#Opioid Use Disorder market

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Global Opioid Use Disorder Market: Navigating the Insights and Innovations

Opioid Use Disorder Market 

KEY MARKET INSIGHTS 

The global Opioid Use Disorder (OUD) Market size was valued at USD 2.88 billion in 2023 and is projected to grow from USD 3.11 billion in 2022 to USD 5.64 billion by 2030, exhibiting a CAGR of 8.9% during the forecast period. Based on our analysis, the global market exhibited a decline of -10.1% in 2020 as compared to 2019. The global COVID-19 pandemic has been unprecedented and staggering, with opioid use disorder experiencing lower-than-anticipated demand across all regions compared to pre-pandemic levels.

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https://www.pharmanucleus.com/reports/opioid-use-disorder 

Opioid Use condition (OUD) is a complicated condition characterised by the compelling use of opioid medicines, even if the individual wishes to quit or if the drugs significantly impact the person's mental and physical well-being. Buprenorphine, methadone, and naltrexone are the three pharmacological groups used in the pharmaceutical therapy. These are the only drug classes authorised by the FDA in the United States. 

The number of prescriptions for painkillers, which commonly contain opioids, is expected to climb as the worldwide population of individuals suffering from chronic pain grows. When these opioid-based medications are used and the patient's suffering is relieved, the patient's reliance or addiction to these drugs rises. This addiction is dangerous since an opioid overdose can result in death or lifelong impairment of a person's normal psychological and physiological functioning. 

Several governments, like the United States, have put laws in place to successfully handle this condition in order to lessen the risk. These legislative reforms, together with the increasing number of product releases by big corporations, are expected to have a positive influence on the sector. 

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POST COVID-19 IMPACT 

Reduced Demand for Medications amid COVID-19 Pandemic to Negatively Impact Market Growth? 

Depending on the demand, the COVID-19 pandemic had both beneficial and bad effects on pharmaceutical firms. Certain pharmaceutical items saw a drop in demand as fewer individuals risked visiting healthcare institutions such as hospitals and clinics. To stop the spread of the coronavirus epidemic, the different governments ordered strict national lockdowns. As a consequence, patient visits to hospitals decreased dramatically. Non-essential medical services cancellation or delay impacted market development as well. 

On the other side, there was a noticeable increase in patients having opioid overdoses and relapses in the OUD market. However, well-known firms in the field, such as Indivior, saw a significant drop in product sales during this time. Sales continued to fall sharply as a result of Covid-19-related problems. As a result, the worldwide market saw a negative trend during the epidemic. 

Click here for full report:

https://www.pharmanucleus.com/reports/opioid-use-disorder

LATEST TRENDS 

Increasing Consideration of Buprenorphine Patches as an Effective Treatment Mode to Propel Market Growth 

The industry has lately seen an increase in the demand for buprenorphine treatment patches. These patches are regarded as an effective medication for the treatment of opioid use disorders. The numerous advantages associated with transdermal patches, such as ease of medication delivery and decreased discomfort, are customary and self-administered. Furthermore, these transdermal patches may be a viable option for individuals requiring round-the-clock opioid medication for opioid use disorder. 

In 2019, for example, WellSpan Health collaborated with York Opioid Collaborative to conduct a clinical study to develop a Lidocaine patch for the treatment of OUD. During the projected period, such collaboration is expected to boost treatment uptake. Furthermore, increased patient participation is expected to drive worldwide Opioid Use Disorder (OUD) market growth throughout the forecast period. 

DRIVING FACTORS 

Growing Opioid Addiction Cases to Augment the OUD Market Share? 

The worldwide population is today suffering from a variety of severe and chronic ailments, including pain, cancer, cardiovascular disease, and other problems. To treat these problems, painkillers, particularly opioids, are used. Drug usage frequently leads to drug addiction in the patient. The patient is expected to have drug withdrawal symptoms as a result of their increasing reliance on these drugs and their sudden discontinuation. 

According to the National Drug Dependence Treatment Centre's (NDDTC) Magnitude of Substance Use in India report published in February 2019, the prevalence of current opioid use is 2.06%, and approximately 0.55% of Indians are expected to require help for opioid use problems (harmful use and dependence). 

On account of these factors, the likelihood that patients will experience tragic outcomes, such as death induced by an opioid overdose, rises. 

Growing Focus of Government & Non-government Institutions to Support Expansion 

Another major driving reason driving market development is the growing involvement of governmental and non-governmental organisations in raising awareness about opioid overdose and associated consequences. The number of opioid addicts has substantially grown, prompting various organisations to take a more comprehensive strategy to combating the problem. Numerous countries have increased their efforts to support patients and reduce the effects of opioid addiction. 

