scholarly journals Communication of Recommendations for the Disposal of Unused Prescription Opioid Medications by Stakeholders in the News Media

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1711-1716 ◽  
Author(s):  
Megan L Petrik ◽  
Patrick J McNamara ◽  
Susan M Moeschler ◽  
Benjamin D Blair
Keyword(s):  
Health Care ◽  
Law Enforcement ◽  
Health Care Providers ◽  
News Media ◽  
Prescription Opioid ◽  
Environmental Harm ◽  
Prescription Opioids ◽  
Care Providers ◽  
Take Back ◽  
Opioid Medications

Abstract Objective The opioid epidemic is a national public health emergency that requires a comprehensive approach to reduce opioid-related deaths. Proper and timely disposal of unused prescription opioids is one method to deter improper use of these medications and prevent overdose. The objective of this study was to understand how recommendations for disposing of unused prescription opioids, including both take-back programs and toilet disposal, are communicated to the public. Methods Two hundred sixty-three US newspaper articles published between January 1, 2014, and June 30, 2017, containing information on opioids and take-back programs were found using LexisNexis. Using content analysis, articles were coded for the presentation of and recommendation for opioid disposal practices, beliefs about environmental harm from toilet disposal, and additional strategies to reduce opioid supply. The entity responsible for the statement was also captured. Results Take-back programs were presented as a recommended disposal strategy for unused prescription opioids in 88.6% of coded articles. Toilet disposal was presented as a recommended disposal strategy for unused prescription opioids in 3.4% of articles and as harmful to the environment in 16.0% of articles. Individuals from health care, government, and law enforcement were primarily involved in discussing opioid disposal practices. Conclusions Although toilet disposal is recommended by the US Food and Drug Administration (FDA) for disposal of unused prescription opioids when a take-back program is not readily available, it was infrequently presented or recommended in news media articles. These results highlight the importance of improving communication of FDA guidelines for opioid disposal in the media, particularly by health care providers, government employees, and law enforcement officials.

Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

2018 ◽  
Vol 52 (5) ◽  
pp. 405-414 ◽  
Author(s):  
Natalia Shcherbakova ◽  
Gary Tereso ◽  
Jacqueline Spain ◽  
Robert J. Roose
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Care Providers ◽  
Opioid Use ◽  
Treatment Persistence ◽  
Factors Associated ◽  
Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

Medical Care in a Police Intervention with Conducted Electrical Weapons: Zaragoza (Spain) Fire Department Protocol

2021 ◽  
pp. 1-6
Author(s):  
Armando Cester-Martínez ◽  
Leticia Serrano-Lasaosa ◽  
Diego Borraz-Clares
Keyword(s):  
Health Care ◽  
Law Enforcement ◽  
Health Care Providers ◽  
Medical Literature ◽  
Fire Department ◽  
Risk Groups ◽  
Clinical Effects ◽  
Care Providers ◽  
Law Enforcement Agencies ◽  
The Subject

Abstract In the last decade, conducted electrical weapons (CEWs) have become a new tool for law enforcement agencies as an alternative to firearms. They provide security in the intervention for both the police and the citizen and try to cause the least possible harm to the subject to immobilize. The health care providers who perform in joint actions with the police in which CEWs are used should be aware of how they work, risk groups, as well as the most frequent clinical effects associated with the application of electrical discharge, and the complications that can be produced according to the area of impact of the electrodes. For this purpose, the current medical literature was reviewed by consulting the main health care sciences database (PubMed) to determine the medical measures to be taken before, during, and after the use of these weapons. Also presented and shared is the Zaragoza (Spain) Fire Department protocol.

Hospital Consent for Disclosure of Medical Records

1998 ◽  
Vol 26 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Jon F. Merz ◽  
Pamela Sankar ◽  
Simon S. Yoo
Keyword(s):  
Health Care ◽  
Child Abuse ◽  
Law Enforcement ◽  
Patient Care ◽  
Health Care Providers ◽  
Medical Records ◽  
General Rule ◽  
Care Providers ◽  
Bodily Harm ◽  
Prior Consent

Physicians and other health care providers owe ethical and legal duties to patients to maintain the secrecy of the information learned during the course of patient care. This obligation is fulfilled by limiting access to such information to only those involved in the patient's care-that is, to those within the “circle of confidentiality.” As a general rule, providers may only disclose to others with the written prior consent of the patient. Exceptions may be “ethically and legally justified because of overriding social considerations,” when permitted or compelled by law. For example, eleven states permit providers to disclose identified records to approved researchers.’ Many states compel disclosure in cases where a patient threatens serious bodily harm to another; require reporting to health or law enforcement authorities of communicable diseases, gunshot or knife wounds, or child abuse; and mandate reporting of cancer or other health care cases to state registries (such as immunization, birth, and abortion).

