From June 2018 JAMA Between 2001 and 2016, the number of opioid-related deaths in the United States increased by 345%, from 9489 to 42 245 deaths (33.3 to 130.7 deaths per million population). By 2016, men accounted for 67.5% of all opioid-related deaths, and the median (interquartile range) age at death was 40 (30-52) years. The… Read More
From May 1, 2018 LA Times and JAMA The U.S. opioid crisis has passed a dubious milestone: Overdose deaths involving synthetic opioids like illicit fentanyl have surpassed deaths involving prescription opioids. This switch occurred in 2016, according to data published Tuesday in the Journal of the American Medical Assn. And it seemed to happen pretty suddenly. Data from the National… Read More
The FDA approved on November15, 2017 a new type considered a “first-in-class” electric neurostimulation device to relieve symptoms of opioid withdrawal. The NSS-2 Bridge device is a small, battery-powered electrical nerve stimulator that is placed behind a patient’s ear and emits electrical pulses to stimulate branches of certain cranial nerves. Patients can use the device… Read More
This is potentially a landmark study published in the October 18, 2017 issue of JAMA Psychiatry that looks at whether a monthly injection of naltrexone (Vivitrol (TM)) is as effective as daily buprenorphine-naloxone (Suboxone(TM)). This study concluded that in the short-term Monthly naltrexone shots (Vivitrol) worked as well as daily buprenorphine/naloxone (Suboxone) for treating opioid… Read More
This article takes an interesting look at whether the “reputation” of your medical school affects your propensity to write opiate prescriptions. This paper published July 7, 2017 by economics professors at Princeton University (seems like some Harvard bias), determined that physicians who studied at “lower-ranked” medical schools prescribe nearly three times as many opioids per… Read More
This CDC link and publication shows opiate prescribing rates by county and state. Interesting to see the discrepancies from county to county and state to state. Here are the highlights of the data After a steady increase in the overall national opioid prescribing rate from 2006, the total number of prescriptions dispensed peaked in 2012… Read More
THis JAMA Internal Medicine article concludes that states that have medical marijuana have lower opiate overdose death rates. It is no secret that the number of patients with noncancer pain who receive opiate prescriptions has nearly doubled in the past decade. As this has occurred, the number of opiate overdoses and deaths has similarly peaked. … Read More
Interesting JAMA article by Emergency Physician Esther Choo regarding the likely transition of opiate use/abuse to marjiuana use/abuse. With the current nationwide epidemic of opioid abuse, dependence, and fatalities, clinicians are being asked by federal agencies and professional societies to control their prescribing of narcotic medications for pain. Federal guidelines emphasize tapering, discontinuing, and limiting… Read More
Opiate abuse is a nationwide epidemic. We are constantly looking for solutions One might be using buprenorphine implants. This study in JAMA found that the implants were as successful as sublingual buprenorphine/naloxone in maintaining clinical stability in opioid-dependent patients. During the 6-month study period, 63% of patients in the buprenorphine implant group and 54% of… Read More
