Presentation
With the addition of a new introduction and two new chapters on heroin addiction and treatment since 1940, Courtwright has updated this compelling work of social history for the present crisis of the Drug War. [books.google.de]
[…] older and more likely to live in rural Australia than a decade ago Experts call for changes to where and how treatment is delivered in light of changing profile of people with dependence People at risk for problems with strong painkillers are likely to present [ndarc.med.unsw.edu.au]
The presentation of both opioid intoxication and withdrawal from opioids is widely variable. [clinicaladvisor.com]
I believe chronic pain patients present a greater challenge for several reasons, including maladaptive coping with ongoing pain complaints, fear of activity and debilitation, high incidence of untreated concurrent psychological problems, and, lastly, [paradigmcorp.com]
Drug-seeking behaviors may be very similar to those presented in patients with inadequately controlled pain. [practicalpainmanagement.com]
Entire Body System
- Weight Loss
Patients in need of moderate weight loss have historically been managed with various pharmacologics modalities. [omicsonline.org]
loss or dehydration secondary to vomiting, diarrhea, or poor feeding. 9 A variety of medications have been utilized for the treatment of NAS. [ppag.org]
Gastrointestinal
- Constipation
Their chief side effects are nausea/vomiting, sedation/respiratory depression, and constipation. The first two usually resolve with continued dosing. Constipation does not, so that patients on opioids need a continual bowel program. [jenniferschneider.com]
Opioids can produce significant side effects such as respiratory depression, mental clouding, nausea, constipation and physical dependence. Opioid prescribing has increased 300% in the last 20 years. [drugabuse.gov]
So while there is relatively rapid tolerance to the cognitive blunting effects of the opioid class of drug, tolerance to the constipating effects of opioids rarely occurs. 21 Concurrent diagnoses such as addiction or pseudoaddiction can be confirmed only [prescriberesponsibly.com]
Adams, writing in the Journal, reminded his colleagues that opiates were highly toxic, that their benefits were offset by side effects ranging from constipation to depression, and that they often led to addiction. [nejm.org]
[…] contributed to rising rates of prescription opioid use and misuse.( Institute of Medicine 2011, Doran 2008, Okie 2010, Moynihan 2002 ) A recent example of the normalization of chronic opioid use was a pharmaceutical industry advertisement for opioid-induced constipation [painandpsa.org]
- Abdominal Cramps
Abrupt cessation of these medications can produce a withdrawal syndrome that can include, but is not limited to, nausea, vomiting, diaphoresis, diarrhea, abdominal cramps, seizures, anhedonia, dysphoria, and in some cases, death. 20 Tolerance is also [prescriberesponsibly.com]
Use of opioid-antagonists concurrently with opioids often results in systemic withdrawal symptoms such as nausea, vomiting, diarrhea, diaphoresis, anxiety, and abdominal cramping. [omicsonline.org]
- Abdominal Pain
Grade two symptoms become more pronounced and include mydriasis, piloerection, muscle twitching, myalgias, arthralgias, and abdominal pain. [clinicaladvisor.com]
Eyes
- Miosis
A respiratory rate of 12 or less, with or without miosis and evidence of opioid abuse, is highly sensitive in predicting opioid overdose in the pre-hospital setting. [clinicaladvisor.com]
Psychiatrical
- Euphoria
Once patients experience euphoria, they seek escalating opioid doses to avoid dysphoria. [consultant360.com]
If they occurred in the absence of pain or involve analgesic use for purposes other than pain control (e.g., mood-altering effects and euphoria), they indicate true addiction [ 35 ]. [link.springer.com]
Euphoria and calmness are also commonly seen in opioid intoxication. [clinicaladvisor.com]
Introduction Detoxification from opiates has probably been a problem for as long as these drugs have been available for the relief of pain or the production of euphoria. [unodc.org]
[…] of 5 current heroin users state that addiction to opioid analgesics preceded their heroin use. ( Muhuri 2013 ) The reasons for the transition from prescription opioids to heroin vary, and include heroin’s easier availability, lower cost, or greater euphoria [painandpsa.org]
- Psychiatric Manifestation
