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Статті в журналах з теми "Prescription opioid education":
1
Weekes, Danielle G., Jenna A. Feldman, Richard E. Campbell, Michael DeFrance, Fotios P. Tjoumakaris, and Luke Austin. "The Incidence of Chronic Opioid Use Following Arthroscopic Rotator Cuff Repair and Patient Opioid Education." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0025. http://dx.doi.org/10.1177/2325967119s00258.
Анотація:
Objectives: Opioids are commonly prescribed for pain management following Arthroscopic Rotator Cuff Repair (ARCR). While their efficacy outweighs their risks in the short term, chronic opioid use is associated with significant adverse effects, such as dependence, endocrine imbalance or respiratory depression. The rate of chronic opioid use and dependence following ARCR is unknown. The purpose of this study is to determine the rate of chronic opioid use following ARCR and establish the effect of preoperative opioid education on reducing chronic consumption. A secondary aim is to determine if any correlation exists between chronic opioid use and shoulder functionality. Methods: A prospective, randomized study of 140 patients undergoing ARCR was performed with a minimum follow-up of 24 months. Patients were randomized to receive preoperative opioid education (risks of abuse, dependence, etc.) or no education. State registry database opioid prescription data monitoring software were utilized to search for all opioid prescriptions following ARCR in our patient population and this was compared to our electronic medical database for accuracy/discrepancy. The total number of opioid prescriptions and number of tablets was determined as well as time from surgery to most recent prescription. Patients were contacted to determine a shoulder Single Assessment Numeric Evaluation (SANE) score and Visual Analog Scale (VAS) pain score. Categorical data was analyzed via chi-squared tests as appropriate. Numeric data was analyzed using t-tests as appropriate. Results: Forty-five patients (32%) continued to fill opioid prescriptions chronically following ARCR. Seventeen (38%) of these patents received pre-operative opioid educated, whereas twenty-eight (62%) did not (p=0.05). Sixty percent of patients with a history of pre-operative opioid use continued to take opioids, while 23% of opioid naive patients continued (p< 0.01). There was no significant difference in SANE (p= 0.53) or VAS (p= 0.65) scores between the education and control group. Patients taking opioids prior to surgery had worse SANE scores (71.28) than the non-users (86.28), p< 0.01. Conclusion: Almost a third of patients will chronically use opioids following ARCR, including 23% of opioid naive patients. Preoperative opioid use is strongly associated with chronic opioid utilization, as well as decreased shoulder function 2 years after ARCR. Preoperative opioid education significantly decreased the rate of chronic opioid use; however, there is no effect on long-term shoulder function. [Table: see text]
2
Manchikanti, Laxmaiah. "Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic." January 2018 1, no. 21;1 (July 15, 2018): 309–26. http://dx.doi.org/10.36076/ppj.2018.4.309.
Анотація:
The opioid epidemic has been called the “most consequential preventable public health problem in the United States.” Though there is wide recognition of the role of prescription opioids in the epidemic, evidence has shown that heroin and synthetic opioids contribute to the majority of opioid overdose deaths. It is essential to reframe the preventive strategies in place against the opioid crisis with attention to factors surrounding the illicit use of fentanyl and heroin. Data on opioid overdose deaths shows 42,000 deaths in 2016. Of these, synthetic opioids other than methadone were responsible for over 20,000, heroin for over 15,000, and natural and semisynthetic opioids other than methadone responsible for over 14,000. Fentanyl deaths increased 520% from 2009 to 2016 (increased by 87.7% annually between 2013 and 2016), and heroin deaths increased 533% from 2000 to 2016. Prescription opioid deaths increased by 18% overall between 2009 and 2016. The Drug Enforcement Administration (DEA) mandated reductions in opioid production by 25% in 2017 and 20% in 2018. The number of prescriptions for opioids declined significantly from 252 million in 2013 to 196 million in 2017 (9% annual decline over this period), falling below the number of prescriptions in 2006. In addition, data from 2017 shows significant reductions in the milligram equivalence of morphine by 12.2% and in the number of patients receiving high dose opioids by 16.1%. This manuscript describes the escalation of opioid use in the United States, discussing the roles played by drug manufacturers and distributors, liberalization by the DEA, the Food and Drug Administration (FDA), licensure boards and legislatures, poor science, and misuse of evidencebased medicine. Moreover, we describe how the influence of pharma, improper advocacy by physician groups, and the promotion of literature considered peer-reviewed led to the explosive use of illicit drugs arising from the issues surrounding prescription opioids. This manuscript describes a 3-tier approach presented to Congress. Tier 1 includes an aggressive education campaign geared toward the public, physicians, and patients. Tier 2 includes facilitation of easier access to non-opioid techniques and the establishment of a National All Schedules Prescription Electronic Reporting Act (NASPER). Finally, Tier 3 focuses on making buprenorphine more available for chronic pain management as well as for medication-assisted treatment. Key words: Opioid epidemic, fentanyl and heroin epidemic, prescription opioids, National All Schedules Prescription Electronic Reporting Act (NASPER), Prescription Drug Monitoring Programs (PDMPs)
3
Samaan, Dr Zainab. "Association Between Socio-Demographic and Health Functioning Variables Among Patients with Opioid Use Disorder Introduced by Prescription: A Prospective Cohort Study." January 2018 1, no. 21;1 (November 14, 2018): E623—E642. http://dx.doi.org/10.36076/ppj.2018.6.e623.
