Alcohol Use in the Elderly
|
|
- Hortense Matthews
- 5 years ago
- Views:
Transcription
1 Substance Use/Abuse in the Geriatric Population Alan L. Schneider, MD DFAPA DABAM Medical Director, Western Region Aetna Behavioral Health Associate Professor of Psychiatry, UCLA School of Medicine Alcohol Use in the Elderly A national cohort study of 4800 adults >64 y/o showed that 10% were binge drinkers in last 30 days. Binge drinking defined at 5 or more drinks for men, or 4 or more for women, in one sitting. Alcohol consumption in senior associated with cognitive decline and increasing risk of hypertension, stroke, and osteoporosis. In surveys, self reported binge drinkers tend to be younger than nonbinge drinkers by ~4 years, and often men vs. women 64 vs 45%. Alcohol Use in the Elderly Binge drinking in the elderly is underreported and underestimated. Elderly adults predominantly hide their habit from family or facilities where they reside. Alcohol consumption creates secondary morbidity through falls, interaction with prescription drugs, or failure to keep up usual health routines. 1
2 Alcohol Use in the Elderly Binge drinkers are often veterans, low income (<25K/year), less likely to be college educated, and higher rates of smoking (24%). Surprisingly, in one analysis binge drinkers had lower incidence of CAD, etiology unclear. Alcohol Use in the Elderly On any average day there are almost 8 million older adults who drank alcohol, 150,000+ who used marijuana, and who used cocaine. These are undoubtedly low estimates based on phone interviews. We do know that of the ER admissions >age 65, there were per day at least 50 related to ETOH use and as many as related to heroin or other opiates. 290 ER visits/day involve nonmedical use of pharmaceuticals combined with ETOH. Alcohol Use in the Elderly Substance use is emerging as a primary public health issue in not just the young, but in the older population. In 2014 there were almost 1,000,000 >65 with an alcohol use disorder, and almost 200K with an illicit drug use disorder. It is estimated that by 2020 this will rise to 5.7 million. This substance use problem will obviously further impact other chronic health conditions. 2
3 Protective Effects of Alcohol For the past 35 years the association btw moderate alcohol intake and cognitive function has been investigated in almost 80 studies. Most show an association between light moderate alcohol consumption and better cognitive function, and reduced risk of Alzheimer s and vascular dementia. However the jury s still out. Some contend that happy people with many friends have the most opportunity for social drinking. They re better educated, don t live alone, and have less depression, have lower overall risk for dementia. Improved vascular function in alcohol drinkers could account for lower vascular dementia rates. Protective Effects of Alcohol Of the studies done to date, most overall participants consume <2 drinks per day, almost 50% drank wine only, 30% drank beer only, and the remainder drank a mixture of those and straight liquor. No association was found between alcohol consumption, smoking, mild cognitive impairment, or Apo E4 status. In adults 75 or older, consumption of gms per day of alcohol was associated with reduced overall dementia of 29%. Screening the Elderly for Alcohol Abuse As a routine part of the health check every practitioner should screen an elderly person >60 for alcohol/substance misuse. Specific tools include the AUDIT or CAGE. Concurrent screen with a monumental status or MOCA also recommended. As part of the screen tolerance levels for daily use should be adjusted down from those of the general adult population (1.5 drinks/day for men, 1 drink/day for women). 3
4 Red Flags for Alcohol Misuse in the Elderly Doing badly at home but functioning seemingly well at the hospital. Unexplained variations in health presentation. Inconsistencies and contradictions in presentations in the patient s history. Unexplained falls, injuries, episodes of incontinence, cognitive problems, or poor self care. Malnutrition. Sleep disturbances, anxiety, depression, mood swings. Legal, financial, family problems. Requiring early refills. Alcohol/Substance Use in the Elderly Several data sets are kept each year to study this problem. SAMHSA (Substance Abuse and Mental Health Services Administration). NSDUH (National Survey on Drug Use and Health) TEDS (Treatment Episode Data Set) DAWN (Drug Abuse Warning Network) How are the Elderly Referred for Treatment? Self or family referred: ~60%. Criminal justice system: 10 15%. Health care provider: 5 10%. Community organization: 5%. Alcohol or drug abuse providers: 5% 4
5 Opiates in the Elderly Compared to alcohol, few studies examine illicit drug use in the elderly. Major studies done have examined opioids and benzodiazepines (tranquilizers), where prevalence rates for nonmedical use appear to be tranquilizers ~1% of the population, opioids ~1%, and amphetamines ~1/2% of the population. HOWEVER, that doesn t tell much of the story. Nonmedical use of prescription opiates Vicodin, Percocet, etc. have an increasingly higher percentage of use in the geriatric population in the last 10 years. It s estimated that 81% of older adults with a prescription opioid use disorder have another substance use disorder. Opiates in the Elderly The axiom is substance use disorders beget other substance use disorders. Interestingly the suggestion is that in the elderly the most common substance use disorder next to alcohol is marijuana, with a rate on the low end approaching 5%. Risks of Opiate Use in the Elderly Oversedation Constipation Cognitive impairment Respiratory depression Bone demineralization Death in combination with other sedating agents 5
