It’s no secret that the Opioid Crisis is here to stay. In the United States, over 115 people die from opioid overdose, including prescription opioids, heroin, and synthetic opiates like fentanyl. The Center for Disease Control and Prevention (CDC) estimates that the total cost of healthcare, loss of productivity, addiction treatment and criminal justice involvement totals to $78.5 billion a year in the US alone. Worldwide, it is estimated that 27 million people suffer from opioid use disorders but less than 10% of them who need treatment are receiving it. With opioid use and death from opiate use on the rise, how did we get here?
In later half of the 1990s, pharmaceutical companies had prescription opioid pain relievers on the market but there was concern for addiction. The companies reassured prescribers, pharmacists, and the medical community as a whole that patients would not become addicted to prescription opioid pain relievers. This led to an increase of opioid prescriptions, and widespread abuse of these medications before it was clear to the medical community that these were highly addictive. As addiction rose so did the rate of opioid overdose, by 2015 33,000 American had died from opioid overdose. In present day, doctors are more reluctant to prescribe opioids and their costs on the black market have increased. This drives abusers to street drugs such as heroin. In order to keep up with demand, dealers and suppliers cut their heroin with high potency opioids acquired from overseas like fentanyl. Fentanyl is a synthetic opioid used in patients with severe pain needing long term pain management, and it is 50 to 100 times more potent than morphine. Most fentanyl-related harm come from illegally made fentanyl mixed into heroin, sometimes without the user’s knowledge. The opioid epidemic has become a public health crisis with devastating consequences far beyond the users. There is a rising incidence of neonatal abstinence syndrome (infants born who suffer from opioid withdrawals), plus an increase in intravenous drug use increases the spread of HIV and hepatitis C. In order to combat this, some US states are offering safe needle programs and increasing overdose prevention intervention. One of these agents is known as naloxone. Naloxone is an inexpensive medication that can completely reverse the effects of opioid overdose and prevent death from opioid overdose. New opioid prescribing and dispensing programs have been started, along with continued education on safe opioid prescribing practices for prescribers. The World Health Organization (WHO) recommends tackling the opioid crisis with a variety of treatment options, including psychological support, opioid maintenance treatments such as methadone and buprenorphine and supported detoxification and treatment with reversal agents such as naloxone. The WHO also supports countries where these treatment programs don’t already exist. The United States, and the world has acknowledged the opioid crisis, but we are a long way from solving it.
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A group of Pharm.D. students received a $10,000 PharmAlliance grant — the first of its kind to be awarded to Pharm.D. students — to support a project promoting medication safety. The project is led by PY3 Clara Kim and PY2 Vraj Patel from the UNC Eshelman School of Pharmacy. It is co-authored by PY3 Ember Lu from the School and students from University College London and Monash University in Melbourne, Australia. Their initiative aims to promote safe use of the three medications most associated with drug errors — opioids, insulins and anticoagulants — through the creation of a comic series that promotes patient education. The comics will be distributed online through social media and offline as posters and fliers posted in community pharmacies in the U.S., England and Australia. “This project will help patients, including those with low health literacy, understand how to take their medications correctly and acknowledge the importance of adherence, while making it fun in the process,” Kim said. Established in 2015, PharmAlliance is an international partnership between the UNC Eshelman School of Pharmacy, University College London and Monash University. PharmAlliance has provided support for research initiatives developed by faculty and Ph.D. students from each of the three schools. This is the first PharmAlliance grant to be awarded to Pharm.D. students. Along with Kim, Patel and Lu, the project’s co-authors include Monash University students Alisha Cloti and Emma Hatherley, and University College of London student Ruby Akkad. “The student leaders of all three schools are very excited and thankful to be the first student group to have received this grant,” Kim said. “This is a very important step for the PharmAlliance student domain.” The students will be mentored by faculty at each school: David Steeb, Pharm.D., M.P.H. at UNC-Chapel Hill, Andreia Bruno, Ph.D. at Monash University, and Oksana Pyzik, M.Pharm. at UCL. The grant will allow the students to develop their project beyond the conceptual stage and travel to Melbourne to discuss their project, as well as ways PharmAlliance can support student initiatives and foster connections between students at each of the schools in the future. Original article found here, published on November 13, 2018 at the UNC Eshelman School of Pharmacy homepage: |
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