Анотація:
Background: Prescription opioid misuse in Canada has become a serious public health concern and has contributed to Canada’s opioid crisis. There are thousands of Canadians who are currently receiving treatment for opioid use disorder, which is a chronic relapsing disorder with enormous impact on individuals and society. Objectives: The aim of this study was to compare the clinical and demographic differences between cohorts of patients who were introduced to opioids through a prescription and those introduced to opioids for non-medical purposes. Study Design: This was an observational, prospective cohort study. Setting: The study took place in 19 Canadian Addiction Treatment Centres across Ontario. Methods: We included a total of 976 participants who were diagnosed with Opioid Use Disorder and currently receiving methadone maintenance treatment. We excluded participants who were on any other type of prescription opioid or who were missing their 6-month follow-up urine screens. We measured the participants’ initial source of introduction to opioids along with other variables using the Maudsley Addiction Profile. We also measured illicit opioid use using urine screens at baseline and at 6-months follow-up. Results: Almost half the sample (n = 469) were initiated to opioids via prescription. Women were more likely to be initiated to opioids via a prescription (OR = 1.385, 95% CI 1.027-1.866, P = .033). Those initiated via prescription were also more likely to have post-secondary education, older age of onset of opioid use, less likely to have hepatitis C and less likely to have use cannabis. Chronic pain was significantly associated with initiation to opioids through prescription (OR = 2.720, 95% CI 1.998-3.722, P < .0001). Analyses by gender revealed that men initiated by prescription were less likely to have liver disease and less likely to use cannabis, while women initiated by prescription had a higher methadone dose. Limitations: This project was limited by its study design being observational in nature; no causal relationships can be inferred. Also, the data did not allow determination of the role that the prescribed opioids played in developing opioid use disorder. Conclusions: Our results have revealed that almost half of this methadone maintenance treatment (MMT) population has been introduced to opioids through a prescription. Given that the increasing prescribing rates of opioids has an impact on this at-risk population, alternative treatments for pain should be considered to help decrease this opioid epidemic in Canada. Key words: Opioid use disorder, chronic pain relief, methadone maintenance treatment, prescriptions, male, female
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Pate, Matthew, Jacob Hall, John Anderson, Donald Bohay, John Maskill, Michelle Padley, Lindsey Behrend, and Omar Yaldo. "Postoperative Pain and Opioid Use Following Surgical Treatment of Ankle Fractures." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0033. http://dx.doi.org/10.1177/2473011419s00339.
