Engaging pharmacogenomics in pain management and opioid selection

2021 ◽  
Author(s):  
David R Bright ◽  
Natasha Petry ◽  
Eric Roath ◽  
Tyler Gibb
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Economic Research ◽  
Successful Implementation ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
And Training ◽  
Legal And Ethical Issues

Opioid misuse and mismanagement has been a public health crisis for several years. Pharmacogenomics (PGx) has been proposed as another tool to enhance opioid selection and optimization, with recent studies demonstrating successful implementation and outcomes. However, broad engagement with PGx for opioid management is presently limited. The purpose of this Perspective is to highlight a series of barriers to PGx implementation within the specific context of opioid management. Areas of advancement needed for more robust pharmacogenomic engagement with opioids will be discussed, including clinical and economic research needs, education and training needs, policy and public health considerations, as well as legal and ethical issues. Continuing efforts to address these issues may help to further operationalize PGx toward improving opioid use.

scholarly journals Opioids and Infectious Diseases: A Converging Public Health Crisis

2019 ◽  
Vol 220 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Tara A Schwetz ◽  
Thomas Calder ◽  
Elana Rosenthal ◽  
Sarah Kattakuzhy ◽  
Anthony S Fauci
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Opioid Use Disorder ◽  
Soft Tissue Infections ◽  
Opioid Use ◽  
Therapeutic Approaches ◽  
Predisposing Factor ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Immunodeficiency Virus

Abstract A converging public health crisis is emerging because the opioid epidemic is fueling a surge in infectious diseases, such as human immunodeficiency virus infection with or without AIDS, the viral hepatitides, infective endocarditis, and skin and soft-tissue infections. An integrated strategy is needed to tailor preventive and therapeutic approaches toward infectious diseases in people who misuse and/or are addicted to opioids and to concurrently address the underlying predisposing factor for the infections—opioid use disorder. This commentary highlights the unique and complementary roles that the infectious diseases and substance use disorder communities can play in addressing this crisis of dual public health concerns.

scholarly journals Alternatives to Arrest for Illicit Opioid Use: A Joint Criminal Justice and Healthcare Treatment Collaboration

2020 ◽  
Vol 14 ◽  
pp. 117822182095339
Author(s):  
Andrea J Yatsco ◽  
Rachel D Garza ◽  
Tiffany Champagne-Langabeer ◽  
James R Langabeer
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
Law Enforcement ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
The Us ◽  
History Of ◽  
Illicit Opioid Use

Opioid overdoses continue to be a leading cause of death in the US. This public health crisis warrants innovative responses to help prevent fatal overdose. There is continued advocacy for collaborations between public health partners to create joint responses. The high correlation between persons with opioid use disorder who have a history of involvement in the criminal justice system is widely recognized, and allows for treatment intervention opportunities. Law enforcement-led treatment initiatives are still relatively new, with a few sparse early programs emerging almost a decade ago and only gaining popularity in the past few years. A lack of published methodologies creates a gap in the knowledge of applied programs that are effective and can be duplicated. This article seeks to outline an interagency relationship between police and healthcare that illustrates arrest is not the only option that law enforcement may utilize when encountering persons who use illicit substances. Program methods of a joint initiative between law enforcement and healthcare in a large, metropolitan area will be reviewed, supplemented with law enforcement overdose data and statistics on law enforcement treatment referrals.

A history of opioid abuse: Why buprenorphine is superior for the management of opioid use disorder and pain

2021 ◽  
Vol 17 (7) ◽  
pp. 43-50
Author(s):  
Michael D. Komrowski, MS ◽  
Nitin K. Sekhri, MD
Keyword(s):  
Public Health ◽  
Opioid Use Disorder ◽  
Opioid Abuse ◽  
Common Side Effect ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
History Of ◽  
Opioid Medications ◽  
Regulatory Economic

Opioid abuse represents a public health crisis that has significant associated morbidity and mortality. Since beginning in the early 1990’s, the opioid abuse epidemic has been difficult to control due to regulatory, economic, and psychosocial factors that have perpetuated its existence. This era of opioid abuse has been punctuated by three distinct rises in mortality, precipitated by unique public health problems that needed to be addressed. Patients affected by opioid abuse have been historically treated with either methadone or naltrexone. While these agents have clinical utility supported by robust literature, we the authors posit that buprenorphine is a superior therapy for both opioid use disorder (OUD) as well as pain. This primacy is due to the pharmacological properties of buprenorphine which render it unique among other opioid medications. One such property is buprenorphine’s ceiling effect of respiratory depression, a common side effect and complicating factor in the administration of many classical opioid medications. This profile renders buprenorphine safer, while simultaneously retaining therapeutic utility in the medical practitioner’s pharmacopeia for the treatment of opioid use disorder and pain.

