Heroin overdose trrends and prevention

Objectives: To study the association of attention-deficit hyperactivity disorder (ADHD) with heroin addiction. Study design: A cross-sectional, hospital based study. Place and duration of study: The study was carried out at Lady Reading Hospital and Khyber Teaching Hospital, Peshawar, Pakistan from 4th April 2012 to 13th September 2012. Subjects and Methods: A sample of 137 adult heroin addicts were analyzed that whether they were ADHD and that childhood problem continues to manifest symptoms in adults. For retrospective assessment of childhood ADHD, the Wender Utah Rating Scale (WURS) as well as the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptom checklist for ADHD was used. The Conners’ Adult ADHD Rating Scales (CAARS) was used to assess the persisting symptoms of ADHD in adults. Inclusion criteria: Patient diagnosed with heroin addiction according to ICD-9 and DSM-IV. Exclusion criteria: Patient has co-morbid with any other mental illnesses. Results: The di...

Executive Summary The nation is currently facing the deadliest drug epidemic in recorded history. With the majority of drug overdose deaths being caused by opioid pain relievers (OPRs) that are commonly prescribed, policy officials and leaders in public health must develop and implement comprehensive strategies to curb the current crisis. This paper examines policies which aim to reduce the inadvertently induced morbidity and mortality associated with OPRs that physicians prescribe. Current efforts in place in the state of Florida are described, and alternative policies are considered and analyzed against selection criteria. Policy options are categorized as those that aim to reduce inappropriate prescribing trends or helping those most at risk for opioid overdose death who suffer from addiction. The paper concludes by providing recommendations for the most feasible options that the state has at this time.

The United States is in the midst of a public health crisis: Every year, well over 24,000 Americans die from opioid overdose. This staggering death toll is equivalent to a weekly jumbo jet crash. After a decade of rapid growth, overdose caused by prescription opioids and heroin now tops the accidental death rankings, beating out automobile accidents, AIDS, and other high-profile killers. Overdose does not discriminate, cutting across all geographic, economic, and racial divides. But some groups are especially vulnerable. This article is dedicated to one such group: individuals re-entering the community from correctional settings. In the immediate two weeks after release, people in this group are almost 130 times more likely to die of an overdose than the general population.

It is easy to cast post-incarceration substance use — and consequent overdose — as the re-entering individual’s character weakness or a propensity towards reckless behavior. Nevertheless, modern addiction science reframes such relapse as a foreseeable consequence of the chronic nature of substance use disorders. This scientific evidence also provides clear guidance on how most of the resulting fatalities can be prevented. This article considers the creation of fatal overdose risk among formerly incarcerated individuals as an unacceptable collateral harm emanating from criminal justice involvement.

In order to address this largely overlooked public health problem, we explore a range of legal channels that can help persuade the state (broadly construed) to address a risk to which it substantially contributes. We consider a number of doctrinal approaches, guided by the belief that spending time behind bars must not translate to a death sentence for so many Americans. Whether as a part of possible legal actions or an action agenda on its own right, we present a number of programmatic interventions and policy reforms that may alleviate this crisis. Our analysis also highlights the potential role of the Affordable Care Act (ACA) in facilitating overdose prevention before, during and post-incarceration. This agenda is especially timely given the current move by federal and state governments towards releasing large numbers of individuals incarcerated on drug-related charges to ease prison over-crowding or as a result of legal reforms, pardons, or exonerations.

In Section I, we provide an overview of the opioid overdose epidemic and the special vulnerability among criminal justice-involved individuals. In Section II, we examine the scientific evidence on prevention measures that should be, but are currently rarely deployed to address this vulnerability. In Section III, we explore various legal theories that could be invoked in efforts to motivate government actors to take a greater responsibility for preventing post-incarceration overdose deaths. In Section IV, we cover additional mechanisms to motivate institutional change. We conclude by outlining a policy and programmatic agenda for reducing the vulnerability of criminal justice-involved individuals to opioid overdose.

Problematic substance use has tremendous implications for the health and wellbeing of communities around the world. Social workers at the frontlines are likely to encounter clients with substance use disorders in the wide array of settings where they are employed. However, few undergraduate and graduate social work programs internationally require students to take coursework in substance use or have substance use specializations. In the short-term, incorporating substance use-related content into existing courses and institutional structures may be more viable for social work programs to educate students about substance-related issues rather than developing entire courses or concentrations.
The rates of opioid overdose death are increasing internationally and it is a multifaceted
public health problem which would provide students with an opportunity to explore a
wide variety of micro, mezzo, and macro practice and policy issues related to substance
use. This paper specifically suggests a number of strategies which could be used in practice
and policy courses throughout the curriculum. Incorporating overdose-related content into
existing courses could be a promising means to still provide students with some knowledge
and skills to work with substance-using populations.

