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Date: April 29, 2024 Mon
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Results for prescription drugs
19 results foundAuthor: U.S. Department of Justice. Drug Enforcement Administration. National Drug Intelligence Center Title: National Prescription Drug Threat Assessment Summary: This assessment focuses primarily on domestic diversion of controlled prescription drugs (CPDs). It examines current nonmedical use of prescription-type psychotherapeutic drugs (opioid pain relievers, tranquilizers, sedatives, or stimulants) and discusses their distribution, and societal impact of CPD diversion and abuse, and Prescription Drug Monitoring Programs that have been established legislatively in many states to stem CPD diversion and abuse. This assessment also examines regional deviations from national trends. Details: Johnstown, PA: National Drug Intelligence Center, 2009. 62p. Source: Internet Resource Year: 2009 Country: United States URL: Shelf Number: 118769 Keywords: Drug Abuse and AddictionOpiodsPrescription DrugsPrescription Fraud |
Author: U.S. Government Accountability Office Title: Prescription Drug Control: DEA Has Enhanced Efforts to Combat Diversion, but Could Better Assess and Report Program Results Summary: The Drug Enforcement Administration's (DEA) Diversion Control Program is responsible for enforcing the Controlled Substances Act (CSA) and ensuring the availability of prescription drugs such as pain relievers and stimulants while preventing their diversion for abuse. The CSA requires entities handling controlled substances--such as manufacturers, pharmacies, and physicians, among others-- to register with DEA, which conducts regulatory investigations of registrants, as well as criminal investigations. GAO was asked (1) how DEA manages diversion investigation efforts, and (2) how DEA ensures policies and procedures are followed for investigations and the extent to which it determines the results of its efforts. GAO reviewed DEA policies and procedures, and interviewed DEA, state, and local officials at eleven locations which were selected on the basis of volume of cases handled, geographic diversity, and other considerations. These observations are not generalizable, but provided insights on DEA operations. To respond to the increasing rate of criminal diversion of prescription drugs and a growing registrant population, DEA has expanded its resources and targeted its investigation strategies to collaborate with state and local entities and enhance the effectiveness of its diversion investigations. Specifically, the agency expanded its use of Tactical Diversion Squads (squads) of DEA personnel as well as other federal, state, and local partners investigating diversion schemes to maximize resources and improve efforts to investigate criminal diversion. DEA currently has 40 squads across the country and plans to establish more. According to squad participants and DEA officials GAO contacted, the squads have improved communication and coordination and simplified information sharing for investigations. Because of the growing registrant population and noncompliance by some with the CSA and implementing regulations, DEA renewed its focus on regulatory oversight of registrants to better ensure compliance. By using the squads to free up resources previously dedicated to both criminal and regulatory cases, DEA used those resources to increase regulatory investigations of the registrants. As a result, the number of regulatory investigations more than tripled between fiscal years 2009 and 2010. DEA also conducted outreach to specific registrant types to inform them of regulatory responsibilities and prepare them for regulatory investigations. DEA has taken steps to ensure that investigators follow policies and procedures for such investigations, but could better assess how its efforts are reducing the diversion of prescription drugs. To ensure that diversion investigators and special agents have the necessary skills to carry out their responsibilities and that DEA monitors the extent to which policies and procedures are followed during investigations, DEA has established internal controls related to guidance, training, and oversight of investigations. These controls include providing and updating guidance to investigators to follow during investigations, providing initial and on-going training to investigators, and monitoring the quality of investigations through a combination of direct supervisory reviews, self-inspections, and on-site internal inspections by DEA's Office of Inspections. Recent reports from on-site internal inspections of each of DEA's field divisions did not identify any widespread or systematic issues related to the timeliness and overall quality of diversion investigations. Given DEA's increased focus on investigations in response to growing prescription drug diversion, it is critical for DEA to determine the extent to which these additional efforts are reducing diversion. DEA has established performance measures for the Diversion Control Program, but these measures do not clearly demonstrate the effect the additional efforts are having on the diversion problem the program seeks to address. For example, for its overall performance measure of the diversion control program, DEA is tracking the development and implementation of an internal information technology project. By more closely linking performance measures to the goal of reducing diversion, DEA could better capture the results of the Diversion Control program to help inform decision makers in allocating resources. GAO recommends DEA reassess the program's performance measures to better link them to the goal of reducing diversion. DEA did not concur. GAO continues to believe the measures could be enhanced as discussed in this report. Details: Washington, DC: GAO, 2011. 55p. Source: Internet Resource: GAO-11-744: Accessed September 27, 2011 at: http://www.gao.gov/new.items/d11744.pdf Year: 2011 Country: United States URL: http://www.gao.gov/new.items/d11744.pdf Shelf Number: 122922 Keywords: Drug Abuse (U.S.)Drug ControlPrescription Drugs |
Author: United States Government Accountability Office (GAO) Title: Prescription Pain Reliever Abuse: Agencies Have Begun Coordinating Education Efforts, but Need to Access Effectiveness Summary: The Centers for Disease Control and Prevention has declared that the United States is in the midst of an epidemic of prescription drug overdose deaths, with deaths associated with prescription pain relievers of particular concern. To address this issue, federal agencies are raising awareness by educating prescribers and the general public. In response to your request, GAO (1) described recent national trends in prescription pain reliever abuse and misuse, (2) described how federal agencies are educating prescribers, (3) assessed the extent to which federal agencies follow key practices for developing public education efforts, and (4) identified educational efforts that use similar strategies and assessed how agencies coordinate those efforts. GAO interviewed officials and reviewed documents and websites from seven agencies involved in federal drug control efforts and analyzed the most recent data from several data sources related to prescription pain reliever abuse and misuse. GAO also assessed the development of public education efforts and federal coordination efforts against key practices from prior GAO work. GAO recommends that the Director of ONDCP establish outcome metrics and implement a plan to evaluate proposed educational efforts, and ensure that agencies share lessons learned among similar efforts. ONDCP did not explicitly agree or disagree with GAO’s recommendations, but noted that it will continue to work for improved coordination of educational efforts and evaluation of outcomes. Details: Washington, DC: U.S. Government Accountability Office Source: Report to Congressional Requesters: Internet Resource: Accessed on January 27, 2012 at http://atforum.com/addiction-resources/documents/GAOReport_000.pdf Year: 0 Country: United States URL: http://atforum.com/addiction-resources/documents/GAOReport_000.pdf Shelf Number: 123839 Keywords: Drug Abuse (U.S.)Drug Abuse PolicyDrug Control PolicyPrescription Drugs |
