Evaluating Abuse, Misuse, Diversion, Overdose, Addiction, and Death in the Patient Population
|
|
- Chester Knight
- 6 years ago
- Views:
Transcription
1 Evaluating Abuse, Misuse, Diversion, Overdose, Addiction, and Death in the Patient Population ISCTM February 18, 2014 Beatrice Setnik, Ph.D. INC Research, Raleigh, NC
2 Overview Prevalence of Rx drug misuse, abuse and diversion amongst patients is not well characterized Initiatives taken to gather more data: Post marketing requirement for long-acting opioids issued Sept stipulating: Assessment of RX opioid abuse, misuse, addiction, overdose and death Development /validation of tools/ instruments to measure outcomes of interest
3 Definitions Smith SM et al., Classification and definition of misuse, abuse, and related events in clinical trials: ACTTION systematic review and recommendations. Pain Nov;154(11): Katz NP, Adams EH, Chilcoat H, Colucci RD, Comer SD, Goliber P, et al. Challenges in the development of prescription opioid abusedeterrent formulations. Clin J Pain 2007 Oct;23(8):
4 A Measurement Dilemma Misuse, abuse, and diversion are behavioral events whereas death, overdose, addiction are tangible, diagnostic events Challenging to create one tool that fits all Instruments that assess overdose, addiction: e.g. Overdose Baseline Questionnaire; Refill Questionnaire e.g. Diagnostic and Statistical Manual, Addiction Severity Index, Alcohol and Drug Diagnostic Instrument Current instruments are insufficient to measure misuse, abuse, and diversion in pain patients Abuse Potential Measures e.g. Drug Effects Questionnaire, ARCI* Not validated in pain patient populations Content validity not established in pain patients e.g. Drug Liking due to euphoria or pain relief? Do not address actual abuse, misuse and diversion *Addiction Research Center Inventory (ARCI)
5 A Measurement Dilemma Current instruments are insufficient to measure misuse, abuse, and diversion in pain patients Abuse/Misuse Assessments e.g. SOAPP-R, ORT, DAST, COMM* Current instruments are in-clinic assessments used to assess risk or presence of aberrant behaviors Lack distinction between abuse and misuse Diversion typically not addressed Tampering/alternate routes of administration not addressed Specific drug products abused/misused are not identified Do not quantify number of attempts at misuse, abuse and diversion Adverse events Aberrant behaviors/events of euphoria often under-reported; patients not likely to admit behaviors, good effects may not always be considered AEs Investigators/clinic staff may not always be trained to identify aberrant behaviors No systematic method to obtain information when aberrant events occurs Adverse events of interest are not direct signals of abuse/misuse; may be indicators of abuse/misuse of another substance *Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP-R); Opioid Risk Tool (ORT); Drug Abuse Screening Test (DAST); Current Opioid Misuse Measure (COMM)
6 Self-Reported Misuse, Abuse & Diversion Questionnaire (SR-MAD) Self-report, confidential, online questionnaire collected via a third party Assesses past behavior and does NOT predict future behavior Intended to be used in a pain patient population Baseline (as part of a clinical trial, registry or survey) and Post baseline (with investigational drug) assessment Probes past (lifetime and/or past 30 days) behaviors related to Rx opioid misuse, abuse and diversion Determines frequency of tampering and use by various (unintended) routes of administration (i.e. snorting, injection) Rx opioid specific Segregates behaviors according to misuse, abuse, and diversion Output to include the severity of Rx opioid MAD (algorithm under early stage of development)
7 Development Path SR-MAD Instrument drafted (comprehension tested in non-pain patients) Early version paper/pencil included in a large patient study as an exploratory assessment; assessed lifetime behaviors Advisory board held with experts to obtain feedback Two of three rounds of cognitive debrief interviews in pain patients completed; last round ongoing: Instrument adapted to online version following first round Past 30 day version and investigational drug version created prior to third round Validation study further planned Setnik et al., Content validation of the prescription opioid misuse, abuse, and diversion instrument in the chronic pain patient population. Poster. College on Problems of Drug Dependence Annual Meeting. June 2013.
8 SR-MAD: Exploratory Phase IV Study Results Early lifetime paper/pencil version of SR-MAD administered at baseline in a clinical trial Phase IV, multicenter, primary care based, open-label study to assess the success of converting opioid experienced patients with chronic moderate to severe pain to extended release morphine. Patients were opioid experienced (taking daily opioid for days), chronic moderate to severe patients ( 3 months) (N=684, safety population) and had no history of opioid and/or alcohol abuse Setnik et al., A primary care-based open-label study assessing the success of converting opioid-experienced patients with chronic pain to EMBEDA using a standardized conversion guide and identifying behaviors related to prescription opioid misuse, abuse, and diversion. (abstract) American Pain Society Annual Scientific Meeting. May 8-11, 2013.
