Could we see a prescription opioid epidemic in the UK?

BMJ ◽  
2017 ◽  
pp. j790 ◽  
Author(s):  
Michael H Basler
Keyword(s):  
Prescription Opioid ◽  
Opioid Epidemic ◽  
The Uk

Prescription Opioid Epidemic and Trends in the Clinical Development of New Pain Medications

2019 ◽  
Vol 94 (12) ◽  
pp. 2437-2443 ◽  
Author(s):  
Thomas J. Hwang ◽  
Michael S. Sinha ◽  
Chintan V. Dave ◽  
Aaron S. Kesselheim
Keyword(s):  
Clinical Development ◽  
Prescription Opioid ◽  
Opioid Epidemic ◽  
Pain Medications

The prescription opioid epidemic in developed versus underdeveloped countries: Is there a happy medium?

2016 ◽  
Vol 12 (2) ◽  
pp. 93 ◽  
Author(s):  
Roland N. Kaddoum, MD ◽  
Doralina L. Anghelescu, MD ◽  
Cynthia Karam ◽  
Marie T. Aouad, MD ◽  
Eveline Hitti, MD, MBA
Keyword(s):  
Prescription Opioid ◽  
Opioid Epidemic ◽  
Underdeveloped Countries

No abstract

scholarly journals Opioid Epidemic or Pain Crisis? Using the Virginia All Payer Claims Database to Describe Opioid Medication Prescribing Patterns and Potential Harms for Patients With Cancer

2019 ◽  
Vol 15 (12) ◽  
pp. e997-e1009 ◽  
Author(s):  
Virginia T. LeBaron ◽  
Fabian Camacho ◽  
Rajesh Balkrishnan ◽  
Nengliang (Aaron) Yao ◽  
Aaron M. Gilson
Keyword(s):  
Essential Element ◽  
The United States ◽  
Prescribing Patterns ◽  
Prescription Opioid ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Opioid Medication ◽  
Claims Database ◽  
Patients With Cancer ◽  
Controlled Substance

PURPOSE: A key challenge regarding the current opioid epidemic is understanding how concerns regarding opioid-related harms affect access to pain management, an essential element of cancer care. In certain regions of the United States where disproportionately high cancer mortality and opioid fatality rates coexist (such as southwest Virginia in central Appalachia), this dilemma is particularly pronounced. METHODS: This longitudinal, exploratory, secondary analysis used the Commonwealth of Virginia All Payer Claims Database to describe prescription opioid medication (POM) prescribing patterns and potential harms for adult patients with cancer living in rural southwest Virginia between 2011 and 2015. Descriptive and inferential statistical analyses were conducted at the patient, prescriber, and prescription levels to identify patterns and predictors of POM prescribing and potential harms. To explore geographic patterns, choropleth and heat maps were created. RESULTS: Of the total sample of patients with cancer (n = 4,324), less than 25% were prescribed a Controlled Substance Schedule II POM at least three times in any study year. More than 60% of patients never received a Controlled Substance Schedule II POM prescription. Six hundred fifty-two patients (15.1%) experienced 1,599 hospitalizations for any reason; 10 or fewer patients were admitted for 11 opioid use disorder–related hospitalizations. The main findings suggest potential undertreatment of cancer-related pain; no difference in risk for opioid-related hospitalization on the basis of frequency of POM prescriptions; and geographic disparities where opioid overdoses are occurring versus where POM prescription use is highest. CONCLUSION: These findings have significant opioid policy and practice implications related to the need for cancer-specific prescribing guidelines, how to optimally allocate health delivery services, and the urgent need to improve data interoperability and access related to POMs.

We Need to Talk About Codeine: an Implementation Study to reduce the number of Emergency Department patients discharged on high-strength co-codamol using the Behaviour Change Wheel

2021 ◽  
pp. emermed-2020-209479
Author(s):  
Rajendra Raman ◽  
Laura Fleming
Keyword(s):  
Emergency Department ◽  
Behaviour Change ◽  
High Strength ◽  
Opioid Addiction ◽  
Prescription Opioid ◽  
Opioid Overdose ◽  
National Guidelines ◽  
Behaviour Change Wheel ◽  
Addiction Risk ◽  
The Uk

BackgroundThe crisis of prescription opioid addiction in the USA is well-documented. Though opioid consumption per capita is lower in the UK, prescribing has increased dramatically in recent decades with an associated increase in deaths from prescription opioid overdose. At one Scottish Emergency Department high rates of prescribing of take-home co-codamol (30/500 mg) were observed, including for conditions where opioids are not recommended by national guidelines. An Implementation Science approach was adopted to investigate this.MethodsA Behaviour Change Wheel analysis suggested several factors contributing to high opioid prescribing: poor awareness of codeine addiction risk, poor knowledge of NICE (National Institute for Health and Care Excellence) guidelines on common painful conditions, mistaken assumptions about patient expectations and ready access to a large stock of take-home co-codamol. Based on this analysis a combined Education/Persuasion intervention was implemented over a 1-month period (January 2019) reaching 93% of prescribers. An Environmental Restructuring intervention was introduced at 4 months, and co-codamol prescriptions were monitored over a 12-month follow-up period. Unplanned re-attendances and complaints related to analgesia were monitored as balancing measures.ResultsThe Education/Persuasion intervention was associated with a 59% reduction in co-codamol prescribing that was maintained over 12 months. The Environmental Restructuring intervention was not associated with any further reduction in prescribing. No increase in unplanned re-attendances occurred during the study period and no complaints were received relating to pain control.ConclusionsThe increasing incidence of prescription opioid addiction in the UK suggests the need for all clinicians who write opioid prescriptions to re-evaluate their practice. This study suggests that knowledge of addiction risk and prescribing guidelines is poor among Emergency Department prescribers. We show that a rapid and sustained reduction in prescribing of take-home opioids is feasible in a UK Emergency Department, and that this reduction was not associated with any increase in unplanned re-attendances or complaints related to analgesia.

scholarly journals The Opioid Epidemic and the Role of the Occupational Health Nurse

2018 ◽  
Vol 67 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Sheila A. Higgins ◽  
Jill Simons
Keyword(s):  
Occupational Health ◽  
Large Scale ◽  
State Level ◽  
Prescription Drug Abuse ◽  
Prescription Opioid ◽  
Opioid Epidemic ◽  
Health Crisis ◽  
Health Nurse ◽  
National Public Health ◽  
Occupational Health Nurse

The opioid epidemic is a national public health crisis. It began with the misuse of commonly used prescription opioid pain relievers and has led to the increased use of heroin and illicit fentanyl. Large-scale initiatives have begun on the federal and state level and place an emphasis on improved opioid prescribing, which have important implications for the workplace. Treatment of work injury may initiate the use of prescription opioids and result in misuse and possible overdose. Prescription drug abuse affects all aspects of society so potentially any workplace could be affected. A multifaceted approach is needed to reduce opioid morbidity and mortality and the occupational health nurse should be actively involved. The intent of this article is to provide an overview of the epidemic and its impact on health, the challenges for the workplace, and recommended strategies for the occupational health nurse to impact the problem.

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