Анотація:
Category: Ankle, Bunion, Trauma Introduction/Purpose: Chronic opioid abuse is one of the greatest public health challenges in the United States. The most common first exposure to opioids comes from acute care prescriptions, such as those after surgery. Moreover, opioids are often prescribed excessively, with current estimates suggesting ˜75% of the pills prescribed are unused. Ankle fractures are the most common operatively treated fracture in orthopaedic surgery, and management of acute pain following surgery is challenging. The optimal perioperative pain regimen is still a point of controversy, as there is limited data available regarding appropriate amount of opioid to prescribe. This study evaluates opioid prescribing techniques of multiple foot and ankle surgeons, and associated patient outcomes. We aim to help surgeons improve their pain management practices and to limit opioid overprescription. Methods: Chart review and phone survey were performed on forty two adult patients within three to six months of ankle fracture fixation at our institution. These patients were offered to voluntarily participate in a standardized questionnaire regarding pain scores, opioid use, non-opioid analgesic use, pain management satisfaction, and patient prescription education. Results: 57% of patients reported that they were given “more” or ”much more” opioid medication than needed, 38% stated that they were given the “right amount”, and 5% reported that they were given ”less” or “much less” than needed. 40.0% were on opioids prior to operation. 53.5% did not require refill of discharge opioid prescriptions, 30.2% of patients did not fill any posteroperative opioid prescription. 16.3% of patients filled their discharge prescription and at least one additionall refill (mean refill = 2.22). Mean number of reported opioid pills taken after surgery was 17.4. Mean satisfaction with overall pain management at phone follow up was 8.6/10. Conclusion: While postoperative pain and management vary substantially, a majority of patients feel that they are given more opioid medication than necessary following ankle fracture repair, and a majority of opioid prescriptions are not completely used. Going forward, it is likely that a majority of patients could experience the same beneficial results with less prescription opioid pain medication, which would reduce overpresciption and potential misuse.
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Harbaugh, Calista M., Preeti Malani, Erica Solway, Matthias Kirch, Dianne Singer, Michael J. Englesbe, Chad M. Brummett, and Jennifer F. Waljee. "Self-reported disposal of leftover opioids among US adults 50–80." Regional Anesthesia & Pain Medicine 45, no. 12 (October 6, 2020): 949–54. http://dx.doi.org/10.1136/rapm-2020-101544.
Анотація:
ObjectiveTo test the association between self-reported opioid disposal education and self-reported disposal of leftover opioids among older adults.DesignWeb-based survey from the National Poll on Healthy Aging (March 2018) using population-based weighting for nationally representative estimates.SubjectsOlder adults aged 50–80 years who reported filling an opioid prescription within the past 2 years.MethodsRespondents were asked whether they received education from a prescriber or pharmacist on how to dispose of leftover opioids and whether they disposed of leftover opioids from recent prescriptions. The association between self-reported opioid disposal education and self-reported disposal of leftover opioids was estimated with multivariable logistic regression, testing for interactions with respondent demographics.ResultsAmong 2013 respondents (74% response rate), 596 (28.9% (26.8%–31.2%)) were prescribed opioids within the past 2 years. Education on opioid disposal was reported by 40.1% of respondents (35.8%–44.5%). Among 295 respondents with leftover medication, 19.0% (14.6%–24.5%) disposed of the leftover medications. Opioid disposal education was associated with a greater likelihood of self-reported disposal of leftover opioids among non-white respondents as compared with white non-Hispanic respondents (36.7% (16.8%–56.6%) vs 7.8% (0.1%–15.6%), p<0.01).ConclusionsIn this nationally representative survey, 49% had leftover opioids, yet only 20% of older adults reported disposal of leftover opioids. Opioid disposal education was variable in delivery, but was associated with disposal behaviors among certain populations. Strategies to promote disposal should integrate patient education on the risks of leftover opioid medications and explore additional barriers to accessing opioid disposal methods.
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Brown, Whitnee C., and Kelli Whitted. "Provider Prescription Drug Monitoring Program Utilization and Self-Auditing—A Pilot Study." Journal of Doctoral Nursing Practice 13, no. 2 (July 1, 2020): 142–47. http://dx.doi.org/10.1891/jdnp-d-19-00064.