9 SR-MAD: Exploratory Phase IV Study Results A total of 587 (85.4%) subjects returned the questionnaire. Of these: The majority of patients (60%) reported taking more prescription opioid medication than prescribed ( 1 time/lifetime) 11% of patients reported having chewed or crushed their opioid 2% of patients reported having tried to snort, smoke, or inject their opioid pills The most common reason was to treat my pain better suggesting misuse; a small number (1-4 patients) per question indicated to feel pleasant or high suggesting abuse 8% of patients reported obtaining an opioid from more than 1 doctor at the same time 7% of patients reported giving away their opioid medication 9% of patients obtained a prescription opioid medication from someone who was not a doctor 17% of patients suspected that someone else may have taken their medication without asking them.
10 Assessing Adverse Events AEs broadly reviewed by CDER/CSS; refined to a screening list of 213 abuse-related AEs for assessing abuse potential of drugs Goal: To improve consistency, sensitivity, and specificity in the identification, reporting and interpretation of abuse related events during development and post-marketing of CNS-active drugs List included AEs related to psychoactive effects; therapeutic indications and excluded risk/comorbid factors, non-specific signs and symptoms; complications & consequences; withdrawal signs & symptoms Considerations to new coding version; improvement of sensitivity and specificity Love L.A. and Sun S. Proposed Query to Capture Abuse-Related Adverse Events. (abstract) College on Problems of Drug Dependence 75 th Annual Meeting, San Diego, CA, June 2013.
11 Proposed Query to Capture Abuse-Related AEs
12 Assessing Adverse Events Methodology for collecting abuse-related AEs requires standardization; differentiation from misuse important Standardized clinical probes/training for eliciting AEs Collection of consistent and meaningful details for case narratives Sample classification of abuse-related AE types (chronological) 1. psychoactive effects (e.g. elevated mood, feeling drunk) 2. behavior (e.g. drug abuse, drug diversion) 3. physical signs of abuse (e.g. needle marks, drug screen positive) 4. outcomes (e.g. accidental death, accidental overdose) Clinical probes will vary according to type of AE (e.g. outcomes event will require different information compared to pyschoactive effect event)
13 Interpreting Adverse Events Clinical probes (standardized questionnaires/ checklists) need to collect information consistently across studies to include (not limited to): Collection at all time-points (AEs are not coded in real time hence probes cannot be triggered in real time) Summarize all aberrant events observed in individual patient over time Intentionality Types of drugs involved; investigational vs. concomitant vs. contraband Causality: drug-related; co-morbidity; other drug? Duration of event Medical history Motive (behavioral)- related to abuse or misuse? Triggering additional data collection e.g. UDT Defining threshold of what is clinically relevant Other signals of interest include aberrant pill counts, concomitant medications, frequent requests for refills, pharmacy /doctor shopping
14 Summary Aberrant behaviors occur in the patient population and are important to measure Currently there are no validated tools that quantify behaviors related to abuse, misuse, and diversion New instruments (e.g. SR-MAD) are required to assess these behaviors in patients Adverse events require a structured approach to obtain meaningful information regarding abuse potential evaluation
Assessing the Clinical Abuse Potential of Abuse Deterrent Opioid Formulations
Assessing the Clinical Abuse Potential of Abuse Deterrent Opioid Formulations November 16, 2016 Beatrice Setnik, PhD VP, Clinical Pharmacology, Early Phase INC Research Disclosure I am an employee of INC
More information2018 CPDD Meeting Wednesday, June 13 1:30 pm-1:45 pm (Pain Session)
2018 CPDD Meeting Wednesday, June 13 1:30 pm-1:45 pm (Pain Session) Assessment of Drug Abuse-Related Events with MADDERS in SUMMIT-07: A Phase-3 Study of NKTR-181 in Patients With Moderate to Severe Chronic
More informationRule Governing the Prescribing of Opioids for Pain
Rule Governing the Prescribing of Opioids for Pain 1.0 Authority This rule is adopted pursuant to Sections 14(e) and 11(e) of Act 75 (2013) and Sections 2(e) and 2a of Act 173 (2016). 2.0 Purpose This