6 Sedatives in the Elderly Benzodiazepine class and so called Z drugs are widely prescribed for anxiety or insomnia. Barbiturates are no longer used. Sedatives are controlled substances due to their potential for abuse and misuse. Psychological dependence is high in all age groups. Often overlooked in the elderly who are not seen as typical abusers. Sedatives in the Elderly In younger individuals, sedatives are more abused for euphoric effects. In older individuals more often abused for anti anxiety effect. Dependency on hypnotic aspect very common. Work via GABA A receptor complex agonism primarily by binding nonselectively to the BZ1 and BZ2 receptors Sedatives in the Elderly Some benzodiazepines: directly conjugated via glucuronyl transferase and excreted. Oxazepam Serax Lorazepam Ativan Temazepam Restoril Some require cytochrome metabolism with multiple active metabolites and long ½ lives: Diazepam Valium Chlordiazepoxide Librium 6
7 Sedatives in the Elderly BZ1 specific drugs that are selective: Zolpidem, eszopiclone: shorter duration of action and ½ life, and have no effect on sleep architecture, HOWEVER can cause: Hallucinations and psychosis Bizarre and complex behavioral effects Contribute to overdose Up to 33% of elderly patients are now prescribed a sedativehypnotic by their physicians. Sedatives in the Elderly The classic sedative dependent patient: Elderly Female Perceived poor health status Often perceived poor physical health is associated with long term sedative use Long term sedative use associated with increasing falls and injury Sedatives in the Elderly Misuse and abuse has grown with time Admissions for BZD abuse has tripled from 22,400 in 1998 to 60,200 in 2008, to what s anticipated to be 100,000 in 2018 Exaggeration of symptoms in anxiety/insomnia often leads to long term use of BZD s or Z drugs Chemical coping is a challenging behavior for all treaters and is the boundary between physical and mental distress. 7
8 Special Focus in the Elderly Elderly pts differ markedly from their younger, middle aged cohorts. Average # concurrent drugs has tripled. # coexistent medical problems is 6 9. Body fat changes volume of distribution of drugs changes. Hepatic and renal function decreased in many patients, consequently ½ life of drugs is increased and protein binding of drugs goes down, so free drug component goes up. Drug: drug interactions become more significant. Special Focus in the Elderly Resiliency in falls, injuries, and drug interactions is markedly less. Resiliency in post hospitalization recovery is markedly less. Propensity for post hospitalization/post op delirium is markedly higher leads to higher incidence of death after one year. Propensity for unintentional death due to drug overdoseundiscovered high. Propensity for substance abuse related suicide in the face of chronic illness high. How Can We Address the Problem? Safe prescribing of controlled substances. Provide screening instruments to assess risks related to opiates or ETOH. History related to previous addiction, especially polysubstance use, is the single biggest predictor. Even single substance abuse (tobacco) lends a higher risk of medication/substance abuse. History of childhood sexual abuse, legal 8
9 How Can We Address the Problem? Take from childhood sexual abuse on fro prior slide Obtaining prescriptions from friends/family. Doctor shopping. All of the above indicate risk factors that arise in multiple treater's offices, not just physicians. Now the PDMP program in CA can be used frequently to assess for multiple prescribers and early refills. Pharmacies also tend to call physicians more frequently to alert them. How Can We Address the Problem? It takes a village As seen from prior slides, the physician cannot be relied upon for primary source of identification and referral for substance abusing elder. Often 1 st indication of ETOH, sedative hypnotic, or opiate withdrawal is seen in a hospital setting for a totally different condition where the pt doesn t acknowledge using any of these substances. What Can You Do? Make routine screening part of your usual work up in your office or facility in which you work. Use motivation interviewing to produce a harm reduction strategy. Refer out to substance abuse specialists rather than generalists, who are often ill acquainted with treating substance abuse problems in young adults or the elderly. Don t be afraid to ask about any substance. You re never too old to use crack cocaine or heroin. 9
The Use, Misuse and Abuse of Alcohol, and Psychoactive Drugs among Older Persons
The Use, Misuse and Abuse of Alcohol, and Psychoactive Drugs among Older Persons Alison A. Moore, MD, MPH Division of Geriatric Medicine David Geffen School of Medicine at UCLA Drinking in Older Adults:
More informationSubstance Abuse in Indiana
February, 2010 For questions and additional information, please contact: Kim Manlove SPF SIG Project Director (317) 232-7887 Kim.Manlove@fssa.in.gov Larry Long SPF SIG Project Coordinator (317) 232-7931
More informationDr. Oslin receives grant support from the NIH, VA, and the Pennsylvania Department of Aging.
