Matching Items (12)

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Systematic Literature Review of Prescription Drug Monitoring Programs

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Prescription opioid abuse has become a serious national problem. To respond to the opioid epidemic, states have created prescription drug monitoring programs (PDMPs) to monitor and reduce opioids use. We

Prescription opioid abuse has become a serious national problem. To respond to the opioid epidemic, states have created prescription drug monitoring programs (PDMPs) to monitor and reduce opioids use. We conducted a systematic literature review to better understand metrics used to quantify the effect that PDMPs have had on reducing opioid abuse, and solutions and challenges related to the integration of PDMPs with EHRs. Lessons learned can help guide federal and state-based efforts to better respond to the current opioid crisis.

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  • 2018-05

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Evaluating the Effectiveness of Opioid Legislation in the United States

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To address and evaluate opioid legislation in the United States and its effectiveness in combating the opioid epidemic.
This paper will assess current and past legislation, on both the

To address and evaluate opioid legislation in the United States and its effectiveness in combating the opioid epidemic.
This paper will assess current and past legislation, on both the state and federal level, in terms of its effectiveness by cross-examining it with existing data. This paper also examines failures on the state and federal levels to properly target at-risk groups. Furthermore, this paper makes recommendations for future legislation to properly allocate resources to localities most affected by the opioid epidemic, and contribute to the decrease in opioid-related overdose deaths.

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  • 2020-05

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Monitoring the Rise of Methamphetamine use Amidst the Opioid Epidemic in Two U.S. Cities via Wastewater-based Epidemiology

Description

The combined use of methamphetamine and opioids has been reported to be on the rise throughout the United States (U.S.). However, our knowledge of this phenomenon is largely based upon

The combined use of methamphetamine and opioids has been reported to be on the rise throughout the United States (U.S.). However, our knowledge of this phenomenon is largely based upon reported overdoses and overdose-related deaths, law enforcement seizures, and drug treatment records; data that are often slow, restricted, and only track a portion of the population participating in drug consumption activities. As an alternative, wastewater-based epidemiology (WBE) has the capability to track licit and illicit drug trends within an entire community, at a low cost and in near real-time, while providing anonymity to those contributing to the sewer shed. In this study, wastewater was collected from two Midwestern U.S. cities (2017-2019) and analyzed for the prevalence of methamphetamine and the opioids oxycodone, codeine, fentanyl, tramadol, hydrocodone, and hydromorphone. Monthly 24-hour time-weighted composite samples (n = 48) from each city were analyzed using isotope dilution liquid chromatography tandem mass spectrometry. Results showed that methamphetamine and total opioid consumption (milligram morphine equivalents) in City 1 were strongly correlated only in 2017 (Spearman rank order correlation coefficient, ρ = 0.78), the relationship driven by fentanyl, hydrocodone, and hydromorphone. For City 2, methamphetamine and total opioid consumption were strongly positively correlated during the entire study (ρ = 0.54), with the correlations driven by hydrocodone and hydromorphone. In both cities, hydrocodone and hydromorphone mass loads were highly correlated, suggesting a parent and metabolite relationship. WBE provides important insights into licit and illicit drug consumption patterns in near real-time as they evolve; important information for community stakeholders in municipalities across the U.S.

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Date Created
  • 2020-05

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Relationship Selling in the Pharmaceutical Industry: Impact of the Opioid Crisis

Description

702,000 and counting. That is the estimated figure of deaths related to drug overdoses from 1997-2017 reported by the CDC. Almost 70% of those deaths can be attributed to prescribed

702,000 and counting. That is the estimated figure of deaths related to drug overdoses from 1997-2017 reported by the CDC. Almost 70% of those deaths can be attributed to prescribed or illicit opioids. Many have been quick to place blame and unsurprisingly no one seems to be coming forward to take responsibility. What was the cause of this crisis? A current lawsuit against Purdue Pharma alleges that they are responsible for not only starting but continuing the crisis. (Strickler 2019) One of the initial indications of how the crisis started was due to unprofessional and deceptive sales tactics. Along with this, there have been many unethical practices involving advertising of various pharmaceutical products to exacerbate the issue. These practices range from general advertising to holding conferences with Doctors. Considering how many different parties are involved with the production, sale, prescription, and use of these products I find it difficult to place blame on one party. I wanted to specifically research how sales representatives build trust and relationships with their clients within this industry and how the crisis itself has impacted these relationships. The majority of my research consists of the foundation of relationships, different types of relationships, and how to build and maintain productive relationships. Relationships can be difficult, especially in a professional sales environment because each party typically has their own interests throughout each interaction. By understanding how professional relationships can be built we can aim to avoid a crisis like this in the future, and ultimately save lives because of it.

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Date Created
  • 2020-05

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Health & Wealthness Podcast

Description

“Health and Wealthness” is a podcast where your hosts, Emily Weigel and Hanaa Khan, discuss pressing and trending topics about health and wealth that everyone should know about. Our thesis

“Health and Wealthness” is a podcast where your hosts, Emily Weigel and Hanaa Khan, discuss pressing and trending topics about health and wealth that everyone should know about. Our thesis focuses primarily on the opioid epidemic - the science and business sides.

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  • 2021-05

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Health & Wealthness Podcast

Description

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first four episodes focus on the opioid crisis. Both the science and healthcare sides. We then go on to talk about burnout and mental health in a conversational episode.