More informationClassification of Abuse-Related Events in Analgesic Clinical Trials: Recommendations and Research Agenda
Classification of Abuse-Related Events in Analgesic Clinical Trials: Recommendations and Research Agenda Nathaniel Katz, MD, MS Analgesic Research, Needham, MA Tufts University, Boston, MA IMMPACT XII,
More informationScreener and Opioid Assessment for Patients with Pain- Revised (SOAPP -R)
Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP -R) The Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP -R) is a tool for clinicians to help determine how much
More informationBest Practices for Prescribing Controlled Substances
Best Practices for Prescribing Controlled Substances Dr. Merrill Norton Pharm.D., D.Ph, ICCDP-D Clinical Associate Professor University of Georgia College of Pharmacy mernort@uga.edu Georgia Composite
More informationEvaluating the Impact of Abuse Deterrent Formulations: Methodological Challenges in Postmarketing Data
Evaluating the Impact of Abuse Deterrent Formulations: Methodological Challenges in Postmarketing Data Judy A. Staffa, Ph.D., R.Ph. Associate Director for Public Health Initiatives Office of Surveillance
More informationUse of Opioids for Chronic Non Malignant Pain (CNMP)
I. PURPOSE Use of Opioids for Chronic Non Malignant Pain (CNMP) We the Safe Opioid Prescribing and Review Committee (SOPARC) are inspired to support a shift in opioid prescribing that improves clinical
More informationAddressing the Opioid Epidemic: Prescribing Opioids for Non-Cancer Pain
Addressing the Opioid Epidemic: Prescribing Opioids for Non-Cancer Pain Ajay D. Wasan, MD, MSc Professor of Anesthesiology and Psychiatry Vice Chair for Pain Medicine, Department of Anesthesiology University
More informationURINE DRUG TESTING FOR SUBSTANCE ABUSE TREATMENT AND CHRONIC PAIN MANAGEMENT
Status Active Medical and Behavioral Health Policy Section: Laboratory Policy Number: VI-47 Effective Date: 07/21/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members
More informationNo disclosures for any of the speakers!
Opiate Use Disorders and Pain in the elderly: Integrating care with the pain specialist Gabriel Paulian M.D Christopher Ong, M.D Yuliet Sanchez, M.D Uma Suryadevara, M.D No disclosures for any of the speakers!
More informationValue of Abuse-Deterrent Opioids. For your personal use. Not for further distribution.
Value of Abuse-Deterrent Opioids HHS Data Show that Prescription Opioid Abuse Continues To Be a Serious Public Health Issue At least half of all opioid overdose deaths in the United States (US) involve
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 informationMedication Management
Marina Treglia, AGPCNP BC April 4, 2019 Medication Management Identify patient criteria for risk mitigation in a medication management program at a multidisciplinary pain clinic Discuss opioid discontinuation
More informationChapter 1. Drug Use: An Overview. The Drug Problem Talking About Drug Use. Talking About Drug Use
Chapter 1 Drug Use: An Overview The Drug Problem Talking About Drug Use To evaluate the extent of the drug problem and propose possible solutions, it helps to ask basic journalism questions: Who? What?
More informationDENOMINATOR: All patients 18 and older prescribed opiates for longer than six weeks duration
Quality ID #414: Evaluation or Interview for Risk of Opioid Misuse National Quality Strategy Domain: Effective Clinical Care Meaningful Measure Area: Prevention and Treatment of Opioid and Substance Use
More informationA LOOK AT ABUSE-DETERRENT OPIOIDS
JULY 2017 Drugs Under Review ICER s report reviewed evidence on ten abuse-deterrent formulations (ADF) of opioids. Nine of the drugs were extended release (ER) opioids, and one was immediate release (IR).
More informationSetting the Stage: Are Abuse-Deterrent Opioids Formulations Ready for Prime Time?
Setting the Stage: Are Abuse-Deterrent Opioids Formulations Ready for Prime Time? Lewis S. Nelson, MD New York University School of Medicine New York City Poison Control Center Opioid Abuse Liability
More informationOPIOID ANALGESICS AND STIMULANT MEDICATIONS: A Clinician Guide to Prevent Misuse
OPIOID ANALGESICS AND STIMULANT MEDICATIONS: A Clinician Guide to Prevent Misuse Advances in pharmacologic therapy have improved quality of life for patients living with pain, ADHD, and other conditions.
