Report CopyRight/DMCA Form For : Epidemic Disclosure Substance Abuse Disorder
escalated and have become major health problems In 2014 2 million Americans abused or were dependent on prescription opioids Every day over 1 000 people are treated in emergency departments for misusing prescription opioids Prescription Opioid Overdose Data 2017 https www cdc gov WHY Opioid Stewardship In early 2015 the Indiana Department of Health noticed a cluster of eleven HIV
Every 8 minutes a person in the U S I am not a bad person trying to get good. dies of a prescription drug overdose I am a sick person trying to get well. Turn the Tide Rx Campaign AS HEALTH CARE PROFESSIONALS WE HAVE THE. UNIQUE POWER TO END THE OPIOID CRISIS,www turnthetiderx org WE CAN PLEDGE TO. Educate ourselves to treat pain safely and,effectively. Screen our patients for opioid use disorder and,provide or connect them with evidence based. Shape how the rest of the country sees addiction, We have to stop treating addiction as a moral failing and by talking about it and treating it as a chronic. start seeing it for what it is a chronic disease that must be illness not a moral failing. treated with urgency and compassion,Dr Vivek H Murthy United States Surgeon General. WHY Opioid Stewardship,Nursing is a, progressive art Misuse abuse and opioid use disorder addiction have. such that to stand escalated and have become major health problems. In 2014 2 million Americans abused or were dependent on. still is to go prescription opioids, backwards Every day over 1 000 people are treated in emergency. departments for misusing prescription opioids,Florence Nightingale. Prescription Opioid Overdose Data 2017 https www cdc gov. Other risks around the opioid Will YOU be a steward in the opioid. epidemic epidemic, In early 2015 the Indiana Department of Health noticed a. cluster of eleven HIV cases in a county that had historically. observed less than one new case of HIV each year The majority This is no longer an opioid crisis said Patrick Kennedy. of these cases were among persons who inject drugs PWID a former Rhode Island congressman who was a member. who had shared needles while injecting the prescription opioid. Opana of President Trump s Commission on Combating Drug. Addiction and the Opioid Crisis This is a moral crisis. Eventually the outbreak grew to more than 180 cases with we know how to answer this problem but we can t get. almost all cases co infected with HCV Hepatitis C virus It is. estimated the lifelong medical costs attributed to this outbreak around our own prejudices. will cost the state of Indiana over 80 million dollars. Washington Post December 2017, https www cdc gov hiv pdf programresources guidance cluster outbreak cdc hiv hcv pwid response plan pdf. Categories of Commonly,You May Know Them As,Abused Drugs. Opioids Benzodiazepines,Hydrocodone Vicodin,for pain Xanax. Benzodiazepines Percocet,CNS Depressants Valium,for anxiety and sleep Nembutal. disorders Demerol,Stimulants,Stimulants Fentanyl,ADHD Heroin. medicines Concerta Adderall, So what do we know about opioids An opioid is an opioid is an opioid. They are a class of drugs available legally by prescription or illegally. such as heroin, They are drugs that block pain signals to the brain by binding to opioid. They aren t made for long term use, They are highly addictive Regular use can lead to dependence. Opioid Opioid,Overdosing can happen accidentally, They have significant side effects such as constipation nausea. vomiting dry mouth sleepiness confusion and increased sensitivity to. https drugabuse gov v,How often are children and teens. Alarming Youth Data,exposed to opioid medication, 1 in 4 teens have taken a prescription drug for reasons other Each year opioid medication poisoning causes more than 300 deaths in. than what it was intended drugfree org 2013 children and teens 1. 17 of 12th grade students report taking a prescription drug Every 45 minutes poison control centers get a call about children and teens. without a prescription 2015 YRBS data CDC exposed to opioid medication 2. Opioid related deaths in youth between the ages of 12 25 has. About 1 in 10 of these cases are admitted to health care facilities 3. either doubled tripled or quadrupled in 35 states TFAH report. More than 90 of adults who develop a substance use disorder 1 National Center for Health Statistics Multiple Cause of Death database 2015. 