Author: Sheridan, Janie Title: Prescription drug misuse: issues for primary care - final report Summary: The misuse of prescription medicines is an internationally recognised problem associated with a number of health and social harms. Qualitative research by the University of Auckland, funded by the National Drug Policy Discretionary Grant Fund, provides a valuable insight into prescription drug misuse in New Zealand through the eyes of primary healthcare practitioners and experts in drug policy and treatment. The authors have also looked at how New Zealand compares to countries such as Australia and USA in terms of available data, as well as summarising possible policy approaches to addressing prescription drug misuse. Details: Auckland, NZ: The University of Auckland, 2008. 146p. Source: Internet Resource: Accessed February 7, 2012 at Year: 2008 Country: New Zealand URL: Shelf Number: 124027 Keywords: Drug Abuse (New Zealand)Drug ControlPrescription Drugs |
Author: Nicholas, Roger Title: Responding to Pharmaceutical Drug Misuse Problems in Australia: A Matter of Balance Summary: A National Pharmaceutical Drug Misuse Strategy (NPDMS) is being developed at the request of the Ministerial Council on Drug Strategy (MCDS). This literature review was prepared as part of the development of the NPDMS. Its purpose is to inform and guide the development of the Strategy. Specifically, the review examines the extent and nature of the existing evidence base of relevance to the NPDMS. The literature review focuses primarily on opioids, benzodiazepines and codeine-containing analgesics as the Strategy, at the request of the MCDS, focus on these drugs. The review is structured in several parts, as follows. First some broader frameworks, strategies, policies, initiatives, perspectives and paradigms which impact upon the development of the Strategy are considered. This is followed by an examination of the Australian situation and then the international situation. The review then examines issues surrounding the quality use of opioids and benzodiazepines. Next issues surrounding medication shopping are considered. Finally, the review examines some of the potential responses to pharmaceutical misuse. Details: Adelaide: National Centre for Education and Training on Addiction (NCETA), Flinders University, 2011. 194p. Source: Internet Resource: Accessed February 27, 2012 at: http://s3.amazonaws.com/zanran_storage/www.nceta.flinders.edu.au/ContentPages/2438891316.pdf Year: 2011 Country: Australia URL: http://s3.amazonaws.com/zanran_storage/www.nceta.flinders.edu.au/ContentPages/2438891316.pdf Shelf Number: 124295 Keywords: Drug Abuse and Addiction (Australia)Drug Abuse PolicyPrescription Drugs |
Author: Blumenschien, Karen Title: Review of Prescription Drug Monitoring Programs in the United States Summary: Prescription drug monitoring programs (PDMPs) collect prescription data on medications classified as federal controlled substances. The information is stored in a central database and can be accessed by authorized users. Although programmatic details differ among states, in general, all PDMPs are designed to assist in detecting and preventing abuse, misuse, and diversion of controlled substances. Specifically, programs are targeted toward reducing the incidence of ‘doctor shopping’ which occurs when patients see multiple providers and pharmacies with the intent of obtaining controlled substances for misuse and/or diversion. Health care professionals who prescribe or dispense controlled substances can access PDMP databases with increasing ease and efficiency. Since the advent of electronic prescription drug monitoring systems, access can occur at the point of care and can assist prescribers and dispensers in making treatment decisions. Patients’ reported use of scheduled medications can be confirmed by accessing PDMP reports, allowing prescribers and dispensers to detect individuals who may be feigning illnesses in an effort to acquire drugs for the purpose of abuse or diversion. The term prescriber as used in this report includes physicians, dentists, nurse practitioners and other health care professionals authorized to prescribe controlled substances; the term dispenser refers to those individuals who dispense controlled substances, the vast majority of whom are community pharmacists. In addition to prescribers and dispensers, most states allow regulatory and law enforcement agencies involved in drug-related investigations to access PDMP databases, enabling them to more efficiently collect and analyze data that may be useful in identifying those individuals involved in illegal trafficking or misuse of prescription drugs. Details: Lexington, KY: Institute for Pharmaceutical Outcomes and Policy, Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, 2010. 28p. Source: Internet Resource: Accessed March 6, 2012 at http://chfs.ky.gov/NR/rdonlyres/85989824-1030-4AA6-91E1-7F9E3EF68827/0/KASPEREvaluationPDMPStatusFinalReport6242010.pdf Year: 2010 Country: United States URL: http://chfs.ky.gov/NR/rdonlyres/85989824-1030-4AA6-91E1-7F9E3EF68827/0/KASPEREvaluationPDMPStatusFinalReport6242010.pdf Shelf Number: 124385 Keywords: Drug AbuseDrug ControlPrescription Drugs |
Author: California State Task Force on Prescription Drug Misuse Title: Prescription Drugs: Misuse, Abuse and Dependency Summary: The nonmedical use of prescription drugs has emerged as a growing and serious problem in California. In response, the California Department of Alcohol and Drug Programs (ADP), under the leadership of Director Renée Zito, convened the Prescription Drug Misuse (PDM) Task Force. The Task Force was charged with studying the problem and developing recommendations to increase awareness, limit access, and reduce misuse rates. For the past year, this group has convened by teleconference. The Task Force developed information and discussed issues concerning use patterns, availability, awareness levels and problems associated with the nonmedical use of prescription drugs by diverse population sub‐groups. This report is a culmination of their efforts. Details: Sacramento: California Department of Alcohol and Drug Programs, 2009. 37p. Source: Internet Resource: Accessed July 3, 2012 at: http://www.adp.ca.gov/director/pdf/Prescription_Drug_Task_Force.pdf Year: 2009 Country: United States URL: http://www.adp.ca.gov/director/pdf/Prescription_Drug_Task_Force.pdf Shelf Number: 125462 Keywords: Drug Abuse and AddictionDrug ControlPrescription Drug AbusePrescription Drugs |
