A study published in the American Journal of Preventive Medicine today finds that more than 2 million Americans who misused opioids between 2012 and 2014 also identified as binge drinkers. Overall, binge drinkers had nearly twice the odds of misusing opioids compared to non-drinkers.
The finding alarmed researchers, who noted that one in five prescription opioid deaths in recent years also involved alcohol. "Combining alcohol and opioids can significantly increase the risk of overdoses and deaths," CDC Director Robert Redfield said in a statement.
Get your quality homework help now and stand out.Our professional writers are committed to excellence. We have trained the best scholars in different fields of study.Contact us now at premiumessays.net and place your order at affordable price done within set deadlines.We always have someone online ready to answer all your queries and take your requests.
National Drug Early Warning (NDEWS) webinar: A more dangerous heroin: Emergin...Dan Ciccarone
This presentation, to an international web audience, was presented alongside one by Dr Wilson Compton, Deputy Director of the National Institute on Drug Abuse. Sponsored by NDEWS, it explores the structural reasons for the emerging heroin overdose epidemic and ways to address it.
More young people in Canada are visiting EDs because of drinking alcoholΔρ. Γιώργος K. Κασάπης
More people are visiting emergency departments after drinking alcohol, a new study finds. Researchers looked at more than 765,000 ED visits in Ontario, Canada’s largest province, and found a 175% increase in such visits between 2003 and 2016 among 25- to 29-year-olds. That spiked to a 240% increase in alcohol-related ED visits for young women, who were also more likely than men to be under Canada’s legal drinking age of 19. For both young men and women, visiting the ED for alcohol-related problems also led to more hospital admissions than other types of ED visits. Other countries, including the U.S., have experienced similar increases in alcohol-related visits to the ED, the authors behind the new study write, urging more research into the reasons behind the growing trend.
Hendricks, the use and abuse of prescription drug nfjca v3 n1 2014William Kritsonis
William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. LaVelle Henricks, Texas A&M University-Commerce and colleagues published in national refereed journal.
Dr. William Allan Kritsonis, Distinguished Alumnus, Central Washington University, College of Education and Professional Studies, Ellensburg, Washington; Invited Guest Lecturer, Oxford Round Table, University of Oxford, United Kingdom; Hall of Honor, Prairie View A&M University/Member of the Texas A&M University System.
Get your quality homework help now and stand out.Our professional writers are committed to excellence. We have trained the best scholars in different fields of study.Contact us now at premiumessays.net and place your order at affordable price done within set deadlines.We always have someone online ready to answer all your queries and take your requests.
National Drug Early Warning (NDEWS) webinar: A more dangerous heroin: Emergin...Dan Ciccarone
This presentation, to an international web audience, was presented alongside one by Dr Wilson Compton, Deputy Director of the National Institute on Drug Abuse. Sponsored by NDEWS, it explores the structural reasons for the emerging heroin overdose epidemic and ways to address it.
More young people in Canada are visiting EDs because of drinking alcoholΔρ. Γιώργος K. Κασάπης
More people are visiting emergency departments after drinking alcohol, a new study finds. Researchers looked at more than 765,000 ED visits in Ontario, Canada’s largest province, and found a 175% increase in such visits between 2003 and 2016 among 25- to 29-year-olds. That spiked to a 240% increase in alcohol-related ED visits for young women, who were also more likely than men to be under Canada’s legal drinking age of 19. For both young men and women, visiting the ED for alcohol-related problems also led to more hospital admissions than other types of ED visits. Other countries, including the U.S., have experienced similar increases in alcohol-related visits to the ED, the authors behind the new study write, urging more research into the reasons behind the growing trend.
Hendricks, the use and abuse of prescription drug nfjca v3 n1 2014William Kritsonis
William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. LaVelle Henricks, Texas A&M University-Commerce and colleagues published in national refereed journal.
Dr. William Allan Kritsonis, Distinguished Alumnus, Central Washington University, College of Education and Professional Studies, Ellensburg, Washington; Invited Guest Lecturer, Oxford Round Table, University of Oxford, United Kingdom; Hall of Honor, Prairie View A&M University/Member of the Texas A&M University System.
Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the ...Δρ. Γιώργος K. Κασάπης
There was a more than twofold increase in the rate of suspected self-poisoning suicide cases between 2011 and 2018, according to a new study that looked at more than 1.6 million such cases.
Here’s what else you need to know:
•Overall trends: Cases of suicide attempts by self-poisoning doubled in those aged 10-18 between 2011 and 2018, rising from around 39,000 to more than 78,000.
•Gender: More girls than boys attempted suicide by self-poisoning. The rate of intentional attempts among girls 10-18 also steadily increased from 2011-2018.
•Outcomes: The number of serious outcomes — including death and hospitalizations — as a result of the poisoning increased 235% between 2000 and 2018, and more than 1,400 children died.
This research paper focuses on prescription opioids and its effects on the African American community. The author discusses the background, best treatment intervention, and ethical considerations associated with prescription opioids and their use within the African American population.
According to the latest government report, the main motivation behind misusing prescription opioids is to relieve pain (62.3 percent). The other reasons for misusing opioids include getting high (12.9 percent) or relieving tension (10.8 percent). The tendency to use prescription opioids at one’s own volition or take a higher dosage than prescribed leads to opioid abuse. In fact, the misuse of prescription drugs has escalated to epidemic proportions in the United States, with the Centers for Disease Control and Prevention (CDC), highlighting the overdose death tally to be more than 64,000 in 2016.
A new data brief reports that deaths from drug abuse among millennials has increased by 400% in the past 20 years. The opioid crisis partly explains the increase, but millennials also face other problems, including high living costs. Here’s more on what the report calls “deaths of despair”:
•Drug deaths: The number of deaths among those in their 20s and 30s went up by 108% between 2007 and 2017.
•Alcohol-related deaths: These deaths in those aged 18-34 went up by nearly 70% between 2007 and 2017, and nearly doubled since 1999.
•Suicides: Between 2011 and 2016, suicide was the second leading cause of death among those aged 15-34, and the following year, suicide rates across all ages increased by 4%.
College Student Perceptions of Marijuana 2015SarahMartin33
This marketing research project was created to better understand college students perceptions on marijuana. In this paper we cover background research concerning legalization of marijuana and behavior. After identifying questions that were not answered during our research, we administered a survey via Qualtrics and received over 700 responses from college students in different colleges in the nation. We took their responses and analyzed our data over SPSS. We discovered that most of our hypotheses held true.
Opioid Addiction: New Approach Gives Hope to Patients Awaiting TreatmentSov Addiction Rehab
Amid the growing opioid crisis in the United States, the capacity of available treatment programs is falling short of demand. As a result, people needing treatment for dependency on heroin or prescription painkillers have to wait for months, sometimes even years, to get appointments with certified doctors or to find slots in rehabilitation programs.
National Academies of Science and Medicine: Intertwined Epidemics: Opioid and...Dan Ciccarone
This presentation explores the current heroin overdose epidemic;how it evolved out of the prescription pill epidemic and how changes in heroin supply are creating regional differences in heroin overdose.
Substance Abuse among Adolescents: 1. Prevalence and Patterns of Alcohol Use ...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Fitness/Substance Abuse
Do Alcohol Consumers Exercise More? Findings
From a National Survey
Michael T. French, PhD; Ioana Popovici, PhD; Johanna Catherine Maclean, MA
Abstract
Purpose. Investigate the relationship between alcohol consumption and physical activity
because understanding whether there are common determinants of health behaviors is critical in
designing programs to change risky activities.
Design. Cross-sectional analysis.
Setting. United States.
Subjects. A sample of adults representative of the U.S. population (N 5 230,856) from the
2005 Behavioral Risk Factor Surveillance System.
Measures. Several measures of drinking and exercise were analyzed. Specifications included
numerous health, health behavior, socioeconomic, and demographic control variables.
Results. For women, current drinkers exercise 7.2 more minutes per week than abstainers.
Ten extra drinks per month are associated with 2.2 extra minutes per week of physical activity.
When compared with current abstainers, light, moderate, and heavy drinkers exercise 5.7,
10.1, and 19.9 more minutes per week. Drinking is associated with a 10.1 percentage point
increase in the probability of exercising vigorously. Ten extra drinks per month are associated
with a 2.0 percentage point increase in the probability of engaging in vigorous physical activity.
Light, moderate, and heavy drinking are associated with 9.0, 14.3, and 13.7 percentage point
increases in the probability of exercising vigorously. The estimation results for men are similar to
those for women.
Conclusions. Our results strongly suggest that alcohol consumption and physical activity are
positively correlated. The association persists at heavy drinking levels. (Am J Health Promot
2009;24[1]:2–10.)