Анотація:
BackgroundAlabama has the highest prescription rate in the country. The national incidence of overdose deaths from prescription opioids exceeds the combined death rates from heroin and cocaine overdose. Monitoring prescription access should be an essential activity among providers and can be used to protect patient health and well-being. Prescription drug monitoring programs (PDMPs) are tools that assist in diminishing opioid therapy risks such as diversion, abuse, overdose, and death.ObjectiveThe purpose of the study was to examine the effects of an educational intervention on opioid prescriptive rates, frequency of self-auditing and days of opioid supply among healthcare providers. The anticipated goal of the project was that rates and days of supply for opioid prescriptions would decrease.MethodA pretest–posttest design was used to assess a sample of 21 DEA licensed providers who attended a PDMP presentation and conducted a self-audit using the PDMP.ResultsAnalysis showed that 81% of the participants had never conducted a self-audit prior to the intervention. Self-report data indicated that 85.7% of the providers planned to increase their self-auditing use postintervention and 14.3% planned to make no changes to their current use of the PDMP. Among those who prescribed opioids, the range of monthly prescriptions written was 3–142 preintervention (M = 32.28, SD = 41.04) and 3–149 postintervention (M = 32.26, SD = 43.32). Analysis also found the days of opioid supply prescribed were also high. In both cases, these numbers were correlated to patient census.Implications for NursingThe PDMP is an effective surveillance tool that provides aggregate data to state public health officials. For a PDMP to be effective, it must be used by prescribing providers. While the anticipated goal for this study was not achieved, the PDMP is an effective surveillance tool for monitoring the controlled substance prescription histories of patients. Using the PDMP before prescribing can aid providers in distinguishing those who legitimately have a need from those who may be seeking to misuse the medications. Additionally, use of a PDMP can provide aggregate data to state public health officials so that education programs, for practitioners and patients, can be developed.
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Lee, Matthew L., Lauren B. Camp, Mehul V. Raval, and Eunice Y. Huang. "Opioid Prescribing and Use After Pediatric Umbilical Hernia Repair." American Surgeon 86, no. 5 (May 2020): 437–40. http://dx.doi.org/10.1177/0003134820918261.
Анотація:
Background Opioid overuse is a concern in adult and pediatric populations. Physician education may improve appropriate opioid prescribing and patient instruction for use. Prescribing and use of opioid for pain control after pediatric umbilical hernia repair (UH) before and after surgeon education was evaluated. This is a substudy of a multi-institutional study assessing prescribing practice before and after surgeon education. This study further assessed patient prescription filling pattern and parent report of pain control. Methods A retrospective study was performed evaluating children who underwent UH 6 months before and after an educational presentation on opioid use. Prescriptions, prescription fills, patient medication use, and pain control effectiveness were assessed. Adverse events were collected. Results There were 78 subjects in the pre- and 99 in the posteducation group. Opioid prescribed changed from 98.7% to 61.6% ( P < .0001), and nonopioid prescriptions increased following education ( P = .0063). The number of opioid prescriptions filled decreased ( P = .0296). There were limited data on opioid doses used and quality of pain control, but the posteducation group showed good pain control. There was no difference in adverse events. Discussion Surgeon education on current opioid epidemic and strategies for opioid stewardship improves opioid prescribing and use without adversely impacting pain control or clinical outcome.
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Madden, Kevin, Akhila Sunkepally Reddy, Maxine Grace De la Cruz, and Eduardo Bruera. "Patterns of storage, use, and disposal of prescription opioids by parents of children with cancer." Journal of Clinical Oncology 37, no. 31_suppl (November 1, 2019): 114. http://dx.doi.org/10.1200/jco.2019.37.31_suppl.114.
Анотація:
114 Background: Multiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents. We investigated whether parents of children with cancer that were prescribed opioids practiced safe storage, use, and disposal techniques. Methods: We conducted a prospective cross-sectional survey of parents whose children were prescribed opioids and asked them about their patterns of storage, use, and disposal of prescription opioids. Results: Virtually all parents (106/109, 97%) completed the survey. Most parents (95/106, 90%) did not store opioids safely. Six of 106 parents (6%) gave their child's opioid pain medication to someone else with pain, and 3 of 106 parents (3%) personally took some of their child’s opioid. Parents who personally took their child’s opioid ( P = .01) or gave it to another person ( P < .001) were more likely to use opioids unsafely with their child. A minority of parents (22/106, 21%) did not use opioids safely in their child. A small number of parents (3/22, 14%) did not dispose of opioids safely. Conclusions: Universal education about the safe, use, and disposal of opioids should be adopted when prescribing opioids. Pediatricians need to maintain vigilance about the nonmedical use of prescription opioid use by parents of children.
