(Press-News.org) PHILADELPHIA – Two reports by addiction researchers at the University of Pennsylvania School of Medicine and the National Institute on Drug Abuse show a drastic shift in prescribing patterns impacting the magnitude of opioid substance abuse in America. The reports, published in JAMA, recommend a comprehensive effort to reduce public health risks while improving patient care, including better training for prescribers, pain management treatment assessment, personal responsibility and public education.
The JAMA Research Report shows that there has been a drastic increase in opioid prescriptions while prescriptions for non-steroidal anti-inflammatory drugs (NSAIDs) have gone down. Prescriptions for hydrocodone and oxycodone account for 84.9 percent of opioid prescriptions. Over ten years, there has been a fivefold increase in admissions to substance abuse programs for opioid addiction.
While effective at reducing pain symptoms, opioid medications such as hydrocodone and oxycodone are associated with high rates of abuse, particularly among young adults. One in four 18-25 year olds will abuse prescription pain killers in their lifetime.
Researchers suggest targeting the relatively high rate of prescriptions to adolescents and young adults, who received 11.7 percent of the 202 million opioid prescriptions in the United States during 2009. A large share of the prescriptions to young adults was from dentists, and researchers believe there is a need for medical professionals to evaluate alternative pain medications in this particularly vulnerable age group.
"The scope of the problem is vast – opioid overdose is now the second leading cause of accidental death in the United States and the prevalence is second only to marijuana," said Thomas McLellan, PhD, co-author of the studies and director of the new Center for Substance Abuse Solutions, housed in the Department of Psychiatry at the University of Pennsylvania School of Medicine. "This study provides valuable information about factors contributing to the high rates of opioid analgesics, and identifies areas ripe for intervention."
In the accompanying Commentary, researchers offer recommendations to improve current pain management in primary care while simultaneously decreasing diversion, abuse and overdoses of opioid medication. These recommendations include:
Comprehensive and contemporary training for pain management care providers –including physicians, nurses, dentists and pharmacists – covering the latest research advances on pain and addiction and new drug treatment options.
Supporting the American Pain Society guidelines, which include plans to develop and roll out screening procedures for those at risk for abuse and dependence (e.g. adolescent or young adults, individual or family history of substance abuse history.)
Increasing public awareness and responsibility of the addiction risks, to curb sharing or theft of the medication within families.
The research was conducted by The National Institute on Drug Abuse, of the National Institutes of Health, while Dr. McLellan was serving as Deputy Director of the United States Office of National Drug Control Policy.
Penn Medicine researchers are already looking into possible solutions to address these issues. Dr. McLellan leads the new Center for Substance Abuse Solutions that will translate addiction research into evidence-based practical applications to be used locally, nationally and globally.
Collaborators from the Penn Pain Medicine Center will partner with Penn's Center for Substance Abuse Solutions and Department of Internal Medicine to develop a "Patient-Centered Medical Home" care model for patients with chronic pain problems. This new process integrates care provided by primary care physicians and specialists in an effort to provide high-quality, comprehensive care to patients. New health care information technology, such as electronic health care records and Internet-based collection of patient outcomes, will be used to improve coordination of care. Researchers hope that Patient-Centered Medical Home model will improve pain care and lower the chances of diversion and abuse of pain medications.
"The research published today clearly demonstrates the risk of harm that pain medications can cause when used incorrectly," said Michael Ashburn, MD, MPH, MBA, professor of Anesthesiology and Critical Care and director of Pain Medicine at the University of Pennsylvania School of Medicine. "We hope our efforts will demonstrate that improvements can be made to the patient care process and lead to improved pain control and a lower risk of abuse and diversion of these medications."
###
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4 billion enterprise.
Penn's School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools and among the top 10 schools for primary care. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $507.6 million awarded in the 2010 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania – recognized as one of the nation's top 10 hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania Hospital – the nation's first hospital, founded in 1751. Penn Medicine also includes additional patient care facilities and services throughout the Philadelphia region.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2010, Penn Medicine provided $788 million to benefit our community.
END
In an unprecedented collaborative analysis published in the journal PLoS Biology, scientists from 49 nations demonstrated that the ability of reef fish systems to produce goods and services to humanity increases rapidly with the number of species. However, growing human populations hamper the ability of reefs to function normally, and counterintuitively, the most diverse reef fish systems suffer the greatest impairments from stressors triggered by human populations. The study documented that the extent of this distress is widespread and likely to worsen because 75% of the ...