David W. Oslin, MD University of Pennsylvania Philadelphia VAMC Dr. Oslin receives grant support from the NIH, VA, and the Pennsylvania Department of Aging. Dr. Oslin is a consultant to the Hazelden Betty
More information11/1/2010. Psychology 472 Pharmacology of Psychoactive Drugs. Listen to the audio lecture while viewing these slides
Treatment for Anxiety Disorders Benzodiazepines and Other Anxiolytics Psychology 472 Pharmacology of Psychoactive Drugs Listen to the audio lecture while viewing these slides Ethanol Barbiturates and related
More informationBenzodiazepines: Comparative Effectiveness and Strategies for Discontinuation. Ann M. Hamer, PharmD, BCPP Rural Oregon Academic Detailing Project
Benzodiazepines: Comparative Effectiveness and Strategies for Discontinuation Ann M. Hamer, PharmD, BCPP Rural Oregon Academic Detailing Project This project is funded through a grant from the Pew Charitable
More informationScreening Patients for Substance Use in Your Practice Setting
Screening Patients for Substance Use in Your Practice Setting Learning Objectives By the end of this session, participants will Understand the rationale for universal screening. Identify potential health
More informationWHAT SHOULD WE DO ABOUT BENZODIAZEPINES? Miriam Komaromy, MD Associate Director, Project ECHO August 2014
WHAT SHOULD WE DO ABOUT BENZODIAZEPINES? Miriam Komaromy, MD Associate Director, Project ECHO August 2014 EPIDEMIOLOGY OF BENZO USE 7-18% of US population uses a benzo for medical purposes each year Average
More informationBenzodiazepines. Benzodiazepines
: History 1950s - Invented by Swiss chemists who identified its sedative effects 1950s 60s - Chlordiazepoxide (Librium) marketed as a safer alternative to barbiturates; along with newer benzodiazepines
More informationINFORMATION BRIEF. Overview. Prescription Drug Abuse Among Young People
Product No. 2002-L0424-004 INFORMATION BRIEF AUGUST 2002 U. S. D E P A R T M E N T O F J U S T I C E Overview Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain
More information1/20/2017. Benzodiazepines Overuse. Pharmacist Objectives. Technician Objectives. A Bit of History. Benzodiazepines: Mechanism of Action
Pharmacist Objectives Participants will review the pharmacology of benzodiazepines and be able to identify how various benzodiazepines differ. Benzodiazepines Overuse Steve Jenkusky, MD January 29, 2017
More information1/26/2016. These are my own thoughts! Safe Workplace Safe Workforce Proven benefits of Stay At Work / Return To Work Process (SAW/RTW)
Dr. Paul A. Farnan farnan@mail.ubc.ca HealthQuest Occupational Health Corporation Alliance Medical Monitoring I have no financial interests or affiliation with any pharmaceutical industry or manufacturer
More informationSubstance Misuse in Older People
Substance Misuse in Older People Dr Tony Rao Consultant Old Age Psychiatrist, SLAM NHS Foundation Trust Visiting Researcher, Institute of Psychiatry, Neurology and Neuroscience Chair of Substance Misuse
More informationThe OAS Report. Issue Suicidal Thoughts, Suicide Attempts, Major Depressive Episode, and Substance Use among Adults.
Office of Applied Studies The OAS Report Issue 34 2006 Suicidal Thoughts, Suicide Attempts, Major Depressive Episode, and Substance Use among Adults In Brief Among adults aged 18 or older who experienced
More informationJUST THE FACTS SUBSTANCE ABUSE IN INDIANA
JUST THE FACTS SUBSTANCE ABUSE IN INDIANA A quick summary on the use of alcohol, tobacco, marijuana, cocaine, heroin, methamphetamine, non-medical prescription drugs, and polysubstances in Indiana Prepared
More informationOHIO S PRESCRIPTION DRUG OVERDOSE EPIDEMIC:
Cuyahoga County Board of Health OHIO S PRESCRIPTION DRUG OVERDOSE EPIDEMIC: NOVEMBER 5, 2014 CONTRIBUTING FACTORS AND ONGOING PREVENTION EFFORTS DEFINITIONS Opiate- originate from naturally-occurring elements
More information[ ASSESSING THE BURDEN OF ILLICIT DRUGS AND ALCOHOL ABUSE:] Macomb County Office of Substance Abuse. A Focus on Heroin and Prescription Drug Abuse
2010 Macomb County Office of Substance Abuse Planning Contracting Monitoring [ ASSESSING THE BURDEN OF ILLICIT DRUGS AND ALCOHOL ABUSE:] A Focus on Heroin and Prescription Drug Abuse 22550 Hall Road Clinton
More informationPreventing Prescription Drug Abuse
Preventing Prescription Drug Abuse Nicholas Reuter Center for Substance Abuse Treatment Substance Abuse Mental Health Services Administration U.S. Department of Health & Human Services Harold Rogers Prescription
More informationAging and Addiction:
Aging and Addiction: How C.U.R.E.S. and other modalities can Assist in Addressing Addiction in Older Adults VCMC CME Series Celia Woods, M.D., VCBH Mike Small, DOJ CURES Administrator April 30, 2014 Learning
