HealthDay Reporter

MONDAY, Sept. 26, 2022 (HealthDay News) — Biking whereas stoned results in 1000’s of great crashes every year, a brand new examine suggests.

Between 2019 and 2020 alone, greater than 11,000 individuals have been handled in U.S. emergency rooms for accidents that occurred as they rode a bicycle whereas excessive on methamphetamine, marijuana or opioids, researchers discovered.

“The individuals affected by these accidents probably have substance use dysfunction, could also be extra more likely to be homeless and should not have entry to different sorts of transportation,” defined lead researcher Bart Hammig, a professor of public well being on the University of Arkansas in Fayetteville. “This is an usually neglected and ignored inhabitants when addressing severe accidents associated to bicycle crashes.”

One strategy to curb these crashes is to get these drugged people off their bikes, he mentioned.

“Better and simpler entry to transportation for individuals who could use bicycles as their principal mode of transportation is required so as to help within the prevention of accidents amongst this inhabitants,” he mentioned. “In addition to remedy of accidents, drug referral methods should be readily accessible in emergency departments.”

Hammig and his University of Arkansas colleague Robert Davis, an assistant professor of public well being, discovered that bicyclists who crashed whereas excessive usually had extra severe accidents than those that weren’t utilizing medication.

Most of these injured have been males (86%), in accordance with the examine. Of these, 22% had damaged bones; 19% injured inside organs; and virtually 33% needed to be hospitalized. In all, 1% suffered a concussion.

Some probably resulted in deaths, however as a result of the information got here from emergency room data, researchers could not report on fatalities.

The commonest medication discovered have been methamphetamine (36%); marijuana (32%); and opioids (19%). Nearly 1 / 4 of injured bikers had additionally been consuming alcohol, the examine discovered.

For the examine, researchers used knowledge from the National Electronic Injury Surveillance System. Of greater than 480,000 accidents reported between 2019 and 2020, about 3% concerned medication.

Dr. Eugene Vortsman, an emergency room doctor at Long Island Jewish Medical Center in New Hyde Park, N.Y., mentioned that using a motorbike stoned can enormously enhance the chance for crashes and severe damage.

He suspects that the variety of crashes recognized within the examine is simply the tip of the iceberg.

“Due to the restrictions in knowledge, this examine is underestimating the true severity of the incidence, in addition to the severity of damage related to any intoxicant,” Vortsman mentioned. “Even with the information out there, it’s clear that the chance of damage is elevated.”

More examine is required to study bikes for main transportation and to search out methods to decrease the chance, Vortsman mentioned.

Some examples embrace evaluating social elements affecting well being to higher earmark sources. Improving entry to public transportation, higher roadside security measures, and training in regards to the risks of working any mode of transportation whereas below the affect are key, he mentioned.

“Proper training permits sufferers to higher perceive their danger of damage and may present a safer street for them in addition to different bicyclists,” Vortsman mentioned.

The examine was just lately printed on-line within the Journal of Studies on Alcohol and Drugs.

More data

For extra about drug abuse, go to the U.S. Substance Abuse and Mental Health Services Administration.

SOURCES: Bart Hammig, PhD, MPH, professor, well being, human efficiency and recreation, University of Arkansas, Fayetteville; Eugene Vortsman, DO, emergency room doctor, Long Island Jewish Medical Center, New Hyde Park, N.Y.; Journal of Studies on Alcohol and Drugs, Aug. 1, 2022

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TUESDAY, Sept. 20, 2022 (HealthDay News) — As opioid overdose deaths proceed to soar, a Canadian program factors to 1 method to save lives: offering “safer” opioids to individuals at excessive threat of overdose.

That’s the conclusion of a research evaluating Canada’s first formal “safer opioid provide,” or SOS, program. Such applications purpose to forestall overdoses by giving susceptible individuals an alternative choice to the more and more harmful road provide of opioids.

In this case, the London, Ontario-based program supplied shoppers with a each day dose of prescription opioid tablets, in addition to primary well being care, counseling and social providers.

The end result was a fast drop in emergency division journeys and hospitalizations among the many 82 shoppers studied, the researchers discovered. And over six years, there was not a single overdose loss of life.

“I believe this can be a landmark research,” stated Thomas Kerr, director of analysis on the British Columbia Centre on Substance Use, in Vancouver, Canada.

Kerr, who was not concerned within the research, acknowledged that SOS applications are controversial and have their critics. Concerns have included the opportunity of opioid capsules being bought, or individuals crushing the tablets and injecting them, which carries the chance of overdose or an infection.

But criticisms of safer provide have been made within the absence of knowledge, Kerr stated.