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Date Created
  • 2021-05

Provider Satisfaction with Chronic Opioid Therapy (COT) Delivery after EHR Transition at a Community Internal Medicine Clinic

Description

With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at

With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at Mayo Clinic initiated a COT program in September of 2017, during the<br/>use of Cerner Electronic Health Record (EHR) system. Study metrics included provider<br/>satisfaction and perceptions regarding opioid prescription. Mayo Clinic transitioned its EHR<br/>system from Cerner to Epic in October 2018. This study aims to understand if provider perceptions<br/>about COT changed after the EHR transition and the reasons underlying those perceptions.

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Date Created
  • 2021-05

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An Examination of Chronic Pain and Opioid Use Among Veterans with and without Alcohol Use Disorder

Description

Chronic pain is devastating and highly prevalent among Veterans in the United States (Johnson, Levesque, Broderick, Bailey & Kerns, 2017). While there are various treatment options for chronic pain, opioids

Chronic pain is devastating and highly prevalent among Veterans in the United States (Johnson, Levesque, Broderick, Bailey & Kerns, 2017). While there are various treatment options for chronic pain, opioids remain high in popularity. Although opioids are fast-acting and effective, potential consequences range from unpleasant side effects to dependence and fatal overdose (Baldini, Korff & Lin, 2012; Park et al., 2015; Kaur, 2007). The effects of opioid treatment can be further complicated by a history of alcohol abuse. Past alcohol abuse is a risk factor for opioid misuse (McCabe et al., 2008). One alternative to opioid medication is Cognitive Behavioral Therapy for Chronic Pain (CBT-CP). CBT-CP has shown small to moderate effects on chronic pain after the end of treatment (Naylor, Keefe, Brigidi, Naud & Helzer, 2008). The current study examined the effect of CBT-CP on opioid prescriptions, as well as the role of past alcohol abuse in CBT-CP efficacy, through an archival data analysis of Veterans Affairs patient charts. In order to determine the effect of CBT-CP on opioid prescriptions, an opioid change score was calculated from treatment start date to twelve months post-treatment. An analysis of 106 patient charts demonstrated no statistically significant difference in opioid prescriptions between Veterans who were referred and attended treatment (n = 24) and those who were referred but did not attend (n = 82). Veterans from both groups showed a reduction in prescribed opioids during a 12-month period. Furthermore, there was no statistically significant difference between Veterans with versus without a history of alcohol abuse in terms of the change in opioid prescriptions over a 12-month period (both groups showed reductions). This research suggests that opioid prescriptions may decrease over time among Veterans referred for CBT-CP, even among those who do not participate in the groups. More work is needed to understand the relationship between opioid prescriptions and actual opioid use over time among Veterans who do and do not choose to participate in CBT-CP. Continuing to address poly-substance use in chronic pain patients also is critical to ensure that Veterans suffering from chronic pain receive appropriate intervention.

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  • 2019-05

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Effects of Heroin on Prosocial Behavior in Rats and its Modulation by the Anterior Insula

Description

Opioid use rates and related deaths continue to be a public health crisis; while there are many contributing factors to opioid use disorders, criteria for diagnosis include problems related to

Opioid use rates and related deaths continue to be a public health crisis; while there are many contributing factors to opioid use disorders, criteria for diagnosis include problems related to social functioning. Previous research indicates that laboratory rats, which are frequently used as animal models of addiction-related behaviors, are capable of prosocial behavior. The following collection of studies were performed to determine the effects of heroin on prosocial behavior in rats, as well as the role of the insula in both self-administration of heroin and prosocial behaviors. All of the experiments were conducted utilizing an established model of prosocial behavior in rats in which a performing rat releases a cagemate from a restrainer. The occurrence of and latency to free the confined rat was recorded. After baseline rescuing behavior was established, rats were allowed to self-administer heroin (0.06 mg/kg/infusion i.v.), and subsequent experimental conditions were imposed.

Experimental conditions, in a series of different studies, included comparing heroin reinforcers with sucrose, chemogenetically modulating the insular cortex (both stimulatory and inhibitory processes) and administering excitotoxic lesions in the insula. There were significant differences in saving behaviors between heroin and sucrose groups demonstrating an opioid induced loss of prosocial behavior. Modulating the insula chemogenetically resulted in some restoration of these opioid related deficits, and insular lesions did not significantly impact prosocial behaviors, however, there were significant differences between rates of heroin intake in lesioned animals versus non-lesioned controls. Taken together, these results demonstrate the deleterious effects of heroin on prosocial behaviors and offer further support for the role of the insula in both addiction and social constructs.

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  • 2020

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Genetic influences on the dynamics of pain and affect in fibromyalgia

Description

Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread pain, fatigue, and a variety of other comorbid physiological and psychological characteristics, including a deficit of positive affect. Recently, the

Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread pain, fatigue, and a variety of other comorbid physiological and psychological characteristics, including a deficit of positive affect. Recently, the focus of research on the pathophysiology of FM has considered the role of a number of genomic variants. In the current manuscript, case-control analyses did not support the hypothesis that FM patients would differ from other chronic pain groups in catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genotype. However, evidence is provided in support of the hypothesis that functional single nucleotide polymorphisms on the COMT and OPRM1 genes would be associated with risk and resilience, respectively, in a dual processing model of pain-related positive affective regulation in FM. Forty-six female patients with a physician-confirmed diagnosis of FM completed an electronic diary that included once-daily assessments of positive affect and soft tissue pain. Multilevel modeling yielded a significant gene X environment interaction, such that individuals with met/met genotype on COMT experienced a greater decline in positive affect as daily pain increased than did either val/met or val/val individuals. A gene X environment interaction for OPRM1 also emerged, indicating that individuals with at least one asp allele were more resilient to elevations in daily pain than those homozygous for the asn allele. In sum, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM.

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Date Created
  • 2011