DOCSLIB.ORG

Prescription Opioids Hydrocodone, Oxycodone, Oxymorphone, Morphine, Codeine, Fentanyl

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prescription Opioids Hydrocodone, Oxycodone, Oxymorphone, Morphine, Codeine, Fentanyl Recognizing Symptoms of Drugs of Abuse Maricel Dela Cruz DO, MPH, FAWM It is the policy of the Intensive Osteopathic Update (IOU) organizers that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All faculty in a position to control content for this session have indicated they have no relevant financial relationships to disclose. The content of this material/presentation in this CME activity will not include discussion of unapproved or investigational uses of products or devices. Faculty Disclosure I have no relevant financial relationships to disclose. The content of this material/presentation in this CME activity will not include discussion of unapproved or investigational uses of products or devices. Learning Objectives • Define illicit and illegal drug abuse • List common drugs of abuse as identified by the National Institute on Drug Abuse • Describe evidence-based screening tools to recognize a history of drug abuse in the outpatient setting • Describe signs and symptoms of drug abuse associated with common drugs of abuse • Demonstrate the current recommendations regarding drug abuse screening as per the United States Preventive Services Task Force Definition The use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Drug abuse may lead to social, physical, emotional, and job-related problems. Background 2018 National Survey on Drug Use and Health More than 19% of all people ages 12 and older in the United States used an illicit drug in the past year More than 53 million Americans Illicit drug use is the most common cause of preventable morbidity and death in the United States Drug Use Screening in Adults American Academy of Family Physicians. Screen Adults for Unhealthy Drug Use, Says Task Force. https://www.aafp.org/news/health-of-the-public/20200616uspstf-illicitdrugscreen.html. United States Preventive Services Task Force June 9, 2020 United States Preventive Services Task Force. Unhealthy Drug Use: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-screening. Recommendations USPSTF recommends that clinicians screen patients 18 and older by asking about unhealth drug use Screening should occur when accurate diagnosis, effective treatment and appropriate care can be offered or referred Insufficient evidence to assess the balance of benefits and harms of screening for unhealthy drug use in adolescents ages 12-17 Evidence USPSTF performed a systematic review that included 99 studies 28 studies focused on the accuracy of drug screening instruments 71 studies addressed specific therapies, such as psychosocial interventions, opioid agonist therapy and naltrexone, to reduce drug use Screening Tools (Examples) Substance Use Brief Screen (SUBS) Tobacco, Alcohol, Prescription Medication and Other Substance Use Tool (TAPS) Drug Abuse Screening Test (DAST) Single-Item Drug Frequency Questions (AUDIT-C, etc.) Substance Use Brief Screen (SUBS) Han BH, Sherman SE, Link AR, Wang B, McNeely. Comparison of the Substance Use Brief Screen (SUBS) to the AUDIT-C and ASSIST for detecting unhealthy alcohol and drug use in a population of hospitalized smokers. Journal of Substance Abuse Treatment. 2017. DOI: 10.1016/j.jsat.2017.05.014. Tobacco, Alcohol, Prescription Medication and Other Substance Use Tool (TAPS) https://cde.drugabuse.gov/sites/nida_cde /files/TAPS%20Tool%20Parts%20I%20and %20II%20V2.pdf Drug Abuse Screening Test (DAST) The Drug Abuse Screening Test (DAST) - United States ...www.uspreventiveservicestaskforce.org Drugs of Abuse List Ethanol MDMA Club Drugs Methamphetamines Cocaine Opioids Fentanyl Over-the-Counter Medicines Hallucinogens Prescription Medications Heroin Steroids (Anabolic) Inhalants Synthetic Cannabinoids Kratom Synthetic Cathinones Marijuana Tobacco/Nicotine and Vaping https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts Ethanol Increase in neurotransmitter gamma- aminobutyric acid (GABA), an inhibitory neurotransmitter. Suppresses the central nervous system. Decrease in anxiety, poor fine motor