DOCSLIB.ORG

Cuyahoga County Opioid Use Disorder Information & Resource

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cuyahoga County Opioid Use Disorder Information & Resource Cuyahoga County Opioid Use Disorder Information & Resource Guide Developed by the MetroHealth Office of Opioid Safety’s First Responders Project 815588MH_Booklet.indd 1 9/25/18 7:42 AM Table of Contents What is Opioid Use Disorder .................................................. 1 Assessments ............................................................................. 1 TREATMENT Treatment Overview ............................................................... 2 Counseling ............................................................................. 3 Opioid Withdrawal .............................................................. 3 Medication Assisted Treatment – How Does it Work? ................................................................. 4 - Buprenorphine Medication Assisted Treatment - Methadone Medication Assisted Treatment - Naltrexone Medication Assisted Treatment Inpatient Treatment .................................................................. 6 Outpatient Treatment ................................................................ 6 RECOVERY Recovery Housing .................................................................. 7 Recovery Support Groups ...................................................... 7 PROGRAMS AND SERVICES Harm Reduction ..................................................................... 8 Project DAWN .......................................................................... 8 Naloxone in Pharmacies with a Prescription .......................... 9 Syringe Exchange Program ................................................... 9 National Suicide Prevention Lifeline ....................................... 9 I am ready for help! Where should I start? ........................... 10 815588MH_Booklet.indd 2 9/25/18 7:42 AM What is Opioid Use Disorder? Opioid Use Disorder (OUD) is a type of drug addiction. Addiction is a chronic brain disease in which a person continuously uses a drug despite negative and harmful consequences. Addiction is a brain disease because it changes the chemistry of the brain and how Assessments the brain works. Addiction affects An assessment is the next step a person’s health, their behavior, toward recovery. An assessment and even how a person thinks and will help a qualified clinician feels. This can last a long time and determine what type of care is have other negative impacts on a appropriate for an individual by person’s life. reviewing detailed questions that help to gain a thorough OUD is characterized by: understanding of the patient. The • Inability to give up drug use clinician will ask patients about various aspects of a patient’s life. • Inability to control one’s behavior A detailed patient profile helps a • Craving clinician develop an appropriate • Inability to recognize problems treatment plan for the patient. with one’s behaviors and relationships Common assessment questions include: • Dysfunction in emotional response • How long has a person been using drugs? Like other chronic diseases such as diabetes and heart disease, • Is there a family history of addiction involves cycles of addiction? relapse and recovery. Without Following an assessment, an proper treatment, addiction is individual will need to complete progressive and can result in a physical examination to assess disability or premature death. the individual’s physical health. There is hope, however, as there This will also include tests such as are treatment options for addiction a drug urine test also known as a and people do recover. urine toxicology screen. Modified from American Society of Addiction Medicine, 2017 1 815588MH_Booklet.indd 3 9/25/18 7:42 AM Treatment Overview Following an assessment, All medications should be used the clinician will discuss alongside other treatment recommended treatment options supports such as counseling. with the patient. Every person is different, and so, treatment Treatment can occur in different should be appropriate to fit the care settings including: needs of each individual. Addiction • Outpatient treatment should be ongoing because addiction is a chronic • Intensive outpatient or partial disease. hospitalization • Residential addiction treatment There are several medication or in a hospital setting options for opioid use disorder including: methadone, buprenorphine, and naltrexone. 