2 Naqvi J 2017 March 20 Poison control centers receive 32 calls a day about children exposed to opioids The Washington Post. began using before age 18 http health usnews com health Retrieved from https www washingtonpost com news to your health wp 2017 03 20 poison control centers receive 32 calls a. day about children exposed to opioids utm term 3838499ac1d0. 2011 3 Allen J D Casavant M J Spiller H A Chounthirath T Hodges N L Smith G A 2017 Prescription Opioid Exposures. Among Children and Adolescents in the United States 2000 2015 Pediatrics 139 4 DOI 10 1542 peds 2016 3382. What ages of children and teens are 96 of these poisonings happen at home. most at risk Medication safety is KEY, Young children ages 5 and younger account for 60 of Store medications locked up and out of sight. these calls Keep track of medications so you know if any go missing. Get rid of old unwanted medications safely, Talk to your children teens about medication abuse. Most cases 86 are unintentional like when a child,Poison Control is available 24 7 1 800 222 1222. finds pills that are within reach, Teach children teens to call 911 right away if OD suspected. Teenagers ages 13 through 19 account for 30 of the For more information. calls http childrenssafetynetwork org infographics opioid medication. Overdose is not the only risk related,to prescription opioids. Misuse abuse and opioid use disorder addiction are also. potential dangers, In 2014 almost 2 million Americans abused or were dependent. on prescription opioids, As many as 1 in 4 people who receive prescription opioids long. term for noncancer pain in primary care settings struggles with. Every day over 1 000 people are treated in emergency. departments for misusing prescription opioids, Prescription Opioid Overdose Data 2017 https www cdc gov. Why do some people become,addicted to drugs while others don t. The physical reason,Most drugs affect the brain s reward circuit. by flooding it with the chemical messenger, This overstimulation of the reward circuit Biology Genetics 1 2 of a person s risk for addiction. causes the intensely pleasurable high that can,lead people to take a drug again and again. As a person continues to use drugs the brain, adjusts to the excess dopamine by making less Environment family friends economic status general quality of life. of it and or reducing the ability of cells in the peer pressure physical sexual abuse early exposure to drugs stress. reward circuit to respond to it, Long term use also causes changes in other and parental guidance. brain chemical systems and circuits as well,affecting functions that include learning. judgment decision making stress memory and, behavior Development the earlier that drug use begins the more likely it will. progress to addiction,NIH 2016 NIH 2016,Addiction IS a chronic disease. Opioid addiction is a chronic disease like heart,disease or diabetes. A chronic disease is a medical condition for life,It cannot be cured but it can be managed. SAMHSA 2011 HHS Publication No SMA 09 4443, Understanding tolerance dependence Are you and your community ready. withdrawal for an opioid overdose,A person who takes opioids can become. tolerant meaning that more of the drug is,needed to obtain its effects. It is also possible to become dependent on,opioids to feel sick if there are no opioids in. This sickness is called withdrawal, An opioid antagonist used to reverse an opioid SAMHSA Opioid Toolkit. Works by counteracting life threatening depression of the central nervous Downloadable Digital Versions. system and respiratory system allowing an overdose victim to breathe. normally Toolkit, Naloxone is a nonscheduled i e non addictive prescription medication. Naloxone only works if a person has opioids in their system the medication Facts for Community Members. has no effect if opioids are absent 5 Essential Steps for 1st Responders. Although traditionally administered by emergency response personnel. naloxone can be administered by minimally trained laypeople which makes Information for Prescribers. it ideal for treating overdose in people who have been prescribed opioid. pain medication and in people who use heroin and other opioids Safety Advice for Pts Families. Naloxone has no potential for abuse Recovery from an OD. Naloxone may be injected in the muscle vein or under the skin or sprayed. into the nose,harmreduction org 2016, https store samhsa gov product Opioid Overdose Prevention Toolkit Updated 2016 SMA16 4742. NASN Questions to Consider in Development