For example, in March 2022, the Department of Health and Human Services (HHS) announced financing for substance use treatment and prevention programmes in order to increase access to medication-assisted treatment for opioid use disorder and prevent prescription drug misuse. 

Similarly, similar programmes are expected to encourage more people suffering from opioid addiction to seek treatment. These factors are expected to have a positive impact on the worldwide market throughout the forecast period. 

RESTRAINING FACTORS 

Adverse Effects of OUD Drugs to Restrain Market Growth? 

The adverse effects of the medications used to treat opioid addiction are expected to stymie the market throughout the projected period. 

These medicines commonly cause muscular pains, vomiting, diarrhoea, bone/joint pain, respiratory difficulties, bladder discomfort, constipation, and stomach cramps. Furthermore, in severe situations of adverse medication response, the patient may suffer from depression and other psychological issues. 

The hazards connected with these pharmaceuticals have resulted in a warning from the US Food and Drug Administration, which has a negative influence on the drug class, lowering the adoption of medications in this form of treatment. 

For instance, in January 2022, the U.S. FDA warned about dental problems with buprenorphine medicines dissolved in the mouth to treat OUD and pain. Dental issues, including oral infections, cavities, tooth decay, and teeth loss can be serious and have been reported even in patients with no history of dental issues. 

Such factors might hamper the market growth during the forecast period to a certain extent. 

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Opioid Use Disorder Market Positioning and Growing Industry Share Worldwide to 2032 | Indivior PLC, Titan Pharmaceuticals Inc, BioDelivery Sciences International

Opioid Use Disorder Market Positioning and Growing Industry Share Worldwide to 2032 | Indivior PLC, Titan Pharmaceuticals Inc, BioDelivery Sciences International

                                                 The report provides an analysis of the global Opioid Use Disorder market with detailed analysis of sizing and growth. This “Global Opioid Use Disorder Market 2023-2032″ research report gives detailed data about the major factors influencing the growth of the Opioid Use Disorder market at the global and domestic level forecast of the market size, in…

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How to choose the right course for your ward

We are in a season of admissions wherein Tenth Standard students want to decide which subjects they should take – whether MPCB ( Maths, Physics, Chemistry, Biology) or Pure Science group or Commerce or Accountancy or Computer Science. Similarly those who have chosen any of the groups and have cleared their Twelfth Standard are also […]

[beardedmrbean]

Chrissy Reifschneider had just left rehab to treat her heroin addiction in 2017 when she started taking tianeptine, popularly dubbed “gas station heroin." The 41-year-old from Alabama was struggling with low energy, so a family member who worked at a gas station recommended she try the pills. 

Within days, Reifschneider was hooked, and three dark years cruised by. Now four years clean, Reifschneider reflects on the deception that contributed to her tianeptine addiction and the overwhelming shame that followed. It's a trend that addiction medicine experts say shines a sobering light on the ongoing mental health crisis that's driving people to "easy" solutions amid widespread healthcare accessibility issues in the U.S.

“I thought well, I'm not sticking a needle in my arm, so I literally convinced myself that I wasn’t a drug addict until I realized I didn't recognize who I was anymore,” Reifschneider said. “It's crazy to think that these gas station pills just controlled me. I was ashamed because I'd rather people know I was shooting up heroin than actually spending all this time and money on over-the-counter (drugs).”

Tianeptine is prescribed as an antidepressant in some European, Asian and Latin American countries, but it’s not approved for any medical use in the U.S. Still, companies are marketing and selling tianeptine products as dietary supplements typically in pill and powder form, claiming it can improve brain function and treat depression, anxiety, pain and even opioid use disorder. 

Tianeptine has been banned in Alabama, Florida, Georgia, Indiana, Kentucky, Michigan, Mississippi, Ohio and Tennessee.

Reifschneider used to take five pills every four hours, which she said gave her enough of a “warm, fuzzy buzz” without making her feel clammy or nauseous, similar to the effects of doing too much heroin, she said. The brand she purchased recommends two capsules daily “or as needed,” and advises against exceeding three capsules in a 24-hour period. 

She started to lose her hair and lots of weight; had auditory hallucinations; developed paranoia surrounding electronics, at times using 10 cellphones at once; and began to convince herself that she was “better off dead.” Reifschneider would even chat with gas station employees about how dangerous the pills were: “I was silently crying out for help.” 