2 Modified from American Society of Addiction Medicine, 2017 815588MH_Booklet.indd 4 9/25/18 7:42 AM Opioid Withdrawal After repeated drug use, individuals can develop a dependence to a drug. When a person stops using that drug, the individual will experience withdrawal. Opioid withdrawal includes a number of symptoms Counseling such as nausea, vomiting, cramps, sweating, anxiety, and Counseling is a key component headaches. Withdrawal can of treatment. Counseling is done last up to 10 days, but usually by a qualified clinician and can lasts between 3-5 days. While be done in the same place a opioid withdrawal symptoms treatment medication is given or are quite uncomfortable, they in a different setting. The purpose are rarely life-threatening. of counseling is to help a patient Withdrawal management, also identify personal, social, or other called detoxification or detox, is problems that contribute to the recommended over trying to quit addiction. Common problems “cold turkey” or trying to stop on addressed in counseling include: one’s own. When individuals try to • Feelings of low self-worth stop drug use “cold turkey” they face strong cravings and often • Difficult situations at home relapse. • Spending time with others who use drugs or alcohol Detox alone is not a treatment for opioid addiction and can increase • Experiences of trauma the risk of relapse and increase Counseling can be conducted in the risk of overdose and overdose a private one-on-one setting with death. Treatment options following the clinician and the patient or detox can include inpatient counseling can be done in group or outpatient therapy and/or a setting, also known as support naltrexone treatment. Medication groups. assisted treatment in combination with counseling, however, is the Counseling is also available for recommended treatment route for family members or friends of opioid use disorder because it less individuals with substance use often results in relapse. disorders. 815588MH_Booklet.indd 5 9/25/18 7:42 AM Modified from American Society of Addiction Medicine, 2017 3 815588MH_Booklet.indd 6 9/25/18 7:42 AM Medication Assisted Treatment: How Does It Work? Research has shown that individuals with opioid use disorder who complete drug detoxification followed by complete abstinence are more likely to relapse and return to drug use than individuals who receive medication assisted treatment. Relapse after a period of abstinence can be life threatening because of the risk for fatal opioid overdose due to lowered drug tolerance. An important treatment method • Counseling is recommended in supporting recovery for with each MAT medication. opioid addiction is treatment • Each medication works with medications that reduce differently and has its own risks withdrawal and craving without and benefits. producing euphoria or a high that • Each medication has a special the original drug of abuse caused. way to be started and can be Methadone and buprenorphine safely used for years. are medications approved for this purpose. • When used properly, MAT medications will NOT create a The type of medication chosen new addiction, instead, these for an individual depends on the medications help the patient person and the type of treatment manage addiction and recover. setting. Medications used for medication assisted treatment of opioid use disorder include: methadone, buprenorphine, and naltrexone. Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012;31(3):207-225. doi:10.1080/10550887.2012.694598. Davoli M, Bargagli AM, Perucci CA, et al. Risk of fatal overdose during and after specialist drug treatment: the VEdeTTE study, a national multi-site prospective cohort study. Addict Abingdon Engl. 2007;102(12):1954-1959. doi:10.1111/j.1360-0443.2007.02025.x. 4 Modified from American Society of Addiction Medicine, 2017 815588MH_Booklet.indd 7 9/25/18 7:42 AM Medication Assisted Treatment for Opioid Use Disorder Buprenorphine provided in a federally qualified methadone clinic. • Buprenorphine helps to relieve opioid withdrawal symptoms • Methadone can be safely started and drug cravings without at the beginning of opioid producing a high or euphoria. withdrawal. • Buprenorphine comes in the • Methadone comes in various form of a tablet or film. Several forms including as a pill, liquid, types of