fatalities. Opioid use disorder prevention and treatment must embrace evidence-based care and integrate with physical and mental health care. Opioid use is widespread, and treatment access is limited.
What can schools do to prevent opioid addiction?
School leaders, teachers and staff can create safe environments and positive cultures for students. They can educate students, each other and families about the dangers of drug use and about how to prevent opioid misuse and addiction. Many evidence-based prevention programs can be delivered in a school setting.
Can opioid use disorder be prevented?
... Older adolescents and young adults (ages 16-30) are at the highest risk for initiation of opioid use, opioid misuse, opioid use disorder (OUD), and death from overdose, and there are no evidence-based interventions to prevent opioid use disorder.
How can opioid usage be reduced?
There are a variety of ways to help reduce exposure to opioids and prevent opioid use disorder, such as:Prescription drug monitoring programs.State prescription drug laws.Formulary management strategies in insurance programs, such as prior authorization, quantity limits, and drug utilization review.More items...
What are the ways in which we can help minimize the negative effect that the opioid epidemic has caused in communities?
Risk Minimization Approaches to AbuseEducating Physicians and Patients. ... Use of Prescription Monitoring Programs. ... Preventing Inappropriate Prescribing and Medical Errors. ... Checking Patients' Photo Identification at the Pharmacy. ... Referral to Pain Specialists.
What are the 5 strategies for combating the opioid crisis?
To combat the ongoing opioid crisis, HHS has prioritized five specific strategies: 1) Better Data by strengthening public health surveillance 2) Better Pain Management 3) Improving access to treatment, prevention and recovery services 4) Increasing the availability of overdose-reversing drugs 5) Supporting cutting-edge ...
What are strategies for treating opioid addictions?
Evidence-based approaches to treating opioid addiction include medications and combining medications with behavioral therapy. A recovery plan that includes medication for opioid addiction increases the chance of success.
How can medication misuse be prevented?
never stopping or changing a dosing regimen without first discussing it with the doctor. never using another person's prescription and never giving their prescription medications to others. storing prescription stimulants, sedatives, and opioids safely.
How can healthcare providers aid in combating the opioid crisis?
Hospitals can combat the opioid crisis by forming multisector partnerships; assessing and refining opioid prescribing practices; screening for and monitoring opioid use among patients; engaging transitional treatment, and supporting overdose rescue efforts.
What can communities do to help the opioid crisis?
Creating referral programs through law enforcement agencies. Some communities are trying innovative programs that allow people to voluntarily obtain help by going to the local sheriff's office and requesting assistance.
How effective is opioid treatment?
Abundant evidence shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms, and they reduce the risk of infectious disease transmission as well as criminal behavior associated with drug use.
What is treatment retention?
Treatment completion is defined as the participant continuing in the assigned medication group for 24 weeks without being withdrawn. Treatment retention is calculated as days in treatment since randomization until the last day of medication during the 24 weeks of treatment.
What is the primary reason for opioid abuse?
Among those with chronic pain who reported pain relief as the primary initial reason for prescription opioid use, 56.5% reported that avoiding withdrawal was their primary current reason for use. The second most common current reason for use was pain relief (22.6%), followed by getting high (13.9%).
What is 5point strategy?
Five points for business strategy. Animated. Sales enablement plan team knowledge action strategy and success. Sales enablement plan team knowledge action strategy and success.
What is the third wave of the opioid epidemic?
The Third Wave of the Opioid Epidemic Fentanyl is 50 to 100 times stronger than morphine, meaning that it's extremely potent even in low doses. Fentanyl is often used to treat severe pain, specifically pain that is associated with cancer. It's almost never prescribed but instead used in a hospital setting.
How does the Department of Education address the opioid crisis?
The Department is taking a two pronged approach to addressing the opioid crisis: 1) Helping to educate students, families and educators about the dangers of opioid misuse and about ways to prevent and overcome opioid addiction and; 2) Supporting State and local education agency efforts to prevent and reduce opioid misuse.
What are opioids, how are they having an impact and what is the Federal government doing?
Opioids are natural or synthetic chemicals that reduce feelings of pain.
What is the role of schools?
School leaders, teachers and staff can create safe environments and positive cultures for students.
What is the first line of defense in preventing opioid misuse and illicit drug use by students?
Educated and empowered parents and guardians are the first line of defense in preventing opioid misuse and illicit drug use by students.
What is the Department of Education?
