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Post by Admin on Dec 21, 2016 12:33:06 GMT -4
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Post by Roger Elliott on Dec 21, 2016 18:02:28 GMT -4
This is a very sad, but eye opening article giving insight into the ongoing opiate epidemic emerging in the United States. According to the CDC, since 2000, the rate of deaths from drug overdoses has increased by 137%. Despite this fact, I feel as though little has been done to decrease the prescribing, manufacturing and distribution of these pain medications. An interesting quote from the article..., "Was it the dealers who were bringing heroin and pain pills to South Charleston? Or the rural doctors who had first prescribed those pain pills at record rates? Or the small-town pharmacies that had profited off extra-strength oxycodone and fentanyl lollipops? Or the drug companies..." and so on. This brings up an interesting question. Who is to blame for the abrupt increase in opiate related deaths in the US? If there are so many areas that can be regulated, how can we decide which regulation will provide the most benefit.
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Post by Anthony B (MS3) on Dec 22, 2016 19:41:30 GMT -4
The article brings to light the very morose current climate with regards to the current opiate epidemic in our country. We accompany 3 individuals as their stories are told. We get a glimpse at the hardships they have faced, and currently face. Unfortunately, addiction does not discriminate. When it comes to drugs: anyone, from any socioeconomic or ethnic background can fall into a vicious cycle. It would be too easy to point the finger at one source. Drugs, just like guns or cars, do not kill people. Unfortunately this is one of those cases where over regulation will not necessarily improve the outcome. Our best policy right now is to facilitate recovery and awareness.
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Post by Ifunanya Akusoba on Dec 23, 2016 1:25:45 GMT -4
This article is very sad and heartbreaking. There is no denying that we have a huge problem in our country with opiate addiction. I think it is natural to want to place the blame on one group of people and assume that if we deal with them the problem will be over. However, the truth of the matter is that the epidemic of addiction to opiates didn't begin over night and therefore the problem will not be solved over night. It is a multifaceted issue and solution is as well. One thing we need to do is focus on prevention. Doctors need to be very conservative with their prescribing of opiates and parents/schools need to start an open and honest dialogue with children at a young age about drugs of all kinds and this discussion needs to be continued throughout middle school, high school, college and so on. Once one becomes addicted to opiates it is very difficult to become and remain sober, but if we can prevent the next generation from becoming addicted at such a high rate then we have overcome half the battle in my opinion.
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Post by Tina Gaskin on Dec 24, 2016 22:12:56 GMT -4
This article highlights the realities of accidental death by drug overdose. This article also speaks to the choices that were forced on Madie, Zhane, Zoie, and Arianna because the choices the parents ELECTED to participate in weather right or wrong. Certainly I understand that drug addiction is a mental illness and listed in DSM V. Interestingly, addiction is defined as: changes of the brain in fundamental ways, disturbing a person's normal hierarchy of needs and desires and substituting new priorities connected with procuring and using the drug. Based on the definition of addiction the article confirms that the parents definitely had other priorities with procuring drugs even to the detriment of Zhane, on one occasion, station right outside the bedroom door in fear of a drug overdose while they were engaging in these behaviors. Though the article does not directly indicate what actually precipitated both parents drug use/abuse/addiction it does speak to there is a county/state problem with opioid related deaths and states many factors related to the high drug use in the county/state. Certainly with the drug epidemic there is enough blame to go around in regards to the medical community, political/governmental system(s), retail pharmacies and pharmaceutical companies but ultimately each individual is responsible for his or her own actions unless deemed incompetent which this does not appear to be the case here. The one good point of this article is the children, especially Zhane, now may begin to have some home stability with Madie and live a drug free childhood.
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Post by Ferhan Saleem on Dec 26, 2016 0:35:36 GMT -4
Drug addiction including opioid addiction appears to be getting worse as the years go by (CDC, 2016). Drug overdose has become the leading cause of accidental death in the USA with 55,403 lethal dose related deaths in 2015 alone, with 20,101 caused by opioids (ASAM, 2016). It is terrifying to see children losing their parents at such a young age to something that is preventable. I remember this video I came across back in November www.washingtonpost.com/news/true-crime/wp/2016/11/30/mother-captured-in-heartbreaking-overdose-video-charged-with-child-endangerment/?utm_term=.093e7ec6024c. As the article states, it is hard to figure out who is responsible for this opioid addiction epidemic. Is it the individuals themselves, pharmaceutical companies, doctors, socioeconomic status or something else? I think all of these factors have contributed to the problem. The article points out how children may become aware of their parents' problems even at an early age. Since many families have just parents and children living in a household, it is important for children to know when their parents need help just like parents may notice a child in trouble. Maybe school curricula can provide education for children to detect signs of drug abuse before it's too late.