buprenorphine are or wafer. It is taken once per combined with naloxone to day, but over time dosing may prevent potential misuse. change. • Buprenorphine can be • People who are in stable prescribed in an office-based recovery may be provided a setting by certified providers supply of medication to be taken including physicians, nurse at home, otherwise, doses must practitioners and physician be taken at the methadone clinic. assistants. • Patients are advised to wait Naltrexone until they are experiencing mild • Naltrexone blocks the effects of to moderate opioid withdrawal opioids on the brain. This takes before taking the first dose. away the ability for a person to get high if he/she uses an opioid. • Buprenorphine is taken once per day and the dosage can be • Naltrexone is a good option for adjusted over time. preventing relapse and may • Insurance can
Load more

Recommended publications
  • Director's Report May 2016
    TABLE OF CONTENTS RESEARCH HIGHLIGHTS ................................................................................................. 1 GRANTEE HONORS AND AWARDS .............................................................................. 22 STAFF HONORS AND AWARDS .................................................................................... 23 STAF F CHANGES ............................................................................................................ 24 RESEARCH HIGHLIGHTS BASIC AND BEHAVIORAL RESEARCH Self-administration Of the Anandamide Transport Inhibitor AM404 By Squirrel Monkeys Schindler CW, Scherma M, Redhi GH, Vadivel SK, Makriyannis A, Goldberg S, Justinova Z. Psychopharmacology (Berl). 2016; [epub ahead of print]. N-(4-hydroxyphenyl)-arachidonamide (AM404) is an anandamide transport inhibitor shown to reduce rewarding and relapse-inducing effects of nicotine in several animal models of tobacco dependence. However, the reinforcing/rewarding effects of AM404 are not clear. The authors investigated whether AM404 maintains self-administration behavior or reinstates extinguished drug seeking in squirrel monkeys. In monkeys with a history of anandamide or cocaine self- administration, we substituted injections of AM404 (1-100 μg/kg/injection). Using a 10-response, fixed-ratio schedule, self-administration behavior was maintained by AM404. Dose-response curves had inverted U shapes, with peak response rates occurring at a dose of 10 μg/kg/injection. In anandamide-experienced monkeys, we also demonstrated
    [Show full text]
  • Epigenetic Regulation of Circadian Clocks and Its Involvement in Drug Addiction
    G C A T T A C G G C A T genes Review Epigenetic Regulation of Circadian Clocks and Its Involvement in Drug Addiction Lamis Saad 1,2,3, Jean Zwiller 1,4, Andries Kalsbeek 2,3 and Patrick Anglard 1,5,* 1 Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR 7364 CNRS, Université de Strasbourg, Neuropôle de Strasbourg, 67000 Strasbourg, France; [email protected] (L.S.); [email protected] (J.Z.) 2 The Netherlands Institute for Neuroscience (NIN), Royal Netherlands Academy of Arts and Sciences (KNAW), 1105 BA Amsterdam, The Netherlands; [email protected] 3 Department of Endocrinology and Metabolism, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands 4 Centre National de la Recherche Scientifique (CNRS), 75016 Paris, France 5 Institut National de la Santé et de la Recherche Médicale (INSERM), 75013 Paris, France * Correspondence: [email protected]; Tel.: +33-03-6885-2009 Abstract: Based on studies describing an increased prevalence of addictive behaviours in several rare sleep disorders and shift workers, a relationship between circadian rhythms and addiction has been hinted for more than a decade. Although circadian rhythm alterations and molecular mechanisms associated with neuropsychiatric conditions are an area of active investigation, success is limited so far, and further investigations are required. Thus, even though compelling evidence connects the circadian clock to addictive behaviour and vice-versa, yet the functional mechanism behind this interaction remains largely unknown. At the molecular level, multiple mechanisms have been proposed to link the circadian timing system to addiction. The molecular mechanism of the circadian Citation: Saad, L.; Zwiller, J.; clock consists of a transcriptional/translational feedback system, with several regulatory loops, that Kalsbeek, A.; Anglard, P.