More informationKathleen J. Farkas and Laurie Drabble
SUBSTANCE USE AND OLDER ADULTS CHAPTER 3: STRENGTHS AND VULNERABILITIES ASSOCIATED WITH OLDER AGE AND SUBSTANCE USE Kathleen J. Farkas and Laurie Drabble While there are many unknowns about the prevalence
More informationFriend or Foe? Review of the Regulations & Benefits: Risk Profiles of the Benzodiazepines
Friend or Foe? Review of the Regulations & Benefits: Risk Profiles of the Benzodiazepines Program Learning Objectives At the conclusion of the activity, participants should be able to: Have a basic understanding
More informationBenzodiazepines. CRIT program May Alex Walley, MD, MSc Assistant Professor of Medicine Boston University School of Medicine
Benzodiazepines CRIT program May 2010 Alex Walley, MD, MSc Assistant Professor of Medicine Boston University School of Medicine Medical Director, Opioid Treatment Program Boston Public Health Commission
More informationSubstance Misuse and Abuse
CHAPTER 18 Substance Misuse and Abuse Lesson Objectives 1. Explain actions that can be taken to help prevent youth from abusing drugs and other substances. 2. Describe specific steps for preventing someone
More informationManaging presenting problems with benzodiazepines. By Dr Gideon Felton MRCPsych Consultant Psychiatrist and Clinical Lead
Managing presenting problems with benzodiazepines By Dr Gideon Felton MRCPsych Consultant Psychiatrist and Clinical Lead OUTLINE OF PRESENTATION Why Benzodiazepines (BDZ s) are used Mechanism of Action
More informationBenzodiazepine Misuse Abuse - Dependence Using for recreational purposes Continued long term use against medical advise Use of drug with other potenti
Benzodiazepine Prescribing In Primary Care Settings: Issue for Concern? Louis E. Baxter, Sr., M.D., FASAM Executive Medical Director Professional Assistance Program, New Jersey, Inc. Benzodiazepine Misuse
More informationsome things you should know about opioids before starting a prescription an informational booklet for opioid pain treatment
some things you should know about opioids before starting a prescription an informational booklet for opioid pain treatment This booklet was created to help you learn about opioids. You probably have lots
More informationNIDA-Modified ASSIST Prescreen V1.0 1
NIDA-Modified ASSIST Prescreen V1.0 1 F Name:... Sex ( ) F ( ) M Age... Interviewer... Date.../.../... Introduction (Please read to patient) Hi, I m, nice to meet you. If it s okay with you, I d like to
More informationSoma (carisoprodol), Soma Compound (carisoprodol and aspirin), Soma Compound w/ Codeine (carisoprodol and aspirin and codeine)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.75.07 Subject: Page: 1 of 7 Last Review Date: September 15, 2016 Description (carisoprodol), Compound
More informationSEDATIVE-HYPNOTIC AGENTS
SEDATIVE-HYPNOTIC AGENTS Documentation A. FDA approved indications 1. Insomnia 2. Sedation for an agitated patient in an inpatient setting Documentation B. Non-FDA approved, commonly used indications 1.
More informationPopping Pills for Thrills Implications for preventing the misuse of pharmaceuticals
Popping Pills for Thrills Implications for preventing the misuse of pharmaceuticals Carla Janáe Brown, M.S. Many Voices, One Vision Conference: Achieving Our Vision through Collaboration August 1, 2007
More informationHOPE. Considerations. Considerations ISING. Safe Opioid Prescribing Guidelines for ACUTE Non-Malignant Pain
Due to the high level of prescription drug use and abuse in Lake County, these guidelines have been developed to standardize prescribing habits and limit risk of unintended harm when prescribing opioid
More informationUnderwriting the Habits Risk of Alcohol Use Gregory Ferrara New York Life Underwriting January, 2013
Underwriting the Habits Risk of Alcohol Use Gregory Ferrara New York Life Underwriting January, 2013 The Company You Keep 1 Antitrust 2 New York Life adheres to the letter and spirit of the antitrust laws.
More informationBaseline Questions for Personal Feedback Report
1. How old are you? years old (Q1) A. Marijuana Use We begin the Teen Marijuana Check-Up by asking about your experiences with marijuana. When we ask about marijuana, we are referring to marijuana or hashish
More informationPrescription Drug Abuse National Perspective
Prescription Drug Abuse National Perspective Timothy P. Condon, Ph.D. Science Policy Advisor Office of the Director White House Office of National Drug Control Policy Commonly Abused Prescription Drugs
More informationWHEN AND HOW TO USE BENZODIAZEPINES IN TREATING ANXIETY: AM I WITHHOLDING TREATMENT IF I DON'T USE BENZODIAZEPINES?