Department of Education (the Department) is joining other Federal agencies in combating the opioid crisis that is killing Americans at unprecedented rates and plaguing families and communities. While the causes of opioid misuse are complex and determined by multiple factors, the goals of prevention and recovery focus on reducing risk ...
What is the Drug Enforcement Agency website?
The Drug Enforcement Agency's Campus Drug Prevention website provides information about drug abuse prevention programs on college campuses and in surrounding communities.
What is the White House Office of National Drug Control Policy?
The White House Office of National Drug Control Policy produced a school resource guide for teachers, administrators, and staff to help educate and protect students from substance abuse.
How can we reduce opioid use?
On a state level, efforts to decrease non-medical opioid use have included establishing and optimizing prescription monitoring programs, closing down “pill mills,” and increasing access to pain experts [49,50]. On a national level, the CDC, DEA, National Institutes of Health (NIH), and Substance Abuse and Mental Health Services Administration (SAMHSA) provide funding for research, coordinate medication take-back drives, and conduct national educational campaigns to raise awareness, including SAMHSA’s recent development of an opioid overdose tool kit with sections for patients, families, and medical providers [9,51].
How can we reduce the number of opioid overdoses?
This end can be achieved by reducing the number of new opioid abusers and by increasing engagement of current users in effective specialized treatment programs. As the opioid epidemic has grown, public health officials, health care professionals, community organizations, law enforcement, and legislators have initiated a variety of strategies to reduce the number of individuals at risk for fatal overdose. Many of these strategies employ educational interventions for primary prevention and target high-risk individuals, such as teens and those with a history of substance abuse disorders, although evidence for the impact of this approach is limited [40]. Other initiatives focus on close contacts, such as family, and on the importance of not sharing prescribed opioids, keeping them locked up, and safely disposing of unused medications. Large quantities of medications have been recovered during local and nationwide medication take-back drives that range from an anonymous mail-in program in Maine to a biweekly collection by pharmacists in parks, police stations, and other public spaces in Florida [36,41,42]. In addition, the Drug Enforcement Administration (DEA) has conducted nine country-wide medication take-back days since 2010, in which pharmacies and hospitals are able to accept and collect unused medications, resulting in the collection of 2,411 tons of controlled medications [43]. While the success in collecting medications can be documented, the actual impact on substance abuse and overdose rates is unknown. The co-occurrence of many educational initiatives and interventions across communities makes it particularly challenging to demonstrate the impact of an isolated program [36].
What are the complications of non-fatal opioid overdose?
Non-fatal opioid overdose has been associated with a number of complications, including anoxic brain injury, pulmonary edema, acute respiratory distress syndrome, hypothermia, rhabdomyolysis, renal failure, compartment syndrome, liver failure, seizures, and traumatic injury [34]. More often than not, though, overdose patients often completely recover with limited morbidity and frequently refuse acute medical care [34]. This was demonstrated in a 2003 case series of 998 individuals with non-fatal opioid overdose who refused ED transfer after naloxone resuscitation in the field and did not experience fatal overdose within the next 12 hours [39].
How does the opioid epidemic affect the public?
The opioid overdose epidemic is a major threat to the public’s health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose [1-3]. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose [4-7].
What are the consequences of a rapid proliferation of overdose prevention programs and health policies?
One consequence of a rapid proliferation of overdose prevention programs and health policies is that we still have an evidence gap in determining the most effective and efficient initiatives. Conducting research and methodical evaluations of these interventions is challenging and complex, but critical. Nevertheless, considerable progress has been made, and the harm reductionists are no longer left to fight this battle on their own. Based on the thousands of successful reversals, it seems prudent to continue to support and expand those initiatives. It also seems prudent for prescribers to consider prescribing naloxone to high-risk populations such as those prescribed high doses of opioids, those with a history of a non-fatal opioid overdose, and those recently released from a controlled environment such as prison or inpatient treatment. Reducing the risk for fatal overdose rests on a combination of prevention, treatment, and harm reduction initiatives, and it is critical that we strive to implement these initiatives as quickly and efficiently as possible.
What is a multifaceted community-initiated overdose prevention program?