Key Words: Health Behavior, Lifestyle, Alcohol, Exercise, Health
Consciousness, Sensation Seeking, Prevention Research. Manuscript format:
research, Research purpose: modeling/relationship testing, Study design:
nonexperimental, Outcome measure: physical activity, behavioral, Setting: state/
national, Health focus: fitness/physical activity, Strategy: skill building/behavior
change, Target population age: adult, Target population circumstances:
education/income level and race/ethnicity
PURPOSE
The epidemiologic literature has
firmly established that certain lifestyle
health-related choices are associated
with an elevated risk of morbidity and
mortality.1–3 Excessive alcohol con-
sumption, physical inactivity, smoking,
and unhealthy dietary practices ac-
count for a large proportion of pre-
ventable chronic diseases and deaths in
the United States. However, the precise
association between these behaviors is
still the subject of longstanding debate.
There are reasons to believe that
health behaviors may not be indepen-
dent of each other. One view purports
that individuals’ motivation to prevent
disease or improve health could cause
the clustering of health behaviors.4 In
other words, health consciousness
could l.
Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the ...Δρ. Γιώργος K. Κασάπης
There was a more than twofold increase in the rate of suspected self-poisoning suicide cases between 2011 and 2018, according to a new study that looked at more than 1.6 million such cases.
Here’s what else you need to know:
•Overall trends: Cases of suicide attempts by self-poisoning doubled in those aged 10-18 between 2011 and 2018, rising from around 39,000 to more than 78,000.
•Gender: More girls than boys attempted suicide by self-poisoning. The rate of intentional attempts among girls 10-18 also steadily increased from 2011-2018.
•Outcomes: The number of serious outcomes — including death and hospitalizations — as a result of the poisoning increased 235% between 2000 and 2018, and more than 1,400 children died.
This research paper focuses on prescription opioids and its effects on the African American community. The author discusses the background, best treatment intervention, and ethical considerations associated with prescription opioids and their use within the African American population.
According to the latest government report, the main motivation behind misusing prescription opioids is to relieve pain (62.3 percent). The other reasons for misusing opioids include getting high (12.9 percent) or relieving tension (10.8 percent). The tendency to use prescription opioids at one’s own volition or take a higher dosage than prescribed leads to opioid abuse. In fact, the misuse of prescription drugs has escalated to epidemic proportions in the United States, with the Centers for Disease Control and Prevention (CDC), highlighting the overdose death tally to be more than 64,000 in 2016.
A new data brief reports that deaths from drug abuse among millennials has increased by 400% in the past 20 years. The opioid crisis partly explains the increase, but millennials also face other problems, including high living costs. Here’s more on what the report calls “deaths of despair”:
•Drug deaths: The number of deaths among those in their 20s and 30s went up by 108% between 2007 and 2017.
•Alcohol-related deaths: These deaths in those aged 18-34 went up by nearly 70% between 2007 and 2017, and nearly doubled since 1999.
•Suicides: Between 2011 and 2016, suicide was the second leading cause of death among those aged 15-34, and the following year, suicide rates across all ages increased by 4%.
College Student Perceptions of Marijuana 2015SarahMartin33
This marketing research project was created to better understand college students perceptions on marijuana. In this paper we cover background research concerning legalization of marijuana and behavior. After identifying questions that were not answered during our research, we administered a survey via Qualtrics and received over 700 responses from college students in different colleges in the nation. We took their responses and analyzed our data over SPSS. We discovered that most of our hypotheses held true.
Opioid Addiction: New Approach Gives Hope to Patients Awaiting TreatmentSov Addiction Rehab
Amid the growing opioid crisis in the United States, the capacity of available treatment programs is falling short of demand. As a result, people needing treatment for dependency on heroin or prescription painkillers have to wait for months, sometimes even years, to get appointments with certified doctors or to find slots in rehabilitation programs.
National Academies of Science and Medicine: Intertwined Epidemics: Opioid and...Dan Ciccarone
This presentation explores the current heroin overdose epidemic;how it evolved out of the prescription pill epidemic and how changes in heroin supply are creating regional differences in heroin overdose.
Substance Abuse among Adolescents: 1. Prevalence and Patterns of Alcohol Use ...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Fitness/Substance Abuse
Do Alcohol Consumers Exercise More? Findings
From a National Survey
Michael T. French, PhD; Ioana Popovici, PhD; Johanna Catherine Maclean, MA
Abstract
Purpose. Investigate the relationship between alcohol consumption and physical activity
because understanding whether there are common determinants of health behaviors is critical in
designing programs to change risky activities.
Design. Cross-sectional analysis.
Setting. United States.
Subjects. A sample of adults representative of the U.S. population (N 5 230,856) from the
2005 Behavioral Risk Factor Surveillance System.
Measures. Several measures of drinking and exercise were analyzed. Specifications included
numerous health, health behavior, socioeconomic, and demographic control variables.
Results. For women, current drinkers exercise 7.2 more minutes per week than abstainers.
Ten extra drinks per month are associated with 2.2 extra minutes per week of physical activity.
When compared with current abstainers, light, moderate, and heavy drinkers exercise 5.7,
10.1, and 19.9 more minutes per week. Drinking is associated with a 10.1 percentage point
increase in the probability of exercising vigorously. Ten extra drinks per month are associated
with a 2.0 percentage point increase in the probability of engaging in vigorous physical activity.
Light, moderate, and heavy drinking are associated with 9.0, 14.3, and 13.7 percentage point
increases in the probability of exercising vigorously. The estimation results for men are similar to
those for women.
Conclusions. Our results strongly suggest that alcohol consumption and physical activity are
positively correlated. The association persists at heavy drinking levels. (Am J Health Promot
2009;24[1]:2–10.)
Key Words: Health Behavior, Lifestyle, Alcohol, Exercise, Health
Consciousness, Sensation Seeking, Prevention Research. Manuscript format:
research, Research purpose: modeling/relationship testing, Study design:
nonexperimental, Outcome measure: physical activity, behavioral, Setting: state/
national, Health focus: fitness/physical activity, Strategy: skill building/behavior
change, Target population age: adult, Target population circumstances:
education/income level and race/ethnicity
PURPOSE
The epidemiologic literature has
firmly established that certain lifestyle
health-related choices are associated
with an elevated risk of morbidity and
mortality.1–3 Excessive alcohol con-
sumption, physical inactivity, smoking,
and unhealthy dietary practices ac-
count for a large proportion of pre-
ventable chronic diseases and deaths in
the United States. However, the precise
association between these behaviors is
still the subject of longstanding debate.
There are reasons to believe that
health behaviors may not be indepen-
dent of each other. One view purports
that individuals’ motivation to prevent
disease or improve health could cause
the clustering of health behaviors.4 In
other words, health consciousness
could l.
Relationship Between Drugs and Health Workers - Sample Essaya1customwritings
A1CustomWritings.com are experienced in all academic levels of assignments and in any academic fields, the team of experts of our custom essay writing service have the ability to help you with any requirements of your essay. Our team takes pride in the quality of work provided to our customers and we pledge to do whatever it takes to ensure you receive a paper of only the highest quality.
1Joseph Role of Opioid Education for the YouthEsther Joscargillfilberto
1
Joseph
Role of Opioid Education for the Youth
Esther Joseph
Miami Regional University ENC 2201— Report Writing and Research MethodsResearch Paper
Dr. Uliana Gancea
April 11, 2020
Opioid Abuse by the Youth
Opioids are substances that act on the opioid receptors so as to produce a morphine like outcome. They are used for pain relief, including anesthesia. They are also used to suppress diarrhoea, replacement therapy for opioid use disorder, suppressing cough as well as for executions in the United States. Opioids apart from being used for medical purposes they are also frequently used for non-medical purposes. When induced they give a euphoric effect and can also be used to prevent withdrawal (Satterley & Anitescu, 2015). In the United States there have been a lot of youths who use opioids for their euphoric effects. Due to their addictive nature, they have seen a lot of youths addicted to the substances which many result to fatal and adverse effects on the substance abuser.
Opioids are responsible for 1.7 deaths in 10, 000 people. Most of these people are young adults between 18 years to 25 years. Due to the rise in the use of this substances there have been introduction of educating the youths about the drugs. This is to create awareness as well as educate the youth on what to expect if they get themselves mixed up with the practice. In this paper we pose the question, what is the role of opioid education to the youth? We will talk about the impact that the program will have on the youths, be it positive or negative (Knaggs, 2019).