After several unsuccessful stays in rehab, Reifschneider quit “cold turkey” and entered a withdrawal state for the next six months, which she said felt similar to but lasted longer than her withdrawal from heroin and fentanyl. Today, she continues to “feel like a 15-year-old in my brain,” alluding to her debilitating memory problems. “It’s one of my more shameful things,” she said.

Poison control cases involving tianeptine have increased nationwide, from 11 total cases between 2000 and 2013 to 151 cases in 2020, the FDA says. Many poison control calls often involve severe withdrawal symptoms, such as agitation, vomiting and diarrhea, because people typically consume higher doses than those prescribed in other countries, according to a 2018 CDC report.

Dr. Holly Geyer, an internal medicine physician specializing in addiction medicine with the Mayo Clinic, said fear of withdrawal and the depression that follows can contribute to addiction to a variety of substances. 

“These often aren't people who are chasing a high. They're just trying to feel normal, and if there's a drug out there that helps them curb that appetite, they're probably going to take it until it as a solution becomes the problem,” Geyer said. “These people are trapped biologically, mentally and spiritually. It's a horrible situation to be in, and I can tell you tianeptine does not let them out of it.” 

Shame and stigma prevail among addiction recovery circles 

Since Reifschneider joined social media to share her tianeptine experience, neighbors and friends have confided in her with their own struggles with the supplement. “It was a very dark secret we all kept in our recovery circle because it was so shameful,” she said. “We all felt better about ourselves because we weren’t doing the worst of the worst.”

Aaron Weiner, an addiction psychologist, says that mentality is “completely reasonable” considering the stigma and “traditionalism” that still weighs on drug use in general. “There’s a very intense mental health burden in this country right now,” he said.

Tianeptine is marketed as a supplement, but it’s really an opioid receptor agonist. That means it binds to the same receptors in the brain that heroin, fentanyl and other opioids do, causing similar euphoric and addictive effects by hijacking the body’s dopamine system. So when people use tianeptine amid their recovery journey to cope with withdrawal or other lingering effects, judgment frequently follows.

“In a lot of recovery circles, the goal is complete abstinence from all intoxicating substances,” Weiner said. “In this scenario, some people may assume they’re substituting one drug for another, and say they’re not really sober.”

Similar judgment occurs among those taking FDA-approved medications for opioid use disorder (MOUD), including methadone, buprenorphine and naltrexone — some of which are opioids themselves. Mounting evidence shows that they reduce opioid cravings and withdrawal symptoms, and block their euphoric effects, Weiner said, but don’t make people “high” or cause withdrawal when dosed properly. 

Although MOUD use has grown by more than 100% over the last decade, nearly 90% of people living with opioid use disorder are not receiving these medications, according to a 2022 study published in the International Journal of Drug Policy. Experts say stigma is partly to blame. 

“One of the greatest problems we have in this country is that of stigma; we label people, then throw them out with their diagnoses,” Geyer said. “So when many of them turn to MOUD, they experience equal amounts of stigma and are led to think that no one could yell at them or be offended if they use supplements like tianeptine that they think are safer.” 

"It kills me to know this is still out there"

Reifschneider said she visited a doctor who specializes in addiction medicine two times for help to detox from tianeptine, but neither attempt was successful.

“The doctor had no idea what these pills were, but he wanted to help me because he could see my desperation,” Reifschneider said. “I was terrified to come off of them alone, so I didn’t know what to do.” 

She ultimately detoxed herself, but this lack of awareness and access to proper treatment, Geyer said, is what deters people away from evidence-based treatment and attracts them to the illicit market.

Data show that nearly 50% of counties in the U.S., don’t have MOUD medication providers and 32% don’t have any specialty substance abuse treatment programs at all. 

“There's not a whole lot of attention paid to tianeptine because it’s one of many drugs that you could find at gas stations these days that are not technically outlawed but certainly not beneficial,” Geyer said. “The big name drugs out there like fentanyl is where the money has historically been in this industry, so that's where most treatment approaches have focused.”

After years of rehab, Reifschneider said she wants to lay low and just live a normal life, but knowing that tianeptine is still being sold on gas station shelves weighs on her.

“I'm honestly grateful that there's been more awareness, but it kills me to know this is still out there,” she said.

[possum-dyke]

I'd love to share with you all my undergrad honors thesis! Warning, it's a long read but well worth it, especially if you're into harm reduction

Why do Chronic Pain Patients Use Opioids Outside of the Realm of Prescription?

