Opiod Overdose- What's New?
1Emergency Medicine, Comanche County, United States of America
Death due to opioids increased alarmingly—more than 5-fold—since 1999. This surge was from heroin and synthetic opioids, especially illicitly manufactured fentanyls. Emergency personnel face the challenge of treating intoxications and deaths from novel compounds whose identities are often unknown and for which analytical standards do not exist. Many novel compounds do not appear in routine assays and may escape detection when a simple assay is used to identify a street drug overdose that is contaminated with fentanyl analogs, hindering appropriate identification and treatment. Moreover, illicit fentanyls may be mixed into street supplies of benzodiazepines and cocaine, likely contributing to increases in overdoses involving these other substances. Roughly 21% to 29% of patients who are prescribed opioids for chronic pain misuse them. These observations point to prescription opioid misuse as a contributor to higher risk of heroin abuse, but are not necessarily an indication that the surge in heroin addiction is coming from patients progressing from legitimate treatment for pain.
Representative Strategies Taken to Restrict Prescribing, Abuse/Diversion or Risks of Prescription Opiate Drugs including rescheduling of drugs within the DEA categories, limiting prescribing of opiates, developing abuse-deterrent formulations, evaluating guidelines for pain management, proper disposal of unused prescription drugs, increasing naloxone distribution , adjusting dosages, and using new and generic formulations of opiate antagonists.