Making DNA sequences being passed through nanochannels a thousand times thinner than a human hair to the point that they take on the form of diminutive spaghetti. This is an innovative technique, known as DNA stretching, and is one of the lines of research in which CIC microGUNE is working, and about which they have already published two scientific articles and are shortly to apply for a patent. The technique basically consists of the analysis of a single molecule of DNA, after stretching it, measuring its length and analysing its sequence.
This novel technology could ...
Paris is a traditional focal point of the celebrations on Labour Day, known as La Fete du Travail in France.
Everything in the city closes except the Eiffel Tower on May 1st, with parades and demonstrations taking place around the Place de la Bastille.
Across Paris, the exchanging of lily of the valley is a well-known custom on La Fete du Travail.
Florists throughout the French capital stock up on the flower in the days running up to the public holiday, as it is traditionally passed between friends and family members as a token of good luck.
Individual traders ...
WINSTON-SALEM, N.C. – April 5, 2011 – Despite a growing number of cities instituting smoking bans across the country, hookah bars are cropping up everywhere – from chic downtown cafes to locations near college campuses, where they've found a loyal customer base in young adults.
A new study done by researchers at Wake Forest Baptist Medical Center sheds light on the increasingly popular pastime, and the results are discouraging.
"The popularity of hookah smoking among young adults is quite alarming given the potential for negative health effects," said Erin L. Sutfin, ...
As our bodies form, cells within the embryo divide and separate. Certain cells come together to form the outer layer, or ectoderm, of the early embryo, and give rise to tissue such as the skin and nervous system (spine, peripheral nerves and brain). Other cells come together to form the mesoderm or middle layer of the embryo, and eventually give rise to tissue like muscle, heart or bone. Once cells have been assigned to the different regions – mesoderm or ectoderm – a mysterious mechanism draws boundaries between them that mark their permanent separation. Any defect in ...
Zucchero, one of the Italian music industry's biggest stars, is set to perform in Paris next month.
The artist's show at the Zenith de Paris on Thursday May 12th will see him play songs from his latest LP Chocabeck, which was released last year.
Born Adelmo Fornaciari, Zucchero has sold more than 40 million albums and won the hearts of fans around the world with his blend of rock, blues and gospel music.
In a career spanning four decades, he has built up an international profile by collaborating with artists such as Joe Cocker, Stevie Ray Vaughan and Eric Clapton.
Zucchero ...
A stellar cast has been assembled for the new West End production of George Bernard Shaw's classic play Pygmalion.
Due to open at the Garrick Theatre on Thursday May 12th, the show will feature former EastEnders actress Kara Tointon as Eliza Doolitte and Rupert Everett as Professor Henry Higgins.
Tointon, who spent four years playing Dawn Swann on the popular BBC1 soap and recently won Strictly Come Dancing, is set to make her West End debut in the production.
Dame Diana Rigg was also recently added to the cast, with the 72-year-old former star of The Avengers ...
That the thyroid can be affected and that the kidneys in rare cases can be damaged are known side-effects of medication with lithium. Female patients who become pregnant are also advised against taking medicine containing lithium, as the substance can affect the foetus.
"The amounts of lithium that the Latin American women are ingesting via their drinking water are perhaps a tenth of what a patient would take daily for bipolar disorder. But, on the other hand, they are absorbing this lithium all their lives, even from before birth", says occupational and environmental ...
It's been a puzzle why our two closest living primate relatives, chimpanzees and bonobos, have widely different social traits, despite belonging to the same genus. Now, a comparative analysis of their brains shows neuroanatomical differences that may be responsible for these behaviors, from the aggression more typical of chimpanzees to the social tolerance of bonobos.
"What's remarkable is that the data appears to match what we know about the human brain and behavior," says Emory anthropologist James Rilling, who led the analysis. "The neural circuitry that mediates ...
Katie Melua is set to play live at the HMV Hammersmith Apollo in London on Thursday May 5th.
The 26-year-old singer's performance in the capital will come in the midst of a major European tour that began in Germany last month.
Melua released her fourth studio album The House in May 2010 and is now playing songs from the LP to audiences across the continent.
Produced by William Orbit, the record features tracks written with Guy Chambers and reached number four in the UK albums chart.
The artist was born in the former soviet republic of Georgia and spent several ...