Opioids act by binding to opioid receptors, these are found principally in the peripheral and central nervous system as well as the gastrointestinal tract. These receptors mediate both the somatic as well as the psychoactive effects that opioids cause. Opioid drugs include antagonists like naloxegol which are used for opioid induced constipation and partial agonists like the anti diarrhoea drug loperamide (McDONOUGH, 2016). Due to opioids nature of being addictive and might result in fatal overdose, most of them are controlled substances. In the year 2013, between 28 and 38 million people were using opioids illicitly. That is 0.6% to 0.8% of the global population between the ages 15 and 65. In the year 2011, it was estimated that 4 million people in the United States used opioids recreationally and were dependent on them. As of 2015, increased numbers of recreational use and addiction were attributed to over prescription of the medication and inexpensive illicit heroin.
Literature review
The National Institutes of Health has a healing initiative for over 50 million Americans who suffer from chronic pain. Opioids medications are the most common for treating pain although effective and safe non opioid options for pain management are lacking. The used of opioids to treat acute and chronic pain has contributed to approximately 10.3 million people aged 12 years and older in the united states in 2018 who abus ...
A National Survey of Marijuana Use Among US Adults With Medical Conditions, 2...Δρ. Γιώργος K. Κασάπης
This survey study using data from 169 036 participants in the 2016 and 2017 Behavioral Risk Factor Surveillance System surveys found that, compared with adults without medical conditions, adults with medical conditions had a significantly higher prevalence of current and daily marijuana use, were more likely to report using marijuana for medical reasons, and were less likely to report using marijuana for recreational purposes. Among respondents with medical conditions, 11.2% of young adults reported using marijuana on a daily basis, and the prevalence of marijuana use decreased with increasing age.
Research MethodsLaShanda McMahonUniversity o.docxverad6
Research Methods
LaShanda McMahon
University of Phoenix
Formulating the Problem Statement and the Purpose Statement
Over the past decade, there have been several changes in drug addiction treatment that has shown results that show reduced associated health and social costs by more than the cost of the treatments. It has been found that treatments cost much less that the alternatives, such as incarcerating people with addictions. There are many savings related to healthcare, which includes, total savings that can exceed costs with a ratio of 12 to 1. Major savings to the individual and to society also stems from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths (Woody, M.D., 2018).
Problem Statement
A common misperception is detoxification cures the addiction, yet addiction is a chronic disorder requiring long term multimodal treatment (Korsmeyer et al., 2009. Long-term treatment for substance abuse and co-occurring disorders might reduce recidivism rates and lessen costs for rehabilitation. Goldstein, A. (1997). examined the benefits of long-term substance abuse and posited the benefits. Goldstein further suggested not treating addiction appropriately or at all contributes to the high costs associated with substance use in the United States.
Insurance companies are reluctant to support long term substance abuse treatment; however, Weisner, Ray, Mertens, Satre and Moore (2003) noted patients receiving a minimum of six months substance treatment abstained from drug and alcohol use at least five years after treatment yet abusers of alcohol were less likely to remain sober for lengthy periods of time after treatment (Weisner et al., 2003).
According to the National Drug Institute (2012), every dollar invested in substance abuse treatment yields a return of $5.50 in reduced drug-related crime, costs associated with criminal justice, and theft. Healthcare savings can exceed costs by a 12 to 1 ratio. Therefore, drug addiction treatment reduces costs associated with primary care and is less costly than incarceration. Addressing addiction also contributes to the more positive aspects of life, such as increase in work productivity, and fewer incidents related to drug use, fewer overdoses and deaths.
Purpose Statement
The purpose of this correlational study is to see if a relationship exists among periods of sobriety and four levels of substance abuse treatment. The research will examine substance abuse treatment throughout various levels of care: higher levels (detox, Inpatient (IP), and Residential (RTC) and lower levels (partial hospitalization (PHP), Intensive Outpatient (IOP), and routine Outpatient (OP). Current trends in substance abuse treatment provides evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. Longer treatment options for addiction may reduce the number of relapses, reduce costs asso.
Running head OPIOID CRISIS PUBLIC POLICY PAPER .docxglendar3
Running head: OPIOID CRISIS PUBLIC POLICY PAPER 1
OPIOID CRISIS PUBLIC POLICY PAPER 7
Opioid Crisis Public Policy Paper
Anniesha Overton
Strayer Umiversity
Summary of the policy
The opioid crisis has been a significant public health concern in the United States since the late 1990s. The inability to develop strategic legislation and regulation to control the use of opioid has been critical to the development of the opioid crisis. The opioid crisis involves the use of both prescription and non-prescription opioid drugs. According to the Center for Disease control and prevention, the rate of opioid addiction has been significantly increasing over the years. From 1999 to 2016, at least 350,000 individuals have died from related opioid addiction, which includes prescription and illicit opioids.
Unlicensed pharmacies and overdependence on these drugs in pain management have been major concepts, which have created a challenging setting where the abuse of prescription drugs can be controlled. The underlying basis of this problem is the current assumption in the United States that medical practitioners can cure almost everything. Even though it is essential to understand that prescription drugs are effective in pain management, the drugs are required to be offered based on the prescriptions issued (McDonald & Lambert, 2016). It is also noted that they should not be used regularly since they created a very detrimental habit to patient wellbeing because they have addictive properties, which make it dangerous when consumed in large portions.
Confronting opioid addiction requires significant efforts by all stakeholders in healthcare in ensuring that there is a common objective in providing that there is a crucial focus in integrating quality focus in preventing opioid addiction. Considering the fact that a prescribed drug mainly propagates opioid addiction. It is essential to ensure that they are issued through consideration of critical healthcare knowledge regarding the admissibility of opioid drugs (Bihel, 2016). Nurses have a significant role to play regarding the overall development of the opioid addiction crisis. Critical issues that have been identified in opioid drug abuse include improper use, lack of the required knowledge and related interpretation in the use of opioid prescribed drugs and decreased regulation and legislation from the government regarding the existing concern on the increasing addiction levels across the country.
Players
The increase in opioid crisis has had a direct and indirect influence on different stakeholders. Therefore developing a strong focus on essential strategies that can help limit the overall impact of the opioid crisis on the lives of an individual is critical. The national institute on drug abuse reported that in 2015, 33,091 deaths were reported be.
Running head OPIOID CRISIS PUBLIC POLICY PAPER .docxtodd581
Running head: OPIOID CRISIS PUBLIC POLICY PAPER 1
OPIOID CRISIS PUBLIC POLICY PAPER 7
Opioid Crisis Public Policy Paper
Anniesha Overton
Strayer Umiversity
Summary of the policy
The opioid crisis has been a significant public health concern in the United States since the late 1990s. The inability to develop strategic legislation and regulation to control the use of opioid has been critical to the development of the opioid crisis. The opioid crisis involves the use of both prescription and non-prescription opioid drugs. According to the Center for Disease control and prevention, the rate of opioid addiction has been significantly increasing over the years. From 1999 to 2016, at least 350,000 individuals have died from related opioid addiction, which includes prescription and illicit opioids.
Unlicensed pharmacies and overdependence on these drugs in pain management have been major concepts, which have created a challenging setting where the abuse of prescription drugs can be controlled. The underlying basis of this problem is the current assumption in the United States that medical practitioners can cure almost everything. Even though it is essential to understand that prescription drugs are effective in pain management, the drugs are required to be offered based on the prescriptions issued (McDonald & Lambert, 2016). It is also noted that they should not be used regularly since they created a very detrimental habit to patient wellbeing because they have addictive properties, which make it dangerous when consumed in large portions.
Confronting opioid addiction requires significant efforts by all stakeholders in healthcare in ensuring that there is a common objective in providing that there is a crucial focus in integrating quality focus in preventing opioid addiction. Considering the fact that a prescribed drug mainly propagates opioid addiction. It is essential to ensure that they are issued through consideration of critical healthcare knowledge regarding the admissibility of opioid drugs (Bihel, 2016). Nurses have a significant role to play regarding the overall development of the opioid addiction crisis. Critical issues that have been identified in opioid drug abuse include improper use, lack of the required knowledge and related interpretation in the use of opioid prescribed drugs and decreased regulation and legislation from the government regarding the existing concern on the increasing addiction levels across the country.
Players
The increase in opioid crisis has had a direct and indirect influence on different stakeholders. Therefore developing a strong focus on essential strategies that can help limit the overall impact of the opioid crisis on the lives of an individual is critical. The national institute on drug abuse reported that in 2015, 33,091 deaths were reported be.
The world stands to lose close to 10% of total economic value by mid-century if climate change stays on the currently-anticipated trajectory, and the Paris Agreement and 2050 net-zero emissions targets are not met.