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences WHEN AND HOW TO USE BENZODIAZEPINES IN TREATING ANXIETY: AM I WITHHOLDING TREATMENT IF I DON'T USE BENZODIAZEPINES?
More informationSoma (carisoprodol), Soma Compound (carisoprodol and aspirin), Soma Compound w/ Codeine (carisoprodol and aspirin and codeine)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.75.07 Subject: Soma Page: 1 of 7 Last Review Date: September 15, 2017 Soma Description Soma (carisoprodol),
More informationUsing Benzodiazepines in Primary Care
Using Benzodiazepines in Primary Care Spencer A. Tighe MD, FRCPC Saturday, Feb. 16, 2008 Overview Historical context Drug information Indications Side effects Abuse vs. physical dependence Clinical practice
More informationNIDA Quick Screen V1.0F1
NIDA Quick Screen V1.0F1 Name:... Sex ( ) F ( ) M Age... Interviewer... Date.../.../... Introduction (Please read to patient) Hi, I m, nice to meet you. If it s okay with you, I d like to ask you a few
More informationManagement of high risk MMT patients. Meldon Kahan MD Methadone Prescribers Conference Toronto, Nov 15, 2013
Management of high risk MMT patients Meldon Kahan MD Methadone Prescribers Conference Toronto, Nov 15, 2013 CFPC CoI Templates: Slide 1 Faculty Disclosure Faculty: Meldon Kahan Relationships with commercial
More informationPROCEDURE REF NO SABP/EXECUTIVE BOARD/0017
PROCEDURE REF NO SABP/EXECUTIVE BOARD/0017 NAME OF GUIDELINE REASON FOR GUIDELINE WHAT THE GUIDELINE WILL ACHIEVE? WHO NEEDS TO KNOW ABOUT IT? Medicines Guideline: Hypnotic Medication Compliance with NICE
More informationSubstance Abuse Trends in Maine. Epidemiological Profile Central District
Substance Abuse Trends in Maine Epidemiological Profile 2013 Central District Produced for Maine Department of Health and Human Services Office of Substance Abuse and Mental Health Services by Hornby Zeller
More informationImplementation of a Community-Wide Screening and Brief Intervention Project
Implementation of a Community-Wide Screening and Brief Intervention Project When you look at what determines morbidity in this country, 80% of that has nothing to do with the quality of health care received
More information1 STUDYING THE STUDY DRUG: ADDERALL. iaddiction.com
1 STUDYING THE STUDY DRUG: ADDERALL Societal Impact of the Drug A stimulant often prescribed for attention deficit hyperactivity disorder (ADHD) and narcolepsy, Adderall has become a drug of choice for
More informationCan you take sleeping pills with ativan
Cari untuk: Cari Cari Can you take sleeping pills with ativan 30-5-2015 Can 't sleep? Consumer Reports Best Buy Drugs explains why the Best Insomnia Treatment Is Not A Drug. 2-3-2018 Sleeping Pills: What
More informationMedical vs. Use of Drugs. Warning Signs of Chemical Dependence. Intent Effect. Legality Pattern 5/5/2010. Daily use above ceiling doses
Identifying and Preventing Drug Abuse By: Lon R. Hays, M.D., M.B.A. Professor and Chairman Department of Psychiatry University of Kentucky Healthcare Medical vs. Non-Medical Use of Drugs Intent Effect
More informationPhysical Issues: Emotional Issues: Legal Issues:
Men s Facility 1119 Ferry Street Lafayette, IN 47901 Phone: (765) 807-0009 Fax: (765) 807-0030 Hope Apartments 920 N 11th St. Lafayette, IN 47904 Phone: (765) 742-3246 Fax: (765) 269-9110 APPLICATION FOR
More informationLisa Marzilli, PharmD, CDOE TOP 3 REASONS PEOPLE VISIT THEIR DOCTOR
Lisa Marzilli, PharmD, CDOE TOP 3 REASONS PEOPLE VISIT THEIR DOCTOR 1 1. Skin disorders, including cysts, acne, and dermatitis. 2. Joint disorders, including osteoarthritis. 3. Back problems. Source: Mayo
More informationAN INTRODUCTION TO THE TREATMENT OF OPIOID USE DISORDERS IN PRIMARY CARE
AN INTRODUCTION TO THE TREATMENT OF OPIOID USE DISORDERS IN PRIMARY CARE Valerie Carrejo, MD Assistant Professor UNM Family Medicine Advances in Primary Care April 14, 2017 Objectives Review the basic
More informationUNHEALTHY ALCOHOL USE SCREENING and FOLLOW-UP (ASF) HEDIS (Administrative)
UNHEALTHY ALCOHOL USE SCREENING and FOLLOW-UP (ASF) APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE NCQA ACCEPTED CODES HEDIS (Administrative)
More informationDAWN. In 2009, nearly 4.6 million emergency
Drug Abuse Warning Network The DAWN Report December 28, 2010 Highlights of the 2009 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits In Brief In 2009, there were nearly