The concept of harm reduction is broad and has no universally accepted definition. However, it can be broadly defined as policies, efforts, and practices aimed at limiting the negative health, social, and legal effects of drug use, drug policy, and drug law. Drug consumption rooms, needle and syringe programs, non-abstinence-based housing and employment attempts, drug testing, overdose prevention and reversal, psychosocial support, and teaching on safer drug use are just a few examples (Harm Reduction International, 2021)

I have been assigned to get vital information out to the world and so I pray that my work is pleased by God and only God, but the good news has to be shared with my country and it seems to me that things are getting worse in 2016, in my country and I am so proud of the great United States, but so sad that people are not taking better care of their own health and believe anything the media shows them, believes what man tells you about your own body, etc.
So, let’s begin to reverse our country’s sickness and live for living for our children in the United States and have faith in God’s healing food, and let’s begin to use our common sense which God gave to each and everyone of us to use not only for ourselves, but to help and share with others.  I truly do believe this is where and when we get our blessings of the world!

For decades, farmers in the most marginalised regions of Mexico have depended for survival on the illicit cultivation of opium poppy for the US heroin market. In 2017 they could earn up to 20,000 pesos ($950–$1,050 dollars) per kilo of opium, which channelled around 19 billion pesos ($1 billion dollars) into the country’s poorest communities, sustaining regional economies, religious ceremonies, and intra-community relations while stemming out-migration to Mexican cities and the US. With the recent upsurge in fentanyl use in the US, however, the demand for Mexican heroin has fallen sharply, meaning that farmers are now being paid around 6000 to 8000 pesos ($315–415 dollars) per kilo of raw opium. Thus the total money being paid to opium producing villages has dropped to an unprecedented low of 7 billion pesos ($370 million dollars). Drawing on fieldwork conducted in two poppy-producing regions of Mexico – one in the State of Nayarit, one in the State of Guerrero – this article shows that today, farmers cannot make a profit from opium once fertilizers and other capital inputs have been taken into account; village economies are starting to dry up; and out-migration is on the up. But this economic emergency opens the possibility of wrestling Mexico’s opium-growing regions from the control of Mexico’s Drug Trafficking Organizations (DTOs). This article concludes by addressing several possible solutions to what we term ‘the Mexican Opium Crisis’ – including crop substitution or opium legalization for medicinal use – and evaluates how realistic they are in the Mexican context.

Keywords: Mexico, Opium, Fentanyl, Crop Substitution, Drug Regulation, Migration, Market Crises

Pakistan’s challenge of heroin addiction is staggering. Among the most recent and reliable studies on estimating the burden of this problem is a UNODC supported national survey held in 2013. That exercise estimated that there were approximately 430,000 regular injecting drug users (IDUs) in Pakistan and that most of them injected heroin (UNODC, 2013). Ungoverned spaces in the country’s western neighbour – Afghanistan – serve as a global reservoir for heroin production. Pakistan’s over 2000 kilometres long and highly permeable border with Afghanistan ensures a steady supply of heroin to those seeking it for pleasure or out of compulsion. Some analysts also observe a nexus between heroin trade and the metastization of Islamic extremism and insurgencies in the Pakistan-Afghanistan region (Dania Ahmed, 2015).

A pesar de la alta cobertura de programas de reducción de daños en Barcelona, los usuarios de drogas por vía parenteral (UDVP) continúan manteniendo prácticas de consumo de riesgo. Analizar los motivos de estas prácticas desde la perspectiva de los usuarios es clave para orientar en las intervenciones de educación sanitaria desde los centros de reducción de daños. El objetivo de este estudio es conocer las razones de los UDVP en torno a las prácticas de consumo de riesgo. Se realizó un estudio etnográfico entre 2012 y 2016 mediante la observación participante en cinco centros de reducción de daños y entrevistas semiestructuradas a 15 UDVP. Se realizó análisis de contenido de los datos. Los UDVP creen erróneamente que algunos utensilios de consumo, como el filtro o el cítrico, sirven para eliminar impurezas o agentes patógenos de las sustancias. Se inyectan en zonas de alto riesgo y se bombean la sangre con la expectativa de obtener efectos más intensos. Manejan un conocimiento fragmentario de las vías de transmisión del VIH y las hepatitis. Desconocen algunos factores determinantes de las sobredosis y tienen un conocimiento parcial de cómo actuar ante ellas. Estas prácticas de consumo de riesgo se atribuyen a creencias erróneas, conocimientos parciales de prevención, el deterioro físico y los procesos de estigmatización entre los UDVP. Se recomienda intensificar la educación sanitaria desde los programas de reducción de daños con la participación de usuarios que realicen educación entre iguales para una mayor adaptación y credibilidad en los mensajes preventivos. Despite the high coverage of harm reduction programs in Barcelona, injected drug users (IDUs) continue to maintain risk-taking practices. The analysis of these practices from the perspective of drug users is a key to guide health education interventions from harm reduction services. The objective of this study is to know the reasons of the IDUs for risk consumption practices. An ethnographic study was carried out between 2012 and 2016 through participant observation in five harm reduction centers and semi-structured interviews with 15 IDUs. Data content analysis was performed. The IDUs believe mistakenly that some consumer tools, such as the filter or citrus, serve to remove impurities or pathogens from the substances. They inject themselves in high-risk areas and pump the blood repeatedly with the expectation of obtaining more intense effects. They hold a fragmentary knowledge about the routes of transmission of HIV and hepatitis. They do not know some determinants of overdoses and have a partial knowledge of how to react in case of it. These risky consumption practices are attributed to erroneous and partial knowledge of prevention, physical deterioration, and stigmatization processes among IDUs. It is recommended to increase action in health education from harm reduction programs involving meaningful participation of drug users who carry out peer education strategies for better adaptation and credibility in preventive messages.