Many emerging markets have most to gain if the world is able to rein in temperature gains. For example, action today to get back to the Paris temperature rise scenario would mean economies in southeast Asia could prevent around a quarter of the gross domestic product (GDP) loss by mid-century that they may otherwise suffer. Our analysis in this report is unique in explicitly simulating for the many uncertainties around the impacts of climate change. It shows that those economies most vulnerable to the potential physical risks of climate change stand to benefit most from keeping temperature rises in check. This includes some of the world's most dynamic emerging economies, the engines of global growth in the years to come. The message from the analysis is clear: no action on climate change is not an option.
Promise and peril: How artificial intelligence is transforming health careΔρ. Γιώργος K. Κασάπης
AI has enormous potential to improve the quality of health care, enable early diagnosis of diseases, and reduce costs. But if implemented incautiously, AI can exacerbate health disparities, endanger patient privacy, and perpetuate bias. STAT, with support from the Commonwealth Fund, explored these possibilities and pitfalls during the past year and a half, illuminating best practices while identifying concerns and regulatory gaps. This report includes many of the articles we published and summarizes our findings, as well as recommendations we heard from caregivers, health care executives, academic experts, patient advocates, and others.
This report covers the judicial use of the death penalty for the period January to December 2020.
As in previous years, information is collected from a variety of sources, including: official figures; judgements; information from individuals sentenced to death and their families and representatives; media reports; and, for a limited number of countries, other civil society organizations.
Amnesty International reports only on executions, death sentences and other aspects of the use of the death penalty, such as commutations and exonerations, where there is reasonable confirmation. In many countries governments do not publish information on their use of the death penalty. In China and Viet Nam, data on the use of the death penalty is classified as a state secret. During 2020 little or no information was available on some countries – in particular Laos and North Korea (Democratic People’s Republic of Korea) – due to restrictive state practice.
Aviva’s first How We Live report was published in September 2020 when the world was firmly in the grip of a global pandemic. In the UK the vaccination programme is well underway and the mood of the nation is hopeful. This latest How We Live report looks at the long-term effects of the Coronavirus outbreak and considers its impact on our future behaviours.
We interviewed 4,000 adults across the UK to gather their views on a wide range of lifestyle decisions including property priorities, home-working, green living, career paths, vehicle choices and holiday plans. We also asked whether people had experienced any positive outcomes from the Covid pandemic. This report considers the practical and emotional skills which have been fostered as a result. Since the beginning of 2020, the UK has seen immense change. As we look forward to a sense of “normality” it remains to be seen which aspects of life will return to their previous states, and where we can expect changes to become permanent fixtures.
The life insurance industry provides protection against the financial consequences of the premature death of a family breadwinner, disability, or outliving one’s retirement assets. But how are life insurance products actually designed and priced?
Product committees comprising agents, underwriters, actuaries, and senior management sit and discuss what new products should be offered. The agents have vast experience visiting with policyholders to determine their needs. Underwriters set the guidelines on which policyholders will be accepted and/or rated. Smart actuaries (while most would find this redundant, some would call it an oxymoron) assess the potential risks in these products and set a potential price. Senior management listens to agents, underwriters, and actuaries and helps finalize the product design, the guidelines for accepting risks, and the price. The programmers will also have to be contacted to determine the cost of administering the products. Many iterations of these discussions may take place before a product is ready for sale. The entire process could take up to a year.
Some of these products are quite complex, taking into account long-term interest rates and probabilities of death/survival, disability, and lapse. With this lengthy and rigorous process, one would imagine that few mistakes are made. However, this is not the case. What follows are a few examples of major product mistakes which cost the life insurance industry a lot of time, money, and bad publicity.
The COVID-19 pandemic and subsequent lockdowns forced many insurers to accelerate the transition to digital business models. In many countries, this transition has been remarkably successful, however, the crisis also highlighted the critical role played by national regulatory frameworks in both hindering and facilitating the shift to digitalisation in the insurance industry. COVID-19 lockdowns highlighted the critical role of national regulatory frameworks in both hindering and facilitating the shift to digitalisation in the insurance industry. Digitalisation is not a goal in itself, but provides insurers and their customers with benefits that are particularly useful in situations where in-person interactions cannot take place, played out in its fullest form during the COVID-19-induced lockdowns. Digitalisation drives an increase in speed and efficiency, irrespective of where the customer is located, and promises improved customer service and satisfaction.
The Internet of Things (IoT) has been developing over the last 20 years and is often referred to as Industry 4.0 or the “fourth industrial revolution.” It is an umbrella term for all the digital assets and entities connected to the internet. Many of these are intangibles, such as data, human capital via artificial intelligence (AI), intellectual property (IP), and cyber; as such, they need to be made tangible to address value on a balance sheet. Others are connected entities, such as sensor devices, collecting and receiving information in an intelligent fashion across networks.
The rapid rise of online political campaigning has made most political financing regulations obsolete, putting transparency and accountability at risk. Seven in 10 countries worldwide do not have any specific limits on online spending on election campaigns, with six out of 10 not having any restrictions on online political advertising at all.
Highlights
• On average, concerns over Innovation was ranked highest, followed by Implications of Covid-19 • Respondents indicated innovation is important, but are mostly in process
• Respondents were mostly confident in implementing their innovation plans.
• Nearly half of respondents indicated their focus was on the customer experience • Most respondents expect some negative impact from Covid-19, with decreased profit indicated most, followed by decreased sales effectiveness, which are likely related
• The most common change in response to the Covid-19 impact were workplace and staffing changes, followed by technology investments
• Of the respondents, 92% indicated cyber security was important or very important.
• Continuous effort was ranked highest, and Mitigating internal threats, Identifying external threats, and Prioritizing identifying cyber risks were ranked next.
• While 95% of respondents indicated emerging threats were important or very important, 28% Indicated they were very good at responding to them
• For resiliency and sustainability, corporate ESG and R&S for internal operations were ranked as the highest priorities
iis the institutes innovation covid-19
What North America’s top finance executives are thinking - and doingΔρ. Γιώργος K. Κασάπης
Each quarter (since 2Q10), CFO Signals has tracked the thinking and actions of CFOs representing many of North America’s largest and most influential companies. All respondents are CFOs from the US, Canada, and Mexico, and the vast majority are from companies with more than $1 billion in annual revenue. The 1Q 2021 survey was open from February 8-19, 2021. A total of 128 CFOs participated, 69% from public companies and 31% from privately held companies.
Democratic watchdog organization Freedom House has released its annual ranking of the world's most free and most suppressed nations.
The report is a key barometer for global democracy and this year's edition found that global freedom has declined for the 15th straight year. 2020 was a turbulent year with the pandemic, violent conflict and economic and physical insecurity leading to democracy's defenders sustaining heavy losses against authoritarian foes which has resulted in a shift in the internatioal baance in favor of tyranny.
A total of 195 countries and 15 territories were analyzed on their levels of access to political rights and civil liberties with the number experiencing a deterioration in their freedom scores exceeding the number that saw improvement by the widest margin since 2006. In 2020, nearly 75 percent of the world's population lived under a government that saw its democracy score decline in the past year.
Women, Business and the Law 2021 is the seventh in a series of annual studies measuring the laws and regulations that affect women’s economic opportunity in 190 economies. Amidst a global pandemic that threatens progress toward gender equality, the report identifies barriers to women’s economic participation and encourages reform of discriminatory laws. This year, the study also includes important findings on government responses to the COVID-19 crisis and pilot research related to childcare and women’s access to justice.
Strong competition undoubtedly contributes to a country’s productivity and economic growth. The primary objective of a competition policy is to enhance consumer welfare by promoting competition and controlling practices that could restrict it. More competitive markets stimulate innovation and generally lead to lower prices for consumers, increased product variety and quality, more entry and enhanced investment. Overall, greater competition is expected to deliver higher levels of welfare and economic growth.
Long-erm Care and Health Care Insurance in OECD and Other CountriesΔρ. Γιώργος K. Κασάπης
This report carries out a stocktaking of what systems have in OECD and non-OECD countries for longterm care and health care, as well as the types of insurance products that are made available in these countries. It is part of a broader project that examines the complementarity of the social security network with the private insurance market, which examines how insurance could support the public sector longterm care and health care systems, as well as considering the financing of long-term care and health care.
This tenth edition of Global Insurance Market Trends provides an overview of market trends to better understand the overall performance and health of the insurance market. This monitoring report is compiled using data from the OECD Global Insurance Statistics (GIS) exercise. The OECD has collected and analysed data on insurance in OECD countries, such as the number of insurance companies and employees, insurance premiums and investments by insurance companies, dating back to the 1980s. Over time, the framework of this exercise has expanded and now includes key items of the balance sheet and income statement of direct insurers and reinsurers.
Does AI threaten and undermine human value in the workplace more than any other technology? There have been significant advances in AI, but will their impact really be different this time?
