Upload File

an introduction on the rise of the opioid crisis in …...an introduction on the rise of the opioid...

  • Home
  • Documents
  • An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat
11
AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat Opioid Abuse Webinar October 26, 2017 Andy McLean, MD, MPH Clinical Professor and Chair Department of Psychiatry and Behavioral Sciences University of North Dakota School of Medicine and Health Sciences [email protected]

Upload: others

Post on 08-Jul-2020

0 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN

THE UNITED STATES.

North Dakota Initiatives for Best Practices to Combat Opioid Abuse Webinar

October 26, 2017

Andy McLean, MD, MPH

Clinical Professor and Chair

Department of Psychiatry and Behavioral Sciences

University of North Dakota School of Medicine and Health Sciences

[email protected]

mailto:[email protected]
Page 2: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

WHAT ARE OPIOIDS?

• Opiates- drugs derived from opium.

• Opioids- term previously used to describe synthetic opiates.

• Now it is common to refer to all as “opioids.”

Page 3: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

WHAT DO WE CALL THE PROBLEM?

A Crisis? “a situation that has reached a critical stage” (Webster’s)

An Epidemic? (regional contagion)

A Pandemic? (global) world hydrocodone use

(2010)

Page 4: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

HOW DID WE GET HERE?

• Focus on management of non-cancer pain

Marketing by pharmaceutical companies

Risk-benefit ratio based on inadequate information

New supply and demand-change back to “street”

Page 5: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

HOW DID WE GET HERE?

• The majority of prescribers are primary care providers

• Historically in our healthcare system, they have had neither the time, nor the staff to adequately

assess complex issues.

• While there are many non-medication treatments for conditions for which controlled substances are

often prescribed, the quick default is usually medication.

• Medicine IS moving toward reimbursement for outcomes, and there are incentives occurring for

screening and referral (SBIRT)

Page 6: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

CDC

Page 7: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

THE WORLD ACCORDING TO NIDA (NATIONAL INSTITUTE ON DRUG ABUSE)

• Roughly 1 out of every 4 individuals taking narcotics for chronic pain misuses them

• While the risk of developing an opioid use disorder from acute use is relatively low, for individuals

using narcotics for chronic pain, it is around 10%

• What is the risk of transitioning to heroin use after misusing prescription narcotics?

• 5% (so, based on the above, for every 1000 people prescribed narcotics for chronic pain, at least a

dozen will transition to heroin.)

• The odds that someone on heroin had at one time misused prescription narcotics?

• 4 out of 5

Page 8: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

PUBLIC HEALTH AND PREVENTION

• Primary Prevention: Preventing disease or injury before it occurs.

(legislation/enforcement; education; immunization, etc…)

• Secondary Prevention: Reducing the impact/harm of injury/disease that has

occurred: (screening, early detection, early intervention/treatment, etc…)

• Tertiary Prevention: Management of chronic disease

• Quaternary Prevention: Reducing iatrogenic causes

(i.e., avoiding inappropriate treatment…)

Page 9: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

FROM A SECONDARY AND TERTIARY PREVENTION STANDPOINT:

•Providers:

• Numbers:

• Types:

• Incentives

Page 10: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

COMPLEXITY- (NOT ONE DRIVER, NOT ONE SOLUTION)

Medical

Economic

Social

Page 11: An Introduction on the Rise of the Opioid Crisis in …...AN INTRODUCTION ON THE RISE OF THE OPIOID CRISIS IN THE UNITED STATES. North Dakota Initiatives for Best Practices to Combat

QUESTIONS? COMMENTS?


Combatting the Heroin and Opioid Crisis

Opioid and neuroHIV Comorbidity - Springer · the constant rise in deaths involving opioids, the U.S. Government declared the opioid crisis/epidemic a public health emergency in 2017

Trends in opioid abuse: Prescription opioid abuse and the … · 2017-12-01 · Trends in opioid abuse: Prescription opioid abuse and the resurgence of heroin Opioid Crisis Summit

opioid roadmap 08jun2018...Opioid Crisis Solutions Summit: A Roadmap for Action 1 Overview The growing crisis of opioid misuse, addiction, and overdose has had a devastating impact

Amidst the Opioid Crisis

The Opioid Crisis and its Effect on Texas

Opioid Crisis: Thinking Outside the Box

The Opioid Crisis and Educational Performance

Addressing the Opioid Crisis: Collaboration between a

Building Community Capacity to Address the Opioid Crisis

The Impact of the Opioid Crisis on the Healthcare System · 2The Impact of the Opioid Crisis on the Healthcare System ... 3The Impact of the Opioid Crisis on the Healthcare System

THE OPIOID CRISIS AND THE BLACK/AFRICAN …

Innovation Institutions and the Opioid Crisis

State Strategies for Addressing the Opioid Crisis · State Strategies for Addressing the Opioid Crisis The Opioid Crisis in Alabama: From Silos to Solutions March 10, 2017 Melinda

State Responses: Opioid Crisis and Substance Use Disorders

Opioid Overdose Crisis - Vancouver€¦ · Opioid Overdose Crisis Presentation to Vancouver City Council November 13, 2018 ... Opioid Use Disorder (Addiction) ... Source: Marlene

The Opioid Crisis: Next Steps - SAMHSA

Pharmacology and The Opioid Crisis

OPIOID CRISIS

Opioid Crisis: Our Schools and Our Students - Missouri ...moschoolcounselor.org/files/2019/10/The-Opioid-Crisis...Opioid Crisis: Our Schools and Our Students A Collaboration Between

The Oklahoma Opioid Crisis and SB1446

The Opioid Crisis - KHCA

Pain Management & the Opioid Crisis: Balancing Quality ...clevelandpainconference.com/wp-content/uploads/2018/02/Pain...& the Opioid Crisis: Balancing Quality & Patient Safety May

2017 State Targeted Response to the Opioid Crisis Grants · 2017 State Targeted Response to the Opioid Crisis Grants (Short Title: Opioid STR) DMHAS submitted its application to the

ANALYSIS ON ADDICTION AND OPIOID CRISIS: IMPLICATIONS …

Responding to the Opioid Crisis - NIEAPA - Home · Responding to the Opioid Crisis ... Pharmaceutical Company. Heinrich Dreser ... suppositories, oral solution, and injectables

Understanding and Addressing the Opioid Crisis

2/20/2017 Opioid Crisisdiscover.pbcgov.org/communityservices/humanservices/PDF/Flyers/… · Palm Beach County’s Approach to the Opioid Crisis 2/20/2017 Opioid Crisis Palm Beach

The Opioid Crisis - ahlamediaqa.blob.core.windows.net · The Opioid Crisis: Understanding the Complexities, Acknowledging the Challenges, ... Federal agencies also have increased

Opioid Courts and Judicial Management of the Opioid Crisis

Opioid Crisis Next Door: It’s Everybody’s Business

Stigma and the Opioid Crisis - Home | Mental Health ... · Canada is in the midst of an opioid crisis. In 2016, there were approximately 3,014 apparent opioid -related deaths in Canada,

REPORT The opioid crisis in America’s · PDF filethis first-of-its-kind study on opioid abuse by examining de-identified and anonymous health data reporting ... THE OPIOID CRISIS

Opioid Crisis Town Hall: Library Needs and Responses€¦ · Opioid Crisis Town Hall: Library Needs and Responses ... Rachel Fewell Central Library ... Opioid Crisis Town Hall: Library

HXR 2016: Addressing the Opioid Crisis