scholarly journals Optimizing Opioid Abuse Prevention Strategies: Role of Pharmacist in Safe Dispensing

2021 ◽  
pp. 259-267
Author(s):  
M. Anusree ◽  
Pravina Mohan ◽  
P. Reshma ◽  
Zuhara Mariyam
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Opioid Abuse ◽  
Drug Misuse ◽  
Health Concern ◽  
Care Providers ◽  
Substance Addiction ◽  
Medical Practitioners ◽  
Take Back ◽  
Red Flag

Misuse, violence, and distribution of opioids are also a public health concern. Pharmacists are at the forefront of the health-care response to the opioid epidemic because they have more opportunities to engage with patients than primary care or specialist medical practitioners. Because of these situations, pharmacists have more chances to provide proper prevention advice and reinforce proper opioid drug usage. Understanding dosage restrictions, learning how to use prescription drug monitoring programmes, knowing when drug take-back programmes are taking place, and advising consumers about the dangers of substance addiction are both techniques that pharmacists should be informed about. Recognising "red flag" actions that may suggest opioid abuse; using tests to determine a patient's risk of opioid abuse; collaborating with other health-care providers to plan a patient's treatment; knowing how abuse-deterrent antidepressants function and what they can't do. Pharmacists can help mitigate substance misuse and improve patient outcomes by implementing these techniques. All patients who require legitimate and effective pain management through the use of opioids must have access to them. While further study is needed in a variety of areas, pharmacists may make efforts today to follow proposed recommendations, rules, and legislation to reduce drug misuse and diversion of restricted drugs.

Human Trafficking: First Responders in Health Care

2021 ◽  
Vol 48 (4) ◽  
pp. 349-367
Author(s):  
Elizabeth Peffer Talbot ◽  
Yumi E. Suzuki
Keyword(s):  
Health Care ◽  
Law Enforcement ◽  
Human Trafficking ◽  
Health Care Providers ◽  
Health Care Workers ◽  
First Responders ◽  
School Nurses ◽  
Care Providers ◽  
First Responder ◽  
Care Workers

This article addresses the problems first responders encounter when attempting to identify and rescue survivors of human trafficking. Research indicates that 87.8% of women who escape captivity report they saw a health care provider at least once during captivity. This makes health care providers a critical first responder partner. First responders include law enforcement officers, health care providers, school nurses, and faith-based organizations. Health care workers are most likely to encounter survivors while in captivity. Multi-disciplinary collaborations between health care workers and law enforcement provide increased opportunities to share knowledge and recognize signs of human trafficking in patients. Theoretical paradigms have been used to analyze and anticipate changes in criminal activity and identify victims. Multi-disciplinary teams have developed a check-list of behaviors typical of captives and a questionnaire that illuminates captivity. The article further comments on the reported impact of COVID 19 on the health care’s system ability to recognize victims. It presents the many contributions of school nurses and the faith community to the first responder movement.        

scholarly journals Effects of prescription drug diversion, misuse and abuse on the health system in eThekwini District, KwaZulu-Natal, South Africa: Key stakeholders’ perceptions

2019 ◽  
Author(s):  
Buyisile Chibi ◽  
Tivani P Mashamba-Thompson
Keyword(s):  
Health Care ◽  
Law Enforcement ◽  
Health System ◽  
Prescription Drug ◽  
Health Care System ◽  
Health Care Providers ◽  
Care Providers ◽  
Drug Diversion ◽  
Key Stakeholders ◽  
Care System

Abstract Background: Prescription drug diversion, misuse and abuse is a growing health threat negatively impacting the health care system and individuals globally. Most research has been conducted in high-income-countries. Little is known about prescription drug diversion, misuse and abuse to support anecdotal reports in resource-limited settings. Purpose: The main objective of this study is to determine prescription drug diversion, misuse and abuse practices in eThekwini district from the perspective of the health care providers, law enforcement, pharmacists, drug users and people living with HIV. Methods: Semi-structured in-depth-interviews were conducted between June-December 2018 among key stakeholders who were purposively sampled in eThekwini district. Thematic analysis was used to identify emergent themes around practices of prescription drug diversion, misuse and abuse. Results: Five main themes emerged during the interviews: manifestation of drug diversion; consumer’s attitude and behaviour; availability of medicines; gaps in the health care system; and lastly challenges and barriers to drug abuse treatment. Accidental addiction, health system gaps and consumer’s attitude and behaviours were perceived as significant contributing factors to the problem therefore negatively impacting health care providers and consumers. Conclusion: The study highlights the emerging practices of prescription drug diversion, misuse and abuse as a serious growing problem occurring through legal and illegal channels to anyone since the addictive medicines are readily available and easily accessible. We recommend a collaborative approach to address prescription drug diversion since the prescriber, dispenser, consumer and law enforcement are involved in the cycle to drug usage.