Author: Bate, Roger Title: The Deadly World of Fake Drugs Summary: The burden of fake and substandard drugs is not evenly distributed across the globe. Even where reporting systems are weak and the media is not free, most reported instances of substandard medicines occur in poorer countries, where poor regulation allows criminals to easily infiltrate weak supply chains. Although rich nations face fewer breakdowns in their regulation and supply systems, they are certainly not safe from this threat. This document provides a plethora of examples of the manufacture, sale, and distribution of fake and substandard drug examples from all over the world. Where possible, data has been summarized to report problems at the continental, regional and national levels. Although no comprehensive data on the magnitude of the counterfeit drug trade exists, this document illustrates the breadth, depth, and danger of the problem globally. Many of these examples were compiled from local news sources. Countries without a free press may not appear at all in the following pages, but it is doubtful that the lack of evidence reflects an inconsequential number of substandard drugs. It is much more likely that these locations have a major problem with counterfeit and substandard drugs but data for these locations are simply unavailable. Evidence we do have suggests that counterfeit products are as much a problem in locations without a free press as they are elsewhere. In fact, in some countries like North Korea, counterfeiting operations are part of a vast, government-sponsored enterprise. Some stories of major counterfeiting rings involve numerous countries. Since the reader may only be interested in a specific countries, key statistics from the study are quoted in each location they pertain to, resulting in some overlap. Finally, because of the nature of the literally hundreds of sources cited in this section, it is inevitable that there will be a confusion of definitions. What one reporter, government agency, police statement, pharmaceutical company, academic researcher and others may call a fake product, their peers may not. For this reason, the reports in this chapter should not be viewed as necessarily comparable. In some instances it is possible to tell the claims made apart but overall it is not, and therefore is rarely attempted. With this major caveat in mind, this document hopefully provides a useful detail of the widespread and dangerous nature of dangerous medicines. Details: Washington, DC: American Enterprise Institute, 2012. 145p. Source: Internet Resource: Accessed July 11, 2012 at: http://www.aei.org/files/2012/02/27/-appendix-a-master-2_170026856632.pdf Year: 2012 Country: International URL: http://www.aei.org/files/2012/02/27/-appendix-a-master-2_170026856632.pdf Shelf Number: 125547 Keywords: Counterfeit MedicinesFake DrugsPrescription Drugs |
Author: Kay, Gary G. Title: Drugged Driving Expert Panel Report: A Consensus Protocol for Assessing the Potential of Drugs to Impair Driving Summary: In November 2008 and again in March 2009, an expert panel was convened by the National Highway Traffic Safety Administration with the goal of determining whether a list could be developed to indicate which medications or classes of medications may pose a hazard to driving. There was particular interest in having the panel develop a list of “safe” medications that do not impair driving. The value of the list would be to better inform patients and physicians regarding the likely effects of a drug on driving. This information could lead to better-informed prescribing practices and to more rational selection of medications by patients. The panel was composed of an international group of behavioral scientists, epidemiologists, pharmacologists, toxicologists, and traffic safety professionals to provide a broad-based perspective on the issue. Discussions included prescription (Rx) medications as well as over-the-counter (OTC) medications and illicit drugs. Although illicit drugs are best known for their impairing effects, Rx and OTC medications are also known to be capable of producing impairment and many are frequently encountered in impaired driver populations. The panel agreed that one of the barriers to categorizing drugs with respect to driving impairment risk is the lack of a common, standardized protocol for assessing the impairing potential of drugs. The panel recognized the need for a structured, standardized protocol for assessing the driving impairment risk of drugs that would lead to better classification of drugs in terms of driving impairment risk. The approach could be useful in providing more meaningful precautions for users and prescribers regarding the impact of drugs on driving. This report provides the background for the project and assembly of the expert panel, a description of the proposed protocol, and offers examples of how the protocol could be useful in evaluating a drug. Details: Washington, DC: National Highway Traffic Safety, Administration Office of Behavioral Safety Research, 2011. 28p. Source: Internet Resource: DOT HS 811 438: Accessed November 24, 2012 at: www.nhtsa.gov/staticfiles/nti/pdf/811438.pdf Year: 2011 Country: United States URL: Shelf Number: 126993 Keywords: Driving Under the InfluenceDrugged Driving (U.S.)Drugs and DrivingPrescription Drugs |
Author: Alpert, Abby Title: Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids Summary: Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010, making this the worst drug overdose epidemic in U.S. history. In response, numerous supply-side interventions have aimed to limit access to opioids. However, these supply disruptions may have the unintended consequence of increasing the use of substitute drugs, including heroin. We study the consequences of one of the largest supply disruptions to date to abusable opioids – the introduction of an abuse-deterrent version of OxyContin in 2010. Our analysis exploits across state variation in exposure to the OxyContin reformulation. Using data from the National Survey on Drug Use and Health (NSDUH), we show that states with higher pre-2010 rates of OxyContin misuse experienced larger reductions in OxyContin misuse, permitting us to isolate consumer substitution responses. We estimate large differential increases in heroin deaths immediately after reformulation in states with the highest initial rates of OxyContin misuse. We find less evidence of differential reductions in overall opioid-related deaths, potentially due to substitution towards other opioids, including more harmful synthetic opioids such as fentanyl. Our results imply that a substantial share of the dramatic increase in heroin deaths since 2010 can be attributed to the reformulation of OxyContin. Details: Cambridge, MA: National Bureau of Economic Research, 2017. 59p. Source: Internet Resource: NBER Working Paper Series: Working paper 23031: Accessed January 26, 2017 at: http://www.nber.org/papers/w23031.pdf Year: 2017 Country: United States URL: http://www.nber.org/papers/w23031.pdf Shelf Number: 145428 Keywords: Drug Abuse and AddictionDrug Abuse PolicyOpioidsOpioids EpidemicOxyContinPrescription Drugs |
Author: Gau, Jacinta M. Title: Non-Medical Use of Prescription Drugs: Policy Change, Law Enforcement Activity, and Diversion Tactics Summary: The crisis in prescription-opioid addiction began long before it was finally brought out into the open (Inciardi et al., 2009). Southern states experienced the most notable rates of addiction and overdose. This finding was attributed to this group’s high level of involvement in manuallabor occupations and tendency to be uninsured and live in areas with few or no medical resources (Young, Havens, & Leukefeld, 2012). Many people's opioid addiction begins when they are prescribed these pills for legitimate pain. The State of Florida emerged as the epicenter of the national opioid epidemic. In 2010, the Florida Medical Examiners Commission's (FMEC) annual report revealed startling rates of deaths due to or related to oxycodone, hydrocodone, and other prescription opioids; in fact, more people died from opioids than from cocaine. The report found that, excluding alcohol, prescription drugs were 81% of all drug-related or drug-caused deaths (FMEC, 2011). In 2011, this rose to 83% (FMEC, 2012). The Florida legislature’s first contribution to the fight against prescription pill abuse was the authorization of the creation of a prescription drug monitoring program (PDMP) in 2009 (also known as E-FORSE; FS 893.055). The PDMP became operational in 2011. Law enforcement officers may become certified to access the PDMP directly; those who are not certified can gain access only via a certified officer or the Florida Department of