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Methadone, sold under the brand names Dolophine and Methadose among others, is a synthetic opioid agonist used for chronic pain and also for opioid use disorder. It is used to treat chronic pain, and it is also used to treat addiction to heroin or other opioids. Prescribed for daily use, the medicine relieves cravings and removes withdrawal symptoms. Withdrawal management using methadone can be accomplished in less than a month, or it may be done gradually over a longer period of time, or simply maintained for the rest of the patient's life. While a single dose has a rapid effect, maximum effect can take up to five days of use. After long-term use, in people with normal liver function, effects last 8 to 36 hours. Methadone is usually taken by mouth and rarely by injection into a muscle or vein.
Woonsocket, is a city in Providence County, Rhode Island, United States. The population was 43,240 at the 2020 census, making it the sixth largest city in the state. Being Rhode Island's northernmost city, Woonsocket lies directly south of the Massachusetts state line and constitutes part of both the Providence metropolitan area and the larger Greater Boston Combined Statistical Area.
Naloxone 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.
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.
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection, as a skin patch (transdermal), or as an implant. For opioid use disorder, the patient must have moderate opioid withdrawal symptoms before buprenorphine can be administered under direct observation of a health-care provider.
Sally L. Satel is an American psychiatrist based in Washington, D.C. She is a lecturer at Yale University School of Medicine, a visiting professor of psychiatry at Columbia University, a senior fellow at the American Enterprise Institute, and an author.
Abdol Hamid Ghodse CBE was an academic in the field of substance abuse and addiction.
Emergent BioSolutions Inc. is an American multinational specialty biopharmaceutical company headquartered in Gaithersburg, Maryland. It develops vaccines and antibody therapeutics for infectious diseases and opioid overdoses, and it provides medical devices for biodefense purposes.
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.
Drug detoxification is variously construed or interpreted as a type of "medical" intervention or technique in regards to a physical dependence mediated by a drug; as well as the process and experience of a withdrawal syndrome or any of the treatments for acute drug overdose (toxidrome). The first definition however, in relation to substance dependence and its treatment is arguably a misnomer and even directly contradictory since withdrawal is neither contingent upon nor alleviated through biological excretion or clearance of the drug. In fact, excretion of a given drug from the body is one of the very processes that leads to withdrawal since the syndrome arises largely due to the cessation itself and the drug being absent from the body; especially the blood plasma, not from ‘leftover toxins’ or traces of the drug still being in the system.
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone. This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing. Other symptoms include small pupils, and unconsciousness; however, its onset can depend on the method of ingestion, the dosage and individual risk factors. Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.
Herbert David Kleber was an American psychiatrist and substance abuse researcher. His career, centered on the evidence-based treatment of addiction, focused on scientific approaches in place of punishment and moralisms. His career focused on pathology of addiction to help patients reduce the severe discomforts of withdrawal, avoid relapse and stay in recovery.
Acetylfentanyl is an opioid analgesic drug that is an analog of fentanyl. Studies have estimated acetylfentanyl to be 15 times more potent than morphine, which would mean that despite being somewhat weaker than fentanyl, it is nevertheless still several times stronger than pure heroin. It has never been licensed for medical use and instead has only been sold on the illicit drug market. Acetylfentanyl was discovered at the same time as fentanyl itself and had only rarely been encountered on the illicit market in the late 1980s. However, in 2013, Canadian police seized 3 kilograms of acetylfentanyl. As a μ-opioid receptor agonist, acetylfentanyl may serve as a direct substitute for oxycodone, heroin or other opioids. Common side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially fatal respiratory depression. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.
Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone. It is used to treat opioid use disorder, and reduces the mortality of opioid use disorder by 50%. It relieves cravings to use and withdrawal symptoms. Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek.
Robert McKinnon Califf is an American cardiologist who currently serves as the 25th Commissioner of the Food and Drug Administration.
The California State Legislature passed an act to amend Section 1714.22 of the Civil Code, relating to drug overdose treatment in 2014. California Assembly Bill 1535 (2014) delegated the authority to all properly licensed California state pharmacists who had undergone a training program of at least one hour of continuing education about the pharmacology of naloxone hydrochloride to dispense naloxone under standards developed by the Medical Board of California in conjunction with the California Society of Addiction Medicine, the California Pharmacists Association, and any other appropriate entities.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States 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 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.
Scott E. Hadland is a Canadian-American physician and scientist who serves as a pediatrician, and addiction specialist at Massachusetts General Hospital and Harvard Medical School, where he is the Chief of the Division of Adolescent and Young Adult Medicine. He previously served as an addiction specialist at the Grayken Center for Addiction at Boston Medical Center.
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
- 1 2 "Biography - Dr Stuart Gitlow". Archived from the original on 2019-01-13. Retrieved 2019-01-12.
- ↑ "Stuart Gitlow, MD, MPH, MBA, DFAPA". American Society of Addiction Medicine . Retrieved 2014-07-30.
- ↑ "Excessive Video Gaming May Not Be An Addiction". Emaxhealth.com. 2007-06-26. Retrieved 2011-02-01.
- ↑ https://www.asam.org/docs/default-source/pressreleases/michael-miller-elected-to-ama-council-of-science-and-public-health_2014-06-16_.pdf [ bare URL PDF ]
- 1 2 "Physician Profile - Open Payments Data - CMS | CMS Open Payments Data". OpenPaymentsData.CMS.gov. Retrieved 2020-08-14.
- ↑ Woonsocket Patch article, Sept. 5, 2012
- ↑ "City doctor's home, office raided by FBI". 19 March 2018.
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