“The complete dialog has been clouded by misinformation,” he stated. “When we’re speaking about issues of life and loss of life, we won’t depend on individuals’s opinions.”

Kerr stated he hoped the brand new findings “will mute a number of the misinformation.”

The research was printed Sept. 19 within the CMAJ (Canadian Medical Association Journal). Itcomes amid an ever-worsening opioid epidemic.

In the United States, opioid overdose deaths have been on the rise for years, and the scenario worsened after the pandemic hit. In 2020, almost 92,000 Americans died of a drug overdose — largely involving opioids, in accordance with the U.S. Centers for Disease Control and Prevention.

The disaster has primarily been pushed by illegally made variations of the painkiller fentanyl, an artificial opioid that’s 50 instances stronger than heroin, well being officers say. Illicit fentanyl is bought in varied varieties, together with capsules made to appear to be different prescription opioids. It’s additionally generally combined into different unlawful medicine, like cocaine and heroin, to spice up their efficiency. The result’s that customers are sometimes unaware they’re taking fentanyl.

Safer provide applications are based mostly on the precept of hurt discount — that overdoses, infections and different penalties of opioid dependancy could be prevented, with out requiring individuals who misuse medicine to be utterly abstinent.

The new findings come from a program begun in 2016 at London InterCommunity Health Centre. It offers shoppers with hydromorphone (Dilaudid) tablets, disbursed each day, in addition to many different providers — together with main well being care, remedy for infections like HIV and hepatitis C, counseling, and assist with housing and different social providers.

The researchers, led by Tara Gomes, of Unity Health Toronto, checked out knowledge on all 94 shoppers who entered this system between 2016 and March 2019. They in contrast 82 of these individuals towards 303 people identified with opioid dependancy who didn’t participate in this system.

Over one 12 months, the research discovered, emergency division visits and hospitalizations fell amongst program shoppers, whereas remaining unchanged within the comparability group. And whereas shoppers had treatment prices — lined by Ontario’s prescription drug plan — their yearly well being care prices outdoors of main care plunged: from about $15,600, on common, to $7,300.

Again, there was no substantial change within the comparability group.

Dr. Sandra Springer is an affiliate professor at Yale School of Medicine, in New Haven, Conn., who has helped craft apply pointers for the American Society of Addiction Medicine.

“This research is additional proof that applications that meet sufferers the place they’re and supply easy accessibility to medical look after remedy of opioid use dysfunction can save extra lives and scale back well being care prices,” stated Springer, who was not concerned within the analysis.

Opioid dependency itself could be handled with medication-assisted remedy, which entails counseling and medicines like buprenorphine, methadone and naltrexone.

“While this SOS program didn’t present conventional medicines for the remedy of opioid use dysfunction to all members, these medicines have been out there to sufferers by means of this system,” Springer famous.

And, she stated, different analysis has proven that when individuals who use medicine are provided “compassionate care,” they’re extra prone to settle for “evidence-based remedy.”

The extent to which SOS applications will unfold stays to be seen. In 2020, Health Canada introduced funding for a number of extra pilot applications. And final 12 months, New York City opened two overdose prevention websites — the place individuals with opioid dependancy can use the medicine in a clear, supervised setting, and be related with well being care and social providers.

The websites are the primary publicly acknowledged overdose prevention facilities within the United States.

Kerr stated that within the face of an opioid disaster that’s solely worsening, “the established order response isn’t ample.”

“We need to strive new approaches,” he stated, “and scientifically consider them.”

         
         More info        

The U.S. National Institute on Drug Abuse has extra on opioid use dysfunction.

SOURCES: Thomas Kerr, PhD, director, analysis, British Columbia Centre on Substance Use, professor, social medication, University of British Columbia, Vancouver, Canada; Sandra Springer, MD, affiliate professor, medication, Yale School of Medicine, New Haven, Conn.; CMAJ, Sept. 19, 2022, on-line

The post Saving Lives With ‘Safer Opioids’ appeared first on Healthy and Slim Life.

WEDNESDAY, May 11, 2022 (HealthDay News) — Could giving surgical procedure sufferers ready-to-use mailed disposal kits for unused opioids decrease the chance of abuse of the medicine?

Yes, claims a brand new research that discovered sufferers with unused opioid ache drugs are more likely to eliminate them correctly when given the kits.

There’s a danger that leftover opioid drugs could also be misused by the individual they had been prescribed to or by others. If they’re put within the trash, they may very well be discovered by youngsters or animals, or could hurt the surroundings. Flushing them down the bathroom additionally poses environmental dangers, the researchers defined.