of, National Association of School Nurses Naloxone in School Community Programs. Naloxone Workgroup Developed to State Laws, Provide school nurses with education to enable their. District Policies,discussions with school districts and other. stakeholders about what to consider in developing a Nurse Practice. stock naloxone program Education for Administration of naloxone. Support school nurses in implementing naloxone,Medication and Storage. policies and protocols in response to the opioid,epidemic and new naloxone laws Community Need. Application of Framework for 21st,Naloxone Administration Protocol. Century School Nursing PracticeTM, Motivational Interviewing NASN Position Document on. Case Management,Standards naloxone in school setting. Critical Thinking,Care Advocacy,Coordination Students Leadership. Change Agents,Access to Care Community Policy,Health Promotion Development. Population Based Care,Risk Reduction,Surveillance Community Quality. and Public, Social Determinants of Health Improvement Meaningful Health. Health Academic Outcomes,The Four R s Recognize, Observe individual for signs and symptoms of opioid overdose. Suspected or confirmed opioid overdose consists of. Respiratory depression evidenced by slow respirations or no breathing apnea. Deep snorting or gurgling, Unresponsiveness to stimuli such as calling name shaking sternal rub. Recognize Respond Reverse Refer Blue lips or fingertips pinpoint pupils. Slowed heart rate pulse,Suspicion of opioid overdose can be based on. Presenting symptoms,Report from bystanders,School nurse or staff prior knowledge of person. Nearby medications illicit drugs or drug paraphernalia. Opioid High vs Opioid Overdose, Adapted from Massachusetts Department of Public Health Opioid Overdose Respond. Education and Naloxone Distribution,Immediately call for help CALL for HELP Dial 911. Request Advanced Life Support, Opioid High Opioid Overdose Assess breathing Perform rescue breathing if needed. Place the person on their back, Relaxed muscles Pale clammy skin Tilt their chin up to open the airway. Breathing Very shallow breathing or not Check to see if there is anything in their mouth blocking their airway such as gum toothpick. breathing undissolved pills syringe cap cheeked Fentanyl patch if present remove it. Speech slowed slurred If using mask place and hold mask over mouth and nose. Appears sleepy nodding off Speech infrequent If not using mask pinch their nose with one hand and place your mouth over their mouth. Responds to stimuli Deep snorting or gurgling Give 2 even regular sized breaths. Blow enough air into their lungs to make their chest rise. Normal heart beat pulse Unresponsive to stimuli calling. If you are using a mask and don t see their chest rise out of the corner of your eye tilt the. name shaking sternal rub, Normal skin color head back more and make sure the seal around the mouth and nose is secure. Normal to small sized pupils Slowed heart beat pulse If you are not using a mask and don t see their chest rise out of the corner of your eye. make sure you re pinching their nose,Cyanotic skin coloration blue Breathe again. lips fingertips Give one breath every 5 seconds,Pinpoint pupils. Protocols and Flowsheets for each,type nasal IM in NASN toolkit. Administer naloxone,Place person in recovery position lying on their. Stay with the person until help arrives,Seize all illegal and or non prescribed opioid. narcotics found on victim and process in,accordance with school district or facility. Spray naloxone,Narcan nasal spray 4 mg 1 mg ml 2mL Leur lock. Link to Narcan Video,https www narcan com,www harmreduction org. Evzio auto injector IM,Naloxone Injection, The first and only intelligent take home auto injection system with voice and. visual guidance designed to help caregivers take fast confident action. administering naloxone in an opioid emergency,https evzio com hcp. Refer Naloxone Administration Reporting, Have the individual transported to nearest medical. facility even if symptoms seem to get better,Contact parent guardians per facility protocol. Complete Naloxone Administration Reporting form,Follow up with treatment referral recommendations. Support family staff,Safeguarding Your Community,Naloxone in Schools. Legal Protections for Overdose Other Important,Responders Documents Legislation. Overdose Prevention Acts 911 and Good,Samaritan Laws June 2014 NASN Position Document. Naloxone in the school setting published, Approximately 46 