Health (FDOH). The second major step occurred in 2010 with the official creation of the term "pain management clinic" (PMC) and requirement that certain medical establishments register with the FDOH as pain clinics under the law (FS 458.3265 (applicable to medical practices) and FS 459.0137 (applicable to osteopathic practice). There are two triggers which would require a medical office to register as a pain clinic: (a) if the clinic advertises in any medium that it offers pain management services; or (b) if in any month a majority of the clinic's patients are prescribed opioids, benzodiazepines, barbiturates, or carisoprodol for the treatment of chronic, nonmalignant pain. The third meaningful piece of legislation was House Bill (HB) 7095. Dubbed the "pill mill law," HB 7095 was signed into law on June 3, 2011 (and went into effect on July 1, 2011) and established several new regulations pertaining to the physical facilities of pain clinics and the acceptable minimum extent of medical examinations and follow-ups physicians must perform on patients before and after prescribing them opioids for the treatment of chronic, nonmalignant pain. HB 7095 was intended to compel physicians and clinics currently operating in a subpar manner to either improve or go out of business, while at the same time adding no burden to physicians already delivering high-quality, ethical care. This law also contained a dispensing ban, which prohibits PMCs from operating on-site pharmacies. Now, patients receiving prescriptions from PMCs must fill those prescriptions at independently operated community pharmacies (CPs). The present project is an overview of trends in PMCs occurring in the three years following the important changes to Florida law and policy that occurred primarily in 2011 (though changes began in 2009). Quantitative and qualitative data were collected. The first source of quantitative data is the FDOH, which is charged with receiving and approving applications, inspecting facilities, handling disciplinary allegations and hearings, and forcibly closing clinics found to be in persistent violation of regulatory standards. Second are three police departments serving large cities across the state, from which geocoded crime-incident data were obtained. Finally, qualitative data from in-depth interviews with law-enforcement officers around the state allow for a detailed look into the challenges law enforcement face in attempting to hold pain-management clinic physicians criminally liable. Details: Orlando, FL: Department of Criminal Justice University of Central Florida, 2017. 22p. Source: Internet Resource: Accessed March 21, 2017 at: https://www.ncjrs.gov/pdffiles1/nij/grants/250603.pdf Year: 2017 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/250603.pdf Shelf Number: 144536 Keywords: Drug Abuse and AddictionDrug Abuse and CrimeDrug AddictionDrug Control PolicyPrescription Drug AbusePrescription Drugs |
Author: Havnes, Ingrid Amalia Title: Violence and diversion of prescribed opioids among individuals in opioid maintenance treatment. A complementary methods study of violent crime convictions in a national cohort and qualitative interviews among prisoners Summary: Background: Opioid dependence is linked to crime, morbidity and mortality, directly through drug overdoses and indirectly via drug-related mortality, accidents, suicides and violence. Violence in general is a major health concern worldwide. Opioid maintenance treatment, OMT, is found to reduce mortality, morbidity and criminal behaviour, but less is known about the effect of OMT on violent crime. A possible negative consequence of OMT is diversion of methadone and buprenorphine and rising overdose deaths related to these medications among individuals not enrolled in OMT. The aim of this thesis is to study violent crimes prior to, during and after OMT in a national cohort and to generate new knowledge about OMT-enrolled individuals' experiences and understandings of being both violent and non-violent offenders, the role of substances in such crimes as well as their understandings and motivations related to diversion of prescribed opioids. Materials and methods: Two complementary data collection methods have been used. Violent convictions were investigated by use of cross-registry methods for a complete longitudinal national OMTcohort of 3221 individuals with an observation period of 9 years and a qualitative study among 12 imprisoned, OMT-enrolled individuals. 28 semi-structured interviews were thematically analyzed with a reflexive and interactive approach. Findings: Violent crime rates were significantly reduced during OMT compared with before treatment. The rate of convictions for violent crime during OMT was halved among those who remained in treatment. The reduction was less pronounced for those who left treatment: for this group, the rate of violent convictions after OMT was higher than before treatment. The risk of convictions for violent and non-violent crime during OMT was highest for those with violent convictions prior to treatment. In the qualitative part of the study, it was found that substances and, in particular, high-dose benzodiazepines were deliberately used to induce temporary 'antisocial selves' capable of transgressing individual moral codes and performing non-violent and violent criminal acts, mainly to support costly heroin use prior to OMT. During OMT, impulsive and uncontrolled substance use just prior to the violent acts that the participants were imprisoned for was reported. Benzodiazepines were also used to reduce memories of and alleviate the guilt associated with having committed violent crimes. The study participants maintain moral standards, engage in complex moral negotiations, and struggle to reconcile their moral transgressions. They were found to exhibit a considerable amount of self-control, selfregulation and/or self-initiation of external control related to intake of methadone and buprenorphine in various settings. Their acquired norm of sharing with others in a drug using community was carried along when entering OMT. Several had developed strategies to avoid selling or giving of methadone or buprenorphine to others. Giving one's opioid prescriptions to an individual in withdrawal, was seen as an act of helping. Individuals enrolled in OMT might thus be trapped between practicing norms of helping and sharing and adhering to treatment regulations. Conclusions: Opioid dependent individuals with violent convictions should have access to OMT. Treatment providers should identify individuals with histories of violent behavior. The situation that precede and motivate violent behavior and the potential role of substances prior to and after such crimes should be explored with the patient in question. What appears as a severe antisocial personality disorder may be partly explained by substance use. Treatment providers should explore the living conditions and social lives of individuals applying for and enrolled in OMT. To following OMT guidelines may entail breaking a personal and drug culture norm of sharing and helping by means of providing OMT medications to those in need. Opioid-dependent couples should be encouraged to apply for and enroll in OMT at the same time, if both are motivated for starting treatment. Some individuals might know what particular configurations of internal and external control they need in order to achieve their own treatment goals in OMT. An individual's experience and ability to execute self-control and self-regulation with regard to drug taking may be seen as a resource throughout the course of treatment. Details: Oslo: University of Oslo, 2015. 118p. Source: Internet Resource: Dissertation: Accessed August 4, 2017 at: https://www.duo.uio.no/handle/10852/42124 Year: 2015 Country: Norway URL: https://www.duo.uio.no/handle/10852/42124 Shelf Number: 146719 Keywords: Drug Abuse and CrimeDrug Abuse TreatmentDrug OffendersOpioid EpidemicOpioidsPrescription DrugsSubstance Abuse TreatmentViolent Crime |
