Tag Archives: addiction

Head in the sand about opioid crisis

America has to get its head out of the sand for the opioid epidemic by Brooke M. Feldman, MSW Candidate, University of Pennsylvania, Social justice activist – Oct 2017

America has a long history of rewriting its own history. While this practice is sadly nothing new, perhaps one of the greatest real time showings of it in my lifetime has been the false narrative being spread like wildfire around the “opioid epidemic.”

It goes something like this:

“Johnny is from a white middle class community. He had everything going for him…Johnny was prescribed narcotic pain medication by an irresponsible doctor peddling a nefarious pharmaceutical company’s wares. Unknowingly, Johnny got hooked and eventually moved onto using heroin. ”   Continue reading

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Chronic Pain, Chronic Opioid Addiction: a Complex Nexus

Chronic Pain, Chronic Opioid Addiction: a Complex Nexus – free full-text /PMC4781803/ – J Med Toxicol. 2016 Mar

Opioid therapy is regarded as necessary in the treatment of acute pain, such as post-operative pain.

Chronic opioid therapy (COT) is often utilized in palliative care and cancer pain paradigms.

However, COT remains controversial for the treatment of chronic non-cancer pain (CNCP), which often leads to physical dependence and may resemble an addictive disorder.   Continue reading

Efforts to Curtail Prescribing Are Backfiring

Opioid Crisis: Efforts to Curtail Prescribing Are Backfiring | National Review by Jeffrey A. Singer – October 25, 2017

This is noteworthy because it is published in a conservative magazine, which usually does little questioning of hard-line “law & order” policies.

For years now, federal and state authorities have focused on the supply side of the problem, targeting prescription-drug producers and providers. 

But new information suggests that this approach is driving opioid abusers away from illegally obtained prescription opioids and towards heroin, fentanyl, and mixtures of the two.

And this is increasing the death rate from drug abuse.   Continue reading

Underlying Factors in Drug Overdose Deaths

Underlying Factors in Drug Overdose Deaths | Substance Use and Addictive Disorders | JAMA | The JAMA Network – October 11, 2017
JAMA Viewpoint:  Deborah Dowell, MD, MPH; Rita K. Noonan, PhD; Debra Houry, MD, MPH

This is the “viewpoint” of the very influential Dr. Houry,  the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC, who has been instrumental in restricting prescription opioids.

Since 2010, overdose deaths involving predominantly illicit opioids (heroin, synthetic nonmethadone opioids, or both) have increased by more than 200% (Figure).

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Chronic pain and opioid misuse: a Review of Reviews

Chronic pain and opioid misuse: a review of reviews – Open Access (free full-text) – August 2017

The review found a high rate of pre-existing pain among non-medical Rx opioid users and found only a low level of opioid use disorder among pain patients.

The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse.

Methods

A systematic database search was conducted to identify systematic reviews published between 2000 and 2016.  Continue reading

What Science Says About Opioid Addiction

What Science Says To Do If Your Loved One Has An Opioid Addiction | FiveThirtyEight – by Maia Szalavitz

This is a well-referenced article providing an overview of the latest scientific understanding of opioid addiction – and the data show that pain patients are NOT likely to be addicted to their opioid medication.

Much of the advice given by treatment groups and programs ignores what the data say in a similar way that anti-vaccination or climate skeptic websites ignore science

The addictions field is neither adequately regulated nor effectively overseen

“There’s nothing professional about it,
and it’s not evidence-based,”
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Remarkable Increases in Alcohol Use Disorders

Remarkable Increases in Alcohol Use Disorders | Psychiatry | JAMA Psychiatry | The JAMA Network

The root problem of the “overdose crisis” is not opioids, but addiction in general, which can also manifest with alcohol:

This issue of JAMA Psychiatry includes a timely article by Grant et al that makes a compelling case that the United States is facing a crisis with alcohol use, one that is currently costly and about to get worse.

The article reminds us that the chilling increases in opioid-related deaths reflect a broader issue regarding additional substance-related problems.
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Taking On the Scourge of Opioids | National Affairs

Taking On the Scourge of Opioids | National Affairs | Summer 2017 By Sally Satel

This article is especially noteworthy because this political publication, “its founding editor, Yuval Levin, and authors are typically considered to be conservative.” 

The author describes the origin and current state of the “opioid issue” in great detail and reasonably concludes that “factors beyond physical pain are most responsible for making individuals vulnerable to problems with opioids”

An estimated 2.5 million Americans abuse or are addicted to opioids — a class of highly addictive drugs that includes Percocet, Vicodin, OxyContin, and heroin.   Continue reading

Will Limits on Opioid Rx Duration Prevent Addiction?

Will Strict Limits on Opioid Prescription Duration Prevent Addiction? Advocating for Evidence-Based Policymaking: Substance Abuse:  , MD, MPH,  , MD, MPH &  , MD, MSc –  Jun 2017

Quick answer: NO!

In 2016, the Centers for Disease Control and Prevention (CDC) issued the first national guideline in the United States regarding opioid prescribing for pain.

The guideline included the recommendation that patients treated for acute pain should receive opioids for no longer than 7 days, prompting at least five states to implement laws requiring prescribers not to exceed this threshold when providing initial opioid supplies.

The rapid conversion of this guideline into policy appears to reflect an underlying assumption that limiting initial opioid supplies will reduce opioid consumption, and thus addiction.   Continue reading

Opioid Addiction Isn’t The Disease; It’s The Symptom

Opioid Addiction Isn’t The Disease; It’s The Symptom | HuffPost – 06/16/2017 – by Clay Marsh, Contributor Vice President and Executive Dean for Health Sciences, West Virginia University

The same issues leading to the opioid epidemic are what drives the tremendous cost and disease burden of our country at large.

The opioid epidemic is merely a symptom of a much larger crisis, one we as Americans must learn to solve: the crisis of isolation, despair and hopelessness. …communities are crucial to our wellbeing: irrespective of genus, the most psychologically damaging experience any young creature, human or animal, can have is being separated from the group and abandoned to fend for itself.  

And yet, increasingly, more and more of us are, in a way, abandoned and afraid.  

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