    [Show full text]
  • Regional Alcohol and Drug Detoxification Manual 2019
    Regional Alcohol and Drug Detoxification Manual 2019 Arkansas Department of Human Services Division of Aging, Adult and Behavioral Health Services Office of the Drug Director RADD Regional Alcohol and Drug Detoxification Regional Alcohol and Drug Detoxification Manual Office of the Drug Director P.O. Box 1437, Slot W-241 Little Rock, Arkansas 72203 501-686-9164 501-686-9396 (fax) 1 Regional Alcohol and Drug Detoxification Manual 2019 2 Regional Alcohol and Drug Detoxification Manual 2019 Contents Regional Alcohol and Drug Detoxification Program ......................................................................................................... 5 Chapter 1 ........................................................................................................................................................................... 7 Overview, Essential Concepts, and Definitions in Detoxification ...................................................................................... 7 Chapter 2 ......................................................................................................................................................................... 12 Settings, Levels of Care, and Patient Placement ............................................................................................................... 12 Chapter 3 ......................................................................................................................................................................... 22 An Overview of Psychosocial and Biomedical
    [Show full text]
  • Stage of Change of Cigarette Smoking in Drug Dependent Patients
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE Original article SWISS MED WKLY 2004;134:322–325provided · www.smw.ch by Serveur académique322 lausannois Peer reviewed article Stage of change of cigarette smoking in drug dependent patients Stéphane Kollya, Jacques Bessona, Jacques Cornuzb, Daniele Fabio Zullinoa a Division of Substance Abuse, University Department of Adult Psychiatry, Lausanne, Switzerland b Lausanne University Outpatient Clinic and Institute of Social and Preventive Medicine, Lausanne, Switzerland Summary Nicotine cessation programmes in Switzer- cessation to be difficult or very difficult. These data land, which are commonly based on the stage of show a discrepancy between the motivation to change model of Prochaska and DiClemente change illegal drug consumption habits and the (1983), are rarely offered to patients with illicit motivation for smoking cessation. The high pro- drug dependence. This stands in contrast to the portion of patients remaining in the precontem- high smoking rates and the heavy burden of to- plation stage for smoking cessation, in spite of their bacco-related problems in these patients. motivation for illicit drug detoxification, may be The stage of change was therefore assessed by due to the perception that cessation of smoking is self-administered questionnaire in 100 inpatients more difficult than illicit drug abuse cessation. attending an illegal drug withdrawal programme. Only 15% of the patients were in the contempla- Key words: substance abuse; smoking; smoking ces- tion or decision stage. 93% considered smoking sation; motivation Introduction The prevalence of smoking has consistently have lower smoking cessation rates [17]. On the been stated to be higher in drug-dependent pa- other hand, efforts to stop smoking have been tients than in the general population.
    [Show full text]
  • Acupuncture for Detoxification in Treatment of Opioid Addiction
    East Asian Arch Psychiatry 2016;26:70-6 Theme Paper Acupuncture for Detoxification in Treatment of Opioid Addiction SLY Wu, AWN Leung, DTW Yew Abstract Opioid is a popular drug of abuse and addiction. We evaluated acupuncture as a non-pharmacological treatment with a focus on managing withdrawal symptoms. Electrical stimulation at a low frequency (2 Hz) accelerates endorphin and encephalin production. High-frequency stimulation (100 Hz) up- regulates the dynorphin level that in turn suppresses withdrawal at the spinal level. The effect of 100-Hz electroacupuncture may be associated with brain-derived neurotrophic factor activation at the ventral tegmental area, down-regulation of cAMP response element-binding protein, and enhanced dynorphin synthesis in the spinal cord, periaqueductal grey, and hypothalamus. Clinical trials of acupuncture for the management of different withdrawal symptoms were reviewed. The potential of acupuncture to allay opioid-associated depression and anxiety, and its possible use as an adjuvant treatment were evident. A lack of effect was indicated for opioid craving. Most studies were hampered by inadequate reporting details and heterogeneity, thus future well-designed studies are needed to confirm the efficacy of acupuncture in opioid addiction treatment. Key words: Acupuncture; Electroacupuncture; Heroin; Opioid-related disorders; Substance withdrawal syndrome Ms Sharon L. Y. Wu, BSc, MCM, School of Chinese Medicine, The Chinese dominant treatment of detoxification.6 Nevertheless, MMT University of Hong Kong, Hong Kong SAR, China. Prof. Albert Wing-Nang Leung, BSc, PhD, BCM, School of Chinese Medicine, is a substitution therapy and contributes to a high relapse The Chinese University of Hong Kong, Hong Kong SAR, China.
