Academic literature on the topic 'Vicodin abuse'

ObjectiveTo utilize New Jersey’s syndromic surveillance data in the study and comparison of trends in injection opioid use and infection with selected bloodborne pathogens (BBPs) over the years 2013-2017.IntroductionWhen the opioid epidemic began in the early 1990s, pills such as oxycodone were the primary means of abuse. Beginning in 2010, injection use of, first, heroin and then synthetic opioids dramatically increased, which led the number of overdose deaths involving opioids to increase fivefold between 1999 and 2016.1 It would be expected that BBP rates would rise with this increase in injection use, and, nationally, there has been a rise in acute hepatitis C (HCV) rates, although the other two main BBPs, acute hepatitis B (HBV) and acute human immunodeficiency virus (HIV) have been flat and declining, respectively.2,3In this study, we compared New Jersey’s reported incidence of these three BBPs (acute HBV, acute HCV, and HIV) over five years (2013-2017) with syndromic surveillance data for opioid use over the same time period in order to test the hypothesis that emergency department (ED) visits for opioid use could be used as a predictor of BBP infection.MethodsTo indirectly track the number of injection opioid users, we wrote a custom classifier for EpiCenter, New Jersey's statewide syndromic surveillance system, to search ED chief complaints for the number of visits related to injection opioid usage. Our custom classifier creation started with the CDC’s National Syndromic Surveillance Program (NSSP) ESSENCE Chief Complaint Category classifier for opioid overdose.4 As we were looking to count not just overdoses but all visits likely to be associated with injection drug use, we chose not to omit the keyword “withdrawal,” differing from CDC’s classifier in which it is a negative indicator.Positive indicator keywords included “opioid,” “heroin,” “narcot,” “opiate,” “fentanyl,” “naloxo,” “narcan,” "ivdu," and the ICD-9 and ICD-10 codes e850.[0-2], 304, 305.5, f11, t40.[0-6], and 965. These keywords were used to target the chief complaints of people using injection opioids. Negative indicators included “patch,” “allerg,” and “med” to eliminate medical opioid use. Negative indicators also included “vicodin,” “tramadol,” “percocet,” “oral,” and t40.5 to filter out opioids most commonly used in pill form, as well as other drugs.Cases of acute HCV and acute HBV were totaled using CDRSS, New Jersey's Communicable Disease Reporting and Surveillance System. In order to maintain consistency, we used the respective 2012 case definition for each disease. Numbers of new HIV infections were accessed from NJ’s reportable disease list.5 All of the data sets followed the epidemiologic years 2013–2017 (based upon MMWR weeks).ResultsHIV diagnosis rates slightly decreased over time. HBV rates trend upwards, similar to the rates of injection drug use (IDU) for the first three years but start to drop after 2015. Aside from an unexplained dip in 2016, the HCV rates generally track the EpiCenter data for IDU (Figure 1). On a regional scale, NJ’s Northwest region had the highest rates per capita of the five NJ regions and the most similar trending between the HCV and EpiCenter data sets (Figure 2). This result follows the nationwide trend of the opioid epidemic occurring more widely in rural areas, as this region is the most rural region in New Jersey.6In figures 1 & 2, IDU (EpiCenter) and HIV are plotted on the primary (left) axis and HCV and HBV are plotted on the secondary (right) axis.ConclusionsBoth IDU related visits and cases of acute HCV show an ongoing upward trend. This result agrees with the initial hypothesis. However, the association between acute HBV cases and IDU wasn’t as strong. This finding can be attributed to the fact that while HBV is a BBP, it is most commonly transmitted vertically from an infected mother to her child at birth, whereas HCV is primarily transmitted through the sharing of needles or syringes.7,8 There is no apparent relationship between HIV rates and injection drug rates, likely because HIV has a 0.3% infection risk rate from a single infected needlestick versus the 1.8% risk of acquiring HCV and 22-31% risk of acquiring HBV.9References1. Centers for Disease Control and Prevention (CDC), Understanding the Epidemic; August 30, 2017. https://www.cdc.gov/drugoverdose/epidemic/index.html. Accessed 13 July 2018.2. CDC, Viral Hepatitis; May 19, 2016. https://www.cdc.gov/hepatitis/hbv/statisticshbv.htm. Accessed 24 July 2018.3. CDC, HIV in the United States: At A Glance; June 26, 2018. https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Accessed 24 July 2018.4. CDC, NSSP Update; May, 2017. https://www.cdc.gov/nssp/documents/nssp-update-2017-05.pdf. Accessed 23 July 2018.5. NJDOH, HIV, STD, and TB Services; December, 2016. https://www.cdc.gov/hiv/statistics/overview/ataglance.html Accessed 27 July 20186. Schranz, A.J., Barrett, J., Hurt, C.B. et al. Challenges Facing a Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C. Curr HIV/AIDS Rep. 2018;15(3):245-254.7. Rolls, David A. et al. Hepatitis C Transmission and Treatment in Contact Networks of People Who Inject Drugs. PLoS ONE. 2013;8(11).8. Perrillo, R.P. Hepatitis B: transmission and natural history. Gut. 1993;34(2):S48-S49.9. Berry, Arnold J. Needle stick and other safety issues. Anesthesiology Clinics of North America. 2004; 22(3):493-508.