More informationQuality ID #414: Evaluation or Interview for Risk of Opioid Misuse National Quality Strategy Domain: Effective Clinical Care
Quality ID #414: Evaluation or Interview for Risk of Opioid Misuse National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION:
More informationPain Management and Addiction: Clinical Challenges
Pain Management and Addiction: Clinical Challenges MMS Pain Management Forum March 12, 2010 Associate Professor of Medicine Boston University School of Medicine Boston Medical Center Conflicts of Interest
More informationDocuments Regarding Drug Abuse Assessments
Overview of the FDA Guidance Documents Regarding Drug Abuse Assessments ABUSE DETERRENT FORMULATION SCIENCE MEETING DISCUSSION OF THE FDA DRAFT GUIDANCE FOR INDUSTRY: ABUSE DETERRENT OPIOIDS EVALUATION
More informationPrescription Opioids
What are prescription opioids? Prescription Opioids Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made
More informationWashington State s Overdose Epidemic
Caleb Banta-Green PhD MPH MSW Senior Research Scientist- Alcohol and Drug Abuse Institute Affiliate Associate Professor- School of Public Health Affiliate Faculty- Harborview Injury Prevention & Research
More informationChallenges in Conducting Postmarketing Abuse Investigations
Challenges in Conducting Postmarketing Abuse Investigations Paul Coplan, ScD, MBA Risk Management & Epidemiology Purdue Pharma, L.P. ADF Guidance Meeting Washington DC, October 1, 2013 1 That which we
More informationIdentification and Treatment of Opioid Use Disorders in Primary Care Settings
Identification and Treatment of Opioid Use Disorders in Primary Care Settings 17th Annual Primary Care Symposium February 24, 2018 Kelly S. Barth, DO Associate Professor, Psychiatry & Internal Medicine
More informationApproaches to Responsible Opioid Prescribing. The Opioid Naïve Patient
Approaches to Responsible Opioid Prescribing The Opioid Naïve Patient Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted
More informationIn Vitro Considerations for Development Abuse Deterrent Dosage Forms
In Vitro Considerations for Development Abuse Deterrent Dosage Forms Presentation to AAPS Annual Meeting Nov 3, 2014 Nagesh Bandi, Ph.D. Global CMC New Products Pfizer Inc. 1 Disclaimer The thoughts and
More informationApplying Universal Precautions to Chronic Opioid Therapy 5P s Assessment
Elements of Leverage Point #3: Applying Universal Precautions to Chronic Opioid Therapy 1. Diagnosis with reasonable differential 2. Psychological assessment including risk of addictive disorders Purpose
More informationThe Challenge of Treating Pain
FDA Charge to the Committee: FDA Opioid Action Plan and Incorporating the Broader Public Health Impact into the Formal Risk-Benefit Assessment for Opioids Robert M. Califf, MD Commissioner of Food and
More informationThe Emergence of Gabapentin as a Drug of Abuse in a Cohort of Rural Appalachian Drug Users
The Emergence of Gabapentin as a Drug of Abuse in a Cohort of Rural Appalachian Drug Users Jennifer R. Havens, PhD, MPH Center on Drug and Alcohol Research Goals Describe the epidemiology of gabapentin
More informationEvidence of Co-occurring Alcohol and Prescription Opioid Abuse in Clinical Populations: Implications for Screening
November 20-21, 2008 Tufts Health Care Institute Program on Opioid Risk Management Conference on Co-Ingestion of Alcohol with Prescription Opioids Evidence of Co-occurring Alcohol and Prescription Opioid
More informationTeaching Objectives Describe the balance a that must be sought in the treatment of pain and the prevention of drug diversion. Discuss regulatory polic
Preventing Controlled Substance Diversion David B. Brushwood, R.Ph.,., J.D. Professor of Pharmaceutical Outcomes & Policy The University of Florida Teaching Objectives Describe the balance a that must
More informationTen Tips for Prescribing Controlled Substances. Charlie Reznikoff MD Hennepin County Medical Center
Ten Tips for Prescribing Controlled Substances Charlie Reznikoff MD Charlie.reznikoff@hcmed.org Hennepin County Medical Center Tip #1: Avoid prescribing highly reinforcing (addictive) drugs Tip #1: Avoid
More information4. The School is committed to the prevention of substance misuse through education and support. PROCEDURE
BISHOP WORDSWORTH S SCHOOL SUBSTANCE USE AND MISUSE POLICY Note: Parent(s) includes guardian(s) or any person who has parental responsibility for the boy or who has care of him. 1. General. This document
