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Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic. It is 30 to 50 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic, and Sublimaze, among others.
Naloxone, sold under the brand name Narcan among others, is an opioid antagonist, a medication used to reverse or reduce the effects of opioids. For example, it is used to restore breathing after an opioid overdose. Effects begin within two minutes when given intravenously, five minutes when injected into a muscle, and ten minutes as a nasal spray. Naloxone blocks the effects of opioids for 30 to 90 minutes.
A drug overdose is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically the term is applied for cases when a risk to health is a potential result. An overdose may result in a toxic state or death.
A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injection drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It is based on the philosophy of harm reduction that attempts to reduce the risk factors for blood-borne diseases such as HIV/AIDS and hepatitis.
Supervised injection sites (SIS) or drug consumption rooms (DCRs) are a health and social response to drug-related problems. They are fixed or mobile spaces where people who use drugs are provided with sterile drug use equipment and can use illicit drugs under the supervision of trained staff. They are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in risky drug use.
Driving under the influence (DUI) is the offense of driving, operating, or being in control of a vehicle while impaired by alcohol or drugs, to a level that renders the driver incapable of operating a motor vehicle safely. Multiple other terms are used for the offense in various jurisdictions.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Mitragyna speciosa is a tropical evergreen tree of the Rubiaceae family native to Southeast Asia. It is indigenous to Cambodia, Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where its leaves, known as kratom, have been used in herbal medicine since at least the 19th century. They have also historically been consumed via chewing, smoking, and as a tea. Kratom has opioid-like properties and some stimulant-like effects.
Cardinal Health, Inc. is an American multinational health care services company, and the 14th highest revenue generating company in the United States. Headquartered in Dublin, Ohio, the company specializes in the distribution of pharmaceuticals and medical products, serving more than 100,000 locations. The company also manufactures medical and surgical product, including gloves, surgical apparel, and fluid management products. In addition, it operates one of the largest networks of radiopharmacies in the U.S. Cardinal Health provides medical products to over 75 percent of hospitals in the United States.
The war on drugs is a global anti-narcotics campaign led by the United States federal government, including drug prohibition, foreign assistance, and military intervention, with the aim of reducing the illegal drug trade in the US. The initiative includes a set of drug policies that are intended to discourage the production, distribution, and consumption of psychoactive drugs that the participating governments, through United Nations treaties, have made illegal.
Drug courts are problem-solving courts that take a public health approach to criminal offending using a specialized model in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service, and treatment communities work together to help addicted offenders into long-term recovery. Instead of punishment, their purpose is to address one of the underlying drivers of crime and, in the process, reduce the use of imprisonment, potentially leading to substantial cost-savings. Drug courts aim to do this by incentivizing or mandating offenders into addiction treatment combined with frequent drug testing and regular monitoring by the judge.
Purdue Pharma L.P., formerly the Purdue Frederick Company (1892–2019), was an American privately held pharmaceutical company founded by John Purdue Gray. It was sold to Arthur, Mortimer, and Raymond Sackler in 1952, and then owned principally by the Sackler family and their descendants.
Crime rates in the state of Washington grew rapidly to large levels from 1960 to 1980, however slowed in growth from 1980 onward. Although the cause of this drop in crime growth from the 1980s cannot be directly determined, it was believed to have been a result from several law enforcement initiatives & policies implemented throughout the state of Washington and across the United States, such as abortion access.
The US federal government is an opponent of the illegal drug trade; however, state laws vary greatly and in some cases contradict federal laws.
Gregory Francis Murphy is an American politician and urologist representing North Carolina's 3rd congressional district in the U.S. House of Representatives since 2019. He served as a representative in the North Carolina General Assembly from 2015 to 2019.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. It has been described as "one of the most devastating public health catastrophes of our time." The opioid epidemic unfolded in three waves. The first wave of the epidemic in the United States began in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The second wave was from an expansion in the heroin market to supply already addicted people. The third wave, starting in 2013, was marked by a steep tenfold increase in the synthetic opioid-involved death rate as synthetic opioids flooded the US market.
A take-home naloxone program is a governmental program that provides naloxone drug kits to those that are at risk of an opioid overdose. Naloxone is a medication that was created to reverse opioid overdoses. As an opioid antagonist, it binds to the μ-opioid receptors blocking the opioid's effects. Naloxone quickly restores normal respiration. The ongoing opioid epidemic has caused many public health authorities to expand access to naloxone.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices. These new laws fell primarily into one of the following four categories:
- Prescription Drug Monitoring Program (PDMP) enrollment laws: prescribers must enroll in their state's PDMP, an electronic database containing a record of all patients' controlled substance prescriptions
- PDMP query laws: prescribers must check the PDMP before prescribing an opioid
- Opioid prescribing cap laws: opioid prescriptions cannot exceed designated doses or durations
- Pill mill laws: pain clinics are closely regulated and monitored to minimize the prescription of opioids non-medically
References
- ↑ DiFiore, Janet (2018). "New York State's Opioid Intervention Court". Trends in State Courts. 2018: 1.
- ↑ Thompson, Carolyn (2017-07-09). "Buffalo launches first opioid intervention court in U.S." CTVNews. Retrieved 2023-04-26.
- ↑ "Opioid court.pdf" (PDF). docs.google.com. Retrieved 2023-04-26.