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Harbaugh, Calista M., Gracia Vargas, Kenneth R. Sloss, Lauren A. Bohm, Karen A. Cooper, Aaron L. Thatcher, David A. Zopf, Kao-Ping Chua, Jennifer F. Waljee, and Samir K. Gadepalli. "Association of Opioid Quantity and Caregiver Education with Pain Control after Pediatric Tonsillectomy." Otolaryngology–Head and Neck Surgery 162, no. 5 (March 24, 2020): 746–53. http://dx.doi.org/10.1177/0194599820912033.
Анотація:
Objective To examine whether a service guideline reducing postoperative opioid prescription quantities and caregiver-reported education to use nonopioid analgesics first are associated with caregiver-reported pain control after pediatric tonsillectomy. Study Design Prospective cohort study (July 2018–April 2019). Setting Pediatric otolaryngology service at a tertiary academic children’s hospital. Subjects and Methods Caregivers of patients aged 1 to 11 years undergoing tonsillectomy (N = 764) were surveyed 7 to 21 days after surgery regarding pain control, education to use nonopioid analgesics first, and opioid use. Respondents who were not prescribed opioids or had missing data were excluded. Logistic regression modeled caregiver-reported pain control as a function of service guideline implementation (December 2018) recommending 20 rather than 30 doses for postoperative opioid prescriptions and caregiver-reported analgesic education, adjusting for patient demographics. Results Among 430 respondents (56% response), 387 patients were included. The sample was 43% female with a mean age of 5.0 years (SD, 2.5). Pain control was reported as good (226 respondents, 58%) or adequate/poor (161 respondents, 42%). Mean opioid prescription quantity was 27 doses (SD, 7.9) before and 21 doses (SD, 6.1) after guideline implementation ( P < .001). Education to use nonopioids first was reported by 308 respondents (80%). In regression, prescribing guideline implementation was not associated with pain control (adjusted odds ratio, 1.3; 95% CI, 0.9-2.0; P = .22), but caregiver-reported education to use nonopioids first was associated with a higher odds of good pain control (adjusted odds ratio, 1.9; 95% CI, 1.1-3.2; P = .02). Conclusion Caregiver education to use nonopioid analgesics first may be a modifiable health care practice to improve pain control as postoperative opioid prescription quantities are reduced.
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Shahi, Niti, Maxene Meier, Ryan Phillips, Gabrielle Shirek, Ashley Banks, John Recicar, Candace Fry, Alan Bielsky, and Steven Moulton. "869 Opioid Utilization in Pediatric Burn Patients." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S273—S274. http://dx.doi.org/10.1093/jbcr/iraa024.435.
Анотація:
Abstract Introduction Childhood burns are extremely common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, disrupting care and increasing the risk of post-traumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of burns in pediatric patients. We sought to evaluate the current use of multimodal therapy as well as the use, storage, and disposal of opioids in this patient population. Methods We prospectively surveyed parents of pediatric burn patients (0–18 years old) who presented to the burn clinic within two weeks of burn injury. Parents were surveyed regarding over-the-counter pain medication use and opioid medication use, storage, and disposal in the treatment of their child. Medians and interquartile ranges were used to describe continuous variables and frequencies and percentages were used for categorical variables. Results A total of 92 parents of burn-injured children were surveyed at a single institution in the outpatient burn clinic. The median age of burn-injured children was 3.1 years old, and 50% of patients were male. The majority had a TBSA of 1%. The hand was the most frequently burned location (45.7%). Acetaminophen (58.7%) and ibuprofen (69.6%) were the most common treatments for both constant and breakthrough pain. Approximately 28% (26/92) of patients were prescribed opioids, of which 18.5% (17/92) filled their prescription. Only 29% of patients (5/17) consumed their entire prescription, and a median of 3 doses of opioids remained for those who did not finish the entire prescription. Parents most commonly decided to give their children opioid pain medications because “my child is in severe pain” or “I give my child pain medications as scheduled (written on prescription).” Approximately 40% (7/17) of patients who filled opioid prescriptions stored them in a locked area, and only 35.3% (6/17) were educated on how to dispose of excess opioid pain medication. Conclusions Presently, multimodal therapy with over-the-counter pain medications is used to treat the majority of pediatric burns. This study demonstrates an increased need for education on opioid administration, storage, and disposal for parents of burn-injured children. Applicability of Research to Practice We aimed to evaluate what current trends in opioid use are in pediatric burn patients and areas for improvement in parent education for over-the-counter pain medication use, opioid use, opioid storage, and disposal. From the study, we were able to glean that the majority of patients are successfully managed with over-the-counter pain medications. However, parents and patients managed with opioids need additional education on appropriate administration of opioid pain medications, safe locked storage of opioids, and opioid disposal. This demonstrates an area for quality improvement inpatient and outpatient.