scholarly journals Transforming Prescription Opioid Practices in Primary Care With Change Theory

2021 ◽  
Vol 14 ◽  
pp. 117863292110582
Author(s):  
Rob E. Carpenter ◽  
Dave Silberman ◽  
Jody K Takemoto
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Change Theory ◽  
Primary Care Providers ◽  
Opioid Therapy ◽  
Prescription Opioid ◽  
Opioid Epidemic ◽  
Care Providers ◽  
Health Crisis

The opioid epidemic continues to be an ongoing public health crisis. Many primary health care providers aptly serve as the gatekeeper to opioid prescriptions. The opioid epidemic has challenged the primary care profession whilst many of these providers have opted out of opioid prescribing altogether. This unintended consequence affirms erosion to primary care that is vital to the ecosystem of opioid management. The purpose of this study was to understand strategies to deliver opioids safely and effectively. Results indicate primary care providers are uniquely positioned to make a positive opioid impact through focused change initiatives. Five common themes arose from the inductive analysis: (1) provide leadership support; (2) define standard of work; (3) conduct pre-visit reviews; (4) conduct post-visit reviews; and (5) measure progress. Then, each common theme was deductively analyzed through a view of Kotter’s change theory to support an effective proxy for implementing and sustaining chronic opioid therapy in a primary care context. These finding have potential to provide actionable implications for health care management professionals and primary care organizations such as hospitals and group practices.

scholarly journals Prevention of Pediatric Pharmaceutical Poisonings

2017 ◽  
Vol 12 (2) ◽  
pp. 117-119 ◽  
Author(s):  
Nicole D. White ◽  
William Kibalama
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Prescription Drug ◽  
Health Care Providers ◽  
Care Providers ◽  
Childhood Injury ◽  
Prescription Drug Use ◽  
Take Back ◽  
Unused Medications

Pediatric poisoning remains a common, preventable childhood injury and incidence is on the rise. Child-resistant packaging has been shown to prevent pharmaceutical poisoning, but must be applied and used appropriately to be effective. Prescription drug use among adults is also increasing and may be contributing to the problem through a greater number of medications in the child’s environment. Drug take back programs are designed to reduce the number of unused medications in the home. These programs are expanding and health care providers should be aware of and encourage safe drug disposal practices.

scholarly journals County and Demographic Differences in Drug Arrests and Controlled Substance Use in Maine

2020 ◽  
Author(s):  
Trajan F Hyde ◽  
Amadea D Bekoe-Tabiri ◽  
Amalie K Kropp Lopez ◽  
Luis G Devia ◽  
Belsy D Gutierrez ◽  
...  
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Law Enforcement ◽  
Health Care Providers ◽  
Oral Morphine ◽  
Additional Treatment ◽  
Care Providers ◽  
Demographic Differences ◽  
Alert Program ◽  
Drug Arrests

Introduction: The Diversion Alert Program (DAP) was established to curb the misuse of drugs and help identify people in need of substance use disorder (SUD) treatment. Law enforcement compiled arrest data into a database accessible by health care providers. The objectives of this investigation were to identify regional and demographic differences in drug use and misuse in Maine. Methods: All arrests (N=11,234) reported to the DAP from 2013 to 2018 were examined by county, arrestee demographics, and classified into families (opioids, stimulants, sedatives). The Automation of Reports and Consolidated Orders System (ARCOS) tracks the distribution of controlled pharmaceuticals (schedule I-V). Opioids were converted to oral morphine mg equivalents (MME). County and zip-code heat maps were constructed. Results: The counties with the most arrests per capita were Cumberland, Androscoggin, and Penobscot. Opioids were the most common drug class in arrests in all counties except Aroostook, where stimulants were most common. Medical distribution of opioids varied. With the exception of buprenorphine, which doubled, many prescription opioids like hydrocodone, fentanyl, and oxymorphone exhibited large (>50%) reductions. Methadone was the predominant opioid statewide (56.4% of the total MME) although there were sizeable differences (Presque Isle=8.6%, Bangor=78.9%) and this is likely impacted by use for SUD treatment. Amphetamine distribution increased by 67.9%. Conclusions: The DAP was useful to prevent information silos and enhance communication between law enforcement and health care providers. Maines DAP was a unique system to identify patients in need of additional treatment resources. The increase in prescription stimulants may warrant continued monitoring.

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