Author: Singer, Jeffrey A. Title: Abuse-Deterrent Opioids and the Law of Unintended Consequences Summary: The United States has seen a surge in deaths from overdoses of opioids, including both prescription drugs and illegal opioids such as heroin. Nonmedical users and abusers often obtain prescription opioids diverted from the legal to the illegal market. In the hope of reducing opioid use, abuse, and overdoses, policymakers have focused on developing and promoting tamper-resistant or abuse-deterrent formulations (ADFs) that render diverted opioids unusable if individuals attempt to use them for nonmedical (i.e., recreational) purposes. Although the benefits of ADFs seem to be nonexistent, these formulations have led to real harms. ADFs have encouraged users to switch to more dangerous opioids, including illegal heroin. In at least one instance, the reformulation of a prescription opioid led to a human immunodeficiency virus (HIV) outbreak. Along the way, ADFs unnecessarily increase drug prices, imposing unnecessary costs on health insurance purchasers, taxpayers, and particularly patients suffering from chronic pain. Like the federal government's promotion of abuse-deterrent alcohol a century ago, these efforts are producing unintended consequences, such as making legal pain relief unaffordable for many patients and possibly increasing morbidity and mortality. Government at all levels should stop promoting ADF opioids. Congress should end or limit the ability of pharmaceutical manufacturers to impose higher costs on pain patients by using ADFs to "evergreen" their opioid patents (evergreening is a practice by which pharmaceutical manufacturers extend or renew the patent protection before the current patent expires by tweaking the formula slightly or repurposing the product). The FDA should end its policy of encouraging ADF opioids and particularly its goal of eliminating non-ADF opioids. Lawmakers should abandon efforts to require consumers to purchase coverage for costlier ADF opioids and should instead allow insurers to steer medical users of these products toward cheaper, non-ADF generic formulations. Details: Washington, DC: Cato Institute, 2018. 9p. Source: Internet Resource: Policy Analysis No. 832: Accessed April 4, 2018 at: https://www.cato.org/publications/policy-analysis/abuse-deterrent-opioids-law-unintended-consequences Year: 2018 Country: United States URL: https://www.cato.org/publications/policy-analysis/abuse-deterrent-opioids-law-unintended-consequences Shelf Number: 149664 Keywords: Drug Abuse and AddictionIllegal DrugsOpioid EpidemicOpioidsPrescription Drugs |
Author: U.S. Government Accountability Office Title: Illicit Opioids: While Greater Attention Given to Combating Synthetic Opioids, Agencies Need to Better Assess their Efforts Summary: What GAO Found Federal agencies collaborate with foreign governments, such as China, Mexico, and Canada, as well as with international organizations, to limit the production of illicit synthetic opioids. They do this by enhancing investigations, sharing information on emerging trends, helping to expand the regulation of illicit substances, and building capacity to thwart the distribution of illicit drugs. Federal agencies have ongoing efforts to limit the domestic availability of and enhance their response to illicit synthetic opioids. For example, federal efforts include treating overdose death scenes as crime scenes where officers collect evidence to investigate and identify the drug source. Federal agencies have also documented specific strategies to combat illicit opioids. However, only one of the five strategies we reviewed included outcome, or results-oriented measures-largely due to agency perceptions that designing such measures posed challenges. The Government Performance and Results Act Modernization Act of 2010 directs agencies to develop goals, as well as performance indicators. Without specific outcome-oriented performance measures, federal agencies will not be able to truly assess whether their respective investments and efforts are helping them to limit the availability of and better respond to the synthetic opioid threat. We also found that while federal law enforcement agencies are increasingly coordinating with the public health sector to share overdose information, both sectors reported ongoing data sharing obstacles and related challenges with the timeliness, accuracy, and accessibility of overdose data. Standards for Internal Control in the Federal Government states that information for decision-making should be appropriate, current, complete, accurate, accessible, and provided on a timely basis. Embarking on a concerted effort, led by the Office of National Drug Control Policy (ONDCP), to examine and address data related concerns will enhance agencies' efforts continue to understand and respond to the opioid epidemic. Federal agencies have adapted to the opioid epidemic by, among other things, expanding prevention programs and treatment options. For example, agencies have increased engagement with medical professionals about the implications of prescribing practices to help reduce opioid abuse, and provided additional resources to states and localities to expand the distribution and use of overdose reversal and treatment options. Why GAO Did This Study Increased illicit use of synthetic (manmade) opioids has contributed to drug-related overdose deaths. Synthetic opioids like fentanyl-a substance 100 times stronger than morphine- accounted for more than 19,000 of the nearly 64,000 overdose deaths in 2016, the most recent year for which federal data are available. GAO was asked to review U.S. agency efforts to combat illicit synthetic opioids. This report examines how U.S. agencies (1) work with international partners to limit production of illicit synthetic opioids; (2) work domestically to limit the availability of and enhance their response to these drugs and how agencies can improve their effectiveness; (3) measure performance in their documented opioid response strategies; and (4) have adapted their approaches to prevention and treatment. GAO reviewed documents that described agencies' international coordination efforts, domestic opioid reduction strategies and prevention and treatment approaches, and interviewed international and federal agency officials engaged in drug control policy. GAO also interviewed state and local law enforcement and public health officials in seven states, selected in part for their high rates of overdose deaths. What GAO Recommends GAO is making six recommendations, including that agencies develop performance metrics. DHS agreed, ONDCP did not state whether they agreed or disagreed, and DOJ did not agree with GAO's recommendations. GAO continues to believe that these recommendations remain valid. Details: Washington, DC; GAO, 2018. 94p. Source: Internet Resource: GAO-18-205: Accessed April 16, 2018 at: https://www.gao.gov/assets/700/690972.pdf Year: 2018 Country: United States URL: https://www.gao.gov/assets/700/690972.pdf Shelf Number: 149801 Keywords: Drug Abuse and AdditionDrug Control PolicyIllegal DrugsIllicit DrugsOpioid EpidemicOpioidsPrescription Drugs |