Дисертації з теми "Prescription opioid education":
1
Haslam, Valynn Christina. "Opioid Prescription and Use After Laparoscopic Cholecystectomy." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6889.
Анотація:
Background: Opioid abuse has become a serious public health issue. While adequate pain management is an ethical responsibility for health care providers, responsible stewardship of controlled substances is of equal concern. Opioids are often prescribed for treatment of acute pain post-operatively. The purpose of this study is to examine opioid prescription practices and use of opioids after laparoscopic cholecystectomy. Methods: A convenience sample of 42 patients scheduled for laparoscopic cholecystectomy were enrolled in the study. Using a descriptive study design, patients were interviewed by phone 6-10 days post-operatively using a scripted questionnaire. The average number of excess prescribed opioid medication pills, patient perception of prescribed quantity, duration of opioid use, and average pain score with and without activity on the date of contact was determined. Participants were also asked about any instruction received regarding proper medication disposal. Results: A final sample of 34 patients met inclusion criteria and completed the phone questionnaire. Average number of excess pills ranged from 0-42 (M:14; SD 11.7). Nearly half of patients (47%) perceived the prescribed quantity as 'too many', 41% indicated the prescription quantity was 'just right' but many had left-over pills, and 11.8% believed the prescribed quantity to be 'too few'. The average number of days of opioid use following surgery was 4.2 days with 71% of patients using opioids for five or fewer days. The average pain score at the time of the interview was 2.0 without activity, and 4.1 with activity. Almost all (88%) patients did not recall any instruction or knowledge of appropriate medication disposal. A few participants volunteered plans to dispose of unused medications by various means, while others indicated they planned to keep excess pills. Conclusion: Pain management experts advise using around-the-clock regimens of over-thecounter analgesics (i.e. acetaminophen or non-steroidal anti-inflammatory medication (NSAID)) and using opioids sparingly as an adjunct therapy following uncomplicated laparoscopic cholecystectomy. The data in this study indicated currently prescribed opioid quantities after laparoscopic cholecystectomy are more than adequate and could be decreased without affecting adequate pain management. In addition, the data show a large majority of patients are not provided with personalized instruction on proper medication disposal procedures.
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Kaplan, Rachel S. W. "The Rhetoric of the Opioid Crisis and Addiction to Prescription Pain Medicine." Thesis, Duquesne University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10787609.
Анотація:
In this historical moment, the United States is amidst an opioid crisis killing the young and the old; at least seventy-eight people die every day from an opioid-related overdose (Enomoto in Murthy III). Changing mindsets of the doctors who prescribe opioids is just as important as asking the patients who are prescribed them to demand an alternative medication. The different parties involved in the crisis all have a different agenda and their rhetorical bias is explored throughout this project. The pharmaceutical companies have launched aggressive marketing campaigns expressing the benefits of opioids and encouraged physicians to prescribe, the CDC has encouraged physicians to stop the overprescribing of opioids, and local police departments and hospitals are overwhelmed with overdoses. Future generations are now being affected by their parents’ opioid usage; one must stop and realize opioids are not the solution. Perhaps one of the most important implications from this project is to suggest all women, regardless of socioeconomic status and level of health literacy, be warned of the dangers opioids pose to her and any future children. When taking opioids during pregnancy, NAS is not the only concern; but also the larger concern is the complete dysfunction that opioid addiction brings and the personal chaos it creates for addicts and their families
3
Miracle, Tessa. "Physician’s knowledge, attitudes, and utilization of the Prescription Drug Monitoring Program." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1593171776627526.