December 21, 2022

Nadiya 

With the guidance of mentors David Frank, PhD and Noa Krawczyk, PhD

Macaulay Honors College Public Health Honors Project

AbstractThis exploratory review aims to summarize the reasons why chronic pain patients have been using opioids not as prescribed. Review and analysis of Reddit posts revealed people’s reasons for not using drugs as prescribed, and yielded meaningful anecdotes about their stories. Results showed four overall themes, with one theme being patients not getting enough supply, either through underprescription, no prescription, or getting cut off prescriptions; one theme being issues with withdrawal, often linked to lack of information or various reasons for patients to DIY the process; one theme being blocked communication between doctors and patients, specifically focusing on stigma in the medical community against drug users; and the last theme focusing on the negative effect of national, state, and practice-based prescription guidelines. These can be summarized by one overarching theme of disconnect between patients and doctors. Recommendations can be made to improve guidelines and to train doctors better.

Background/Introduction/LiteratureThe use of opium as an analgesic can be traced back to the times of ancient Sumer, with references to it written on a clay tablet of medical preparations (Norn et al., 2005). Since then, opium and increasingly stronger opioids, including synthetic opioids, have been used in a widespread manner, primarily for pain management and for recreational use, as opioid euphoric properties hold similar levels of power as analgesic properties (Norn et al., 2005). Although there had been previous opioid “epidemics” such as the high level of Opioid Use Disorder following the Civil War, the most currently thought of opioid “epidemic” is the one that occurred in the late 1990s and early 2000s, whose dangerous aftereffects we are seeing today with the advent of fentanyl (Jones et al., 2018). A perfect storm of the medical institution starting to briefly acknowledge the importance of pain and the invention and widespread marketing of preparations like OxyContin, as well as the willingness of many physicians to prescribe of opioids, caused an increase in the rates of opioid use, unfortunately leading to dependence and overdose in some cases (Jones et al., 2018). These negative consequences caused a shift in the pendulum in the complete other direction, with more crackdown on prescribing doctors, crackdown on users, and low rates of prescription of opioids (Marchetti et al., 2020). By now, the CDC has put out federal guidelines about opioid prescription for doctors (2016 guidelines dealt with how much opioids can be prescribed and what risk factors can be considered in prescription) (Bohnert et al., 2018). Furthermore, states have set up their own guidelines to try to curb causing dependence (Soelberg et al., 2017). Also, private healthcare companies often have blanket rules or limits that either they won’t prescribe opioids or no more than a limited dose of opioids (Webster & Grabois, 2015). In theory this was to cut down on pill mills, where anyone could claim any injury for a prescription they could get multiple refills of (Kennedy-Hendricks et al., 2016).When reading this paper, it is important to note the different kinds of opioids mentioned.OxyContin, Norco, Lortab, and tramadol are all available by prescription but also on the street; in the US, heroin is only available on the street. Methadone and suboxone are forms of medication-assisted treatment (MAT); suboxone, which was mentioned more often in this research, is a partial opioid agonist which also often includes naloxone, an antagonist, in its preparation to block users from getting high on other opioids (Velander, 2018). Although mostly obtained via prescription, suboxone can be acquired on the street (Hswen et al., 2020). Kratom is a plant with opioid characteristics that while still often used for pain or euphoria, is most frequently associated with assisting with withdrawal symptoms or tapering off stronger opioids (Eastlack et al., 2020). It is not legal in all states or countries, but where it is legal, it is typically sold in headshops or online; it is never prescribed (Prozialeck et al., 2020).Another important concept that received several mentions in patient posts was withdrawal, which requires explanation. After some level of dependence, an opioid user will start developing withdrawal symptoms when they stop using (Kosten & Baxter, 2019). These will worsen over the duration of use (Kosten & Baxter, 2019). Symptoms include an agitated/anxious mental state, insomnia, sweats, chills, flu-like symptoms, cramps, diarrhea, nausea, and vomiting (Kosten & Baxter, 2019).