This literature review takes stock of what is known about the impact of artificial intelligence on the labour market, including the impact on employment and wages, how AI will transform jobs and skill needs, and the impact on the work environment. The purpose is to identify gaps in the evidence base and inform future research on AI and the labour market.
The OECD has estimated that 14% of jobs are at high risk of automation.
•Despite this, employment grew in nearly all OECD countries over the period 2012-2019.
•At the country level, a higher risk of automation was associated with higher employment growth over the period. This might be because automation promotes employment growth by increasing productivity, although other factors are also at play.
•At the occupational level, however, employment growth was much lower in occupations at high risk of automation (6%) than in occupations at low risk (18%).
•Low-educated workers were more concentrated in high-risk occupations in 2012 and have become even more concentrated in these occupations since then.
•The low growth in jobs in high risk occupations has not led to a drop in the employment rate of low-educated workers. This is largely because the number of workers with a low education has fallen in line with the demand for these workers.
•Going forward, however, the risk of automation is increasingly falling on low-educated workers and the COVID-19 crisis is likely to accelerate automation, as companies reduce reliance on human labour and contact between workers, or re-shore some production.
Prescription drug prices in U.S. more than 2.5 times higher than in other cou...Δρ. Γιώργος K. Κασάπης
Prescription drugs cost an average of 2.56 times more in the United States than they do in 32 other countries, according to a new report from RAND Corporation.
That disparity is even greater for brand name drugs, with U.S. prices averaging 3.44 times those in comparison nations. The study also found that prices for unbranded generic drugs — which account for 84% of drugs sold in the United States by volume but only 12% of U.S. spending — are slightly lower in the United States than in most other countries.
‘A circular nightmare’: Short-staffed nursing homes spark Covid-19 outbreaks,...Δρ. Γιώργος K. Κασάπης
Nursing homes have suffered grievously in the coronavirus pandemic. Chronically understaffed, that’s getting worse, a new US Pirg Education Fund analysis says. The shortage of direct-care workers rose from 20% of U.S. nursing homes in May to 23% in December. Too few workers raises stress among staff, the authors argue, making them and the residents they care for more vulnerable to Covid-19 infections, reducing staff further in “a circular nightmare.”
Keeping the lights on, the water running, and the landlord at bay could turn out to be good ways to control Covid-19 infection, a new NBER (National Bureau of Economic Research) analysis suggests, based on the idea that social distancing is easier for people who can stay home. When utility shutoffs and evictions were halted, Covid-19 cases in certain counties across the country fell by 8% from March through November 2020, the report says. The study can't prove cause and effect, but the authors venture that if such measures had been implemented nationwide, eviction moratoria would have resulted in a 14% decrease in Covid-19 cases and up to a 40% decrease in deaths. Utility shutoff moratoria would have cut infections by 9% and deaths by 15%, the study estimates.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
CDC researchers see link between opioid misuse, binge drinking.
1. RESEARCH ARTICLE
Binge Drinking and Prescription Opioid Misuse in the
U.S., 2012−2014
Marissa B. Esser, PhD, MPH,1
Gery P. Guy Jr., PhD, MPH,2
Kun Zhang, PhD, MA,2
Robert D. Brewer, MD, MSPH1
Introduction: Prescription opioids were responsible for approximately 17,000 deaths in the U.S. in
2016. One in five prescription opioid deaths also involve alcohol. Drinkers who misuse prescription
opioids (i.e., use without a prescription or use only for the experience or feeling it causes) are at a
heightened risk of overdose. However, little is known about the relationship between drinking
patterns and prescription opioid misuse.
Methods: Data were analyzed from 160,812 individuals (aged ≥12 years) who responded to ques-
tions about prescription opioid misuse and alcohol consumption in the 2012, 2013, or 2014
National Survey on Drug Use and Health (analyzed in 2017−2018). The prevalence of self-reported
past-30-days prescription opioid misuse was assessed by sociodemographic characteristics, other
substance use (i.e., cigarettes, marijuana), and drinking patterns. Multiple logistic regression analyses
were used to calculate AORs.
Results: From 2012 to 2014, 1.6% (95% CI=1.5, 1.7) of all individuals aged ≥12 years (estimated
4.2 million) and 3.5% (95% CI=3.3, 3.8) of binge drinkers (estimated 2.2 million) reported prescrip-
tion opioid misuse. Prescription opioid misuse was more common among binge drinkers than
among nondrinkers (AOR=1.7, 95% CI=1.5, 1.9). Overall, the prevalence of prescription opioid
misuse increased significantly with binge drinking frequency (p-value<0.001).
Conclusions: More than half of the 4.2 million people who misused prescription opioids during
2012−2014 were binge drinkers, and binge drinkers had nearly twice the odds of misusing prescrip-
tion opioids, compared with nondrinkers. Widespread use of evidence-based strategies for prevent-
ing binge drinking might reduce opioid misuse and overdoses involving alcohol.
Am J Prev Med 2019;000(000):1−12. Published by Elsevier Inc. on behalf of American Journal of Preventive
Medicine.
INTRODUCTION
P
rescription opioids were involved in approxi-
mately 17,000 deaths in the U.S. in 2016,1
tripling
since 1999.2,3
The number of opioid prescriptions
written also tripled during this time, substantially increas-
ing opioid availability.4
In addition, prescription opioid
overdose, abuse, and dependence cost the U.S. $78.5 bil-
lion in 2013, including healthcare claims, substance use
disorder treatment, criminal justice costs, and lost pro-
ductivity.5
Consequently, the opioid overdose epidemic
has been declared a public health emergency.6
Compared with those who use opioids as prescribed,
people who misuse prescription opioids (defined in this
analysis as using an opioid without a prescription, or
using these drugs only for the experience or feeling it
caused) may consume higher doses of these drugs, use
them more frequently, or both, increasing the risk of non-
fatal and fatal overdoses.7−9
One study analyzed data
from the Drug Abuse Warning Network on emergency
department (ED) visits and found that there were 305,900
From the 1
Division of Population Health, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control
and Prevention, Atlanta, Georgia; and 2
Division of Unintentional Injury
Prevention, National Center for Injury Prevention and Control, Centers
for Disease Control and Prevention, Atlanta, Georgia
Address correspondence to: Marissa B. Esser, PhD, MPH, 4770 Buford
Hwy NE, MS-S107-6, Atlanta GA 30341. E-mail: messer@cdc.gov.
0749-3797/$36.00
https://doi.org/10.1016/j.amepre.2019.02.025
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. Am J Prev Med 2019;000(000):1−12 1
ARTICLE IN PRESS
2. ED visits because of prescription opioid misuse in 2008,
which was double the number reported in 2004.10
An important, though generally under-recognized, risk
factor for opioid misuse is alcohol consumption, particu-
larly excessive drinking. For example, a study using 2006
data from the National Survey on Drug Use and Health
(NSDUH) found that men and women who consumed
alcohol during the previous year were 70% and 90% more
likely to misuse opioids during the previous year, respec-
tively, than their nondrinker counterparts.11
However, the
authors did not assess the association between prescrip-
tion opioid misuse and alcohol use by sociodemographic
characteristics other than gender, nor did they examine
this relationship by drinking patterns (e.g., binge drink-
ing). Another study using the 2001−2002 National Epide-
miologic Survey on Alcohol and Related Conditions
found that 1.1% of past-year drinkers who did not binge
drink, and 2.2% of binge drinkers who did not have alco-
hol abuse or dependence, misused prescription opioids
during the past year.12
After controlling for sex, age, and
race or ethnicity, past-year drinkers who did not binge
drink, and binge drinkers who did not meet DSM-IV cri-
teria for alcohol abuse or dependence, were 1.8 and
3.6 times more likely to report past-year prescription opi-
oid misuse than nondrinkers, respectively. However, the
authors did not assess this relationship by sociodemo-
graphic characteristics, nor did they control for differen-
ces in annual household income, which has been shown
to be associated with both binge drinking and prescription
opioid misuse.13,14
In addition, the authors were unable to
fully assess the relationship between binge drinking and
prescription opioid misuse because of the exclusion of
respondents who met DSM-IV criteria for alcohol abuse
or dependence from their binge drinking population.
Alcohol consumption has also been associated with pre-
scription opioid overdoses. In 2010, one in five opioid-
involved deaths in the U.S. also involved alcohol.15
In addi-
tion, alcohol was involved in 18% of the prescription opi-
oid−involved ED visits in 2010, and more than 40% of
these prescription opioid−involved overdoses were among
ED patients aged 30−54 years.15
Similarly, in 2008, a
nationwide study found that 20% of hospitalizations for
prescription opioid overdoses among young adults aged
18−24 years involved excessive alcohol use (i.e., ICD-9-
CM codes 980, E860, 303.0, 305.0, or 790.3), which is sim-
ilar to the proportion of opioid overdoses among people
in this age group that involved excessive alcohol use in
1999 (17%).16
The concurrent use of alcohol and prescrip-
tion opioids is concerning because both have a depressant
effect on the central nervous system, and the concurrent
use of these drugs could therefore lead to a dangerous
drug interaction that could significantly increase the risk
of respiratory depression and death.17−21
The purpose of this study is to assess the association
between past-30-days drinking patterns (e.g., current
nonbinge drinking and binge drinking) and prescrip-
tion opioid misuse among U.S. adults and adolescents.