More informationIn 2009, nearly 4.6 million emergency
Drug Abuse Warning Network The DAWN Report December 28, 2010 Highlights of the 2009 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits In Brief In 2009, there were nearly
More informationOutline. Who are the elderly? Older Adults and Alcohol Problems
Older Adults and Alcohol Problems Suzanna Waters Castillo PhD, MSSW Distinguished Faculty Associate and Director of Professional Development in Geriatric Mental Health Division of Continuing Studies at
More informationOpioid Use and Other Trends
Opioid Use and Other Trends National Overview Across the nation communities are struggling with a devastating increase in the number of people misusing opioid drugs, leading many to identify the current
More informationAlcoholism And Addiction In The Elderly
Alcoholism And Addiction In The Elderly 1) The National Institute on Drug Abuse states that addiction is defined as a chronic, relapsing disease. a) Brain b) Moral c) Physical d) Impulse Control 2) Approximately
More informationBAPTIST HEALTH SCHOOL OF NURSING NSG 3036A: PSYCHIATRIC-MENTAL HEALTH
BAPTIST HEALTH SCHOOL OF NURSING NSG 3036A: PSYCHIATRIC-MENTAL HEALTH THERAPEUTIC INTERVENTION AND RESOURCE MANAGEMENT: SUBSTANCE RELATED DISORDERS: CO-DEPENDENCY AND THE IMPAIRED NURSE LECTURE OBJECTIVES:
More informationSuicide and Substance Abuse: Challenge and Opportunity. Richard McKeon Ph.D., MPH Branch Chief, Suicide Prevention SAMHSA
Suicide and Substance Abuse: Challenge and Opportunity Richard McKeon Ph.D., MPH Branch Chief, Suicide Prevention SAMHSA Suicide and Substance Use With suicide increasing and given the magnitude of the
More informationBarbour County. West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report Barbour County
County West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report County The West Virginia Violence and Injury Prevention Program ( VIPP), in collaboration with
More informationEpidemiology of Addiction
Epidemiology of Addiction M.-L. Brecht UCLA Integrated Substance Abuse Programs California Society of Addiction Medicine Review Course Oct. 24, 2008 The presenter has no conflicts related to this material.
More informationPrescription Drug Misuse/Abuse in Seniors. April Rovero Founder/Executive Director
Prescription Drug Misuse/Abuse in Seniors April Rovero Founder/Executive Director Deaths per 100,000 Population 30 25 Overdose Demographics Drug Poisoning Death Rates by Age: United States (2010) 20 15
More informationLinking Opioid Treatment in Primary Care. Roxanne Lewin M.D.
Roxanne Lewin M.D. The Facts Fewer than 10 percent of individuals with an alcohol use disorder and only about 20 percent of individuals with an opioid use disorder receive specialty treatment. Many individuals
More informationPrescription Drugs MODULE 5 ALLIED TRADES ASSISTANCE PROGRAM. Preventative Education: Substance Use Disorder
Prescription Drugs MODULE 5 ALLIED TRADES ASSISTANCE PROGRAM Preventative Education: Substance Use Disorder Misuse of prescription pain relievers is, after marijuana use, the second most common form of
More informationManaging Narcotics on Workers Comp Claims. Presented By: Craig S. Stern, PharmD, MBA President Pro Pharma Pharmaceutical Consultants, Inc.
Managing Narcotics on Workers Comp Claims Presented By: Craig S. Stern, PharmD, MBA President Pro Pharma Pharmaceutical Consultants, Inc. October 21, 2014 Outline Rationale Scope list drug list Recommended
More informationSubstance Abuse Trends in Maine Epidemiological Profile 2013
Substance Abuse Trends in Maine Epidemiological Profile 2013 Western District Produced for Maine Department of Health and Human Services Office of Substance Abuse and Mental Health Services by Hornby Zeller
More informationMingo County. West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report
West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators Report The West Virginia Violence and Injury Prevention Program ( VIPP), in collaboration with the West Virginia Board
More informationNew Mexico Board of Pharmacy Prescription Monitoring Program (PMP)
New Mexico Board of Pharmacy Prescription Monitoring Program (PMP) PDMP West Regional Meeting PMP Collaboration with the NM Department of Health April 26, 2018 New Mexico Board of Pharmacy Prescription
More informationMedication-Assisted Treatment. What Is It and Why Do We Use It?