Author: Yeh, Brian T. Title: Legal Authorities Under the Controlled Substances Act to Combat the Opioid Crisis Summary: According to the Centers for Disease Control and Prevention, the annual number of drug overdose deaths involving prescription opioids (such as hydrocodone, oxycodone, and methadone) and illicit opioids (such as heroin and non-pharmaceutical fentanyl) has more than quadrupled since 1999. A November 2017 report issued by the President's Commission on Combating Drug Addiction and the Opioid Crisis also observed that "[t]he crisis in opioid overdose deaths has reached epidemic proportions in the United States ... and currently exceeds all other drug-related deaths or traffic fatalities." How the current opioid epidemic happened, and who may be responsible for fueling it, are complicated questions, though reports suggest that several parties likely played contributing roles, including pharmaceutical manufacturers and distributors, doctors, health insurance companies, rogue pharmacies, and drug dealers and addicts. Many federal departments and agencies are involved in efforts to combat opioid abuse and addiction, including a law enforcement agency within the U.S. Department of Justice, the Drug Enforcement Administration (DEA), which is the focus of this report. The primary federal law governing the manufacture, distribution, and use of prescription and illicit opioids is the Controlled Substances Act (CSA), a statute that the DEA is principally responsible for administering and enforcing. The CSA and DEA regulations promulgated thereunder establish a framework through which the federal government regulates the manufacture, distribution, importation, exportation, and use of certain substances which have the potential for abuse or psychological or physical dependence, including opioids. Congress enacted the CSA in 1970 to facilitate the availability of controlled substances for authorized medical, scientific, research, and industrial purposes, while also preventing these substances from being diverted out of legitimate channels for illegal purposes such as drug abuse and drug trafficking activities. The CSA aims to protect the public's health and safety from dangers posed by highly addictive or dangerous controlled substances that are diverted into the illicit market, while also ensuring that patients have access to pharmaceutical controlled substances for legitimate medical purposes such as the treatment of pain. This report describes the current federal legal regime governing opioids and other controlled substances under the CSA and its implementing regulations, including (1) the classification of various plants, drugs, and chemicals into one of five schedules based on the substance's medical use, potential for abuse, and safety or dependence liability; (2) who must register with the DEA in order to receive authorization to handle the substances (such as drug manufacturers, wholesale distributors, doctors, hospitals, pharmacies, and scientific researchers); (3) what obligations registrants must satisfy in order to maintain a valid registration (such as keeping records of drug inventories and transactions, submitting reports to the DEA, and providing security measures to safeguard controlled substances); and (4) the DEA's administrative, civil, and criminal authorities for enforcing regulatory compliance with the CSA (such as suspending or revoking a registrant's legal authority to handle controlled substances if the DEA Administrator finds that the registrant has "committed such acts as would render his registration ... inconsistent with the public interest."). The report then examines DEA initiatives and actions taken, pursuant to its legal authorities under the CSA, which specifically target the abuse of opioids. The report concludes by discussing selected opioid-related legislative proposals in the 115th Congress that would amend the CSA. Details: Washington, DC: Congressional Research Service, 2018. 36p. Source: Internet Resource: Accessed April 19, 2018 at: https://fas.org/sgp/crs/misc/R45164.pdf Year: 2018 Country: United States URL: https://fas.org/sgp/crs/misc/R45164.pdf Shelf Number: 149853 Keywords: Drug Control PolicyOpioid EpidemicOpioidsPrescription Drugs |
Author: Wartell, Julie Title: Prescription Drug Fraud and Misuse. 2nd edition Summary: This guide describes the problem of prescription drug fraud and misuse and reviews some of the factors that increase their risks. It then identifies a series of questions to help you analyze your local problem. Finally, it reviews responses to the problem, and what is known about them from evaluative research and police practice, For the purposes of this guide, prescription drug fraud, which falls under the broader heading of pharmaceutical diversion, is defined as the illegal acquisition of prescription drugs for personal use or profit. This definition excludes theft, burglary, backdoor pharmacies, and illegal importation or distribution of prescription drugs. This guide also discusses common forms of prescription drug diversion, as not all cases of diversion are fraudulent. For example, sharing medication and taking medication without permission are not acts categorized as fraudulent yet still warrant police attention. The related issue of prescription misuse and addiction is also covered, as many offenders become addicted and begin more widespread use through illegally obtaining prescription drugs from family and friends. "Backdoor pharmacies" are businesses not licensed/authorized to distribute pharmaceutical drugs. Prescription drug fraud and misuse is but one aspect of the larger set of problems related to the unlawful use of controlled substances. This guide is limited to addressing the particular harms created by prescription fraud and misuse. Details: Washington, DC: U.S. Department of Justice, Office of Community Oriented Policing Services, 2013. 72p. Source: Internet Resource: Problem-Specific Guides Series Problem-Oriented Guides for Police, no. 24: Accessed May 23, 2018 at: https://ric-zai-inc.com/Publications/cops-p257-pub.pdf Year: 2013 Country: United States URL: https://ric-zai-inc.com/Publications/cops-p257-pub.pdf Shelf Number: 130303 Keywords: Drug Abuse and AddictionOpioid CrisisOpioidsPrescription Drug FraudPrescription Drugs |
Author: Australian Institute of Health and Welfare Title: Opioid harm in Australia: and comparisons between Australia and Canada Summary: Locally and internationally, the rising use of opioids is a cause of concern. All opioids-including codeine-can be addictive and their use can result in dependence, accidental overdose, hospitalisation or death. This report brings together information from a range of data sources to tell the national story of opioid use and its harmful effects. It is the first time that the AIHW has produced such a comprehensive report that presents current national data and trends on opioid use and harms in Australia. The report also presents findings from a collaboration between the AIHW and the Canadian Institute for Health Information (CIHI). This includes comparisons between ED presentations and hospitalisations in Australia and Canada, where possible, and discussion of the benefits and challenges of international collaboration. In Australia in 2016-17, 3.1 million people had 1 or more prescriptions dispensed for opioids (most commonly for oxycodone); about 40,000 people used Heroin; and about 715,000 people used Pain-killers/analgesics and pharmaceutical opioids for illicit or non-medical purposes. Opioid deaths and poisoning hospitalisations have increased in the last 10 years Legal or pharmaceutical opioids (including codeine and oxycodone) are responsible for far more deaths and poisoning hospitalisations than illegal opioids (such as heroin). Every day in Australia, nearly 150 hospitalisations and 14 emergency department (ED) presentations involve opioid harm, and 3 people die from drug-induced deaths involving opioid use. In 2016, the number of opioid deaths (1,119) was the highest number since the peak in 1999 (1,245 deaths). After 1999, the number of deaths fell to a low of 439 in 2006, then began to climb again. In 2016, opioid deaths accounted for 62% of all drug-induced deaths. From 2007 to 2016, after adjusting for differences in the age structure of the population, the rate of opioid deaths