In addition, this study seeks to examine the relationship
between binge drinking frequency and prescription
opioid misuse.
METHODS
Study Sample
The NSDUH is a nationally representative, cross-sectional house-
hold survey of the noninstitutionalized U.S. adult and adolescent
population aged ≥12 years residing in the 50 states and the Dis-
trict of Columbia that is conducted annually by the Substance
Abuse and Mental Health Services Administration. For each state
and the District of Columbia, a multistage probability sample was
independently determined. A computer-assisted personal inter-
view and audio computer-assisted self-interview (to improve
respondents’ privacy during visits to households and group living
residences) were used to collect survey data. Respondents were
given $30 as compensation for their participation in the survey.
More details on the NSDUH methods are available elsewhere.22
Data for this study were pooled from the 2012, 2013, and 2014
NSDUH public use files to smooth out random fluctuations in
self-reported alcohol use and prescription opioid misuse, particu-
larly when assessing prescription opioid misuse by drinking pat-
terns and sociodemographic characteristics. Weighted response
rates were 73.0% (2012), 71.7% (2013), and 71.2% (2014). There
were 204,048 survey respondents during the 3-year study period.
The study sample included 160,812 (78.8%) of the total respond-
ents who answered questions about the misuse of prescription
opioids and alcohol consumption.
Measures
Respondents were categorized into three drinking categories (i.e.,
nondrinkers, current/nonbinge drinkers, and binge drinkers)
based on their responses to the following questions:
1. During the past 30 days, on how many days did you drink one
or more drinks of an alcoholic beverage?
2. During the past 30 days, that is since (datefill), on how many
days did you have 5 or more drinks on the same occasion? By
“occasion,” we mean at the same time or within a couple of
hours of each other. (Question for male respondents)
3. During the past 30 days, that is since (datefill), on how many
days did you have 4 or more drinks on the same occasion?
(Question for female respondents)
Nondrinking was defined as not consuming an alcoholic drink
on any day during the past 30 days, including lifetime abstainers.
Current drinking was defined as consuming one or more alcoholic
drinks on ≥1 day during the past 30 days. Binge drinking was
defined as consuming five or more drinks (for male respondents)
or four or more drinks (for female respondents), per occasion, on
≥1 day during the past 30 days. Current/nonbinge drinking was
defined as current drinking below binge levels. Binge drinking fre-
quency was defined as the number of days a respondent
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3. consumed five or more drinks (for male respondents) or four or
more drinks (for female respondents) per occasion during the
past 30 days.
In the survey section on use of prescription medications, the
NSDUH interviewers asked a series of questions about use of spe-
cific types of opioids (e.g., codeine, hydrocodone, and morphine).
This study assessed prescription opioid misuse based on responses
to the following question: How long has it been since you last used
any prescription pain reliever that was not prescribed for you or
that you took only for the experience or feeling it caused? Prescrip-
tion opioid misuse was defined as the use of an opioid without a
prescription, or the use of these drugs only for the experience or
feeling it caused, at least one time during the past 30 days.
Statistical Analysis
The prevalence of past-30-days prescription opioid misuse, non-
drinking, current/nonbinge drinking, and binge drinking were
assessed overall and by sociodemographic characteristics and
other substance use (i.e., past-30-days cigarette use or marijuana
use). Prescription opioid misuse was also assessed by drinking
pattern, sociodemographic characteristics, and other substance
use. The relationship between binge drinking frequency and pre-
scription opioid misuse was assessed overall and by age group.
NSDUH survey weights and design variables were used to com-
pute prevalence estimates and 95% CIs. A new population weight
was created for this 3-year dataset by dividing the single-year
dataset weights by three. p-values were calculated using Pearson’s
chi-squared tests (p-values<0.05 were used to assess statistical sig-
nificance). When measuring the association between prescription
opioid misuse and binge drinking, multiple logistic regression was
used to adjust ORs for potential confounders, including age group,
sex, race or ethnicity, total annual family income, rural or urban
status,22
cigarette use,23,24
and marijuana use.23−25
Respondents who were missing data on sociodemographic char-
acteristics or on drinking patterns were excluded from item-specific
analyses (missing data were <3%). Data were analyzed using Stata,
version 14.2 (analyses were conducted in 2017−2018).
RESULTS
During 2012−2014, 1.6% (95% CI=1.5, 1.7) of U.S.
adults and adolescents, or an estimated 4.2 million
people, reported past-30-days prescription opioid
misuse (Table 1). Prescription opioid misuse was most
common among male respondents (1.9%, 95% CI=1.7,
2.1), those aged 18−25 years (2.9%, 95% CI=2.7, 3.1)
and 26−34 years (2.8%, 95% CI=2.4, 3.1), those with an
annual family income of <$20,000 (2.3%, 95% CI=2.1,
2.6), and those with no health insurance coverage (2.9%,
95% CI=2.6, 3.2). Current/nonbinge drinking was most
common among adults aged ≥50 years (33.4%, 95%
CI=32.6, 34.3); white, non-Hispanic adults (31.1%, 95%
CI=30.5, 31.6); college graduates (43.4%, 95% CI=42.5,
44.4); and those with an annual family income of >$75,000
(36.9%, 95% CI=36.1, 37.6). Binge drinking was most com-
mon among male respondents (29.6%, 95% CI=29.0, 30.2);
those aged 18−25 years (40.4%, 95% CI=39.7, 41.1) and
26−34 years (38.8%, 95% CI=38.0, 39.7); white, non-His-
panic adults (25.8%, 95% CI=25.3, 26.3); and adults with
some college education (28.7%, 95% CI=28.0, 29.5).
The prevalence of prescription opioid misuse was similar
among nondrinkers (1.0%, 95% CI=0.9, 1.2) and current/
nonbinge drinkers (1.0%, 95% CI=0.9, 1.2), but was
3.5 times higher among binge drinkers (3.5%, 95% CI=3.3,
3.8; Table 2). This translates to an estimated 2.2 million
binge drinkers engaging in prescription opioid misuse in
the past 30 days. Across all sociodemographic groups, pre-
scription opioid misuse was more common among binge
drinkers than among nondrinkers and current/nonbinge
drinkers. Prescription opioid misuse was most common
among nondrinkers aged 18−25 years (1.5%, 95% CI=1.3,
1.8) and 26−34 years (1.7%, 95% CI=1.4, 2.2), current/
nonbinge drinkers aged 12−17 years (3.6%, 95% CI=2.8,
4.7), and binge drinkers aged 12−17 years (8.1%, 95%
CI=6.8, 9.7). However, about 1.4 million (65%) of the esti-
mated 2.2 million binge drinkers who reported misusing
prescription opioids were aged ≥26 years.
Among binge drinkers, prescription opioid misuse was
most common among black, non-Hispanic people (4.6%,
95% CI=3.7, 5.6; Table 2). Among binge drinkers, having
no health insurance coverage (prevalence of prescription
opioid misuse: 5.6%, 95% CI=4.9, 6.4) or having public
health insurance (prevalence of prescription opioid mis-
use: 5.0%, 95% CI=4.2, 6.0) was also associated with a
higher prevalence of prescription opioid misuse, whereas
having private health insurance coverage was associated
with a lower rate of prescription opioid misuse (2.6%,
95% CI=2.4, 2.9). The prevalence of prescription opioid
misuse was inversely related to education and family
income across all drinking categories but was similar
among male and female respondents. Across all drinking
categories, prescription opioid misuse was more common
among those who used marijuana than those who smoked
cigarettes. Prescription opioid misuse was also more com-
mon among binge drinkers who smoked cigarettes (5.6%,
95% CI=5.1, 6.0) or used marijuana (10.1%, 95% CI=9.3,
11.1) than among nondrinkers and current/nonbinge
drinkers who used these substances, respectively.
After adjusting for potential confounders, binge
drinkers had 1.7 times greater odds (95% CI=1.5, 1.9,
p<0.001) of reporting prescription opioid misuse than
nondrinkers (Table 3). Current/nonbinge drinking was
not associated with prescription opioid misuse (AOR=1.0,
95% CI=0.8, 1.1, p=0.580).