skills, euphoria, stupor. https://openphoto.net/gallery/name/illustration/1505 Addiction, long term liver disease, cardiovascular disease and cancer. Club Drugs GHB – CNS depressant, binds to the receptors of the inhibitory neurotransmitter GABA, particularly GABA-B. Rohypnol (flunitrazepam) – CNS depressant, leads to anterograde amnesia, CNS depressant, binds to receptors of GABA, particularly GABA-A. Ketamine – NMDA (N-methyl-D-aspartate) receptor antagonists, leads to anesthetic, analgesic and dissociative effects. Can lead to leukocytosis, low glucose and rhabdomyolysis. https://commons.wikimedia.o rg/wiki/File:AbuGnost_anaboli c_steroids_GHB_poppers_080 LSD – activates serotonin receptors (5HT2A receptors), 810_48.jpg modulates others (5HT2C and 5HT1A), leading to impaired cognition and induction of hallucinations. GABA-A versus GABA-B receptors GABA-A receptors are GABA-B receptors are G- ligand-gated ion channels protein-coupled receptors (inotropic receptors), (metabotropic receptors), produce sedative and produce sedative effects. hypnotic effects with anti- Can lead to changes in convulsion properties. gene transcription. https://www.researchgate.net/figure/Fig-3-Schematic- https://alchetron.com/GABA-receptor representation-of-the-GABA-B-receptor_fig2_286488910 Cocaine Base – crack, free base, rock crystals that vaporize when heated to smoke making a “crackling noise”; Salt – blow, coke, snow. Stimulant, from leaves of coca plant, native to South America. Leads to central and peripheral nervous system effects, blocking the reuptake of monoamine transporters (Dopamine, Norepinephrine and Serotonin). Tremor, alertness, hypertension, euphoria. Acute MI, aortic dissection, CVA, seizures. Hallucinations, hyperthermia, paranoia. Crack lung (diffuse alveolar damage. https://www.pexels.com/photo/black-black-and-white-business-cocaine-322251/ https://commons.wikimedia.org/wiki/File:Kokain_-_Cocaine.svg Hallucinogens Alter perception (awareness of surrounding objects and conditions), thoughts, and feelings. Lead to hallucinations, or sensations and images that seem real though they are not. Primarily affect 5HT2A receptors (serotonin). Can be found in plants and mushrooms or are human-made. Ayahuasca, LSD, peyote (mescaline), 4-phosphoryloxy-N, N- dimethyltryptamine (psilocybin). https://commons.wikimedia.org/wiki/File:Peyote_Cactus.jpg https://en.wikipedia.org/wiki/File:Psilocybe_semilanceata_6514.jpg Inhalants Chemical vapors or gases that produce a “high” when inhaled. Solvents – benzene, toluene, xylene, acetone, naptha, hexane Aerosol Sprays – hair spray, spray paint, cooking spray, pressurized liquids or gases (fluorocarbon, butane) Gases – nitrous oxide (“laughing gas”), chloroform, halothane, https://www.lejeune.marines.mil/Ne ws/Article/511694/a-cheap-way-to- ether, butane lighters, propane tanks get-high-a-quick-way-to-die/ Nitrites – amyl nitrite, butyl nitrite, cyclohexyl nitrite (poppers) Can cause cardiac sensitization (dysrhythmias), methemoglobinemia. Kratom Southeast Asian tropical tree with weak opioid effects. Used as a supplement to treat chronic pain and opioid withdrawal. Smoked or brewed in tea; can also chew on leaves. Stimulant-like effects at lower doses, opioid at higher. Withdrawal can occur when stopped. Addiction potential. https://commons.wikimedia.org/wiki/File:Kratom_leaves.jpg Marijuana Dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa. Plant contains the chemical delta-9-tetrahydrocannabinol (THC) and other related compounds. Partial agonist of CB1 and CB2 cannabinoid receptors. Extracts can also be made from the cannabis plant. Giddiness, feeling of well being, euphoria, relaxation, altered perception of time, drowsiness, diminished coordination, increased appetite, increased risk of psychosis, diminished cognitive function, withdrawal. https://pixabay.com/photos/marijuana-leaves-cannabis-green-3678222/ MDMA (3,4-methylenedioxymethamphetamine) Ecstasy, Lover’s Speed, Molly, X. Sympathomimetic, Hallucinogenic and Psychedelic Effects. Increased energy and pleasure, enhanced tactile stimulation. Indirect effect on the serotonin receptor (5HT2A). Stimulates release of dopamine, serotonin and norepinephrine, as well as cortisol, oxytocin