states and the District of Columbia have enacted some. form of a Good Samaritan or 911 drug immunity law, Affords immunity from arrest for use simple possession offenses to the. First responders carrying naloxone, overdose victim and to the person who sought medical assistance. The scope of what offenses and violations are covered by immunity Community Based Naloxone Access. provisions varies by state, These laws often require a caller to have a reasonable belief that Programs. someone is experiencing an overdose emergency and is reporting that. emergency in good faith, http www ncsl org research civil and criminal justice drug overdose immunity good. samaritan laws aspx,Essential Elements of Stopping the. Heroin Epidemic,Prevention,Ensure access to medication assisted. treatment MAT,Treat people addicted to heroin,or prescription opioids with a. combination of MAT and behavioral,MAT medications, MAT works by tricking the brain into thinking it is still getting. Medication assisted treatment is one way to help those with. the problem opioid The person taking the medication feels. opioid addiction recover their lives,normal not high and withdrawal does not occur. There are three equally important parts to this form of. treatment Methadone Dolophine Methadose, Medication Buprenorphine Suboxone Subutex Probuphine. Counseling, Support from family and friends Naltrexone Vivitrol blocks the effect of opioid drugs This. takes away the feeling of getting high if the problem drug is. used again,Components of a Comprehensive,Drug Addiction Treatment. Fentanyl is a powerful synthetic opioid analgesic Schedule II. that is similar to morphine but is 50 to 100 times more potent. In its prescription form fentanyl is known by such names as. Actiq Duragesic and Sublimaze, Non pharmaceutical fentanyl is sold in the following forms as a. powder spiked on blotter paper mixed with or substituted for. heroin or as tablets that mimic other less potent opioids. Fentanyl sold on the street can be mixed with heroin or cocaine. which markedly amplifies its potency and potential dangers. http drugfree org newsroom news item overdose deaths fentanyl rise know. https www drugabuse gov publications drugfacts treatment approaches drug addiction. Carfentanil DEA Warning for,First Responders What can YOU do. Resembles powdered cocaine or heroin, Dangerous opioid 10 000 times more potent than morphine and 100 x more. potent then fentanyl, Comes in several forms power blotter paper tablets and spray which can. be absorbed through the skin or accidental inhalation of airborne powder. Wear gloves avoid actions that may cause powder to become airborne. Do not use hand sanitizers as they may enhance absorption. Monitor first responders for exposure that can happen within minutes of. DEA 2016 and NIOSH 2017,https www cdc gov niosh topics fentanyl risk html. Change Our Language Teach Medication Safety,Store medications locked up and out of sight. Keep track of medications so you know if any go missing. Get rid of old unwanted medications safely, Talk to your children teens about medication abuse. Poison Control is available 24 7 1 800 222 1222, Teach EVERYONE to call 911 right away if OD suspected. 911 Good Samaritan gives legal protection for those who call 911 in the. event of an overdose,For more information, http childrenssafetynetwork org infographics opioid medication. Promote Prescription Drug 14 Drug Take Back Events. Disposal in Delaware 2010 2017,Reduce avoidable poisonings. Children adults Total Amount of Drugs Collected,76 000 lbs. Prevent prescription drug abuse addiction,Mostly teens. Protect water,Are drug take back events the best,Treatment that supports families. No Treatment that,supports the family,as a unit has been. Permanent Drug Collection Sites Are proved to be,effective for. the Best Long Term Solution maintaining maternal,drug abstinence and. child well being,A woman must not,be unnecessarily. separated from her,family in order to,receive appropriate. Safe Plans of Care for Substance,Exposed Infants,HelpIsHereDE com. The Delaware SEI IDTA,funded by the Substance,Abuse and Mental. Health Services,Administration,A system to prevent. recognize and treat,substance exposure in,infants and implement. the plan of safe care, Brochures Fact Sheets Opioid Prescription Guidelines for. and Flyers Delaware Healthcare Providers, Prescribers will be asked to evaluate patients for substance. abuse disorder, If a patient appears at