The overall prevalence of prescription opioid misuse
increased significantly with the frequency of binge
drinking (p<0.001), ranging from 2.4% (95% CI=2.2,
2.7) among those who reported binge drinking one to
two times during the past 30 days to 6.5% (95% CI=5.6,
7.6) among those who reported binge drinking ten or
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5. Table 1. Prevalence of Past-30-Days Prescription Opioid
a
Misuse and Drinking Patterns by Characteristics (continued)
Characteristics
Prescription opioid
misusera
(n=160,812)
Weighted total
population who
misused prescription
opioidsa Nondrinkersb
(n=89,898)
Current/nonbinge
drinkersc
(n=30,296)
Binge drinkersd
(n=40,618)
Weighted %
(95% CI) p-value n
Weighted %
(95% CI) p-value
Weighted %
(95% CI) p-value
Weighted %
(95% CI) p-value
Health insuranceh
<0.001 <0.001 <0.001 <0.001
Private 1.3 (1.2, 1.4) 2,136,255 42.9 (42.4, 43.4) 32.1 (31.5, 32.6) 25.0 (24.6, 25.5)
Public 1.9 (1.7, 2.2) 954,184 67.1 (66.1, 68.1) 16.9 (16.1, 17.7) 16.0 (15.3, 16.7)
Other 2.0 (1.5, 2.6) 94,362 47.9 (45.1, 50.7) 20.5 (18.3, 23.0) 31.5 (29.2, 34.0)
No coverage 2.9 (2.6, 3.2) 1,011,484 50.2 (48.9, 51.4) 18.4 (17.4, 19.4) 31.5 (30.3, 32.6)
Other substance use
Cigarettei
4.0 (3.7, 4.3) <0.001 2,163,917 35.8 (34.9, 36.7) <0.001 19.3 (18.5, 20.1) <0.001 44.9 (44.1, 45.7) <0.001
Marijuanaj
8.7 (8.0, 9.5) <0.001 1,681,373 19.0 (18.0, 20.2) <0.001 21.3 (20.1, 22.6) <0.001 59.6 (58.2, 61.0) <0.001
Note: Boldface indicates statistical significance (p<0.05).
a
Used an opioid pain reliever without a prescription or use only for the experience or feeling it caused ≥1 time in the past 30 days.
b
Did not consume an alcoholic drink on any day in past 30 days, including lifetime abstainers.
c
Consumed ≥1 alcoholic drink on ≥1 day but did not consume ≥5 drinks (men) or ≥4 drinks (women), per occasion, on ≥1 day in the past 30 days.
d
Consumed ≥5 drinks (men) or ≥4 drinks (women), per occasion, on ≥1 day in the past 30 days.
e
Including Asian, American Indian, Alaskan Native, Native Hawaiian or other Pacific Islander, or more than one race or ethnicity.
f
Includes adults aged ≥18 years only.
g
Based on the “Rural/Urban Continuum Codes” developed in 2003 by the U.S. Department of Agriculture. Large metropolitan counties have a total population of 1 million or more. Small metropolitan
counties have a total population of fewer than 1 million. Nonmetropolitan areas include counties in micropolitan statistical areas as well as counties outside of both metropolitan and micropolitan statis-
tical areas.19
h
Respondents could indicate more than one type of health insurance. Public includes Medicaid, Medicare, Children’s Health Insurance Program (CHIP), CHAMPUS, TRICARE, CHAMPVA, the VA, or mili-
tary health care.
i
Smoked part or all of a cigarette in the past 30 days.
j
Used marijuana or hashish in the past 30 days.
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7. Table 2. Prevalence of Past-30-Days Prescription Opioid Misuse
a
by Drinking Pattern and by Characteristics (continued)
Characteristics
Nondrinkersb
(n=89,898)
Current/nonbinge
drinkersc
(n=30,296) Binge drinkersd
(n=40,618)
Weighted population
of binge drinkers
who misused
prescription opioids
Weighted %
(95% CI) p-value
Weighted %
(95% CI) p-value
Weighted %
(95% CI) p-value n
Health insuranceh
<0.001 <0.001 <0.001
Private 0.8 (0.7, 1.0) 0.9 (0.7, 1.0) 2.6 (2.4, 2.9) 1,103,411
Public 1.4 (1.2, 1.7) 1.2 (0.8, 1.6) 5.0 (4.2, 6.0) 394,563
Other 0.6 (0.3, 1.0) 2.2 (1.2, 4.0) 4.0 (2.7, 5.9) 59,998
No coverage 1.4 (1.2, 1.7) 2.1 (1.5, 3.0) 5.6 (4.9, 6.4) 621,414
Other substance use
Cigarettei
2.6 (2.2, 3.0) <0.001 3.1 (2.4, 3.9) <0.001 5.6 (5.1, 6.0) <0.001 1,348,826
Marijuanaj
6.6 (5.4, 7.9) <0.001 6.6 (5.3, 8.3) <0.001 10.1 (9.3, 11.1) <0.001 1,166,856
Note: Boldface indicates statistical significance (p<0.05).
a
Used an opioid pain reliever without a prescription or used only for the experience or feeling it caused ≥1 time in the past 30 days.
b
Did not consume an alcoholic drink on any day in past 30 days, including lifetime abstainers.
c
Consumed ≥1 alcoholic drink on ≥1 day but did not consume ≥5 drinks (men) or ≥4 drinks (women), per occasion, on ≥1 day in the past 30 days.
d
Consumed ≥5 drinks (men) or ≥4 drinks (women), per occasion, on ≥1 day in the past 30 days.
e
Including Asian, American Indian, Alaskan Native, Native Hawaiian or other Pacific Islander, or more than one race or ethnicity.
f
Includes adults aged ≥18 years only.
g
Based on the “Rural/Urban Continuum Codes” developed in 2003 by the U.S. Department of Agriculture. Large metropolitan counties have a total population of 1 million or more. Small metropolitan
counties have a total population of fewer than 1 million. Nonmetropolitan areas include counties in micropolitan statistical areas as well as counties outside of both metropolitan and micropolitan statis-
tical areas.19
h
Respondents could indicate more than one type of health insurance. Public includes Medicaid, Medicare, Children’s Health Insurance Program (CHIP), CHAMPUS, TRICARE, CHAMPVA, the VA, or mili-
tary health care.
i
Smoked part or all of a cigarette in the past 30 days.
j
Used marijuana or hashish in the past 30 days.
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8. more times (Figure 1). When stratified by age group, the
prevalence of prescription opioid misuse increased sig-
nificantly with the frequency of binge drinking among
those aged 12−49 years (p<0.001), as well as among
adults aged ≥50 years (p=0.04). Among adults aged
≥50 years, the prevalence of opioid misuse was similar
for those who reported either binge drinking five to nine
times (3.2%, 95% CI=1.8, 5.5) or ten or more times
(2.8%, 95% CI=1.5, 5.0) during the previous 30 days.
DISCUSSION
The results of this study indicate that more than half (2.2
million) of the estimated 4.2 million adolescents and adults
Table 3. Odds of Reporting Past-30-Days Prescription Opioid Misusea
by Drinking Pattern and Characteristics
Drinking pattern and
characteristics
Unadjusted ORs AORsb
OR (95% CI) p-value AOR (95% CI) p-value
Drinking pattern
Nondrinkingc
Ref Ref
Current drinking/nonbinged
1.0 (0.8, 1.2) 0.869 1.0 (0.8, 1.1) 0.580
Binge drinkinge
3.4 (3.0, 3.9) <0.001 1.7 (1.5, 1.9) <0.001
Sex
Male 1.3 (1.2, 1.5) <0.001 1.0 (0.9, 1.2) 0.871
Female Ref Ref
Age group, years
12−17 2.1 (1.7, 2.7) <0.001 2.2 (1.7, 2.8) <0.001
18−25 3.8 (3.1, 4.6) <0.001 1.7 (1.4, 2.1) <0.001
26−34 3.5 (2.8, 4.5) <0.001 2.0 (1.6, 2.6) <0.001
35−49 2.1 (1.7, 2.7) <0.001 1.6 (1.3, 2.1) <0.001
≥50 Ref Ref
Race or ethnicity
White, non-Hispanic 1.6 (1.3, 2.0) <0.001 1.4 (1.1, 1.8) <0.01
Black, non-Hispanic 1.9 (1.4, 2.5) <0.001 1.5 (1.1, 2.1) <0.01
Hispanic or Latino 1.5 (1.2, 2.0) <0.01 1.3 (1.0, 1.8) <0.05
Otherf
Ref Ref
Family income, annual
<$20,000 1.8 (1.5, 2.2) <0.001 1.3 (1.1, 1.5) <0.01
$20,000−<$50,000 1.4 (1.2, 1.6) <0.001 1.2 (1.0, 1.4) 0.111
$50,000−<$75,000 1.1 (0.9, 1.3) 0.332 1.0 (0.8, 1.2) 0.993
≥$75,000 Ref Ref
Rural or urban statusg
Large metropolitan 1.3 (1.1, 1.6) <0.01 1.3 (1.1, 1.6) <0.01
Small metropolitan 1.4 (1.2, 1.7) <0.001 1.4 (1.2, 1.6) <0.001
Nonmetropolitan Ref Ref
Other substance use
Cigaretteh
4.1 (3.7, 4.5) <0.001 2.1 (1.9, 2.4) <0.001
Marijuanai
8.8 (7.8, 10.0) <0.001 4.6 (4.0, 5.3) <0.001
Note: Boldface indicates statistical significance (p<0.05).