More informationBlueprint for Prescriber Continuing Education Program
CDER Final 10/25/11 Blueprint for Prescriber Continuing Education Program I. Introduction: Why Prescriber Education is Important Health care professionals who prescribe extended-release (ER) and long-acting
More informationBest Practices in Prescribing Opioids for Chronic Non-cancer Pain
Best Practices in Prescribing Opioids for Chronic Non-cancer Pain Disclosures S C O T T S T E I G E R, M D, F A C P, D A B A M A S S I S T A N T C L I N I C A L P R O F E S S O R D I V I S I O N O F G
More informationRetrospective analyses of abuse-related outcomes in clinical trials of analgesic drugs and their interpretation
Retrospective analyses of abuse-related outcomes in clinical trials of analgesic drugs and their interpretation IMMPACT-X Abuse Deterrent Opioid Analgesics June 2-4, 2009 Arlington, Virginia USA Michael
More informationNBPDP Drug Utilization Review Process Update
Bulletin # 802 December 1, 2010 NBPDP Drug Utilization Review Process Update The New Brunswick Prescription Drug Program (NBPDP) employs a Drug Utilization Review (DUR) process which identifies, investigates
More informationOpioid Analgesics with Abuse- Deterrent Properties: Current Data and Future Opportunities
1 National Academy of Medicine Session 4 Opioid Analgesics with Abuse- Deterrent Properties: Current Data and Future Opportunities Richard C. Dart, MD, PhD Director, Rocky Mountain Poison and Drug Center
More informationTrends in Opioid Analgesic Abuse and Mortality in Europe
Current Challenges of Opioids EAPCCT Annual Congress 26 May 2016 Trends in Opioid Analgesic Abuse and Mortality in Europe Jody L. Green, PhD, CCRP Denver Health Rocky Mountain Poison & Drug Center Disclosure
More informationOpioid Harm Reduction
Opioid Harm Reduction Lucas G. Hill, PharmD Clinical Assistant Professor, The University of Texas at Austin College of Pharmacy Clinical Pharmacist, CommUnityCare FQHCs Director, Operation Naloxone Mark
More informationLessons Learned from the US Prescription Opioid Abuse Epidemic
Lessons Learned from the US Prescription Opioid Abuse Epidemic Michelle Lofwall, M.D. University of KY, Dept. of Psychiatry Center on Drug and Alcohol Research October 3, 2012 Outline for today s talk
More informationUniversity of Pittsburgh
Learning Objectives Participants will be able to: Associate the history of prescription drug use in America with the current trend of prescription drug abuse; Differentiate between the three most commonly
More informationRisk Reduction Strategies in Pain Management
Risk Reduction Strategies in Pain Management Melissa J. Durham, PharmD, MACM, BCACP, DAAPM Assistant Professor of Clinical Pharmacy USC School of Pharmacy Clinical Pharmacist, The USC Pain Center Learning
More informationFact Sheet. Zohydro ER (hydrocodone bitartrate) Extended-Release Capsules, CII
Zohydro ER (hydrocodone bitartrate) Extended-Release Capsules, CII Fact Sheet Zohydro ER (hydrocodone bitartrate) Extended-Release Capsule, CII, is a long-acting (extendedrelease) type of pain medication
More informationEgalet Corporate Presentation
Egalet Corporate Presentation Specialty Pharmaceutical Company Focused on Pain 1 NASDAQ: EGLT Forward-Looking Statements Statements included in this presentation that are not historical in nature are "forward-looking
More informationOpioids: Use and Misuse/Steven Feinberg, MD; Scott Levy, MD, MPH, FACOEM
Western Occupational Health Conference September 14, 2012 Opioid - Use & Misuse Scott Levy, MD MPH FACOEM Steven Feinberg, MD, MPH Disclosure Information Western Occupational Health Conference 2012 Steven
More informationOregon Prescription Drug Monitoring Program
Oregon Prescription Drug Monitoring Program 2013 Annual Report to the PDMP Advisory Commission PUBLIC HEALTH DIVISION Prescription Drug Monitoring Program Oregon Prescription Drug Monitoring Program 2013
More informationSponsored CME Lecture: Update on Opioid Management for Chronic Pain. Steven Stanos, DO
Sponsored CME Lecture: Update on Opioid Management for Chronic Pain Steven Stanos, DO ACOFP FULL DISCLOSURE FOR CME ACTIVITIES Please check where applicable and sign below. Provide additional pages as
More informationFDA Briefing Document
FDA Briefing Document Joint Meeting of Anesthetic and Analgesic Drug Products Advisory Committee and Drug Safety and Risk Management Advisory Committee September 11, 2015 Page 1 DISCLAIMER STATEMENT The
More informationOpioids: Real People. Real Stories. Real Science.
