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Abuse of Prescription Opioids • 7 million Americans (2.5% of the population) over the age of 12 admit to misuse of prescription psychotherapeutic medications • 1.9 million prescription narcotic users meet diagnostic criteria for opioid abuse or dependence (second only to marijuana, 4.3 million) • New users of prescription opioids are about the same as that of marijuana (National Survey on Drug Use and Health, 2010)
Fatal Drug Poisoning • Between 1999 and 2002, the number of opioid analgesic poisonings on death certificates rose 91.2% • During this time period, poisoning from methadone surpassed both cocaine and heroin poisoning as the most frequent type of drug poisoning found on death certificates in the U.S. • New Mexico led the country in overdose deaths and one of the higher rates of nonmedical use of prescription opioids. CDC MMWR Nov 4, 2011 60(43) 1487-1492 Paulozzi, L.J., Budnitz, D.S., Xi, Y, 2006. Increasing deaths from opioid analgesics in the United States. Pharmacoedidemiology and Drug Safety 15, 613-7.
Page 1 and 2: Patricia Pade, MD University of Col
Page 3 and 4: Objectives • To provide a brief o
Page 5 and 6: Chronic Pain • 116 million people
Page 7: Opioid Use • Use of opioids has i
Page 11 and 12: Opioid Pharmacology: How do these M
Page 13 and 14: • Tolerance: Repeated Dosing: Opi
Page 15 and 16: Brief pharmacology overview: full o
Page 17 and 18: Brief pharmacology overview: opioid
Page 19 and 20: The Use of Buprenorphine/Naloxone t
Page 21 and 22: The Problem for Veterans
Page 23 and 24: Improvement Change: Creation of Co-
Page 25 and 26: Patient population • Referrals fr
Page 27 and 28: Initial Evaluation A. PAIN Detailed
Page 29 and 30: Buprenorphine induction process •
Page 31 and 32: Study participants Participant Data
Page 33 and 34: Months Average duration of opioid u
Page 35 and 36: Number Number Number 60 40 Co-morbi
Page 37 and 38: Adjuvant Medications Na and Interve
Page 39 and 40: Ongoing monitoring for compliance
Page 41 and 42: 93/143 patients remained in treatme
Page 43 and 44: Conclusions 11. Patients with co-oc
Page 45 and 46: Office Based Opioid Treatment: Bupr
Page 47: References 1. Institute of Medicine

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