a
Used an opioid pain reliever without a prescription or used only for the experience or feeling it caused ≥1 time in the past 30 days.
b
Multivariable logistic regression models adjusted for sex, age group, race or ethnicity, total annual family income, rural or urban status, cigarette use,
and marijuana use.
c
Did not consume an alcoholic drink on any day in past 30 days, including lifetime abstainers.
d
Consumed ≥1 alcoholic drink on ≥1 day but did not consume ≥5 drinks (men) or ≥4 drinks (women), per occasion, on at ≥1 day in the past
30 days.
e
Consumed ≥5 drinks (men) or ≥4 drinks (women), per occasion, on ≥1 day in the past 30 days.
f
Including Asian, American Indian, Alaskan Native, Native Hawaiian or other Pacific Islander, or more than one race or ethnicity.
g
Based on the “Rural/Urban Continuum Codes” developed in 2003 by the U.S. Department of Agriculture. Large metropolitan counties have a total
population of 1 million or more. Small metropolitan counties have a total population of fewer than 1 million. Nonmetropolitan areas include counties
in micropolitan statistical areas as well as counties outside of both metropolitan and micropolitan statistical areas.19
h
Smoked part or all of a cigarette in the past 30 days.
i
Used marijuana or hashish in the past 30 days.
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9. who reported past-30-days misuse of prescription opioids
during 2012−2014 were binge drinkers. Binge drinkers
had nearly twice the odds of misusing prescription opioids
compared with nondrinkers, even after controlling for
other factors that could affect the relationship between
binge drinking and prescription opioid misuse. Prescrip-
tion opioid misuse was most common among youth aged
12−17 years who were binge drinkers, but about 1.4 million
(65%) of the estimated 2.2 million binge drinkers who
reported prescription opioid misuse were aged 26 years or
older. The prevalence of prescription opioid misuse
increased with the frequency of binge drinking, particularly
among youth and young adults.
Across drinking categories, this study generally did not
find differences in the prevalence of prescription opioid
misuse by sex or by rural or urban status. However,
among binge drinkers, this study found a higher preva-
lence of prescription opioid misuse among those with
lower levels of education, lower household incomes, and
those who were either covered by publicly funded health
insurance or were uninsured. This finding is consistent
with the findings of other research that has shown that
prescription opioid misuse is generally more common
among low-income populations, including those on
Medicaid.26
It is also consistent with a recent study
showing that binge drinkers with lower household
incomes consume significantly more total binge drinks
per binge drinker annually than those with higher house-
hold incomes (532.3 drinks versus 419.0 drinks, respec-
tively).13
However, people with higher household
incomes (e.g., $75,000 or more) have a higher prevalence
of binge drinking than those with lower household
incomes (<$25,000), underscoring the importance of
addressing binge drinking among the entire population.13
The finding that the prevalence of prescription opioid
misuse generally increased with binge drinking fre-
quency is consistent with literature showing that the
likelihood of engaging in alcohol-related health risk
behaviors increases with the number of binge drinking
occasions. For example, a study of U.S. high school stu-
dents found a positive relationship between binge drink-
ing frequency and use of other drugs, including tobacco,
marijuana, cocaine, and inhalants (prescription opioid
misuse was not assessed).27
Adult binge drinkers tend to binge about once a week
on average and consume an average of seven drinks per
binge,13
and people who misuse prescription opioids also
report doing so about once a week (an average of 54 days
a year).7
This is concerning given that the risk of a dan-
gerous interaction between alcohol and opioids is likely to
Figure 1. Prevalence and 95% CIa
of Past-30-Days Prescription Opioid Misuseb
by Age Group and Binge Drinking Frequencyc
Among
Binge Drinkers.
a
95% CIs denoted by bracketed lines on each bar.
b
Used a prescription opioid without a prescription or used only for the experience or feeling it caused ≥1 time in the past 30 days.
c
Number of days consuming ≥5 drinks (men) or ≥4 drinks (women), per occasion, in the past 30 days.
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10. be greatest among those who are misusing opioids and
binge drinking frequently and at high intensity.
The odds of prescription opioid misuse among binge
drinkers being nearly twice that of nondrinkers suggests
the importance of population-level policies to reduce
binge drinking. The U.S. Community Preventive Services
Task Force recommends several effective strategies for
reducing binge drinking, including increasing alcohol
taxes,28
regulating the density of alcohol outlets,29
and
having commercial host liability laws.30
In addition, the
U.S. Preventive Services Task Force recommends screen-
ing and brief intervention for adults as a strategy to
reduce excessive alcohol use.31
This intervention may also
be effectively administered electronically (also known as
e-screening and brief intervention) using computers, tab-
lets, smartphones, and other electronic tools in a variety
of settings (e.g., primary care clinics, health departments,
and on college campuses).32
Effective strategies to reduce
overdoses involving prescription opioids include safe pre-
scribing practices, as described in the Centers for Disease
Control and Prevention Guideline for Prescribing Opioids
for Chronic Pain,33
as well as strategies to prevent and treat
opioid use disorder,34
and reverse opioid overdoses.35
Finally, the 2015−2020 U.S. Dietary Guidelines for
Americans indicate that some people should not drink at
all, including those who are taking medications that could
interact with alcohol, as well as youth under age 21 years
and women who are pregnant or might be pregnant.36
The U.S. Food and Drug Administration has also advised
healthcare professionals to avoid prescribing opioids to
patients using alcohol or other central nervous system
depressants.17
Therefore, adult drinkers aged 21 years or
older should only do so in moderation (i.e., consume up
to one drink per day for women and up to two drinks per
day for men) or not drink at all, particularly while using
prescription opioids.17,36
Future research examining the relationship between
evidence-based alcohol policies (e.g., increasing alcohol
taxes28
and regulating the density of alcohol outlets30
),
total binge drinks per binge drinker, and the risk of opioid
overdoses in states could help guide the prevention of opi-
oid misuse and opioid overdoses involving alcohol. In
addition, future research could assess whether improved
opioid prescribing could also help reduce opioid misuse
and opioid overdoses involving alcohol.
Limitations
This study has limitations. First, this study was not able
to examine whether alcohol and opioids were used con-
currently. Second, data were based on self-reports, and
therefore, both prescription opioid misuse and alcohol
consumption (particularly binge drinking) are likely to
have been under-reported. However, the NSDUH audio
computer-assisted self-interview process assesses the
internal consistency of responses, which has been shown
to improve the sensitivity of NSDUH estimates of binge
drinking among adults.37
Third, because this study was
focused on the misuse of prescription opioids, it did not
consider the use of illicit opioids, such as heroin and
illicitly manufactured fentanyl, which has been increas-
ing,38
including among people who binge drink and peo-
ple who misuse prescription opioids.39
CONCLUSIONS
Binge drinking is associated with prescription opioid
misuse, and the prevalence of prescription opioid mis-
use increased with the frequency of binge drinking.
Binge drinkers who misuse prescription opioids are
likely to be at substantially increased risk of overdose
because of the combined effect of high blood alcohol
levels and prescription opioids on the central nervous
system.17
The high prevalence, frequency, and intensity
of binge drinking among adults and adolescents in the
U.S.,13,40
along with the heightened prevalence of pre-
scription opioid misuse among binge drinkers, empha-
sizes the importance of adopting a comprehensive and
coordinated approach to addressing both binge drink-
ing and prescription opioid misuse to reduce the risk of
opioid overdoses.
ACKNOWLEDGMENTS
The findings and conclusions in this report are those of the
authors and do not necessarily represent the official position of
the Centers for Disease Control and Prevention or HHS. Dr
Esser conceptualized the study and led the drafting of the arti-
cle. Dr Guy led the data analysis. Dr Zhang assisted with the
data analysis and presentation of the results. Dr Brewer drafted
sections of the article. All authors contributed to the interpreta-
tion of the findings, reviewed and edited drafts of the article,
and approved the final version.
No financial disclosures were reported by the authors of this
paper.
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