Medication-Assisted Treatment What Is It and Why Do We Use It? What is addiction, really? o The four C s of addiction: Craving. Loss of Control of amount or frequency of use. Compulsion to use. Use despite
More informationVERA L. BERNARDINO, BSC, RN; JANETTE R. BAIRD, PhD; TAO LIU, PhD; ROLAND C. MERCHANT, MD, MPH, ScD METHODS
Comparison of Substance-Use Prevalence among Rhode Island and The Miriam Hospital Emergency Department Patients to State and National General Population Prevalence Estimates VERA L. BERNARDINO, BSC, RN;
More informationSUBSTANCE ABUSE PATIENT
PREVENTION IN THE SUBSTANCE ABUSE PATIENT Valerie Carrejo, MD UNM Family and Community Medicine DISCLOSURES NONE OBJECTIVES Identify the importance of addressing substance abuse in the primary care setting
More informationPutnam County. West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report
West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators Report The West Virginia Violence and Injury Prevention Program ( VIPP), in collaboration with the West Virginia Board
More informationRon Morton, M.A. Director of Recovery and Resiliency ValueOptions Tennessee
Ron Morton, M.A. Director of Recovery and Resiliency ValueOptions Tennessee Copyright December 2010 1 The abuse of opiates and benzodiazepines has increased to a frightening degree nationally and in the
More informationOHIO S OPIOID DRUG OVERDOSE EPIDEMIC: CONTRIBUTING FACTORS AND ONGOING PREVENTION EFFORTS
OHIO S OPIOID DRUG OVERDOSE EPIDEMIC: CONTRIBUTING FACTORS AND ONGOING PREVENTION EFFORTS DEFINITIONS Opiate- originate from naturally-occurring elements found in the opium poppy plant. These drugs are
More informationBenzodiazepine abuse code
Search Benzodiazepine abuse code 20-10-2017 The adverse effects of benzodiazepine use and withdrawal can be remarkably similar to the impact of TEENhood trauma. Oxazepam is a short-to-intermediate-acting
More informationSUBSTANCE ABUSE IN THE ELDERLY. The Invisible Epidemic
SUBSTANCE ABUSE IN THE ELDERLY The Invisible Epidemic IS IT POSSIBLE TO TEACH AN OLD DOG NEW TRICKS? GUIDELINES All forms of addiction know no age limit. Don t blame all problems on aging. Few realize
More informationWilliam H. Swiggart, MS
William H. Swiggart, MS Co-Director, Center for Professional Health Vanderbilt University Medical Center 2015 All rights reserved. I have no financial relationships to disclose. The purpose of this session
More informationPARTICIPANT GENERAL INFORMATION
PARTICIPANT GENERAL INFORMATION Instructions: Please complete entire form (print) First name: Last Name: Other names used: Street address: City/State/Zip: County: Region: East TN Middle West Social Security
More informationDavid Bienenfeld, M.D. Wright State University Department of Psychiatry
David Bienenfeld, M.D. Wright State University Department of Psychiatry 1 Describe the epidemiologic patterns of substance abuse over age and time List the metabolic changes that influence the effect of
More informationEnd the Epidemic. Miami-Dade County COMPREHENSIVE COMMUNITY PREVENTION ACTION PLAN
End the Epidemic Miami-Dade County COMPREHENSIVE COMMUNITY PREVENTION ACTION PLAN 2018 2021 Miami-Dade County along with the State of Florida and the Nation are dramatically impacted by an Opioid Epidemic
More informationSedative / Hypnotics
Sedative / Hypnotics David H. Rubin, MD Executive Director, Massachusetts General Hospital Psychiatry Academy Director of Child and Adolescent Psychiatry Residency Training Massachusetts General Hospital
More informationDrugs. January 30, , 2008 Pearson Education, Inc. Upper Saddle River, NJ 07458
Drugs January 30, 2018 5-1 Breaking the Ice 1. Introduce Yourself to your neighbor. 2. Discuss/Define the following two words: A. Drugs B. Dependence 3. Find a writing utensil and your notebook! 5-2 Video:
More informationMain Questions. Why study addiction? Substance Use Disorders, Part 1 Alecia Schweinsburg, MA Abnromal Psychology, Fall Substance Use Disorders
Substance Use Disorders Main Questions Why study addiction? What is addiction? Why do people become addicted? What do alcohol and drugs do? How do we treat substance use disorders? Why study addiction?