and ADH. Can last up to 3-6 hours, repeated doses to maintain high. 10x greater serotonin release than methamphetamine, causing intense mood effects. https://commons.wikimedia.org/wiki/File:MDMA2.jpg Methamphetamine Chalk, crank, crystal, glass, ice, meth. Oral, smoke, snort, inject. Blocks reuptake of monoamines (dopamine, norepinephrine, serotonin). Stimulates dopamine release causing a longer duration of action. Sympathomimetic, dysrhythmias, hypertension, hyperthermia, acute MI, insomnia, seizures, stroke, rhabdomyolysis. Weight loss, impaired verbal and learning. Cardiomyopathy, psychiatric disorders. https://commons.wikimedia.org/wiki/File:Suspectedmethmouth09-19-05closeup.jpg https://commons.wikimedia.org/wiki/File:Crystal_Meth.jpg Over
Load more

Recommended publications
  • Catawba Valley Community College Drug-Free Schools And
    Catawba Valley Community College Drug-Free Schools and Communities Act Introduction Catawba Valley Community College complies with The Federal Drug-Free Schools and Communities Act Regulations [EDGAR Part 86]. These regulations include the following: 1. Standards of conduct that clearly prohibit the unlawful possession, use, or distribution of illicit drugs and alcohol by students and employees on the school’s property or as part of the school’s activities; 2. A description of the sanctions under local, state, and federal law for unlawful possession, use, or distribution of illicit drugs and alcohol; 3. A description of the health risks associated with the use of illicit drugs and alcohol; 4. A description of any drug and alcohol counseling, treatment, or rehabilitation programs available to students and employees; and 5. A clear statement that the school will impose sanctions on students and employees for violations of the standards of conduct (consistent with local, state, and federal law) and a description of these sanctions, up to and including expulsion, termination, of employment, and referral for prosecution. The required information will be distributed to all students and employees by the following methods: All new curriculum students receive this information when they are admitted to the College. All curriculum students receive this information when they register for classes. All continuing education students will receive notification by USPS mail about where to find this information. This information is included in the Annual Security Report. This information is posted on the CVCC website on the Safety and Security page Catawba Valley Community College conducts a biannual review of this program in accordance with the regulations.
    [Show full text]
  • Stopping the Shipment of Synthetic Opioids: Oversight of U.S. Strategy to Combat Illicit Drugs MAY 25, 2017
    1 STATEMENT OF CHAIRMAN ROB PORTMAN U.S. SENATE PERMANENT SUBCOMMITTEE ON INVESTIGATIONS Stopping the Shipment of Synthetic Opioids: Oversight of U.S. Strategy to Combat Illicit Drugs MAY 25, 2017 This hearing will come to order. [gavel] I’ve called this hearing to address a crisis in our communities. And it’s getting worse, not better. Our country is gripped by an opioid epidemic. It’s a crisis that doesn’t discriminate and can be found in every corner of my state. Earlier this month, Police Officer Chris Green in East Liverpool, Ohio suffered a fentanyl overdose following a routine traffic stop. He noticed white powder in the car and took the necessary precaution of wearing a mask and gloves during the arrest. When he was back at the police station, he noticed a small amount of powder on his shirt and brushed it off with his bare hand. From that mere exposure to his fingers, he passed out from an overdose. Officer Green was given one dose of Narcan on the scene, which is a drug used to reverse the effects of opioid overdose. But Officer Green needed three more doses of Narcan at the hospital to revive him. Fentanyl is a powerful drug that is killing Americans and putting our first responders at risk. It is 30-50 times more powerful than heroin and 100 times stronger than morphine. A lethal dose of fentanyl can be as little as two milligrams. 2 The number of Americans overdosing on fentanyl and its analogues has increased dramatically over the past few years.
