Introduction
Jenny Svanberg in The Psychology of Addiction, 2018
This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book explores some of the opposing views about addiction, and defines it as a deeply entrenched learned habit that is followed compulsively. It discusses the neuroscience underlying addictive behaviours and their development, investigating the factors that make addiction more or less likely. The book presents some of the interventions that have been designed to regain control and grow through addiction to forge a new and stronger identity. It investigates psychological roadmap for understanding and treating addiction more compassionately, building on a global recovery movement. Drug overdose is the number one cause of accidental death in the US and is continuing to rise. Recovery from addiction, despite the challenges and setbacks along the way, can be an intensely hopeful process.
Opioid Crisis
Eldo E. Frezza in Medical Ethics, 2018
Drug overdose deaths and opioid-involved deaths continue to increase in the United States. The majority of drug overdose deaths involve an opioid. The commission of the Congress notes that the committee had to mandate educational initiatives at medical and dental schools to tighten opioid prescribing, and funding a program to expand access to medications used to treat addictions. The underassessment of pain may be related to the physician’s failure to assess pain often enough or correctly. The physician is to do the utmost to have a paper signed contract, mandatory urine for drug screens before prescribing further opioids, and patient referrals to a specialist if it gets out of hand. Physicians dedicate their lives to helping people; therefore, in the realm of chronic pain, there is always a fine line between treating the patient appropriately for their pain and overtreatment.
Medicolegal Guidelines for The Clinical Toxicology Laboratory
H. Y. Wong Steven in Therapeutic Drug Monitoring and Toxicology by Liquid Chromatography, 2017
The primary goal of the clinical toxicology laboratory is to provide timely analytical and interpretive services to aid the medical community in the diagnosis of drug overdose, the management of drug therapy, and in the evaluation of toxicity from a wide variety of commercial, industrial, and environmental agents. As the medical profession increases its reliance on laboratory analyses for diagnosis and treatment, the direct cause/effect relationship between laboratory error and patient harm becomes increasingly evident. This therefore exposes the clinical toxicology laboratory to increased liability. The best way to minimize liability is adherence of good laboratory standards. Proper sample handling procedures may also minimize the disruption of normal laboratory routine that medicolegal testimony can produce. In conjunction with proper sample handling and appropriate analytical methodology, reliable medicolegal testimony forms a successful medicolegal analysis. Medicolegal testimony can be divided into three separate but interrelated categories: evidential, descriptive, and expert.
Drug Overdose Deaths Among US Hispanics: Trends (2000–2017) and Recent Patterns
Published in Substance Use & Misuse, 2020
Background The US drug overdose crisis has devastated communities across the nation, yet relatively little is known about recent impacts in diverse Hispanic populations. Purpose: This study explored demographic and drug patterns in overdose deaths among US Hispanics in 2017, as well as longer-term time trends in drug overdose mortality among Hispanics from 2000 to 2017. Methods: Death certificate data were obtained from the National Center for Health Statistics. Bivariate analyses examined demographic and drug characteristics of the 5,988 drug overdose deaths among Hispanics in 2017. Data from 2017 were also utilized to compute age-adjusted drug overdose mortality rates for Hispanics overall, for specific Hispanic heritage groups, and for Non-Hispanic Whites (as a frame of reference). Joinpoint Regression was used to characterize trends in drug overdose mortality among US Hispanic men and women between 2000 and 2017. Results: The majority of Hispanic drug overdose decedents in 2017 were male (76.1%) and US-born (70.0%). Synthetic opioids were involved in the highest proportion of deaths in all Hispanic heritages, except the Mexican heritage group, in which psychostimulants were most commonly involved. The 2017 age-adjusted drug overdose mortality rate for Hispanics overall was lower than the rate among Non-Hispanic Whites, yet the rate among Puerto Rican-heritage Hispanics (29.0, 95% CI 27.6–30.4) was 6% higher than among Non-Hispanic Whites (27.4, 95% CI 27.2–27.6). Conclusions: Results highlight substantial variation in Hispanic drug overdose mortality rates, indicating that national rates for Hispanics obscure higher-risk subgroups. The diverse demographic profiles of Hispanic drug overdose decedents underscore the need for culturally tailored interventions.
Compositional and contextual factors associated with drug overdose deaths in the United States
Published in Journal of Addictive Diseases, 2020
Satish Kedia, Nikhil Ahuja, David K. Wyant, Patrick J. Dillon, Cem Akkus, George Relyea
Background: In 2017, the US Department of Health and Human Services declared the Opioid epidemic a public health emergency. In the US, emergency rooms treat more than 1,000 people each day for drug overdose, and 115 of them die. This study examines compositional and contextual factors associated with drug overdose deaths rates in the US. Methods: Local spatial autocorrelation statistics were used to estimate hot spot areas to identify census tracts with high risk of drug overdose death. Logistic regressions investigated the relationship between drug overdose death rates and various compositional and contextual variables across census tracks. Results: The adjusted logistic model shows that compositional variables: depression (OR = 2.47 [2.37–2.58]), poor mental health (OR = 1.71 [1.63–1.79]), median age 1.41 (1.36–1.47) and the percentage of people with a high school diploma (OR = 1.30 [1.24–1.35]) were positively associated with the rate of drug overdose deaths. On the other hand, contextual variables: the percentage having health insurance (OR = 0.66 [0.64–0.69]), the Theil’s H index (OR = 0.69 [0.66–0.71]), population density (OR = 0.80 [0.77–0.84]), poverty (OR = 0.90 [0.86–0.95]), and median household income (OR = 0.91[0.86–0.96]) were negatively associated with drug overdose deaths. Discussion: The analysis reveals a consistently strong association between compositional mental health factors and census tract-level death rates from drug overdose.
Walking Overdoses: A Re-Appraisal of Non-Fatal Illicit Drug Overdose
Published in Addiction Research, 2000
J. Fitzgerald, M. Hamilton, P. Dietze
The increase in the number of non-fatal opioid overdoses in Melbourne, Australia has occurred concomitantly with the emergence of street heroin dealing / using areas across different parts of Melbourne. The aim of this study was to examine the social and environmental factors that contribute to the risk of illicit drug overdose in a street heroin dealing / using setting. A detailed examination of overdose experiences, and consultations with drug users, police and shop traders, suggests that the harm related to drug overdose and the factors which contribute to the risk of overdose in a street-using / dealing environment may be significantly underestimated. The clinical definition of drug overdose may underestimate the harm associated with illicit drug use. Through not fully understanding drug user's experiences of drug overdose, and thus incorrectly defining drug overdose, significant opportunities to intervene in what is a significant medical and social problem may be lost.
Related Knowledge Centers
- Toxicity
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