Opioids: Real People. Real Stories. Real Science. Virtual Field Trip Companion Activity The use and misuse of opioids in the United States is a problem that is not going away. Although we continue to learn
More informationAddressing Alaska s Opioid Epidemic From Understanding to Action
Addressing Alaska s Opioid Epidemic From Understanding to Action The opioid epidemic is devastating American families and communities. To curb these trends and save lives, we must help prevent addiction
More informationMedicinal product no longer authorised
EMA/764409/2015 Summary of the risk management plan (RMP) for Ionsys (fentanyl) This is a summary of the risk management plan (RMP) for Ionsys, which details the measures to be taken in order to ensure
More informationImplementing Pain and Opioid Management Guidelines in Primary Care Practice
Implementing Pain and Opioid Management Guidelines in Primary Care Practice Objectives 1. What is the issue? 2. Why use a dedicated dissemination & implementation process? a. Historical perspective Cooperative
More informationEmbeda. Embeda (morphine sulfate and naltrexone hydrochloride) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.39 Subject: Embeda Page: 1 of 6 Last Review Date: March 18, 2016 Embeda Description Embeda (morphine
More informationOPIOID PRESCRIBING RULES. May 17, 2017 Webinar
OPIOID PRESCRIBING RULES May 17, 2017 Webinar Outline Introduction and Universal Precautions Dr. Levine, Commissioner, Health Department 15 Minutes Acute Pain Dr. Patti Fisher, UVMMC 20 Minutes Chronic
More informationChronic Disease Management for Pain: It CAN be done in primary care!
Chronic Disease Management for Pain: It CAN be done in primary care! Sondra Adkinson, PharmD, DAAPM, CPE Thomas B. Gregory, Pharm.D., BCPS, DASPE, CPE Chris Herndon, PharmD, BCPS, CPE Disclosures Adkinson:
More informationPatient-reported and interview-rated abuse-related outcomes
Patient-reported and interview-rated abuse-related outcomes Jennifer A. Haythornthwaite, Ph.D. Department of Psychiatry & Behavioral Sciences Johns Hopkins University School of Medicine October 2, 2009:
More informationCOUNSELING PATIENTS & CAREGIVERS ABOUT THE SAFE USE OF ER/LA OPIOID ANALGESICS
COUNSELING PATIENTS & CAREGIVERS ABOUT THE SAFE USE OF ER/LA OPIOID ANALGESICS Unit IV Melvin Pohl, MD, FASAM Use Patient Counseling Document to help counsel patients Download www.er-laopioidrems.com/iwgui/re
More informationTake Home Naloxone elearning Module Script
elearning Module Script Slide 1-3 Review the outline and the plan for the presentation. Slide 4 We do accept the cynicism of this poster. Slide 5 Read from the slide the definition of Harm Reduction Slide
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 informationInvestors Update: Abuse-Deterrent d-amphetamine Immediate Release (ADAIR) for ADHD
Investors Update: Abuse-Deterrent d-amphetamine Immediate Release (ADAIR) for ADHD February 7, 2017 1 Forward-Looking Statements This presentation contains forward-looking statements within the meaning
More informationRAPID Analysis of Routes of Administration: Oral to Non-Oral Transitions
RAPID Analysis of Routes of Administration: Oral to Non-Oral Transitions Dr. Theodore J. Cicero, PhD John P. Feighner Professor of Psychiatry Washington University in St. Louis, MO RAPID Program Overview
More information25/03/2014. Workshop Overview. Hot Topics in FDA Regulations and Pharmacotherapy Research that Impact Patient Care:
Hot Topics in FDA Regulations and Pharmacotherapy Research that Impact Patient Care: Sharon L. Walsh, Ph.D. Shanna Babalonis, Ph.D. Michelle Lofwall, M.D. Center on Drug and Alcohol Research Department
More informationHow does polydrug use contribute to heroin overdose deaths? Risk to heroin users of concurrent use of pregabalin and gabapentin
How does polydrug use contribute to heroin overdose deaths? Risk to heroin users of concurrent use of pregabalin and gabapentin Graeme Henderson Suzanne Audrey Matt Hickman Abi Lyndon Rob Hill Claudia
More informationChronic Pain, Opioids, & Addiction: Assessing and Managing Risk
Chronic Pain, Opioids, & Addiction: Assessing and Managing Risk Randy Brown MD, PhD, FASAM Associate Professor, Dept of Family Medicine Director, Center for Addictive Disorders, UWHC Director, UW Addiction
More informationNa#onal Ins#tute for Health Care Management Founda#on Webinar