risk alternatives to opioids will be. discussed and the patient will be monitored closely. Key elements to be considered around prescribing, Acute episode a first time prescription will not be 7 days. documentation of the condition Informed Consent drug screens. as needed follow up visits, New tool How to Screen Pregnant Patients Chronic long term query the PMP drug screens every 6 months. for Substance Use Disorder and Alcohol Use Informed Consent treatment agreement. Overdose Fatality Review Commissions, Informed Consent DE Maryland General Article 5 901 and Delaware. Program Goals, The drug s potential for addiction abuse and misuse Investigate and review the facts and circumstances of all. The risks of life threatening respiratory depression overdose deaths involving opiates fentanyl or heroin. associated with the drug Identify missed opportunities for prevention and gaps in. Potential for fatal overdose as a result of accidental system. exposure especially children Recommend policies programs or changes to law that prevent. Neonatal opioid withdrawal symptoms overdose deaths and better serve people at risk for overdose. Potential for fatal overdose when interacting with alcohol Inform local and state overdose and opioid misuse prevention. Other potentially fatal drug interactions such as with strategy. benzodiazepines,National Council of State Boards of. Behavioral Health Consortium, An advisory body that will assess and outline an integrated plan for. action to address prevention treatment resilience and recovery of. mental health which includes substance use and co occurring. The mission is to foster collaboration amongst individuals family The Opioid Toolkit includes the following. members providers advocates governmental agencies first. responders and community members to develop measureable Continuing Education materials from organizations like the. solutions that directly and positively impact behavioral health American Society of Addiction Medicine and the National. outcomes throughout the State of Delaware Institute on Drug Abuse. 3 year action plan Guidelines for Prescribing Opioids from the CDC and. Federation of State Medical Boards FSMB,Links to toolkits on Overdose Prevention. Law Enforcement Role,www attackaddiction org,Education and awareness. Monthly meetings and,support groups in all 3,The HERO HELP Program is a counties. partnership with the New Castle,County Police DOJ Delaware Community events. Department of Justice and,DSAMH the state Division of. Legislative efforts, Substance Abuse and Mental Transition and recovery. Health to provide drug and or housing,alcohol addiction treatment to. qualifying adults who contact the,police and ask for treatment or to. individuals in lieu of an immediate,arrest for lesser crimes. A community based drug Education in schools communities. awareness and prevention,program developed by,nonprofit CANDLE Inc. Takes you into the life experiences, of a teen addicted to drugs SAMHSA s National Registry of Evidence based Programs and. Practices NREPP promotes the adoption of scientifically. Visit www attackaddicition org for more information established behavioral health interventions. Pharmacists Teach,A program to educate teens and,parents about prescription drug abuse. offered at no cost,PharmacistsTeach CVSHealth com,Thank YOU References. Adapt Pharma 2016 Adapt Pharma to offer all U S high schools a free NARCAN Nasal Spray and fund school based opioid overdose education. Retrieved from http adaptpharma com adapt press release january 25 2016. Allen J D Casavant M J Spiller H A Chounthirath T Hodges N L Smith G A 2017 Prescription Opioid Exposures Among Children and. Adolescents in the United States 2000 2015 Pediatrics 139 4 DOI 10 1542 peds 2016 3382. American Nurse Today Journal November 2016 Vol 11 No 11 Authors Janet Haebler MSN RN and Tim Casey. https www nursingald com articles 17824 nurses lead in fighting opioid crisis. American Society of Addictive Medicine 2016 Opiod addiction disease Facts and figures Retrieved from http www asam org docs default. source advocacy opioid addiction disease facts figures pdf. rebecca king state de us Almeida V March 2016 The opiat opioid epidemic what a pain in the ED Retrieved from http drugfreenj org mediakit file 40. Center of Disease Control and Prevention 2015 Expanding Naloxone use could reduce drug overdose deaths and save lives Where you live makes. a difference Retrieved from http www cdc gov