increased by 62%, from 2.9 to 4.7 deaths per 100,000 population. The increase was driven by an increase in accidental opioid deaths and in pharmaceutical opioid deaths. Similarly, from 2007-08 to 2016-17, after adjusting for age, the rate of hospitalisations per 100,000 population with a principal diagnosis (main reason for hospitalisation) of opioid poisoning increased by 25%, while the rate of hospitalisations with any diagnosis (all reasons for hospitalisation) of opioid poisoning increased by 38%. Pharmaceutical opioids are responsible for more opioid deaths and poisoning hospitalisations than heroin In 2016, the most commonly mentioned opioid in opioid deaths was Naturally derived opioids (for example, oxycodone, codeine and morphine), which was mentioned in 49% of opioid deaths. Similarly, in 2016-17, hospitalisations with a principal diagnosis of opioid poisoning were more likely to involve pharmaceutical opioids than heroin or opium. The rate per 100,000 for those by Naturally derived opioids was more than twice as high as for those by Heroin. More opioid prescriptions were dispensed but on average prescriptions were for lower doses and/or quantities In 2016-17, 15.4 million opioid prescriptions were dispensed under the Pharmaceutical Benefits Scheme (PBS) to 3.1 million people. The oral morphine equivalent (OME) is a measure of opioid use that adjusts for the difference in potency between different opioids. It converts the amount of each opioid dispensed to the amount of oral morphine that would be required to produce the same pain-relieving effect. After adjusting for differences in the age structure of the population, from 2012-13 to 2016-17, although there was a rise in the rate of prescriptions dispensed per 100,000 population and the number of people per 100,000 population receiving them (9% and 4% respectively), the OME stayed the same over the same period (989 to 987 OME mg per 1,000 population per day)-on average, the prescriptions dispensed were for lower doses and/or quantities. Oxycodone and codeine most commonly dispensed opioids -- Oxycodone was the most commonly dispensed prescription opioid in 2016-17, with 5.7 million prescriptions dispensed to 1.3 million people, followed by codeine (3.7 million prescriptions to 1.7 million people) and tramadol (2.7 million prescriptions to 600,000 people). Similar to the results for all opioid prescriptions dispensed, on average prescriptions dispensed for oxycodone were for lower doses and/or quantities. After adjusting for differences in the age structure of the population over time, from 2012-13 to 2016-17 there was approximately a 30% rise in both the number of oxycodone prescriptions dispensed per 100,000 population and the number of people receiving them per 100,000 population, but the OME over the same period remained the same (338 to 340 OME mg for oxycodone per 1,000 population per day). Higher rates of OME for opioids dispensed in Inner regional and Outer regional areas -- After adjusting for differences in the age structure of the population, the total number of prescriptions dispensed per 100,000 population was highest for Inner regional areas (74,000 per 100,000 population) and lowest for Very remote areas (38,000 per 100,000 population). The rate of OME was also highest for Inner regional areas (1,374 OME mg per 1,000 population per day), followed closely by Outer regional areas (1,362 OME mg per 1,000 population per day). These rates of OMEs are 2 times higher than in Very remote areas, which at 645 OME mg per 1,000 population per day was the lowest of all areas. 1 in 10 Australians have ever used any type of opioid for illicit or non-medical purposes In 2016, around 1 in 10 (11%) of Australians aged 14 and over had ever used at least 1 type of opioid for illicit or non-medical purposes; recent use (that is, use in the last 12 months) was much lower, at 3.7%. Most had used pharmaceutical opioids rather than illegal opioids, with 9.7% having ever used Pain-killers/analgesics and pharmaceutical opioids, compared with 1.3% who had ever used Heroin. Of people who reported non-medical use of Pain-killers/analgesics and pharmaceutical opioids, 75% had used Over-the-counter codeine products, 40% had used Prescription codeine products and 17% had used Oxycodone. Opioid use varies between Australia and Canada -- Both Australia and Canada have government-funded pharmaceuticals. Overall, there was a downward trend in both countries in the total average opioid dosage (the defined daily dose or DDD) per 1,000 people, per day prescribed in the 5 years to 2016-17. However there were slight differences in the types of opioids prescribed, with the DDD rate for hydromorphone substantially higher in Canada, and the DDD rate for tramadol and buprenorphine higher in Australia. Both countries had a similar DDD rate for fentanyl. Illicit use of fentanyl is more common in Canada than it is in Australia, while heroin use is comparatively higher in Australia than in Canada. The impact of this difference is that people using these different drugs-while they are all opioids-have different trajectories and contact with the acute care system. Fentanyl is more potent than heroin and has a greater potential to be lethal, meaning many users die before they can receive acute care. Side effects from opioid use are responsible for the greatest number of hospitalisations in both Canada and Australia Despite differences in the rates of hospital care in Australia and Canada for opioid harms-due in part to differences in systems and infrastructure for health services-there are similarities in the profiles of people most likely to receive hospital care for opioid harm. In both Australia and Canada, the greatest volume of harm treated in hospitals came from side effects from opioid use. The age distribution for people hospitalised for this reason was similar in Australia and Canada, with rates of hospitalisation increasing with increasing age, reflecting the rates of prescription opioids in both countries. Details: Canberra: AIHW, 2018. 130p. Source: Internet Resource: Accessed November 14, 2018 at: https://www.aihw.gov.au/getmedia/605a6cf8-6e53-488e-ac6e-925e9086df33/aihw-hse-210.pdf.aspx?inline=true Year: 2018 Country: Australia URL: https://www.aihw.gov.au/getmedia/605a6cf8-6e53-488e-ac6e-925e9086df33/aihw-hse-210.pdf.aspx?inline=true Shelf Number: 153417 Keywords: Drug Abuse and AddictionIllicit DrugsOpioid CrisisOpioid DeathsOpioids Prescription Drug Abuse Prescription Drugs |
Author: South Australia. Drug and Alcohol Services Title: Opioid Use and Associated Harms in South Australia Summary: The term opioids encompasses both naturally occurring opiates (morphine and codeine) derived from the resin of the opium poppy, semi-synthetic (oxycodone) and synthetic (fentanyl) opioids. These drugs are only available via prescription; however they can be obtained and used illicitly. Heroin (diamorphine) is also derived from the opium poppy, but is produced illegally and not available by prescription. Opioids can be highly effective for the treatment of pain, although there is a risk of adverse effects and potential for dependence when not used appropriately . Global estimates suggest that the number of opiate users has remained stable in recent years, comprising around 0.4% of the global population aged 15-64 years in 20144 . Opiate use is highest in South-West Asia (0.9%), Central Asia, (0.8%), Europe (0.6%) and North America (0.5%). There is evidence of increased use or harm in some countries, with heroin-related deaths rising substantially in the United Kingdom between 2012 and 2014. In addition, estimates of problem opiate users in France have shown a marked increase in recent years, and heroin use in Italy based on population surveys increased significantly between 2008 (0.4%) and 2014 (0.8%), although