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Post by Arshpal S. Gill on Dec 26, 2016 0:51:04 GMT -4
This article highlights an unfortunate yet expanding problem within healthcare. As future providers, it is important to recognize the fact that drug addiction is on the rise and the consequences are dire. This study stated an alarming figure; in which middle-aged white men lost 1 year of life expectancy and middle-aged white females lost 2 years of life expectancy. While these numbers are a concern in itself, the emotional trauma caused to young children (as illustrated in this article) is a more complex problem to quantify. The other concern is an ethical dilemma; this particular journal stated that drug companies targeted rural West Virginia rural towns. They pulled data from court records indicating that in a 5 year period 60 million doses of hydrocodone were shipped to an area with less than 1 million adults. The alarming part of this particular figure is that 60 million is only from one drug company. As future healthcare providers, it is imperative to understand the responsibility that is afforded to us and do everything possible to prevent this epidemic from growing. Psychiatry is a good learning experience and perhaps the best clerkship to learn about drug addictions. In addition to dependence being a diagnosis in DSM-5; the lengthy interviews in psychiatry are unique and helps identify those who are more likely to succumb to drug addiction.
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Post by Ryan Davies on Dec 27, 2016 12:47:41 GMT -4
I appreciated that the author recognized the need to put human faces to the epidemic, and did so by highlighting the experiences of the children affected. It is devastating to realize that a child, recognizing the reality and prejudices of society that exist against those who struggle with addiction, would have to go to the measures Zaine did when he found his parents dead. Just to highlight Zaine's experience from the article, "He already knew they were dead, and he already knew what some people in South Charleston would say. Just addicts. Just a couple more overdoses. Nobody’s fault but their own. So, while he waited for the medics, he had cleaned the drug residue off the bedroom counter and hid his parents’ used needles in his shoe, hoping the police might mistake it for carbon-monoxide poisoning." I once watched a PBS Frontline documentary on the opioid problem in the US, which also highlighted society's attitudes towards addicts and some of their stories and it changed my perspective on the matter, which has further been changed being here in the clinic and working with some of those suffering from opioid dependence. I remember the first patient I visited with who told me they regretted ever taking the prescribed pain meds because it led them down the road of addiction. They were piecing their life back together little by little with suboxone, but still lived daily with the aftermath of their disease. I definitely feel fortunate to have had these experiences that will guide me, my perceptions of addicts and actions in prescribing, as I go forward to care for patients in the coming years.
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Post by Robert Kim on Dec 27, 2016 12:49:12 GMT -4
I have a very close family member who is/was addicted to heroin. I hedge and say "is/was" because it's never clear nor ever certain of their sobriety. Opioid addiction is an ugly world. Young men and women become slaves to this highly addictive substance and it is painful to see their lives deteriorate. I can't imagine what it would be like to be a child watching a mom or dad do this. Tackling the problem of addiction is very frustrating because we can acknowledge that something needs to be done but it ultimately depends on the individual. Family members want to help, friends want to help, coworkers - but at the end of the day it really needs to be the individual that wants to turn their life around. I think we need to trained as health care professionals to help those pts struggling with this problem.
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Post by Hector Rodriguez on Dec 28, 2016 11:46:58 GMT -4
As sad as this story is, the worst part is what are health officials and providers doing to stop this? The problem we have today is the huge emphasis on patient satisfaction. I have worked in several hospitals and unfortunately this country hasn't found that balance, why you have patients coming in with google print outs and "medical information" they printed off the internet. There isn't much education that doctors are doing these days, and institutions are so worried about the patient satisfaction surveys, the issue of pain is real and I am sure there are people who truly need pain medications. I do see that physicians don't educate the patients and aren't firm with their decisions on prolonged treatment of controlled substances that can be addictive. Its a sad story, but at the same time, what are health providers doing about it?
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Post by M. Ismail on Dec 29, 2016 13:04:39 GMT -4
Addiction of any kind imparts devastating consequences on the individual, family and community at large. As physicians, we have a duty to our patients to "promote health". It can be quite challenging when you are faced with the tasks of being responsible for promoting health, managing chronic conditions, managing pain all while simultaneously trying not to be a "pusher" of sorts. One example that comes to mind is Sickle cell anemia (SCA). A preceptor of mine once mentioned that a lot of SCA pts end up being addicted to opiates as a result of over-prescribing opiates during crises. Unless you suffer from the disease, one cannot imagine how painful a crisis is so it makes sense that a physician would feel compelled to treat a patient's crisis pain with opiates. Overtime, this routine does not increase overall survival but in the acute phase, it would be very hard to withhold pain medication for fear of the possibility of the development of addiction. It would be easy for one to say that a judicious prescription of opiates would solve the problem but "judicious" is a relative term. How do you qualify "judicious"? How would one treat a patient with chronic back pain of unknown etiology who has failed to find relief from surgical, pharmacological and other treatment modalities? It's a controversial topic that needs further analysis and quite frankly, solutions.