Na#onal Ins#tute for Health Care Management Founda#on Webinar Blue Cross Blue Shield of Massachuse=s Opioid Safety Management Program Thomas Kowalski, RPh November 2, 2015 National and Local Concern National
More informationOpioid Overdose in Oregon Report to the Legislature
SEPTEMBER 2018 Opioid Overdose in Oregon Report to the Legislature This report summarizes the burden of opioid overdose among Oregonians as required by ORS 432.141. It describes Oregon s progress in reducing
More informationNutrition & Wellness for Life 2012 Chapter 19: Drug and Supplement Use and Your Health
Chapter 19: Drug and Supplement Use and Your Health Tools: Printer 8.5 x 11 paper Scissors Directions: 1. Print 2. Fold paper in half vertically 3. Cut along dashed lines Copyright Goodheart-Willcox Co.,
More informationDisclosures. The Problem. The Problem. The Problem. The Problem. Buprenorphine Use in Combined Chronic Pain and Opioid Addiction
Buprenorphine Use in Combined Chronic Pain and Opioid Addiction Sandra D. Comer, Ph.D. Disclosures Within the last 3 years, consulted for AstraZeneca, BioDelivery Sciences, Camarus, Clinilabs, Grunenthal,
More informationFentanyl, Opioid Overdose and Naloxone
Fentanyl, Opioid Overdose and Naloxone Opioid Agonist Therapy Conference Saskatoon, SK April, 2016 Declaration No conflict of interest. Consultant in Addiction Medicine, SHR. Chair, College of Physicians
More informationBENZODIAZEPINE DEPENDENCE AMONG MULTIDRUG USERS IN THE CLUB SCENE. Steven P. Kurtz and Mance E. Buttram
BENZODIAZEPINE DEPENDENCE AMONG MULTIDRUG USERS IN THE CLUB SCENE Steven P. Kurtz and Mance E. Buttram Global Addiction 2016 2 4 October 2016 Venice, Italy This research was supported by grant number DA0196048
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 informationsolutions MEDICATION MIS MANAGEMENT and Chronic Pain 10/4/2016 Opioid Abuse: Current Data Opioid Abuse: Current Data
MEDICATION MIS MANAGEMENT and Chronic Pain solutions Opioid Abuse: Current Data Americans consume 80% of the global supply of opioids This includes 99% of the world s hydrocodone and 2/3s of the world
More informationThe Practical Aspects of Prescribing Opioids for Chronic Pain
The Practical Aspects of Prescribing Opioids for Chronic Pain - 2018 Lloyd Saberski, MD Internal medicine, Anesthesiology Pain management Faculty: Yale School of Medicine Department of Medicine Palliative
More information2004-L SEPTEMBER
BULLETIN INTELLIGENCE Buprenorphine: Potential for Abuse Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III
More informationTobacco, Alcohol, Drugs. Chapter 11, 12, & 13
Tobacco, Alcohol, Drugs Chapter 11, 12, & 13 Four Corners (Walls) Title a new entry: ACTIVITY - FOUR CORNERS Write the following in your comp. book: Alcohol is a drug. Four Corners (Walls) Choose one response
More informationClinical and Contextual Evidence Reviews
Clinical and Contextual Evidence Reviews Roger Chou, MD Professor of Medicine Oregon Health & Science University Director, Pacific Northwest Evidence-based Practice Center Purpose Summarize methods for
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 information4/3/2018. The Role of Pharmacists in the Safe Prescribing of Opioids: Having the Tough Talks with Patients and Prescribers. Learning Objectives
The Role of Pharmacists in the Safe Prescribing of Opioids: Having the Tough Talks with Patients and Prescribers Melissa Durham Tania Gregorian Vlada Manzur Learning Objectives Describe current issues
More informationHouse of Pain? A Standardized Approach to Chronic Pain In the Patient-Centered Medical Home. MAJ Meghan Raleigh, MD 17 MAR 2014
House of Pain? A Standardized Approach to Chronic Pain In the Patient-Centered Medical Home MAJ Meghan Raleigh, MD 17 MAR 2014 Make this house your own! Objectives Review key components in PCMH Identify
More informationDisclosures. Your Facilitator: Brian J. Isetts, RPh, PhD, BCPS
Performance Improvement: The Opiate Use Challenge Iowa Healthcare Collaborative: 13 th Annual Conference Brian J. Isetts, RPh, PhD, BCPS August 16, 2016 100 E. Grand Ave., Ste. 360 Des Moines, IA 50309-1800
More informationIdentifying Key Characteristics and Habits of the Recreational Drug User
Identifying Key Characteristics and Habits of the Recreational Drug User Beatrice Setnik, PhD VP Scientific & Medical Affairs, Early Phase CBI Abuse Deterrent Formulations Summit Alexandria, VA March 7,