abstract: Mathematical models are important tools for addressing problems that exceed experimental capabilities. In this work, I present ordinary and partial differential equation (ODE, PDE) models for two problems: Vicodin abuse and impact cratering. The prescription opioid Vicodin is the nation's most widely prescribed pain reliever. The majority of Vicodin abusers are first introduced via prescription, distinguishing it from other drugs in which the most common path to abuse begins with experimentation. I develop and analyze two mathematical models of Vicodin use and abuse, considering only those patients with an initial Vicodin prescription. Through adjoint sensitivity analysis, I show that focusing efforts on prevention rather than treatment has greater success at reducing the total population of abusers. I prove that solutions to each model exist, are unique, and are non-negative. I also derive conditions for which these solutions are asymptotically stable. Verification and Validation (V&V) are necessary processes to ensure accuracy of computational methods. Simulations are essential for addressing impact cratering problems, because these problems often exceed experimental capabilities. I show that the Free Lagrange (FLAG) hydrocode, developed and maintained by Los Alamos National Laboratory, can be used for impact cratering simulations by verifying FLAG against two analytical models of aluminum-on-aluminum impacts at different impact velocities and validating FLAG against a glass-into-water laboratory impact experiment. My verification results show good agreement with the theoretical maximum pressures, and my mesh resolution study shows that FLAG converges at resolutions low enough to reduce the required computation time from about 28 hours to about 25 minutes. Asteroid 16 Psyche is the largest M-type (metallic) asteroid in the Main Asteroid Belt. Radar albedo data indicate Psyche's surface is rich in metallic content, but estimates for Psyche's composition vary widely. Psyche has two large impact structures in its Southern hemisphere, with estimated diameters from 50 km to 70 km and estimated depths up to 6.4 km. I use the FLAG hydrocode to model the formation of the largest of these impact structures. My results indicate an oblique angle of impact rather than a vertical impact. These results also support previous claims that Psyche is metallic and porous.
Dissertation/Thesis
Psyche asteroid impact simulation initialization
Psyche asteroid impact simulation video
Doctoral Dissertation Applied Mathematics 2019

When used appropriately under medical supervision, hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin), morphine, and similar prescription pain relievers provide indispensable medical benefit by reducing pain and suffering, but when taken without appropriate direction and oversight, these medications can cause serious adverse consequences and produce dependence and abuse. Approximately 324,000 emergency department visits in 2006 involved the nonmedical use of pain relievers (including both prescription and over-the-counter pain medications). This chapter discusses how, when individuals wish to detoxify from opiate dependence, there are several options available, including both conventional and newer, more rapid approaches.