Background: Opioid overdose (OD) rates in the United States have reached unprece- dented levels. Current OD prevention strategies largely consist of distribution of naloxone and in-person trainings, which face obstacles to expedient, widespread dissemination. Web-based interventions have increased opioid-OD response knowledge in patients with opioid-use disorders; however, these interventions have not been tested in the larger population of individuals that are prescribed opioid analgesics. This study assessed a web-based intervention providing education across three knowledge domains: opioid effects, opioid-OD symptoms, and opioid-OD response. Methods: Participants (N = 197) were adults recruited on Amazon Mechanical Turk from May to June 2017, who were prescribed an opioid medication for pain. Participants were randomly assigned to a Presentation (n = 97) intervention communicating relevant facts in each knowl- edge domain, or a Presentation + Mastery (n = 100) intervention including the same facts but requiring that participants respond correctly to ≥80% of embedded questions in each module before advancing. Participants completed the Brief Opioid Overdose Knowledge (BOOK) measure before and after the interventions, and provided feedback on acceptability. Results: Both versions of the intervention resulted in signi cant pre to postintervention increases in BOOK scores across all knowledge domains (p < 0.001), with no signi cant knowledge differences between groups. The Presentation intervention took signi cantly less time to complete (p < 0.001) and was completed by signi cantly more participants than the Presentation + Mastery intervention (p < 0.001). Most participants rated both interventions as highly acceptable. Conclusion: Results replicate a previous study (1) and suggest the web-based Presentation intervention may be a convenient, cost-effective method for disseminating crucial public health information for preventing opioid OD.

C'était un temps où les usines textiles brûlaient, ou une gauche intégriste par peur du Front National gardait les Maghrébins dans la marge sinon dans le ruisseau, la faute à Rousseau, ou parterre, la faute à Voltaire. L'overdose devenait un rêve d'au-delà.

This is a selection of passages from Get Tough & Smart - How to Start Winning the War on Drug Addiction, together with a list summarizing the causes of the Opioid Crisis.

                                            For sale at Amazon Books:

https://www.amazon.com/Get-Tough-Smart-Winning-Addiction-ebook/dp/B07YXGRHX1

The non-medical use of pharmaceutical opioids is associated with a range of negative health consequences, including the development of dependence, emergency room presentations and overdose deaths. Drawing on life history data from a broader qualitative study of the non-medical use of painkillers, this brief report presents two cases of transitions from recreational or non-medical pharmaceutical opioid use to intravenous heroin use by young adults in Australia. Although our study was not designed to assess whether recreational oxycodone use is causally linked to transitions to intravenous use, polyopioid use places individuals at high risk for progression to heroin and injecting. Our first case, Jake, used a range of analgesics before he transitioned to intravenous use, and the first drug he injected was methadone. Our second case, Emma, engaged in a broad spectrum of polydrug use, involving a range of opioid preparations, as well as benzodiazepines, cannabis and alcohol. Both cases ...

Introduction: The non-medical use of pharmaceutical opioids is associated with a range of negative health consequences including the development of dependence, emergency room presentations and overdose deaths.
Methods: Drawing on life history data from a broader qualitative study of the non-medical use of painkillers, this brief report presents two cases of transitions from recreational or non-medical pharmaceutical opioids use to intravenous heroin use by young adults in Australia.
Results: While our study was not designed to assess whether recreational oxycodone use is causally linked to transitions to intravenous use, poly-opioid use places individuals at high risk for progression to heroin and injecting. Our first case, Jake, used a range of analgesics before he transitioned to intravenous use and the first drug he injected was methadone. Our second case, Emma, engaged in a broad spectrum of polydrug use, involving a range of opioid preparations, as well as benzodiazepines, cannabis and alcohol. Both cases transitioned from oral to intravenous pharmaceutical opioids use and subsequent intravenous heroin use.
Discussion: These cases represent the first documented reports of transitions from the non-medical or recreational use of oxycodone to intravenous heroin use in Australia. As such, they represent an important starting point for the examination of pharmaceutical opioids as a pathway to injecting drug use among young Australians and highlight the need for further research designed to identify pharmaceutical opioids users at risk of transitions to injecting and to develop interventions designed to prevent or delay these transitions.