▸ Educating providers and patients on these drugs can minimize opioid abuse; current approaches include prescription monitoring programs, preventing prescription/medical errors, checking patient identification at the pharmacy, referral to pain specialists, and the use of abuse-deterrent opioid formulations.
Full Answer
Can we reduce the risk for opioid misuse and abuse?
To review current strategies that may reduce the risk for misuse and abuse of opioid medications, which in turn can enhance patient outcomes and lower costs to health insurers and patients. Discussion
What is the research being done to address opioid misuse?
The research being undertaken will: 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.
Should we change the formulation of opioids to treat depression and other conditions?
Effectively treating depression, schizophrenia, and chronic pain is as, if not more, critical than changing the formulation of an opioid if the goal is to prevent opioid misuse and abuse.
How has the use of opioids changed over the past decade?
During the past decade, the treatment of noncancer pain with opioids has expanded.20Between 1997 and 2006, retail sales of opioids (grams per 100,000 population) have increased20: Sales of hydrocodone increased by 244% Oxycodone by 732% Methadone by 1177%.
How can opioid abuse be prevented?
Take and Store Opioids ProperlyNever take prescription opioids in greater amounts or more often than prescribed.Always let your doctor know about any side effects or concerns you may have about using opioids.Avoid taking opioids with alcohol and other substances or medications.More items...
What strategies are used for drug abuse prevention?
What are the Basic Prevention Strategies?Information Dissemination. ... Prevention Education. ... Alternatives. ... Problem Identification and Referral. ... Community-Based Process. ... Environmental Approach.
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.
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 two practical strategies that could be implemented by the community to ensure that the anti substance abuse campaigns are effective?
Strategies to be Implemented to Ensure Anti-Substance Campaigns are Effective.Design a campaign which would "achieve" widespread, frequent, and "prolonged exposure" to a message. ... Use "formative research" throughout the "audience segmentation, message design", and "channel selection" phases.
What is drug abuse prevention and Control?
Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings.
What does treatment retention mean?
One of the more robust predictors of positive outcomes for substance abuse treatment is retention, which is defined as the length of time clients remain in treatment.
What is Narcan used for?
NARCAN® Nasal Spray is a prescription medicine used for the treatment of a known or suspected opioid overdose emergency with signs of breathing problems and severe sleepiness or not being able to respond. NARCAN® Nasal Spray is to be given right away and does not take the place of emergency medical care.
What is the treatment of pain?
pain medicines. physical therapies (such as heat or cold packs, massage, hydrotherapy and exercise) psychological therapies (such as cognitive behavioural therapy, relaxation techniques and meditation) mind and body techniques (such as acupuncture)
How is opioid overdose driven?
Opioid overdose is driven by many different mechanisms and human experiences, and people may follow a variety of paths toward opioid misuse and overdose. The realities faced by people who use drugs may be common across regions or vary within tight social groups. Make collaboration your strategy.
What is targeted naloxone?
Targeted Naloxone Distribution#N#Naloxone – a non-addictive, life-saving drug that can reverse the effects of an opioid overdose when administered in time. Targeted naloxone distribution programs seek to train and equip individuals who are most likely to encounter or witness an overdose—especially people who use drugs and first responders— with naloxone kits, which they can use in an emergency to save a life.
What is an opioid?
What Are Opioids? Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legal ly by prescription, such as oxycodone (OxyContin ®), hydrocodone (Vicodin®), codeine, morphine, and many others.
Can opioid pain pills be used with heroin?
Some prescription opioid pain medicines have effects similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use. The Drug Enforcement Administration’s (DEA’s) resource guide is designed to be a reliable resource on the most commonly abused and misused drugs in the United States.
Is fentanyl a synthetic opioid?
Fentanyl and similar compounds like carfentanil are powerful synthetic opioids -- 50 to 100 times more potent than morphine. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death. A Patient’s Guide to Fentanyl.
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.
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].
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].
Who developed the opioid prescribing guidelines?
To ensure that physicians are writing prescriptions only for those who truly need opioids, Weiner worked with two dozen physicians to develop prescribing guidelines, drawing on those of the Centers for Disease Control and Prevention.
What can psychologists do to help the health care system?
"There are lots of opportunities for psychologists to establish lines of funding for research, training and clinical services that address some of the systemic gaps that have existed in the health-care system," says Piotrowski. These new funding streams and programs also create opportunities for psychologists to use their skills in translating research findings for use in real-life settings and in evaluating outcomes.
Does Missouri have a drug monitoring program?
The association is working with physician groups and others to urge legislators to enact a statewide prescription drug monitoring program to help reduce misuse of drugs. "Missouri is the only state in the union that still doesn't have one," says Korte, explaining that such programs help prevent "doctor-shopping" by those seeking inappropriate access to drugs. "It's just one more tool to help control prescription opioids," says Korte.
Does Ohio have Medicaid expansion?
The Ohio Psychological Association, for example, is fighting to protect the state's Medicaid expansion, which now covers almost 630,000 of the state's most vulnerable residents, including those with substance use problems. "For many of them, it's the first time they've had coverage of any type," says Michael Ranney, the association's CEO.
What is the purpose of the Opioid Working Group?
The Opioid Working Group was established to provide independent, broad, external, transparent input on the diverse and complex issues involved in updating the Guideline. The primary purpose of the OWG was to review the draft updated Guideline (as prepared by CDC) and to deliver a report describing the OWG’s findings and observations about the draft to the BSC/NCIPC.
When will the CDC update the guidelines?
CDC carefully considers all input when revising the draft updated Guideline. Release of a final updated Guideline is anticipated in late 2022, along with a suite of translation and communication resources to facilitate effective implementation.
What is the goal of pain management?
One key way we do promote patient-centered pain care is through the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. In this context, our ultimate goal is to help people set and achieve personal goals to reduce pain and improve function.
What is the 2016 CDC guidelines?
The 2016 Guideline was developed using the best available scientific evidence and followed a rigorous scientific process. The update to the Guideline is following a similar process and includes several opportunities for community and partner engagement. CDC highly values public engagement and has ensured there are multiple opportunities to hear from and incorporate feedback from patients with pain, caregivers, clinicians, and partners.
What is systematic review?
Systematic reviews summarizing the new scientific evidence related to the treatment of chronic and acute pain.
When is peer review planned?
Peer review is planned to occur at the same time as the public comment period for the draft updated Guideline.
How are peer reviewers selected?
Peer reviewers will be selected based on their expertise relevant to opioid prescribing, clinical and research practice, and related factors, while ensuring balance in scientific and technical perspectives, avoiding conflicts of interest, and ensuring independence from CDC and the process of developing the updated Guideline.