    [Show full text]
  • A Review of Cases of Marijuana and Violence
    Open Access Int. J. Environ. Res. Public Health 2020, 17(5), 1578; https://doi.org/10.3390/ijerph17051578 Review A Review of Cases of Marijuana and Violence by Redon Ipeku 3 and Thersilla Oberbarnscheidt 4 1 CEO of Health Advocates PLLC, East Lansing, MI 48823, USA 2 Department of Psychiatry Augusta University, Augusta, GA 30912, USA 3 College of Law, Michigan State University, East Lansing, MI 48823, USA 4 Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA * Author to whom correspondence should be addressed. Received: 9 December 2019 / Accepted: 25 February 2020 / Published: 29 February 2020 Download PDF Abstract : Marijuana is the most consumed illicit drug in the world, with over 192 million users. Due to the current legalization push of marijuana in the United States, there has been a lack of oversight regarding its public health policies, as marijuana advocates downplay the drug’s negative effects. This paper’s approach is from a public health perspective, focusing specifically on the cases of violence amongst some marijuana users. Here, we present 14 cases of violence with chronic marijuana users that highlight reoccurring consequences of: marijuana induced paranoia (exaggerated, unfounded distrust) and marijuana induced psychosis (radical personality change, loss of contact with reality). When individuals suffering from pre-existing medical conditions use marijuana in an attempt to alleviate their symptoms, ultimately this worsens their conditions over time. Although marijuana effects depend on the individual’s endocannabinoid receptors (which control behavioral functions, like aggression) and the potency level of tetrahydrocannabinol (THC) in the drug, scientifically documented links between certain marijuana users and violence do exist.
    [Show full text]
  • Staying Safe on Prescription Opioids Together We Can
    Staying Safe on Prescription Opioids Together We Can. Suicide Prevention Information for Veterans, Their Families, and Caregivers Understanding Opioid Use Opioids are drugs a doctor might prescribe for pain relief. For example, your doctor might give you a How to Stay Safe on Prescription Opioids medication with codeine, hydrocodone, morphine, You can do several things to protect yourself and others from the or oxycodone to relieve pain from an injury or after risks associated with prescription opioids: a surgery. Some brand names for these medications include OxyContin, Percocet, and Vicodin. But there are Before you are prescribed opioids, tell your health care many more. provider about all other medications and supplements you are taking. Opioids are highly addictive. This means you could lose control over your use of them and feel sick without Tell your health care provider if you or your family has a them. That’s why they should only be taken under the history of alcohol or drug addiction. There are other pain care and guidance of a medical professional. Opioid treatment options that are equally as effective as (or more misuse can lead to both addiction and overdose. effective than) opioids and don’t carry the same risks for addiction and overdose. An opioid overdose is when a person takes more than the body can handle. It causes difficulty breathing Only take opioids prescribed to you and as directed by your and can result in suffocation and death. Overdose is health care provider. Never accept opioids from anyone else. especially likely with the use of heroin, fentanyl, and other illegal opioids obtainable on the street or online.