media releases 2015 p0424 naloxone html. becky king attackaddiction org Center of Disease Control and Prevention 2015 Increase in drug and opioid overdose death US 2000 2014 MMWR Retrieved from. http www cdc gov drugoverdose data index html, Center of Disease Control and Prevention 2015 Today s Heroin Epidemic Retrieved from http www cdc gov vitalsigns heroin index html. Center of Disease Control and Prevention National Center for Health Statistics 2015 Accidents or Unintentional Injuries Retrieved from. http www cdc gov nchs fastats accidental injury htm. Center of Disease Control and Prevention National Center for Health Statistics 2017 Drug Overdose Deaths in the United States 1999 2015. Follow me on Twitter Retrieved from https www cdc gov nchs products databriefs db273 htm. Center of Disease Control and Prevention 2017 Prescription Opioid Overdose Data Retrieved from https www cdc gov. Drug Enforcement Agency 2016 DEA Issues Carfentanil Warning to Police and Public Dangerous opioid 10 000 times more potent than morphine. Tylers atTAcK and 100 times more potent than fentanyl Retrieved from https www dea gov divisions hq 2016 hq092216 shtml. savinglives ScienceOverStigma, Drugs com 2016 Naloxone Retrieved from http www drugs com search php q naloxone from opensearch. Harm Reduction 2016 Retrieved from http harmreduction org our work policy advocacy international. Hedegaard H Warner M Mini o AM Drug overdose deaths in the United States 1999 2015 NCHS data brief no 273 Hyattsville MD National Center. for Health Statistics 2017,References, Jones C M Logan J Gladden R M Bohm M K 2015 Vital Signs Demographic and Substance Use Trends Among Heroin Users United States 2002 2013 MMWR Morbidity and mortality weekly. report 64 26 719 725, King R 2016 Science Over Stigma Saving Lives Implementation of Naloxone Use in the School Setting NASN school nurse Print 31 2 96 101. Maryland Department of Health and Mental Hygiene Retrieved from http bha dhmh maryland gov OVERDOSE PREVENTION Pages OFR aspx. National Association of School Nurse 2016 Naloxone in Schools Toolkit Retrieved from https www pathlms com nasn courses 3353. Naqvi J 2017 March 20 Poison control centers receive 32 calls a day about children exposed to opioids The Washington Post Retrieved from https www washingtonpost com news to your. health wp 2017 03 20 poison control centers receive 32 calls a day about children exposed to opioids utm term 3838499ac1d0. National Association of School Nurses 2016 Naloxone in Schools Toolkit 2016 https www pathlms com nasn courses 3353. National Center for Health Statistics Multiple Cause of Death database 2015. National Conference of State Legislators Drug Overdose Immunity and Good Samaritan Laws f 1 20 17 Retrieved from http www ncsl org research civil and criminal justice drug overdose immunity. good samaritan laws aspx, National Federation of State High School Associations 2016 High school sports participation increases for 27th consecutive year Retrieved from https www nfhs org articles high school sports. participation increases for 27th consecutive year, National Institute on Drug Abuse National Institutes of Health U S Department of Health and Human Services August 2016. Drug Facts Understanding drug use and addiction Retrieved from https www drugabuse gov publications drugfacts understanding drug use addiction. Partnership for Drug Free Kids 2017 Overdose Deaths from Fentanyl are on the Rise What You Should Know Retrieved from http drugfree org newsroom news item overdose deaths fentanyl rise. Prescription Opioid Overdose Data 2017 https www cdc gov. Safe Kids Worldwide 2013 1 35 million children seen in emergency rooms for sports related injuries Retrieved from http www safekids org press release 135 million children seen emergency rooms. sports related injuries, Substance Abuse and Mental Health Services Administration National Survey on Drug Use and Health 2014. Substance Abuse and Mental Health Service Administration 2011 SAMHSA Medication Assisted Treatment for Opioid Addiction Publication No SMA 09 4443 Available at http www kap samhsa gov. Substance Abuse and Mental Health Service Administration 2016 SAMHSA Opioid Overdose Prevention TOOLKIT Retrieved from http store samhsa gov shin content SMA16 4742 SMA16 4742 pdf. Veliz P T Boyd C McCabe S E 2013 Playing through pain sports participation and nonmedical use of opioid medications among adolescents American Journal of Public Health 103 5 e28 e30.