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Post by janaya on Dec 31, 2016 16:56:27 GMT -4
I'm really glad to see that this opiate problem is finally coming into light and being taken seriously. It's just horrible that it's taken so long and had to reach epidemic levels to do so. One of my closest friends from undergrad has struggled with heroin addiction for the last 5 years on and off, and I've been witness to some of the hardships this disease has placed on him, his friends, and his family. It's truly tragic. And what's worse is the lack of treatment resources these patients suffering from addiction have. These people are sick and society demands for them to get well, but has not given them the means do to so, because addiction has long been viewed as self inflicted, a decision to be a junkie, not as an illness. As Zaine stated in the article, “As soon as you’re on drugs, it’s like everything is your fault." “People think you’re trash.” “You’re a damn druggie. You’re nothing.” And I think it's for this same reason that we've allowed things to get so bad and the death toll to rise so much. A middle age white male found dead in his suburban home, is a shocking news story until it's found due to a heroin overdose. Then nobody seems concerned, as if that's simply what happens when you do drugs. "Just addicts. Just a couple more overdoses. Nobody’s fault but their own." We've begun taking small steps to deal with this still growing problem of opiate and opioid addiction, thankfully. The media has started to shed more light on the issue, even John Oliver covered opioid addiction on his HBO show Last Week Tonight. It's a great clip if anyone cares to see I've included the video link. Government has also begun to respond, as many firefighters (as seen in the clip) and even law enforcement officials have begun carrying naloxone. My sister is a cop and her department made them all start carrying naloxone over the summer. And just this month Georgia passed a standing order to make naloxone available over the counter at pharmacies statewide. However, I feel that the greatest responsibility in dealing with this issue lies with us as health care providers. We need to educate ourselves on addiction medicine, which is not a topic covered or studied in our curriculum at any point really, despite being something our country desperately needs more of. We need to educate our patients, and our peers. And we need to practice good medicine, prescribing opiates appropriately and cautiously, carefully monitoring patients to recognize signs of abuse, and offering appropriate treatment and therapy for addiction. www.youtube.com/watch?v=5pdPrQFjo2o
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Post by Andrej Gabrovsek on Jan 1, 2017 21:02:13 GMT -4
A good article trying to show how and who is affected by this disease. I unfortunately have friends who have died of this and left children behind. It is a disease that seems to be impossible to understand in that it is the only one that seems to lie to the user and tell them they do not have a problem. The article goes into some of the recovery 12 step meetings that work for some people and suboxone which seems to allow others to function in life. The article points out even though many have seen the direct dangers and death from this addiction they still are in denial and go down the same path. How to keep people from going down this path may be one of the greatest challenges or our generation.
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Post by Pujyitha Mandiga on Jan 3, 2017 4:19:12 GMT -4
This article is very saddening. It is very important for people to take use of opioids seriously. There has been an increase in the opioid involving drug overdose deaths in the United States since the 90's. Most of us know that the oerdoses are from prescription opioids leading to overdose deaths. I was reading this fact in an article one day that the prescription opioids have quadrupled since the last 15 years, but the amount of pain that Americans reported has not changed. Sadly, heroin use has increased in the young population and most of the users reported abusing other prescription opiates before the start of heroin use. Heroin related deaths have also increased significantly and it is so sad to see that there is so much awareness, but there is still increase in heroin related deaths. I hope we find alternatives to control this drug abuse problem and stop giving opioids to people like they are just candy. But, it is unfair to blame the physicians because pain cannot be measured or tested. It can only be felt by the patients and it is based on the trust by the doctor in the patient to be honest. i hope people understand the seriousness in the usage of the medications one day and we can all respect the people with real pain versus drug abusers.
Thank you.
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Post by Pavankumar on Jan 6, 2017 3:06:22 GMT -4
This article definitely brings to light the wide ramifications of the opiate epidemic. Anytime you move form just statistics to putting a face on those numbers then your going to make an impact on people's views. The thing I wonder though is how much are doctors really to blame for this. Sure there are Some Doctors who are clearly unethical and put their on financial gains over their patients health. I remember sitting in ethics class and having are teacher tell us that if a patient says they are in pain then you have to assume they are. The reasoning being when weighing the costs and benefits that the cost of not treating a person in pain is far greater then a person getting addicted to opioids. The truth there are a number of people Who are legitimately in pain and require opioids to live any semblence of a life. The real question is why do some people get addicted to them and some dont't. If addiction is based on genetics I think it Might be better for everybody if we could just spend the time developing a screening test for "addictive perosoites". This way we can truly inform the patient all the costs and benefits associated with their decisions.
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