    [Show full text]
  • 2020 Drug and Alcohol Prevention Program (DAAPP)
    Drug and Alcohol Abuse Prevention Program (DAAPP) For Students and Employees Biennial Review Period: August 2018 to July 2020 Published: October 7, 2020 Asheville-Buncombe Technical Community College The Drug Free Schools and Campuses Regulations (34 CFR Part 86) of the Drug-Free Schools and Communities Act (DFSCA) requires an Institution of Higher Education (IHE) such as Asheville-Buncombe Technical Community College (A-B Tech), to certify that it has implemented programs to prevent the abuse of alcohol, use and/or distribution of illicit drugs both by A-B Tech students and employees either on its premises and as a part of any of its activities. At a minimum, an IHE must annually distribute the following in writing to all students and employees: • Standards of conduct that clearly prohibit the unlawful possession, use or distribution of illicit drugs and alcohol by students and employees; (see Appendix A for the Drug and Alcohol Policy and Procedures, Appendix B for the Code of Student Conduct Policy and Procedures, and Appendix D for the Threat Assessment Policy and Procedures) • A description of the legal sanctions under local, state, or federal law for the unlawful possession or distribution of illicit drugs and alcohol (see Legal Sanctions on page 6); • A description of the health risks associated with the use of illicit drugs and alcohol abuse (see Health Risks on page 7; • A description of any drug or alcohol counseling, treatment, or rehabilitation or reentry programs that are available to employees or students (see Drug and Alcohol Programs on Page 12); and • A clear statement that the institution will impose sanctions on students and employees and a description of those sanctions, up to and including expulsion or termination of employment and referral for prosecution, for violations of the standards of conduct or law (see Disciplinary Sanctions on Page 14).
    [Show full text]
  • The Opioid Crisis
    America Wakes Up: The Opioid Crisis Matt Feehery, LCDC Senior Vice President & CEO PaRC (Prevention & Recovery Center) Behavioral Health Services July 5, 2017 A Pill for Your Pain “But my doctor prescribed it, so it can’t be bad.” “We started on this whole thing because we were on a mission to help people in pain,” states Dr. Jane C. Ballantyne, a Seattle pain expert. “But the long-term outcomes for many of these patients are appalling, and it is ending up destroying lives.” The use, overuse and misuse of prescription opioids continues to rise. Source: New York Times 2012 A Pill for Your Pain • 2014 the CDC issued a report headlined PHYSICIANS ARE FUELING PRESCRIPTION PAINKILLER OVERDOSES. • The study found that doctors were engaging in "dangerous" and "inappropriate" prescription practices. • Physician lack understanding of opiates and their addictive tendencies. (Source: CDC, 2014) A Pill for Your Pain Many Physicians Don’t Understand Key Facts about Prescription Opioid Addictions • Surveyed physicians do not understand the addictive nature of the opioids they prescribe or how people become addicted to them. • Doctors continue to overestimate the effectiveness of prescription pain medications and underestimate their risks. • One-third of the doctors erroneously believed that most prescription drug abuse is by means other than swallowing the pills as intended. Ingestion accounts up to 97%, followed by snorting and injection. • Physicians and patients often mistakenly view these medicines as safe in one form and dangerous in another. (Source: Johns Hopkins Bloomberg School of Public Health, June, 2015) A Pill for Your Pain While cumulative pain levels remained constant among Americans, prescriptions for pain medications quadrupled between 1999 and 2010.
    [Show full text]
  • MF3404 the Opioid Crisis: What You Need to Know
    The Opioid Crisis: What You Need to Know The opioid crisis has swept across the nation at an Key Facts alarming rate. Drug abuse, dependence, and overdose are • Opioids are a class of drugs that include powerful issues that affect the lives of millions of Americans. Given prescription pain relievers — such as oxycodone, codeine, the severity of the opioid crisis in the United States, action morphine, and fentanyl — and the illegal drug heroin. must be taken at multiple levels to stop the devastating • Opioids work by binding to opioid receptors in your body consequences. One of those steps is education. This fact to relieve pain. sheet will discuss: • Prescription opioids can be an important part of treatment • what opioids are, but carry significant risks for addiction and overdose • which opioids are most commonly abused and why, because of the addictive euphoria they create and the tolerance that occurs after repetitive dosing. • the risks associated with abusing opioids and who is • Drug overdose is the leading cause of accidental death most vulnerable to an opioid addiction, in the United States, of which a large majority is due to • the signs of an opioid addiction and overdose, prescription and illegal opioids. Seven drug related deaths occur every hour in the United States. • how to respond to an opioid overdose, • There are effective treatment options for opioid • how to safely store and dispose of opioid medications, dependence, yet only 10 percent of people who need such and treatment are receiving it. • steps individuals and communities can take to address • Naloxone, also called Narcan® or Evzio®, can completely the opioid crisis.