Withdrawal can present from minutes to days of cessation of an opioid or the administration of an antagonist and can have a number of physical and psychiatric manifestations. [clinicaladvisor.com]
Treatment
“This can result in barriers to treatment access,” she says. “In particular some may be reluctant to come forward because of the stigma associated with traditional treatment for heroin dependence.” [ndarc.med.unsw.edu.au]
Some will need a more intensive treatment setting. Even individuals who were unsuccessful maintaining abstinence with outpatient treatment may achieve recovery in a more intensive treatment setting. [chicagotribune.com]
Evidence of iatrogenic harm after emergency treatment of heroin/opioid overdose. / Neale, Joanne ; Strang, John. In: Addiction, Vol. 110, No. 10, 01.10.2015, p. 1644-1652. [kclpure.kcl.ac.uk]
[…] the Narcotic Addict Treatment Act (NATA). [uspharmacist.com]
or refer the patient to a dependence treatment alternative. [apha.confex.com]
Prognosis
Advances in opioid treatment have greatly improved the prognosis for patients suffering from opioid addiction. [chicagotribune.com]
Prognosis and Patient Counseling. Overall relapse is high in patients with opioid dependence but this is exacerbated in patients who undergo detoxification without subsequent follow up treatment. [clinicaladvisor.com]
Etiology
It is important to remember that a need for increased doses may also represent a change in pain causes (new etiology, advancement of original process, etc.) requiring reassessment. [msu.edu]
[…] providers via a virtual clinical encounter where they can develop proper pain management and opioid risk assessment and intervention skills including: screening for pain treatment “red flags” and addiction history, full assessment and diagnosis of pain etiology [opioidrisk.com]
We know that for this segment of the population, iatrogenic benzo dependence will frequently compound and accelerate their addiction, and in some cases even be a causative factor in the etiology of their addiction. [madinamerica.com]
We know that for this segment of the population iatrogenic benzo dependence will frequently compound and accelerate their addiction and, in some cases, even be a causative factor in the etiology of their addiction. [beyondmeds.com]
Epidemiology
Each chapter is designed to provide a brief discussion of background infor- tion including epidemiology,risk factors,and staging principles followed by a description of standard therapies according to stage as well as current investigational approaches [books.google.de]
Although well studied in the paediatric population, little is known about the epidemiology, risk factors and optimal screening methods in adults. Studying this problem is essential as we strive to develop proper weaning strategies. [clinicaltrials.gov]
Breivik, Oslo University Hospital, Oslo, Norway Senior Editors Torsten Gordh, Uppsala Universitet, Uppsala, Sweden Troels Jensen, Aarhus University, Aarhus, Denmark Eija Kalso, Helsinki University Central Hospital, Helsinki, Finland Clinical Science and Epidemiology [scandinavianjournalpain.com]
Conclusions There is a high prevalence in the use of prescription opioids in the pediatric population (see the earlier section “Epidemiology of Opioid Use in the Pediatric Population”) for durations exceeding 1 week. [pediatrics.aappublications.org]
There have been 25 and five studies, respectively, on the epidemiology of opioid addiction in patients with chronic nonmalignant and chronic malignant pain. [consultant360.com]
Prevention
but does not prevent overdose itself. [painandpsa.org]
The influence of sociocultural factors on drug dependence and alcohol related problems-on their cause, development, and consequences as well as on their treatment and prevention-has been taken into account in the preparation of this manual in order to [books.google.de]
Finally, for individuals at high risk of relapse, new measures are in place to help prevent death in the event of accidental overdose. [chicagotribune.com]
On September 29-30, NIDA along with the NIH Pain Consortium, the NIH Office of Disease Prevention, and the National Institute of Neurological Disorders and Stroke is cosponsoring a Pathways to Prevention workshop to discuss what we know and don’t know [drugabuse.gov]
Prevention of opioid overdose Beyond approaches to reducing drug use in general in the community, specific measures to prevent opioid overdose include: increasing the availability of opioid dependence treatment, including for those dependent on prescription [who.int]