There are secure disposal websites, comparable to sure pharmacies, however sufferers usually do not use them as a result of they might be out of the best way or it takes additional effort.

In this research, University of Pennsylvania researchers assessed whether or not mailed secure disposal kits would possibly make a distinction.

The research included 235 sufferers who had been prescribed opioid painkillers after orthopedic or urologic procedures. The typical process was adopted for about half of the sufferers, who had been texted directions to eliminate their unused drugs together with a hyperlink to places of native secure disposal websites.

The different sufferers obtained the identical textual content message however had been mailed disposal kits 4 to seven days after their procedures.

Leftover opioids had been disposed of correctly by 60% of those that obtained the disposal package, in contrast with 43% of the sufferers who did not obtain the kits, the investigators discovered.

Some research present that solely about 20% to 30% of U.S. sufferers correctly eliminate unused opioid drugs, so these findings counsel that mailed disposal kits might double or triple that fee, based on the authors of the research revealed on-line May 6 in JAMA Network Open.

The researchers famous that using mailed disposal kits by 125 sufferers within the research resulted within the secure disposal of 480 unused opioid drugs.

“I used to be happy to see that such a easy, ‘snail mail’ method might change conduct and promote self-reported disposal,” mentioned research lead creator Dr. Anish Agarwal, an assistant professor of emergency medication and chief wellness officer of the division of emergency medication at Penn Medicine.

“The opioid epidemic clearly continues to be entrance and heart for sufferers, and the considerations with opioid use and misuse have gotten an actual a part of the dialog between physicians and sufferers,” Agarwal added in a college information launch. “I feel sufferers are extra conscious of the dangers and penalties of utilizing opioids and storing them of their properties.”

More info

For extra on the secure disposal of medication, go to the U.S. Department of Health and Human Services.

SOURCE: University of Pennsylvania, information launch, May 6, 2022

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MONDAY, April 4, 2022 (HealthDay News) — Efforts to chop again on dangerous opioid use for ache after surgical procedure are trickling right down to youngsters.

New analysis reveals that fewer Americans beneath the age of 18 have been prescribed narcotics to deal with surgical ache between 2014 and 2017, and these numbers dropped much more quickly starting in late 2017.

While opioids can assist youngsters handle gentle or reasonable ache, latest research have proven that youngsters do exactly as properly with restricted or no opioids. Additionally, opioids carry their justifiable share of dangers for youths, together with respiratory despair (gradual and shallow respiration) and the potential for abuse. The U.S. Centers for Disease Control and Prevention just lately urged medical doctors to prescribe different ache medicine every time doable in an effort to assist stem the nationwide epidemic of opioid use and overdose deaths.

“Our findings recommend that surgical suppliers are prescribing fewer opioids for procedures the place they may not be wanted,” stated research writer Dr. Tori Sutherland, an attending anesthesiologist at Children’s Hospital of Philadelphia. “If applicable in your youngster, nonsteroidal anti-inflammatory medicine [NSAIDs] like ibuprofen might be pretty much as good or higher than opioids for procedures related to gentle to reasonable ache, like dental surgical procedure or adenoidectomy,” stated Sutherland.

For the research, Sutherland’s staff tapped into insurance coverage information on greater than 124,000 youngsters youthful than 18 who underwent certainly one of eight surgical procedures between 2014 and 2019, together with tonsillectomies, dental surgical procedures, appendix elimination or knee surgical procedure.

The total proportion of youngsters who had an opioid prescription stuffed within the week after their surgical procedure dropped throughout adolescents, school-aged youngsters, and preschool-aged youngsters throughout the five-year research interval.

Broken down by age group, prescriptions dropped from simply over 78% to 48% for adolescents, from practically 54% to 25.5% amongst school-aged youngsters, and from about 30% to 11.5% for preschool-aged youngsters, the investigators discovered.

What’s extra, the typical morphine milligram equal declined by roughly 50% throughout all three age teams. (Morphine is an opioid ache killer.)

Parents ought to ask about non-opioid alternate options if their youngsters are having probably painful surgical procedure, Sutherland stated.

“If the process is related to gentle to reasonable ache, and they’re allowed to take an NSAID [or Tylenol], they may not want opioids most often,” she stated. “For main surgical procedures requiring an inpatient keep, mother and father can focus on with their medical doctors if alternate options, like a nerve block or non-opioid medicines, may be applicable.”

The research was revealed on-line April 4 within the journal Pediatrics.

Dr. Lorraine Kelley-Quon is a pediatric surgeon at Children’s Hospital, Los Angeles. She has studied opioid use amongst youngsters prior to now.