    [Show full text]
  • Fentanyl Analogs and Pre-Hospital Agitation
    Trending in the Emergency Department: Fentanyl Analogs and Pre-hospital agitation PATRICK AARONSON PHARM.D., DABAT CLINICAL PHARMACIST - EMERGENCY MEDICINE UNIVERSITY OF FLORIDA AND SHANDS – JACKSONVILLE [email protected] Goals and Objectives Pharmacist: – Recognize the most recent drug abuse crisis - Fentanyl Analogs – Recognize the challenges of naloxone dosing for Fentanyl analogs – Evaluate the risks and benefits of pre-hospital Ketamine for undifferentiated agitation Goals and Objectives Technician: – Discuss the Fentanyl analog crisis trajectories – Recognize the pharmacological effects of Ketamine for undifferentiated agitation Disclosure I do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education activity, or any affiliation with an organization whose philosophy could potentially bias my presentation. DEA: 2013: 700 Fentanyl deaths nationally CDC.gov/drugoverdose/pdf/pbss/PBSS-Report-072017.pdf Mortality Weekly Report (MMWR), 64(50–51), 378–1382 statnews.com/2016/09/29/fentanyl-heroin-photo-fatal-doses/ dea.gov/divisions/hq/2016/hq092216_attach.pdf Poison Center / Emergency Department Data • Lag time between experimentation and academic outlet • Poison center data less useful (disguised substances, familiar toxidrome) • Nonfatal fentanyl cases attributed to heroin • ELISA reports Fentanyl unless GC/MS was utilized to detect analogs Year Cases Deaths Year Cases National Florida 2015 1402 47 2017 69 2014 1418 5 2016 83 Clinical Toxicology
    [Show full text]
  • TRUVER-DISSERTATION-2019.Pdf
    IDENTIFYING THE CHALLENGES OF EMERGING NOVEL PSYCHOACTIVE SUBSTANCES ___________ A Dissertation Presented to The Faculty of the Department of Forensic Science Sam Houston State University ___________ In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy ___________ by Michael Thomas Truver December, 2019 IDENTIFYING THE CHALLENGES OF EMERGING NOVEL PSYCHOACTIVE SUBSTANCES by Michael Thomas Truver ___________ APPROVED: Madeleine Swortwood, PhD Committee Director Sarah Kerrigan, PhD Committee Member Patrick Buzzini, PhD Committee Member Kayla Ellefsen, PhD Committee Member Svante Vikingsson, PhD Committee Member Phillip Lyons, PhD Dean, College of Criminal Justice DEDICATION "I see now that the circumstances of one's birth are irrelevant. It is what you do with the gift of life that determines who you are." – Mewtwo For my advisor, Madeleine Swortwood, thank you for convincing me to stay here to continue my degree and for all the opportunities and experiences you gave me. I couldn’t have done it without you For my parents, thank you for all the love and support you have given me throughout my entire college career. Thank you for believing in me and helping me in any way possible. For Patrick, thank you for being a supportive partner throughout my PhD. Your love and support have allowed to better handle the stress of this degree. For my PhD cohort, thank you for making the PhD suite a place of positivity and laughter. Britni Skillman, thank you for staying and completing your degree with me, we did it! Christina Smith, thank you for being my lab buddy and the late night Facetimes.
