As health care providers lower opioid doses for pain patients to minimize the risk of addiction; increase doses to manage worsening pain; or re-start dosing after a period of time without opioid pain relievers, patients could be getting confused about safe dose levels, putting them at risk for overdose. A new study funded by the National Institute on Drug Abuse found that high dose variability increases the odds for an opioid overdose independent of dose alone. Even among patients receiving low doses of opioids, dose variability increases the risk of overdose.
The study followed long-term opioid therapy patients enrolled in Kaiser Permanente Colorado, from January 1, 2006 to December 31, 2017. The study matched 228 patients who had experienced an opioid overdose with 3,547 control patients who had not experienced an opioid overdose.
Results suggested that more dose variability correlates with a more than three-fold increase in overdose risk. The authors suggested patients in long-term opioid therapy are exposed to changes in dose for a variety of reasons, including worsened pain, practitioner-initiated tapers, changing physicians, missed appointments, poor adherence to urine toxicology screening, or travel. The periods of greatest risk could follow abrupt changes in dosage, such as resuming opioid use after a period with no pain reliever use, prompting patients to seek a dose that may heighten their risk for overdose. Alternatively, a dose reduction may cause patients to seek pharmaceutical opioids from other sources.
Full story at drugabuse.gov
The National Institute on Drug Abuse (NIDA) today announced the availability of informational resources for clinicians interested in initiating buprenorphine treatment in emergency department settings. Buprenorphine is one of several medicines available for use in many emergency departments to treat opioid use disorders (OUD). The materials were developed by emergency department specialists at Yale University with grant support from NIDA, and contract support from NIDA’s Clinical Trials Network. NIDA is part of the National Institutes of Health.
Emergency department clinicians face unique challenges when faced with patients suffering from opioid overdoses or other effects of OUD. They can often reverse overdoses using the medication naloxone, however, that medication alone does not constitute treatment for the addiction itself. This makes the emergency setting an ideal place for clinicians to begin treatment conversations with patients, however, there have been few tools available to guide them. Since 2002, emergency clinicians have been able to administer buprenorphine to help patients manage opioid withdrawal symptoms, but the practice is still new in many emergency department settings.
Full story at drugabuse.org
The National Institute on Drug Abuse (NIDA) announced that the latest Monitoring the Future (MTF) survey results on substance use trends as teens transition to adulthood are now available online, comparing substance use patterns of full-time college students to their non-college peers. Most notably, more than 13 percent of young adults not in college report daily, or near daily, marijuana use; alcohol use is more common among college students; some opioid use is declining in both groups, and the most sizeable difference is the higher rate of cigarette smoking in the non-college group.
Below are the highlights from the 2017 MTF survey results on drug use among college students compared to their peers not attending college (ages 19-22).
- Daily, or near daily,marijuana use among non-college young adults has continued to rise, reaching its highest level (13.2 percent). As a result, daily, or near daily, marijuana use is now nearly three times as high among non-college young adults as among college students.
Full story at drugabuse.org
Dan Kallen, a detective in southern New Jersey, was searching a home with fellow officers in August 2015, when they found a bag of white powder. Kallen removed a scoop of powder for testing. When he was done, he closed the bag, and a bit of air escaped, carrying a puff of powder with it. It was enough to send Kallen and a fellow officer to the emergency room.
The drugs in the bag had been spiked with fentanyl, a synthetic drug that, like heroin, is an opioid. But it is 50 times more potent than heroin — even a tiny amount inhaled or absorbed through the skin can be extremely dangerous or deadly. Kallen described his experience in a Drug Enforcement Agency video that warns first responders of the dangers of handling unknown powders.
Scientists from the National Institute of Standards and Technology (NIST) are working to address this hazard. In a paper published in Forensic Chemistry, they report that two technologies, Ion Mobility Spectrometry (IMS) and Direct Analysis in Real Time Mass Spectrometry (DART-MS), can detect trace amounts of fentanyl even when mixed with heroin and other substances.
Full story of Fentanyl danger to first responders at Science Daily
Nearly 70 percent of prescription opioid medications kept in homes with children are not stored safely, a new study by researchers at the Johns Hopkins Bloomberg School of Public Health finds.
In a national survey of 681 adults who used opioid pain relievers in the past year and had children ages 17 and younger living with them, only 31 percent reported safely storing them away from their children. Among those homes with children seven to 17 years old, just 12 percent reported safe storage.
The researchers defined safe storage as keeping the medication in a locked or latched place for homes with younger children and a locked place for homes with older children.
Full story of safely storing opioid medication in home at Science Daily