“This research provides much-needed epidemiologic information outlining how opioid prescribing practices have modified in recent times for youngsters present process surgical procedure,” stated Kelley-Quon, who was not concerned with the brand new analysis. “Parents ought to proceed to interact their surgeons and well being care suppliers in discussions about find out how to safely use, retailer and eliminate prescription opioids when wanted and choices for non-opioid ache reduction methods.”

More info

The American Academy of Pediatrics presents ideas for fogeys on find out how to handle a baby’s ache after surgical procedure.

SOURCES: Tori Sutherland, MD, attending anesthesiologist, Children’s Hospital of Philadelphia; Lorraine Kelley-Quon, MD, pediatric surgeon, Children’s Hospital, Los Angeles; Pediatrics, April 4 2022, on-line

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TUESDAY, March 22, 2022 (HealthDay News) — Medical marijuana might be a viable various to opioid painkillers for individuals coping with arthritis or persistent again ache, two new research present.

Many sufferers prescribed opioids for his or her persistent ache wound up taking fewer painkillers — or stopping them altogether — after docs licensed them for medical hashish, stated lead researcher Dr. Asif Ilyas, an orthopedic surgeon at Rothman Orthopaedic Institute in Philadelphia.

“We discovered broadly a big discount in opioid use after they began utilizing medical hashish,” Ilyas stated. “We noticed a lower in roughly 40% of opioid use after beginning medical hashish, with 37% to 38% of sufferers utterly discontinuing opioid use altogether.”

If validated, these outcomes point out that medical marijuana might be a possible technique of combating America’s opioid epidemic, which has been pushed partly by prescription painkillers, stated Dr. Stuart Fischer, an orthopedic surgeon with Summit Orthopaedics and Sports Medicine in Summit, N.J.

“We have an enormous variety of people who find themselves on opioids who’re being handled for persistent again ache,” stated Fischer, who wasn’t a part of the research. “If we may transfer that inhabitants to one thing that is safer however simply as efficient, we might do very effectively.”

For the research, Ilyas and his colleagues recruited 186 sufferers with persistent again ache and 40 sufferers with persistent arthritis ache.

Between February 2018 and July 2019, docs licensed the sufferers to buy medical marijuana within the state of Pennsylvania. The sufferers have been allowed to make use of pot as they selected — some vaped or smoked, whereas others used edibles.

Doctors then tracked the sufferers’ opioid painkiller use for six months utilizing a state-run prescription drug monitoring database, and utilizing an opioid measurement referred to as morphine milligram equivalents (MME):

• Average every day opioid prescriptions for arthritis sufferers declined throughout the research interval, falling from 18.2 to 9.8 MME.
• Back ache sufferers additionally expertise a discount of their common every day opioid prescriptions, from 15.1 to 11 MME.
• About 37% of arthritis sufferers and 38% of again ache sufferers give up opioid painkillers altogether.

Patients in each teams skilled a discount of their ache signs and an enchancment of their bodily well being.

Medical hashish additionally does not seem to hold the identical danger of habit as opioid painkillers, Ilyas added.

“One of the largest central issues with opioids is each habit and the necessity for greater dosages to realize the identical outcomes,” Ilyas stated. “Based on our present understanding of medical hashish, you don’t want rising doses to realize the identical outcomes and we’re not but seeing any addictive qualities to it.”

These outcomes present contemporary proof for the potential to deal with ache with medical pot, Fischer stated.

“Obviously these research are early. Medical marijuana has not been in public use for all that lengthy, so we’d like extra knowledge and we’d like extra research. We want extra data,” Fischer continued. “Nonetheless, these two research are a really, excellent begin.”

More analysis is required, partly, to persuade insurance coverage firms to cowl the price of medical pot as they do prescription opioids, the specialists stated.

“One of the largest obstacles to utilization is value,” Ilyas defined. “It’s fairly costly, and there is not any insurance coverage protection for it at the moment, even with non-public carriers.”

Ilyas stated his future analysis will concentrate on how advantages differ, relying on the kind of medical hashish product, and completely different supply strategies.

“We wish to emphasize this appears very promising, however we’re very early in our understanding of this. More investigation is required,” Ilyas stated.

Ilyas introduced outcomes from the 2 research on the annual assembly of the American Academy of Orthopedic Surgeons, happening this week in Chicago. Information introduced at conferences needs to be thought of preliminary till revealed in a peer-reviewed journal.

More data

The Mayo Clinic has extra about medical hashish.