scholarly journals The state of naloxone: Access amid a public health crisis

2019 ◽  
Vol 3 ◽  
pp. 239920261984763
Author(s):  
Jeffrey Fudin ◽  
Amelia L Persico ◽  
Jeffrey J Bettinger ◽  
Erica L Wegrzyn
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Mitigation Strategies ◽  
Patient Specific ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Risk Patients

Over the past decade, opioid use has been at the forefront of a public health crisis throughout the United States. In response to the tremendous negative societal, personal, and economic impacts that the growing opioid crisis has caused, several governmental agencies began to respond. These efforts include declaration of a nationwide public health emergency, increased public health surveillance of the epidemic, research support for pain and addiction, and increased access to overdose-reversing drugs such as naloxone. Naloxone access, in particular, has become a priority. In the United States, pharmacists have had the opportunity to play a crucial role in promoting access to naloxone. Since initial approval by the Food and Drug Administration (FDA) in 1971 as an antidote to opioid agonist overdose, naloxone access has evolved significantly. Today many states have authorized standing orders for naloxone, allowing it to be dispensed by pharmacists without a patient-specific prescription, and all 50 states and the District of Columbia allow medical providers to prescribe take-home naloxone to at-risk patients. While the opioid epidemic itself remains a contentious topic of political, ethical, and medical debate, it is widely acknowledged that mitigation strategies that could lessen morbidity and mortality are essential. Improved access to naloxone is one such strategy which remains at the forefront during this public health crisis.

Molecular characterization of SARS-CoV-2

2020 ◽  
Vol 20 ◽  
Author(s):  
Miribane Dërmaku-Sopjani ◽  
Mentor Sopjani
Keyword(s):  
Public Health ◽  
Drug Targets ◽  
Virus Genome ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Therapeutic Drugs ◽  
New Public Health ◽  
New Public ◽  
And Function

Abstract:: The coronavirus disease 2019 (COVID-19) is currently a new public health crisis threatening the world. This pandemic disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus has been reported to be originated in bats and by yet unknown intermediary animals were transmitted to humans in China 2019. The SARSCoV- 2 spreads faster than its two ancestors the SARS-CoV and Middle East respiratory syndrome coronavirus (MERSCoV) but has reduced fatality. At present, the SARS-CoV-2 has caused about a 1.16 million of deaths with more than 43.4 million confirmed cases worldwide, resulting in a serious threat to public health globally with yet uncertain impact. The disease is transmitted by inhalation or direct contact with an infected person. The incubation period ranges from 1 to 14 days. COVID-19 is accompanied by various symptoms, including cough, fatigue. In most people the disease is mild, but in some other people, such as in elderly and people with chronic diseases, it may progress from pneumonia to a multi-organ dysfunction. Many people are reported asymptomatic. The virus genome is sequenced, but new variants are reported. Numerous biochemical aspects of its structure and function are revealed. To date, no clinically approved vaccines and/or specific therapeutic drugs are available to prevent or treat the COVID-19. However, there are reported intensive researches on the SARSCoV- 2 to potentially identify vaccines and/or drug targets, which may help to overcome the disease. In this review, we discuss recent advances in understanding the molecular structure of SARS-CoV-2 and its biochemical characteristics.

Anticipating on a post covid-19 world and the pivotal role of science and technology

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saeed Khan ◽  
Tusha Sharma ◽  
Basu Dev Banerjee ◽  
Scotty Branch ◽  
Shea Harrelson
Keyword(s):  
Public Health ◽  
Pivotal Role ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Health Crisis ◽  
Outbreak Management ◽  
The Public ◽  
Public Health Crisis ◽  
Future Outbreak

: Currently, Coronavirus disease 2019 (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses and highlighted the urgent need for investments in scientific programs and policies. A comprehensive program utilizing the science and technologydriven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.

Communications and Politics

2018 ◽  
Author(s):  
Joshua M. Sharfstein
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Accurate Information ◽  
Political Judgment ◽  
Political Leaders ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Control And Prevention ◽  
Public Health Officials ◽  
Centers For Disease Control

An effective communications approach starts with a basic dictum set forth by the Centers for Disease Control and Prevention: “Be first, be right, be credible.” Agencies must establish themselves as vital sources of accurate information to maintain the public’s trust. At the same time, public health officials must recognize that communications play out in the context of ideological debates, electoral rivalries, and other political considerations. During a public health crisis, this means that health officials often need to constructively engage political leaders in communications and management. Navigating these waters in the middle of a crisis can be treacherous. Figuring out the best way to engage elected leaders is a core aspect of political judgment.

Sign in / Sign up

Export Citation Format

Share Document