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Gonzalez, Mabel Gonzalez. "Factors related to prescription drug abuse among young adults in Florida." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2821.
Анотація:
A lack of available data exists regarding environmental factors related to prescription drug abuse (PDA), which could explain the ineffectiveness of efforts to reduce PDA in Florida. Prescription drug abuse among adults older than age 18 varies with the level of education achieved, and these metrics potentially reflect socioeconomic differences. The purpose of this quantitative study was to examine the connections between contextual aspects of prescription opioid abuse among Florida's middle and high school students to understand youth PDA in relation to their environments. This study consisted of a secondary analysis of existing PDA data (dependent variable) in relation to a number of independent variables, including the incidence of female-headed households, the nature of residential environment, adherence to religious precepts, and students' ability to achieve educational goals. Incidence of female-headed households, the nature of residential environment, and adherence to religious precepts were not found to predict youth PDA. The only finding of significance was that PDA predicted lowered students' ability to achieve educational goals (p = .015). Data collected from this study might be used by school counselors and administrators when developing drug abuse prevention, intervention, and educational programs, thereby leading to positive social change in helping to reduce PDA among youth.
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Samuel-Ojo, Catherine Olubunmi. "The Influence of Pain Self-Management Education on the Prevalence of Opioid Prescription among Patients with Chronic Non-Cancer Pain: An Agent-Based Modeling Simulation." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/594392.
Анотація:
Chronic pain has no cure. It is a lifelong condition presenting a growing concern due to its high occurrence and effects on every facet of life. It cost about $635 billion each year in medical treatment and lost productivity (IOM, 2011). The management of chronic pain using prescription painkiller opioids has increased drastically in the last two decades, leading to a consequential increase in deaths from chronic opioid use. This Plan-Do-Study-Act quality improvement project investigates the problem of the prevalence of opioid prescription using agent-based computational modeling method. The simulation models the interaction of 50 patient-agents with pain self-management messages in an episode of 50 patient iterations (visits) for 10 simulated years. This interaction generates health benefit and risk outcomes represented by wellness data obtained when messages are processed. As the simulation runs, data are dynamically captured and visualized using wellness charts, time series plots, and benefit and risk regression plots. The result of the project provides evidence for research and practice on the process of achieving more impact of programs based on administering pain self-management education to patients with chronic non-cancer pain who are currently on opioid therapy and on the process of customizing interventions that might take advantage of the conditions of behavior change driven by pain self-management messages. The tools and the evidences in this project are highly recommended to nurse practitioners primary care providers involve with providing care to the vulnerable groups of patient with chronic non-cancer pain. These evidences might inform the formation of self-management interventions that might lead to a decline in opioid use and prescription and accelerate the acceptance of self-management practices.
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Rice, Cameron R. "Review and Implementation of Orthopedic Patient Medication Education Best Practices." Wittenberg University Honors Theses / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=wuhonors162402923964133.
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Briggs-Bolling, Izetta Mounice. "Non Medical Prescription Drug use in Rural Communities and Social Work." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4424.
Анотація:
This study explored the roles and responsibilities of social workers providing services to nonmedical prescription drug users (NMPDU). Researchers have indicated NMPDU disproportionately affects people living in rural communities. The overarching research question sought to explore the concerns of social workers when providing services to patients coping with NMPDU in the rural community of Ulster County, New York. The intention was to examine systemic challenges facing rural social workers when attempting to decrease morbidity risks and increase the health of Ulster County residents. A total of 7 social workers participated in 3 focus groups to explore their ideas for defining, clarifying, and identifying solutions to the problem. The social exchange theory was used to frame the roles and responsibilities of social workers within rural communities at the macro, mezzo, and micro levels. Qualitative content analysis identified 5 themes: roles and responsibilities, barriers, education, treatment interventions, NMPDU and illicit substances of use. The results of the study included advocating for the fair and equitable distribution of resources for all residents coping with NMPDU in Ulster County, their responsibility to collaborate on pressing matters and educate physicians, community service providers, local legislators, individuals, and families of the warning signs and harmful effects of NMPDU. Findings may effect social change by enhancing the role of social workers by reducing overdose and death rates of NMPDUs.