More informationPrescription Drug Abuse Among the Disabled
Prescription Drug Abuse Among the Disabled As of 2006, the U.S. Department of Health and Human Services Office on Disability estimated that 4.7 million adults experienced a substance abuse problem in addition
More informationTeaming Up for Safer Pain Management: Strategies for Effective Collaboration
Teaming Up for Safer Pain Management: Strategies for Effective Collaboration Noah Nesin, MD, FAAFP, Vice President of Medical Affairs, Penobscot Community Health Care Felicity Homsted, PharmD, DPLA, Chief
More informationHow to inject op oxycontin
How to inject op oxycontin The Borg System is 100 % How to inject op oxycontin Injecting oxycontin is one of the primary methods of abusing this highly addictive prescription drug. Injecting oxycontin
More informationHuntington Beach City School District DAC/DELAC February 7, 2013
Huntington Beach City School District DAC/DELAC February 7, 2013 Project funded by the County of Orange Health Care Agency Alcohol and Drug Education and Prevention Team 1 out of 5 teens have abused a
More informationSuboxone, Zubsolv, Bunavail (buprenorphine with naloxone sublingual tablets and film), Buprenorphine sublingual tablets
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.32 Subject: Suboxone Drug Class Page: 1 of 7 Last Review Date: June 24, 2016 Suboxone Drug Class Description
More informationMedication Misuse and Abuse: A Growing Epidemic
Medication Misuse and Abuse: A Growing Epidemic Colorado Providers Association Professionalizing Prevention June 19, 2015 Mancia Ko, PharmD, MBA Associate Director, Medical Affairs,, Ameritox Assistant
More informationInformation Sheet 10. Medication Hints and Tips (Updated August 2014)
An information sheet on Medication problems and how to prevent them. Memory Loss... People who suffer from dementia or Alzheimer s disease may simply forget to take their medications, causing them to skip
More informationLearn how MORPHABOND ER can help manage your pain
Your healthcare provider has prescribed Learn how can help manage your pain What is? MORPHABOND ER (morphine sulfate) extended-release tablets, CII is a strong prescription pain medicine that contains
More informationAnyone Can Become Addicted. Anyone.
Anyone Can Become Addicted. Anyone. PAStop.org Family Toolkit Seeking Drug Abuse Treatment: Know What to Ask Trying to identify the right treatment programs for a loved one can be a difficult process.
More informationGOVERNMENT S ROLE IN ADDRESSING PRESCRIPTION DRUG ABUSE
POSITION PAPER GOVERNMENT S ROLE IN ADDRESSING PRESCRIPTION DRUG ABUSE Governments across Canada are concerned about the abuse of prescription drugs, with recent policy discussions focused on mitigating
More informationHeroin. What is heroin?
What is heroin? Heroin Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the Asian opium poppy plant. Heroin can be a white or brown powder, or a black sticky
More informationReport to the Legislature: Unsolicited Reporting Criteria Established and Process Review MN Prescription Monitoring Program
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Board of
More informationRED FLAGS, SCREENING AND DIAGNOSING OUD IN CHRONIC PAIN PATIENTS DR. PAULA COOK & DR. ELIZABETH HOWELL
RED FLAGS, SCREENING AND DIAGNOSING OUD IN CHRONIC PAIN PATIENTS DR. PAULA COOK & DR. ELIZABETH HOWELL OBJECTIVES A look at chronic pain and opioid therapy Screening for opioid use disorder (OUD) in chronic
More informationAddressing the Opioid Epidemic in Tennessee
Addressing the Opioid Epidemic in Tennessee A Multidisciplinary Approach Melissa McPheeters, PhD, MPH Director, Informatics and Public Health Analytics 26 108 733 *Source: CDC References Centers for
More informationD. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine
D. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine Financial Disclosure I have no relevant financial relationships
More informationDiversion, misuse and trafficking of methadone and buprenorphine: Impact on recovery
Diversion, misuse and trafficking of methadone and buprenorphine: Impact on recovery Hannu Alho, Ph.D., M.D. Professor of Addiction Medicine, University of Helsinki Research Professor, National Institute
More information