    [Show full text]
  • Safe Withdrawal in Jail Settings Preventing Deaths, Reducing Risk to Counties and States
    Safe Withdrawal in Jail Settings Preventing Deaths, Reducing Risk to Counties and States This brief is for jail administrators and other public safety leaders, as well as county and state policymakers who work on issues related to public safety, public health, and behavioral health. Jail administrators and policymakers are responsible for managing health issues of those incarcerated in their facilities. As the opioid crisis continues, jails may face a growing need to save detainee lives and reduce their own exposure to litigation risk by ensuring safe withdrawal from illicit drugs and alcohol. This document addresses the need for withdrawal management procedures and services in jail settings. Overview As the opioid crisis continues, jails across the country are encountering people with opioid use disorders who are actively using heroin, fentanyl, illicit prescription medications, and other opioids. These individuals often experience withdrawal syndrome upon abrupt substance discontinuation, and they may need withdrawal management services while detained.1,2,3,4 Withdrawal syndrome can occur with discontinuation of non-opioid substances as well, including alcohol and benzodiazepines. Contrary to commonly held notions, withdrawal is often not only uncomfortable or painful, but also may be harmful to health and even fatal.5,6,7 Jails without adequate services and protocols for withdrawal management face risk liability under state statutes and tort law, the Americans with Disabilities Act (“ADA”), Rehabilitation Act of 1973 (“Rehabilitation
    [Show full text]
  • Treatment for Alcohol and Other Drug Abuse: Opportunities for Coordination
    Treatment for Alcohol and Other Drug Abuse: Opportunities for Coordination Technical Assistance Publication Series 11 Ann H. Crowe, M.S.S.W., A.C.S.W. Rhonda Reeves, M.A. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fisher Lane Rockville, MD 20857 Foreword of TAP 11: Treatment for Alcohol and Other Drug Abuse: Opportunities for Coordination This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except quoted passages from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Center for Substance Abuse Treatment (CSAT) or the author. Citation of the source is appreciated. This publication was written by Ann H. Crowe, M.S.S.W., A.C.S.W., and Rhonda Reeves, M.A., of the Council of State Governements. Contributors to the publication were Thomas B. Kosten, M.D., of the Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine, and Bert Pepper, M.D., and Jackie Massaro, C.S.W., of the Information Exchange. It was prepared under contract number 270-92-0007 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Roberta Messalle of CSAT served as the Government project officer. The opinions expressed herein are the views of the authors and do not necessarily reflect the official position of CSAT or any other part of the U.S. Department of Health and Human Services (DHHS).
    [Show full text]
  • Opioid-Related US Hospital Discharges by Type, 1993–2016
    HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author J Subst Manuscript Author Abuse Treat. Author Manuscript Author manuscript; available in PMC 2019 August 01. Published in final edited form as: J Subst Abuse Treat. 2019 August ; 103: 9–13. doi:10.1016/j.jsat.2019.05.003. Opioid-related US hospital discharges by type, 1993–2016 Cora Peterson*, Likang Xu, Curtis Florence, and Karin A. Mack National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA Abstract Objective: To classify and compare US nationwide opioid-related hospital inpatient discharges over time by discharge type: 1) opioid use disorder (OUD) diagnosis without opioid overdose, detoxification, or rehabilitation services, 2) opioid overdose, 3) OUD diagnosis or opioid overdose with detoxification services, and 4) OUD diagnosis or opioid overdose with rehabilitation services. Methods: Survey-weighted national analysis of hospital discharges in the Healthcare Cost and Utilization Project National Inpatient Sample yielded age-adjusted annual rates per 100,000 population. Annual percentage change (APC) in the rate of opioid-related discharges by type during 1993–2016 was assessed. Results: The annual rate of hospital discharges documenting OUD without opioid overdose, detoxification, or rehabilitation services quadrupled during 1993–2016, and at an increased rate (8% annually) during 2003–2016. The discharge rate for all types of opioid overdose increased an average 5–9% annually during 1993–2010; discharges for non-heroin overdoses declined 2010– 2016 (3–12% annually) while heroin overdose discharges increased sharply (23% annually). The rate of discharges including detoxification services among OUD and overdose patients declined (−4% annually) during 2008–2016 and rehabilitation services (e.g., counselling, pharmacotherapy) among those discharges decreased (−2% annually) during 1993–2016.