SOURCES: Asif Ilyas, MD, orthopedic surgeon, Rothman Orthopaedic Institute, Philadelphia; Stuart Fischer, MD, orthopedic surgeon, Summit Orthopaedics and Sports Medicine, Summit, N.J.; March 22-26, 2022 displays, American Academy of Orthopedic Surgeons, annual assembly, Chicago

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TUESDAY, Nov 23, 2021 (HealthDay News) — Addictive opioid painkillers aren’t the one choice for sufferers searching for aid following anterior cruciate ligament (ACL) knee reconstruction, researchers say.

As the United States wrestles with skyrocketing charges of opioid abuse and drug overdose deaths, the findings might come as excellent news.

After ACL surgical procedure, Advil and different nonsteroidal anti-inflammatory medication (NSAIDs), acetaminophen (Tylenol) and muscle relaxers seem to supply the identical diploma of ache management to sufferers as prescription opioids like morphine, hydrocodone or oxycodone, the small research concluded.

“Opioid medicines could be useful in managing excessive ranges of ache when appropriately prescribed,” defined research co-author Dr. Kelechi Okoroha. He is an orthopedic surgeon and sports activities damage specialist with the Mayo Clinic in Minneapolis.

“However, when used for lengthy durations of time, opioids could be addicting,” Okoroha cautioned. And “when used incorrectly, or in excessive doses, opioids can have unintended effects, together with drowsiness, confusion, slowed respiratory and even demise.”

Drug overdose deaths within the United States are at an all-time excessive, the U.S. Centers for Disease Control and Prevention reported this month — 100,000 drug-related fatalities between April 2020 and April 2021. This represents a 30% leap over the prior 12 months. And greater than three-quarters of those deaths have been attributed to opioid use alone.

For many individuals, opioid habit begins with reputable prescription painkiller use after surgical procedure. Orthopedic and backbone circumstances account for practically 28% of all opioid prescriptions issued within the United States, the analysis staff mentioned in background notes. That has led consultants to hunt safer technique of minimizing post-surgical discomfort.

ACL surgical procedure is a standard operation, and “knee surgical procedure could cause excessive ranges of ache,” Okoroha mentioned.

But the excellent news is that the brand new research exhibits that “with applicable multimodal administration, we will make this ache tolerable,” whereas eliminating opioid use, he added.

The findings have been printed on-line lately within the American Journal of Sports Medicine.

For the research, Okoroha’s staff examined their ache administration protocol with 34 sufferers who underwent ACL surgical procedure between February 2019 and January 2020.

All have been provided opioid-free ache medicines post-op, together with NSAIDs, acetaminophen and muscle relaxers. Pain ranges 10 days after ache therapy started have been in contrast with these of 28 different sufferers handled with an opioid medicine.

The investigators decided that ache aid was the identical throughout each teams, with no considerable variations by way of unintended effects (habit threat apart), even after accounting for age, gender and physique mass index (a typical indicator of weight problems standing).

The findings do not shock one knowledgeable who was not a part of Okoroha’s research staff.

“I’ve truly had each of my ACLs reconstructed, so I do know the related ache effectively,” mentioned Dr. David Katz, director of the Yale University Prevention Research Center, in New Haven, Conn. “I consider I used opioids for a day or two each instances, after which rapidly transitioned to non-opioid therapy.”

That therapy went past medicine. “An automated, cooling compress across the surgical web site offered the best aid,” mentioned Katz.

“Based on private expertise, I’m not in any respect stunned that opioids could be omitted from the routine, whereas preserving comparable ache administration,” he added.

Nevertheless, Katz expressed some reservations in regards to the present research’s strategy.

“The routine on this research doesn’t impress me all that a lot, to be brutally sincere,” he mentioned. “It avoids opioids, which could be dangerously habit-forming, however features a benzodiazepine (Valium), which could be dangerously habit-forming. And there is no such thing as a point out of non-medication choices, such because the cooling compress I described,” Katz famous.

“As the positioning begins to heal, there’s a case for mild therapeutic massage as effectively. Truly ‘multimodal’ ache aid isn’t just completely different medicines. It ought to embrace non-medication choices that work, too,” he steered.

Still, Katz did not dismiss the work solely. “In normal, opioids are overused, whereas plenty of persistent ache is undertreated. So there may be definitely a must broadcast any advance that may assist tackle these twin threats,” he mentioned.

More info

There’s extra on opioids and associated dangers on the U.S. Centers for Disease Control and Prevention.

SOURCES: Kelechi R. Okoroha, MD, orthopedic surgeon and sports activities damage specialist, division of sports activities drugs, Mayo Clinic, Minneapolis; David Katz, MD, MPH, director, Yale University Prevention Research Center, New Haven, Conn.; American Journal of Sports Medicine, Oct. 20, 2021, on-line

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