One example of a multi-faceted community-initiated overdose prevention program that included targeted prescriber education is Project Lazarus in Wilkes County, North Carolina. In 2007, Project Lazarus began training local physicians to use an overdose risk assessment tool. If a patient was deemed to be at-risk, he or she watched a 20-minute training video on recognizing and responding to overdose and were prescribed naloxone, to be collected at a pre-specified community pharmacy [36]. Overdose risk assessment was coupled with other initiatives, including town hall meetings, promotion of prescription monitoring program (PMP) use, a new buprenorphine-based treatment clinic, and new prescribing policies in the local Emergency Department and hospital. Additionally, a program involving “academic detailing,” a concept borrowed from the pharmaceutical industry to influence prescribing habits, was employed. From 2008 to 2010, they provided one-on-one prescriber education on evidence-based opioid prescribing, which corresponded to a decrease from 80 percent to 10 percent of individuals with fatal overdoses having an active prescription for opioids from a Wilkes county physician [36]. Preliminary unadjusted data from Wilkes County demonstrated that the overdose rate dropped from 43 per 100,000 in 2008 to 29 per 100,000 in 2010, which authors suggest may be related to these community-based overdose prevention efforts, although a definitive causal link cannot be determined [36].
How to increase engagement in treatment for opioid abuse?
On an individual level, targeted educational initiatives and referral to treatment may be used to increase treatment engagement . Close contacts such as friends and family also may play a role in encouraging patients with opioid use disorders to seek and continue to engage in treatment. Communities and states can work to improve known deficits in local treatment services, with particular attention to those that offer medication-assisted treatment [3,56]. Communities, states, and the medical community can work to increase the general knowledge of the biologic underpinnings of addiction, which would facilitate the treatment of addiction as a disease rather than a moral failure [33,70]. The American Board of Addiction Medicine recently has become an American College of Graduate Medical Education (ACGME)-accredited subspecialty, which will increase specialized training opportunities and the incorporation of addiction-specific teaching in general medical training [71]. On a national level, the U.S. Department of Health and Human Services, which oversees many governmental research, health care, and evaluation agencies, can continue to make opioid overdose prevention a priority, as it did in early 2015 when it announced dedicated funding to increase 1) health care provider training and resources, 2) increasing use of naloxone, and 3) expand the use of MAT [8].
Who is at risk for opioid abuse?
Target adolescent and young adult populations that are at risk of and particularly affected by opioid misuse and OUD, including American Indians/Alaska Natives, homeless individuals, young people in the juvenile or criminal justice system, and families involved in the child welfare system.
What age group is most at risk for opioid use?
Older adolescents and young adults (ages 16-30) are at the highest risk for initiation of opioid use, opioid misuse, opioid use disorder (OUD), and death from overdose, and there are no evidence-based interventions to prevent opioid use disorder.
What is the NIH study?
NIH is supporting a series of studies to develop and test effective strategies to prevent opioid misuse and OUD among vulnerable populations, including older adolescents and young adults and AI/AN communities. The studies will expand knowledge of characteristics that increase risk or confer protection for opioid use and related behavioral health and drug use outcomes, including suicide. The studies will focus on strategies for settings that can identify and reach at-risk individuals and populations, such as health care, justice, school, and child welfare systems.
What should be considered when taking opioids?
If opioids are being considered, assess the patient’s psychiatric status. A physical exam should also be completed, keeping in mind signs and symptoms of possible substance abuse, such as advanced periodontitis, traumatic lesions and poor oral hygiene.
What is the role of a nurse in opioid abuse?
Preventing Opioid Abuse: The Role of the Nurse. Opioids have become a leading cause of unintentional injury death in Washington , even more than motor vehicle accidents or firearm fatalities, according to 2016 state data. Nationwide, the Centers for Disease Control and Prevention (CDC) reports that overdose deaths related to prescription ...
What should nurses do to help patients with pain?
Nurses should complete continuing education courses in pain management and document they did so, which can provide evidence of their knowledge in event of legal action. Educate patients. Nurses have an opportunity to educate patients about the role of pain medication in their care.
What can a nurse do to help with substance abuse?
Nurses also can help detect patients with substance misuse with the National Institute on Drug Abuse Quick Screen (NIDA). If a substance use disorder is suspected, the nurse should remain nonjudgmental while referring patients for further evaluation and treatment, so they receive the care they need.
What is the most commonly prescribed opioid?
The most commonly dispensed opioid was hydrocodone (78 percent), followed by oxycodone (15.4 percent).
Can nurses discuss opioids?
The same survey found that about 20 percent shared the opioid with another person, so education material should mention not to do this. Nurses should also discuss the perils of driving or undertaking complex tasks while taking an opioid. Document in the patient’s health record that this information was provided and the patient acknowledged receipt and understanding. An office visit can also provide the opportunity for nurses to address opioid abuse on a larger scale.