    [Show full text]
  • Cigarette Smoking, Nicotine Dependence, and Treatment
    578 I || Addiction Medicinel and the Primary Care Phlysician Cigarette Smoking, Nicotine Dependence, and Treatment KAREN LEA SEES, DO, San Francisco Since the 1988 Surgeon General's report on nicotine addiction, more attention is being given to nicotine dependence as a substantial contributing factorin cigarette smokers' inability to quit. Manynew medica- tions are being investigated for treating nicotine withdrawal and for assisting in long-term smoking abstinence. Medications alone probably will not be helpful; they should be used as adjuncts in compre- hensive smoking abstinence programs that address not only the physical dependence on nicotine but also the psychological dependence on cigarette smoking. (Sees KL: Cigarette smoking, nicotine dependence, and treatment, In Addiction Medicine [Special Issue]. West J Med 1990 May; 152:578-584) Physicians have long been frustrated in attempts to DSM-III-R Diagnostic Criteria for Psychoactive Substance help patients stop smoking, and, until recently, they Dependence have had few tools other than advice. Cigarette smoking and now ac- * Substance often taken in larger amounts or over a other forms of tobacco consumption, however, are the person intended. knowledged as causing nicotine dependence, and with that longer period than recognition comes the acceptance oftreating tobacco use not * Persistent desire or one or more unsuccessful efforts to merely as a bad habit, or nasty vice, but as the disease of cut down or control substance use. Most cigarette smokers nicotine addiction. The recognition
    [Show full text]
  • Drug Detoxification Protocol Using Microdosing
    (19) & (11) EP 2 399 581 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 28.12.2011 Bulletin 2011/52 A61K 31/485 (2006.01) A61K 31/49 (2006.01) A61K 31/554 (2006.01) A61K 9/20 (2006.01) (21) Application number: 11170065.4 (22) Date of filing: 15.02.2008 (84) Designated Contracting States: (72) Inventors: AT BE BG CH CY CZ DE DK EE ES FI FR GB GR • Slater, Kenneth C. HR HU IE IS IT LI LT LU LV MC MT NL NO PL PT Manchester MA 01944 (US) RO SE SI SK TR • Richardson, Brenda E. Manchester MA 01944 (US) (30) Priority: 15.02.2007 US 675560 • Connors, Scott M. Methuen MA 01844 (US) (62) Document number(s) of the earlier application(s) in accordance with Art. 76 EPC: (74) Representative: Richaud, Fabien 08002803.8 / 1 958 621 Murgitroyd & Company Immeuble Atlantis (71) Applicants: 55, Allée Pierre Ziller • Slater, Kenneth C. 06560 Valbonne Sophia Antipolis (FR) Manchester MA 01944 (US) • Richardson, Brenda E. Remarks: Manchester MA 01944 (US) This application was filed on 15-06-2011 as a • Connors, Scott M. divisional application to the application mentioned Methuen MA 01844 (US) under INID code 62. (54) Drug detoxification protocol using microdosing (57) This invention relates to use of an opioid recep- the withdrawal symptoms associated with discontinuing tor agonist in microdose quantities to reduce or eliminate drug use. The dosage of the agonist is reduced over an extended period of time. EP 2 399 581 A1 Printed by Jouve, 75001 PARIS (FR) EP 2 399 581 A1 Description FIELD OF THE TECHNOLOGY 5 [0001] This invention relates to methods to decrease the withdrawal symptoms a patient suffers of discontinuing drug use.
