Author: Pollen Williamson

Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants 2015-2016

  From 1999 to 2015, the drug overdose epidemic resulted in approximately 568,699 deaths. In 2015, 52,404 drug overdose deaths occurred; 63.1% (33,091) involved an opioid. From 2014 to 2015, the age-adjusted opioid-involved death rate increased by 15.6%; the rapid increase in deaths was driven in large part by synthetic opioids other than methadone (e.g., fentanyl). What is added by this report? In 2016, there were 63,632 drug overdose deaths in the United States. Opioids accounted for 66.4% (42,249) of deaths, with increases across age groups, racial/ethnic groups, urbanization levels, and multiple states. Age-adjusted death rates for overdoses involving...

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Diagnostic Overshadowing, Frequent Flyer Icons and Implicit Bias

Dr. Jana Burson explores the idea of “diagnostic overshadowing” presented by an article in the Journal of the American Medical Association. She urges advocates of Medication Assisted Treatment to remain patient, yet persistent in educating their healthcare colleagues to help eliminate this stigma. In the JAMA article, the authors describe several examples of this bias, including at least one electronic medical record (EMR) system that includes an icon shaped like an airplane, as a way to inform treating physicians that the patient is a “frequent flyer.” This term has long been used to describe patients who repeatedly come to...

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NC CSRS Connects to Multi-State Data Sharing Network

Physicians and other controlled substances prescribers registered with the state’s prescription drug database now can see what medications their patients have received in other states. The North Carolina Medical Board shares what this means for providers and features the director of Duke Health’s Medical Pain Service, Steven D. Prakken, MD, presenting his thoughts on how this new capability fits in to clinical practice.   NCMB Article on NC CSRS Q&A with Dr....

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Overshadowed by the Opioid Crisis: A Comeback by Cocaine

The opioid epidemic shows no sign of abating, but opioids are not America’s only significant drug problem. Among illicit drugs, cocaine is the number 2 killer and claims the lives of more African-Americans than heroin does. For the most recent years of analysis (2012-15), the study found that deaths of men from heroin exceeded those from any other type of opioid, such as those found in pain medications. For women, deaths related to opioid medications were the most common. But among non-Hispanic black Americans, cocaine has been a larger problem than heroin for nearly 20 years. For example, over...

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Opioid Tapering for Outpatients with Chronic Pain

A study recently published in JAMA looked at solutions for patients and physicians to successfully reduce long-term prescription opioid dosages in settings without behavioral services. The risks associated with prescription opioids are well described. Although reducing opioid use is a national priority, existing opioid tapering models use costly interdisciplinary teams that are largely inaccessible to patients and their physicians. This study of voluntary, patient-centered opioid tapering in outpatients with chronic pain without behavioral treatment suggests that a substantial fraction of patients at a pain clinic may wish to engage in voluntary opioid tapering. The data collected challenged common notions...

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