    [Show full text]
  • Safe Drug Handling Class for Law Enforcement
    Safe Handling Training October 9, 2018 Office of the Indiana Attorney General Indiana Drug Enforcement Association Indiana State Police Evansville Police Department Fentanyl, Opiates and Opioids: The Silent Killers and a National Epidemic Det. Brock Hensley Course Objectives • OBSERVE HOW COMMON CULTURE IS USED FOR OPOID/OPIATE DISTRIBUTION • LEARN THE DIFFERENCE BETWEEN OPIATES AND OPIOIDS • IDENTIFY THE TYPES OF OPIOIDS COMMON ON THE STREET Course Objectives • LEARN COMMON TYPES OF FENTANYL AND ITS DERIVITIVES • LEARN AND DISCUSS THE DANGERS OF FENTANYL • RECITE RECOMMENDED PPE FOR SAFELY HANDLING FENATNYL • HAVE A GOOD TIME! Modern Culture How it all Began How would you like to be conducting a traffic stop and locate an unknown powder? Opiate v/s Opioid • Opiate: A drug with morphine like effects, derived from opium. • Opioid: An opium like COMPOUND that binds to one or more of the opioid receptors of the body. Opiate • Natural occurring • Derivative of the poppy plant • Heroin is an opiate • Morphine is an opiate Opium Opioid Common Opioids Lortab Roxicodone “ Death By Fentanyl” Video Fentanyl • Opioid narcotic drug- man made v/s opiate • High risk of addiction • Respiratory distress • High death rate when taken in higher dose • Normal dose in micrograms • Lipid loving narcotic • Very small molecular size Your Brain on Fentanyl….. Common fentanyl types • Patches • Pills • Injectable • Powder • Heroin laced • Car-fentanyl Fentanyl patches • Transdermal- absorbed through the skin • Inconsistent dosage due to numerous body types • Easily
    [Show full text]
  • Wednesday Keynote
    America’s Decades-Long Overdose Crisis and the Radical Transformation of the Illicit Drug Market: Implications for Public Health Jon E. Zibbell, PhD Senior Scientist RTI International Atlanta, GA August 11, 2021 Faculty Disclosure I have no financial disclosures to declare. 2 Educational Need/Practice Gap • Educational Need: Drug-related health outcomes and overdose deaths will continue to occur in Kentucky and throughout the United States based upon the current overdose crisis and illicit drug market. Many of these harms could be avoided if there were more interventions and awareness programs put in place by local, state, and federal organizations. • Practice Gap: Organizations will have to work together at the local, state, and federal level to effectively address the current overdose crisis in Kentucky and the United States. 3 Objectives • Learn how the illicit drug market is serving as a social determinant of health with the capacity to influence individual drug preferences, consumption patterns, and health outcomes. • Understand the pharmacologic effects associated with a changing drug supply and its impact on consumers' drug use behavior, overdose risk, and quality of life. • Discover how people who use illicit drugs are responding to the rapidly changing illicit drug supply while attempting to navigate volatile and unregulated illicit drug markets more safely. 4 Expected Outcome Learners will have a better understanding of the current illicit drug market and the implications for public health agencies throughout the United States.
    [Show full text]
  • ASPR TRACIE Tip Sheet Opioids: Frequently Asked Questions
    Opioids: Frequently Asked Questions Originally Published: September 2017 Updated October 2019 On October 16, 2019, the Secretary of the Department of Health and Human Services (HHS) renewed the determination that a “public health emergency” exists as a result of the opioid1 crisis. This type of declaration allows federal and state agencies to waive certain funding requirements, make temporary staff assignments, modify certain practices, and modify deadlines. In 2017, HHS released a 5-Point Strategy to Combat the Opioid Crisis, designed to help communities fight the epidemic. Prior to the renewal, at least eight states had declared a formal emergency, public health emergency, or made a similar type of pronouncement to address this public health crisis at the state level. Several states are currently using the Centers for Medicare & Medicaid coverage and reimbursement policy to tackle the epidemic. The most current data available from the Centers for Disease Control and Prevention (CDC 2018) indicates that: • 130 Americans die every day from an opioid overdose; • The number of opioid-related overdose deaths was six times higher in 2017 versus 1999 (a statistic closely aligned with the amount of prescription opioids sold in the U.S. in the same timeframe); and • Synthetic opioid death rates (which include Illegally-produced fentanyl) increased by nearly 47% between 2016 and 2017 (CDC 2018). The impact of the crisis is far reaching and not limited to deaths. Emergency departments are reporting large numbers of opioid-related visits, Emergency Medical Services (EMS) agencies across the country are answering many more narcotic related calls, and questions and calls for policy and protective recommendations abound.
    [Show full text]