    [Show full text]
  • National Trends and Characteristics of Inpatient Detoxification for Drug Use Disorders in the United States He Zhu1* and Li-Tzy Wu1,2,3,4*
    Zhu and Wu BMC Public Health (2018) 18:1073 https://doi.org/10.1186/s12889-018-5982-8 RESEARCH ARTICLE Open Access National trends and characteristics of inpatient detoxification for drug use disorders in the United States He Zhu1* and Li-Tzy Wu1,2,3,4* Abstract Background: Prior studies indicate that the opportunity from detoxification to engage in subsequent drug use disorder (DUD) treatment may be missed. This study examined national trends and characteristics of inpatient detoxification for DUDs and explored factors associated with receiving DUD treatment (i.e., inpatient drug detoxification plus rehabilitation) and discharges against medical advice (DAMA). Methods: We analyzed inpatient hospitalization data involving the drug detoxification procedure for patients aged≥12 years (n = 271,403) in the 2003–2011 Nationwide Inpatient Samples. We compared the estimated rate and characteristics of inpatient drug-detoxification hospitalizations between 2003 and 2011 and determined demographic and clinical correlates of inpatient drug detoxification plus rehabilitation (versus detoxification-only) and DAMA (versus transfer to further treatment). Results: There was no significant yearly change in the population rate of inpatient drug-detoxification hospitalizations during 2003–2011. The majority of inpatient drug detoxification were patients aged 35–64 years, males, and those on Medicaid. Among inpatient drug-detoxification hospitalizations, only 13% received detoxification plus rehabilitation during inpatient care, and up to 14% were DAMA; the most commonly identified diagnoses were opioid use disorder (OUD; 75%) and non-addiction mental health disorders (48%). Being on Medicaid (vs. having private insurance) and having OUD (vs. no OUD) were associated with decreased odds of receiving detoxification plus rehabilitation, as well as increased odds of DAMA.
    [Show full text]
  • Pharmacist's Role in Substance Abuse Prevention, Education, And
    Medication Therapy and Patient Care: Specific Practice Areas–Statements 371 ASHP Statement on the Pharmacist’s Role in Substance Abuse Prevention, Education, and Assistance Position reported the following lifetime prevalence figures: 30.3% for alcohol-use disorders,3 10.3% for drug-use disorders,4 The American Society of Health-System Pharmacists 12.5% for alcohol dependence (alcoholism) (17.4% for men, 3 (ASHP) believes that pharmacists have the unique knowl- 8.0% for women), and 2.6% for dependence on other drugs edge, skills, and responsibilities for assuming an important (drug addiction), excluding tobacco (3.3% for men, 2.0% for 4 role in substance abuse prevention, education, and assistance. women). Studies suggest that the prevalence of drug abuse Pharmacists, as healthcare providers, should be actively in- among health professionals appears to be similar to that in 5-7 volved in reducing the negative effects that substance abuse the general population. However, given their access to has on society, health systems, and the pharmacy profession. drugs, health professionals abuse prescription drugs more Further, ASHP supports efforts to rehabilitate pharmacists often and street drugs less often compared with the general and other health-system employees whose mental or physi- population. cal impairments are caused by substance abuse. Substance abuse frequently coexists with and compli- cates other psychiatric disorders and is a common and often unrecognized cause of physical morbidity. Intravenous drug Background abuse is a major factor in the spread of human immunode- ficiency virus and hepatitis. Alcohol is a major factor in the The term substance abuse is commonly used to describe development of cirrhosis of the liver, and tobacco is a key the hazardous or addictive use of psychoactive substances contributor to emphysema and lung cancer.
    [Show full text]