More informationBasics of Benzodiazepine Use Disorder. DATE: October 3, 2017 PRESENTED BY: Melissa B. Weimer, DO, MCR
Basics of Benzodiazepine Use Disorder DATE: October 3, 2017 PRESENTED BY: Melissa B. Weimer, DO, MCR Disclosures Speaker disclosure: One time lecture sponsored by Indivior about overlap of pain and opioid
More informationPocahontas County. West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report
West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators Report The West Virginia Violence and Injury Prevention Program ( VIPP), in collaboration with the West Virginia Board
More informationKanawha County. West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators County Report
West Virginia Board of Pharmacy Prescription Opioid Problematic Prescribing Indicators Report The West Virginia Violence and Injury Prevention Program ( VIPP), in collaboration with the West Virginia Board
More informationThe growing problem nationally
Today s presentation The growing problem Why diagnosing the problem can be challenging Understanding misuse as well as abuse Treatment for older adults Prevention programs for older adults The growing
More informationHow many days does hydrocodone stay in your system
How many days does hydrocodone stay in your system The Borg System is 100 % How many days does hydrocodone stay in your system Jun 21, 2017. It passes through to the urine where it can be detected for
More informationTeaching Medical Learners about Substance Abuse Screening, Brief Intervention, and Referral to Treatment
Teaching Medical Learners about Substance Abuse Screening, Brief Intervention, and Referral to Treatment J.Aaron Johnson, PhD Associate Professor Institute of Public & Preventive Health Augusta University
More informationNIDA-Modified ASSIST - Prescreen V1.0*
NIDA-Modified ASSIST Assessment Instrument [1] NIDA-Modified ASSIST - Prescreen V1.0* *This screening tool was adapted from the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Version
More informationPrescription Drug Abuse and Heroin: Impact on Oregon s Youth and Young Adults
North Coast Opioid Summit Prescription Drug Abuse and Heroin: Impact on Oregon s Youth and Young Adults April 28, 2016 The Oregon Epidemic Oregon ranks #2 in Non-Medical Use of Opioids, 5% of population
More informationSAMHSA State/Tribal/Adolescents at Risk Suicide Prevention Grantee Technical Assistance Meeting
SAMHSA State/Tribal/Adolescents at Risk Suicide Prevention Grantee Technical Assistance Meeting H. Westley Clark, MD, JD, MPH, CAS, FASAM Director Center for Substance Abuse Treatment Substance Abuse and
More informationDelirium Avoid it Recognize it Find the cause of it
Delirium Delirium is acute cognitive dysfunction. It has a 20% - 30 day mortality (usually because of underlying conditions). It is associated with increased lengths of hospital stay, increased disability,
More informationH NDS-ONHealth. Prescription Drug Abuse. Drug overdose death rates in the United States have more than tripled since 1990 and have never been higher.
H NDS-ONHealth Health Wave Newsletter, October 2013 Visit us on our website at www.healthwaveinc.com Drug overdose death rates in the United States have more than tripled since 1990 and have never been
More informationPlease review the following slides prior to class. Information from these slides will be used to answer patient cases. Come prepared!
Please review the following slides prior to class Information from these slides will be used to answer patient cases. Come prepared! Alcohol and Opiate Dependence Reference Slides Substances of Abuse A
More informationPrescription Drug Abuse
Prescription Drug Abuse Providers Need Drug Rehab Before They Can Lead Our Nation Into Recovery Roneet Lev, MD FACEP SCOPE OF PROBLEM Health Ledger 1979-2008 Oxycodone Hydocodone Diazepam (valium) Temazepam
More information9/5/2011. Outline. 1. Past and Current Trends re: RX Abuse 2. Diversion Methods 3. Regulatory Reporting Requirements 4. Q/A
Prescription Drug Abuse Crises Outline 1. Past and Current Trends re: RX Abuse 2. Diversion Methods 3. Regulatory Reporting Requirements 4. Q/A 1 1970s 1980s 2 The 1990s OXYCODONE Oxycodone/APAP OxyContin
More informationDrugs, Society and Behavior
SOCI 270 Drugs, Society and Behavior Spring 2016 Professor Kurt Reymers, Ph.D. Depressants & Inhalants = drugs that slow activity in the central nervous system Includes prescription drugs that treat anxiety
More informationNew Guidelines for Opioid Prescribing
New Guidelines for Opioid Prescribing What They Mean for Elders with Chronic Pain Manu Thakral, PhD, ARNP Kaiser Permanente Washington Health Research Institute Kaiser Permanente Washington Health Research
More informationScreening Brief Intervention and Referral for Treatment (SBIRT) for Substance Use: A Simple, Effective Method for Intervention
Screening Brief Intervention and Referral for Treatment (SBIRT) for Substance Use: A Simple, Effective Method for Intervention Julie Worley, PhD, FNP, PMHNP Kathy Delaney, PhD, PMHNP, FAAN SBIRT Screening:
More informationTennessee. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile Tennessee Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationPrescription Drug Abuse Understanding a Global Epidemic and How Tribal Nations are Working to Combat It
Prescription Drug Abuse Understanding a Global Epidemic and How Tribal Nations are Working to Combat It Sarah Reckess & Precious Benally Center for Court Innovation Center for Court Innovation Outline
More informationImplementing the 2017 President s Challenge: Primary, Secondary & Tertiary Prevention of Addiction & Substance Misuse
Implementing the 2017 President s Challenge: Primary, Secondary & Tertiary Prevention of Addiction & Substance Misuse Jay Butler, MD, President of ASTHO, Chief Medical Officer, Alaska Department of Health
More informationStrategies in Managing Opioid and Benzodiazepine Co-Prescribing
Strategies in Managing Opioid and Benzodiazepine Co-Prescribing Scott Endsley, MD Associate Medical Director, Quality Partnership HealthPlan of California October 25, 2016 Audio Instructions To avoid echoes
More information