opioid addiction crisis

Introducción: El consumo de opioides es uno de los indicadores de la calidad de alivio de dolor de un país. Colombia presenta un bajo consumo de opioides para uso médico, debido a diferentes factores a lo largo de una cadena de distribución, cuyo usuario final es el paciente. Identificar las barreras que los pacientes encuentran para acceder a dichos medicamentos, permitirá sugerir soluciones.Métodos: Mediante una encuesta estructurada se determinaron las barreras para acceder a los opioides de pacientes con dolor crónico que asistieron a una consulta ambulatoria de dolor en una institución hospitalaria en Colombia.Resultados: Se encuestaron 24 pacientes entre 40 y 59 años. El 67% tuvo problemas para obtener el medicamento; 33% reportó problemas de autorización con sus aseguradoras; 33% tuvo inconvenientes con el sitio de entrega del medicamento; 17% tuvo problemas con la información sobre cómo hacer el trámite y, 17%, problemas con la fórmula médica. Conclusiones: La mayoría de los...

Objectives: Xylazine is an α 2-agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from people who use drugs (PWUDs). Specifically, we sought to answer the following: (1) What are the demographics of Reddit subscribers reporting exposure to xylazine? (2) Is xylazine a desired additive? And (3) what adverse effects of xylazine are PWUDs experiencing? Methods: Natural language processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022. Results: Seventy-six posts were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. Sixty-one participants completed the survey. Of those who disclosed their location, 25 of 50 participants (50%) reported locations in the Northeastern United States. The most common route of xylazine use was intranasal use (57%). Thirty-one of 59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%). Conclusions: Among respondents on these Reddit forums, xylazine seems to be an unwanted adulterant. People who use drugs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This seemed to be more common in the Northeast.

Introduction: Cognitive dysfunction related to opioid use disorder (OUD) requires investigation of the interconnected network of cognitive domains through behavioral experiments and graph data modeling.

Methods: We conducted n-back, selective and divided attention, and Wisconsin card sorting tests and reconstructed the interactive cognitive network of subscales or domains for individuals who use opioids and controls to identify the most central cognitive functions and their connections using graph model analysis. Each two subscales with significant correlations were connected by an edge that incorporated in formation of interactive networks. Each network was analyzed topologically based on the betweenness and closeness centrality measures.

Results: Results from the network reconstructed for individuals who use opioids show that in the divided attention module, reaction time and number of commission errors were the most central subscales of cognitive function. Whereas in controls, the number of correct responses and commission errors were the most central cognitive measure. We found that the subscale measures of divided attention module are significantly correlated with those of other tests. These findings corroborate that persons who use opioids show impaired divided attention as higher reaction time and errors in performing tasks. Divided attention is the most central cognitive function in both OUD subjects and controls, although differences were observed between the two groups in various subscales.

Discussion: Although equal proportions of males and females may be used in future studies, divided attention and its subscales may be the most promising target for cognitive therapies, treatments and rehabilitation as their improvement can enhance overall cognitive domain performance.

Opioids are a class of drugs (narcotics), derived from the opium plant, which are prescribed to relieve moderate to severe pain and relax the user. Prescription opioids can either be synthetic variations or derived from the plant directly and include such drugs as OxyContin (oxycodone), Vicodin (hydrocodone), morphine, codeine, and fentanyl (National Institute on Drug Addiction, 2021). Misuse of prescription painkillers is defined as using more than prescribed, using them in a way other than prescribed, and using someone else’s medication, or using them specifically to get high. Over the last couple of decades, the rates of prescription opioid abuse have skyrocketed in this country, disrupting families, and impacting the prescription of these drugs to those who need them and do not abuse them (NIDA, 2021).

Health officials in the U.S. have approved an injectable medication intended to treat addiction to opioids, painkillers and heroin. The active ingredient, Buprenorphine, is already used in several orally-administered medications that come in the form of sublingual tablets and dissolvable strips, most commonly under the trade names Suboxone and Subutex.

(MASS TORT NEXUS MEDIA) Economically hard hit Gary, Indiana is the latest local government to join the hundreds of other cities, counties and states across the country, along with private entities such as hospitals and unions in suing opioid manufacturers and distributors for their roles in the opioid addiction crisis.  Gary joins other Indiana communities including Indianapolis, Hammond, Fort Wayne and more than 10 Indiana counties in filing lawsuits against Big Pharma drug makers such as Purdue, Endo, Abbott, Watson-Actavis and others, asserting that the marketing campaigns and a boardroom supported corporate philosophy of “profits before patients” would result in records profits from opioid drugs, which it clearly has for more than 10 years.  Many major cities have also filed lawsuits against the same opioid drugmakers and distributors, New York City sues Big Pharma over opioids – joining Chicago, Seattle, Milwaukee and other major cities.