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Samaila, Daniel. "Living Arrangements, Referral Source and Young Adult Admissions to Drug Treatment." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6660.
Анотація:
Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse and Mental Health Services Administration. Multiple logistic regression analyses were performed to test the hypotheses regarding a predictive relationship between independent living arrangement, the principal source of treatment referral, and admissions to treatment for abuse of opioid, heroin, and cocaine. The results showed a significant association between the source of treatment referrals and independent living arrangement, and the increased odds of admissions for prescription opioids use disorder, heroin use disorder, and cocaine use disorder among adults aged 18-34 living in the United States. The implication for positive social change included a need for a targeted treatment and other intervention programs for young adults' users with associated higher-risk treatment referral categories and exposed to neighborhoods factors and health-risk behaviors in reducing the crisis of drug abuse in the United States.
Книги з теми "Prescription opioid education":
1
Sullivan, Maria A. Conclusion. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199392063.003.0012.
Анотація:
Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.
Частини книг з теми "Prescription opioid education":
1
Morgan Snell, L., Andrew J. Barnes, and Peter Cunningham. "Epidemiology of Substance Use Disorders." In Substance Use Disorders, 3–28. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190920197.003.0001.
Анотація:
Nearly 3 million Americans have a current or previous opioid use disorder, and recent data indicate that 10.2% of US adults have ever misused pain relievers. In 2015, approximately 800,000 individuals used heroin, while 4 million misused prescription opioids. Although use of other drugs such as alcohol and cannabis is more prevalent, opioid use contributes to significant morbidity, mortality, and social and economic costs. While the current US opioid overdose epidemic began with prescription opioids, since 2015, heroin and synthetic opioids (e.g., fentanyl) have driven continued increases in opioid overdose deaths, contributing to a recent decline in overall life expectancy in the United States. Policies to address the opioid epidemic by changing clinical practice include provider education, monitoring prescribing practices, and expanding the clinical workforce necessary to treat opioid use disorders. The opioid epidemic appears to be largely a US phenomenon and a consequence of both structural challenges in the US healthcare system and growing socioeconomic disparities, and thus it will require policies including and beyond delivery system reforms to resolve it.
2
Pergolizzi, Joseph V., Jo Ann LeQuang, Flaminia Coluzzi, Dean Mariano, Andrew Nicolaou, and Christopher Gharibo. "Opioid therapy." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 416–23. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0040.
Анотація:
Opioid use disorder (OUD) is a prevalent condition associated with substantial morbidity, mortality, and healthcare utilization. Prescribers must rely on multiple tools and tactics to help reduce the risk of OUD. These include identification of risk factors for OUD and risk stratification, which must be individualized for each patient. Opioid diversion must be considered distinct from OUD and it has some unique risk factors. Aberrant drug-related behaviours may be observed in those taking opioids and may or may not suggest OUD; risk factors for OUD are dynamic. However, many aberrant drug-related behaviours may be harmless or misinterpreted. A variety of validated risk assessment tools are available to better quantify risk for OUD. An important factor in thwarting OUD remains patient and prescriber education as well as specialized resources such as patient–prescriber agreements, abuse-deterrent formulations of opioids, urine drug screens, and prescription drug monitoring programmes. There is no single, easy way to reduce OUD; instead, prescribers must be aware and make use of the many tools at their disposal to better pre-emptively identify those at elevated risk for OUD and to offer help to those who develop OUD over the course of prescribed opioid therapy.
3
Webster, Lynn R. "The Chilling Effect." In The Painful Truth. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190659721.003.0010.
Анотація:
“The Chilling Effect” takes a look at the issues surrounding opioids in our society today. An overzealous Drug Enforcement Administration is sometimes prosecuting the wrong physicians, thus creating a chilling effect in the medical community with regard to opioid prescription and making it harder for people in pain to get the help they need. Certainly there are serious risks that come with using opioids to treat pain. But the solution is not to use legislation and legal prosecution to hamper medical professionals who are doing their best for their patients. That approach is responsible for doing further harm to a population that is already hurting. The solution, instead, is to increase education about opioids while allowing physicians to use opioids according to the best knowledge and guidelines available at the time. Chapter key idea: Doctors have second thoughts about prescribing opioids when they know authorities are looking over their shoulders.