Opioid-related Overdose Deaths Are a National Epidemic

A report on the increase in unintentional drug overdoses emphasizes the role of nonmedical opioid abuse, but also says physicians share some blame.

A recently released report authored by experts from the CDC, the University of North Carolina at Chapel Hill School of Medicine, and Duke University Medical Center shows that in 40% of US states, unintentional drug overdoses kill more people than motor vehicle accidents and suicides.

Calling this trend a “national epidemic,” the authors of the report, published on the website of the Journal of Clinical Psychiatry, wrote that one potential contributor to the dramatic increase in unintentional overdose deaths in the US in the last two decades is that “psychiatrists and many primary care physicians might not be familiar with existing evidence-based guidelines for opioid prescribing or with programs designed to reduce the abuse of prescription drugs such as state prescription drug monitoring programs.”

A University of North Carolina at Chapel Hill School of Medicine news release accompanying the publication of the report noted that prescription opioid pain medications “are driving this overdose epidemic,” with data showing that in 2007 “unintentional deaths due to prescription opioid pain killers were involved in more overdose deaths than heroin and cocaine combined.”

via hcplive.com

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Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States - Birnbaum - 2011 - Pain Medicine - Wiley Online Library

Abstract

Objectives.  The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States.

Methods.  Costs were grouped into three categories: health care, workplace, and criminal justice. Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse. Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries. Other data/information were derived from publicly available survey and other secondary sources.

via onlinelibrary.wiley.com

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HITLab Projects : VR Pain Control (Virtual Reality, Distraction Techniques)

The University of Washington Harborview Burn Center, directed by Dr. Nicole Gibran, is a regional burn center. Patients with severe burns from 5 surrounding states are sent to Harborview for special care. Harborview has pioneered a number of advanced treatments (e.g., early skin grafting). As a result of advances here and elsewhere, the chances of surviving a bad burn, and quality of living for survivors has improved dramatically over the past 20 years.

Unfortunately, the amount of pain and suffering experienced by patients during wound care remains a worldwide problem for burn victims as well as a number of other patient populations.

When patients are resting (most of the time), opioids (morphine and morphine-related chemicals) are adequate for controlling their burn pain.

In sharp contrast, during wound care such as daily bandage changes, wound cleaning, staple removals etc., opioids are not enough, not even close. As shown in the figure on the right above, over 86% of the burn patients reported having severe to excruciating pain during wound care (shown in red), even when standard levels of opioids were used. The pain management techniques in use are not good enough. Patients are suffering, a fact particularly disturbing when the patients are children.

via hitl.washington.edu

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FDA seeks less acetaminophen in prescription drugs | Reuters

U.S. health regulators are requesting a limit on the amount of acetaminophen in prescription pain medicines in an effort to curb the risk of liver damage.

The move announced on on Thursday aims to limit combination drugs such as the opioids Percocet and Vicodin to 325 milligrams of acetaminophen per pill and calls for them to carry a "black box" warning about potential liver failure.

Some of these medicines now contain as much as 750 milligrams of acetaminophen, a drug also sold over the counter in lower doses as a generic painkiller and Johnson & Johnson's Tylenol.

"This change will provide an increased margin of safety to help prevent liver damage due to acetaminophen overdosing, a serious public health problem," the U.S. Food and Drug Administration wrote in a public notice.

via reuters.com

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