overall use is still low. However, household surveys have shown decreases in heroin use (measured as use in the last 12 months) in the general population between 1999 and 2014 in countries such as Hungary, Norway, the UK, Austria, France and Denmark, with use stable in Germany, Spain and Ireland. Prevalence of use in the last 12 months is also low, at 0.5% or less in all countries surveyed in 2014, with the exception of Italy (0.8%). In contrast, heroin use has been increasing in North America, reflected in national household surveys (use in the last 12 months among those aged 12 years and over increased from 0.1% in 2003 to 0.3% in 20146 ) and in the number of heroin-related deaths (from 0.7 deaths per 100,000 population in 1999 to 2.7 deaths in 2013) . The UNODC has also documented increases in opiate use in Africa, whereas it has remained largely unchanged in Asia between 1998 and 2014 and has declined in Oceania. This is primarily due to decreases in heroin use in Australia, where prevalence of use in the last 12 months decreased from 0.8% in 1998 to 0.2% in 2001, and remaining between 0.1% and 0.2% from 2010 to 2016. In the United States, deaths due to prescription opioids are greater than those for heroin and non-opioid drugs such as cocaine. In Australia, there has been an almost four-fold increase between 1990 and 2014 in the prescription of opioids for medicinal purposes, primarily due to a rise in the prescription of drugs such as morphine and methadone for the management of chronic non-cancer pain . In addition, the use of other synthetic opioids such as oxycodone, fentanyl and buprenorphine rose markedly between 2000 and 2011 . Australian research looking at opioid prescriptions from the Pharmaceutical Benefits Scheme (PBS) and Repatriation Schedule of Pharmaceutical Benefits Scheme (RPBS) reported a marked increase in prescriptions for oxycodone between 2002-03 and 2007-08, but a decrease in prescriptions for morphine. Prescriptions for fentanyl also increased between 2002 and 2011 . National sales data for over-the-counter (OTC) codeine and prescription opioids estimated community use in 2013, and found that OTC codeine was the most commonly sold opioid. In addition, most prescription use was for the stronger opioids, which includes fentanyl, oxycodone and morphine. The study concluded that opioid use is considerably higher than is suggested by PBS/RPBS data alone. However, national data after 2013 are not included in these studies; this bulletin presents South Australian PBS/RPBS data up to 2017. National data are also available on opioid-related overdose deaths from the National Coronial Information System (NCIS), and include oxycodone, fentanyl and codeine . Although numbers are small (465 in total for oxycodone, 136 for fentanyl and 113 for codeine), deaths where the underlying or contributing cause was related to these drugs increased from 2000 to 2013. For 53% of oxycodone-related deaths, it was recorded that the drug was prescribed, compared with 37% of fentanyl-related deaths, and 60% of codeine-related deaths . In addition, 27% of oxycodone-related deaths were persons with a history of drug injecting (55% of fentanyl-related deaths and 16% of codeine-related deaths) and multiple drugs (in particular alcohol and benzodiazepines) were recorded in the majority of deaths for all three opioids. A study looking at all deaths in Australia for those aged 15-74 years where opioid overdose was the underlying cause found that pharmaceutical opioid overdose deaths increased from 21.9 per million population in 2001 to 36.2 per million population in 2012. The pharmaceutical opioid death rate in 2012 was 2.5 times higher than that of heroin overdose deaths. The death rate for fentanyl and oxycodone increased significantly between 2001 and 2012, and the death rate was highest for oxycodone (7.8 per million persons) in 2012. This study also calculated death rates per 100,000 Oral Morphine Equivalent (OME)21 grams dispensed, which enabled a comparison of the different pharmaceutical opioids by taking into account the different formulations and strengths of each drug. There was no change between 2001 and 2012 in morphine or oxycodone deaths per 100,000 OME grams, but a significant increase for fentanyl. In 2012, morphine-related death rates per 100,000 OME grams were significantly higher than those for oxycodone (1.7 times) and fentanyl (2.2 times). More recent data on opioid overdose deaths for Australians aged 15-54 years found that 76% of these deaths in 2013 were attributed to pharmaceutical opioids, compared with 68% in 2010. For accidental deaths only, the proportion attributable to pharmaceutical opioids increased slightly from 67% in 2010 to 68% in 2013. Data were only available to 2013, which includes the period in which the consumption and prescription of opioids began to rise in South Australia (as presented in this bulletin); mortality data from 2014-2017 are not available. Population survey data also indicate a small increase in non-medical use of prescription pain-killers/analgesics and opioids , and there has been an increase since the 1990s in the proportion of accidental overdose deaths due to prescription opioids, as well as an increase since 2006 in accidental overdose deaths due to heroin . In response to these findings, this report presents data on current trends in opioid26 use and harms, specifically: 1. The prevalence of opioid use in the population (via surveys, prescriptions, and wastewater data); 2. Hospitalisations, emergency department presentations and deaths related to opioid use; 3. Specialised services provided for opioid misuse. Where possible, South Australian data are compared with data from other States and Territories, as well as nationally. Unless otherwise stated, data presented are from South Australia. Details: Adelaide?: DASSA, 2018. 24p. Source: Internet Resource: DASSA Statistical Bulletin No. 14: Accessed November 15, 2018 at: https://www.sahealth.sa.gov.au/wps/wcm/connect/1181fe4b-0d60-4d59-b1b1-c6c001481021/Statistical+Bulletin+Opioids+Review+of+Data+2018+Update+FINAL.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-1181fe4b-0d60-4d59-b1b1-c6c001481021-mnRwR8j Year: 2018 Country: Australia URL: https://www.sahealth.sa.gov.au/wps/wcm/connect/1181fe4b-0d60-4d59-b1b1-c6c001481021/Statistical+Bulletin+Opioids+Review+of+Data+2018+Update+FINAL.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-1181fe4b-0d60-4d59-b1b1-c6c001481021-mnRw Shelf Number: 153475 Keywords: Drug Abuse and Addiction Illicit Drugs Opioid Crisis Opioid Deaths Opioids Prescription Drug Abuse Prescription Drugs |
Author: Ghandnoosh, Nazgol Title: Opioids: Treating an Illness, Ending a War Summary: More people died from opioid-related deaths in 2015 than in any previous year. This record number quadrupled the level of such deaths in 1999. Unlike the heroin and crack crises of the past, the current opioid emergency has disproportionately affected white Americans-poor and rural, but also middle class or affluent and suburban. This association has boosted support for preventative and treatment-based policy solutions. But the pace of the response has been slow, critical components of the solution-such as health insurance coverage expansion and improved access to medication-assisted treatment-face resistance, and there are growing efforts to revamp the failed and costly War on Drugs. Details: Washington, DC: The Sentencing Project, 2018. 32p. Source: Internet Resource: Accessed January 24, 2019 at: https://www.sentencingproject.org/publications/opioids-treating-illness-ending-war/ Year: 2018 Country: United States URL: https://www.sentencingproject.org/publications/opioids-treating-illness-ending-war/ Shelf Number: 154399 Keywords: Drug Abuse and AddictionDrug Abuse and CrimeOpioid EpidemicOpioidsPrescription Drugs |