MethodologyIn this exploratory review and analysis, Reddit posts were analyzed to answer the question of why current chronic pain patients use opioids in an illicit and/or non-prescribed way to manage pain. The social media forum Reddit, through its subreddit r/opiates, was used to sort through posts that might be of relevance. The search term used was “chronic pain.” Inclusion criteria used when considering posts for analysis incorporated posts consisting of at least 5 words in the body, and if there was repeat posting, only first posting in order of the algorithm was counted. Non-prescribed use had to be present or heavily implied in the content of the post. The project defined non-prescribed use as use beyond the scope of a prescription, encompassing everything from using drugs bought on the black market to doubling the dose of a prescription or using non-prescribed supplements. At this point, 50 posts that matched criteria were collected.The posts were coded on Google Sheets using the following list of categories, which were picked after thematic analysis of the topic.Can’t obtain a prescriptionAlready dependent from previous prescriptions or non-prescribed useWant more after prescription but can't getPrescription too lowRan out of prescription earlyRaised toleranceOff label use of prescriptionAre using for recreational reasonsDon’t want to go to a doctorCan't afford a doctor/doctor doesn't take insuranceReceived shared pills from othersWere already using pre-pain,Want the high from a stronger drugAvoidance of dopesickness/withdrawal symptomsUse vs suicideNo illicit use mentioned (still not using as prescribed)On medication-assisted treatmentUse of kratom,Different route of administrationRelief from dopesickness/withdrawal symptomsFear/avoidance of painUsing from non-prescribed supply on top of prescriptionUse of non-opiate drugs mentioned,Doctor lowered/took off scriptNew or worsening chronic pain after withdrawal/abstinence (post-acute withdrawal syndrome)Use of heroin.Each category was given a code and these codes were marked next to posts that pertained to them. Then important quotes were gathered and several themes were identified, some stemming from criteria, and some from analysis.Limitations include the fact that posters could use other terms than “chronic pain” to describe their pain, and the fact that posts were shown in the order of Reddit’s proprietary algorithm. Another limitation is the lack of inclusion of “should I” posts, or posters who haven't yet made the jump but are asking about using their prescriptions in a different way or trying new substances. Another limitation involves the fact that this study does not take into account the people who would not be using Reddit to talk about their experiences, including, notably, many elderly individuals who may be a part of the target demographic.

Results

Quantitative AnalysisOut of 50 data points, here’s how many were counted positive for each category:Category Count

Can’t obtain a prescription  13

Prescription too low  11

Use of heroin  10

Are using for recreational reasons  9

No illicit use mentioned (still not using as prescribed)  9

Using from non-prescribed supply on top of prescription  8

Different route of administration  7

Want more after prescription but can't get  7

Off label use of prescription  6

Use of kratom  6

Use of non-opiate drugs mentioned  5

Raised tolerance  5

On medication-assisted treatment  5

Relief from dopesickness/withdrawal symptoms  5

Ran out of prescription early  4

Fear/avoidance of pain  4

New or worsening chronic pain after withdrawal/abstinence (post-acute withdrawal syndrome)  4

Use vs suicide  3

Doctor lowered/took off script  3

Don’t want to go to a doctor  2

Received shared pills from others  2

Were already using pre-pain  2

Avoidance of dopesickness/withdrawal symptoms  2

Can't afford a doctor/doctor doesn't take insurance  1

Want the high from a stronger drug  1

Already dependent from previous prescriptions or nonprescribed use  0

Qualitative AnalysisAnalysis of the Reddit posts revealed four umbrella themes:1. Patients aren’t getting enough medication to manage pain.2. Patients are dealing with issues related to opioid withdrawal/dependence/tolerance.3. Patients are not consulting with their doctors about their opioid use.4. Guidelines for prescription of opioids are not serving patients well.

Umbrella Theme 1: Patients aren’t getting enough medication to manage pain.Multiple Reddit users found that although they were getting prescriptions, the prescriptions were insufficient to their levels of pain. Some patients feel their doctors aren’t understanding their pain, and are acting out of a fear of overprescription.One poster described their frustration at not being prescribed opioids.“and what got me so pissed off, was when I talked to one of the docs he was saying “we really don’t want to use any narcotics as they’re dangerous and we want to keep you safe, if you have excruciating pain, you can have a small dose of norco once a day.” ”Self-management of pain medication is a strategy many use to allow for their low prescriptions. Here, one patient described using dietary changes to make their dose have a higher effect, in this case using grapefruit juice to potentiate the effects of opioids. (Nieminen et al, 2020)“It's gotten so bad that I've begun to starve myself most of the day and drinking mostly grapefruit juice to have my limited dose hit as hard as possible.” Others, like the next two posters, stretch their limited prescription, finding themselves in a conflict to take multiple doses to alleviate pain versus risking having nothing left to deal with a potential flare-up.“Try to keep it in the 15 - 30mg range per day so I don't max out my script in one week.”“I hate that so far today, I've taken 75mgs of oxy [Oxycontin], yet my back is still screaming at me. I hate that I only have one 15mg pill left, and I'm trying so hard not to take it just yet.”Many users found themselves unable to take prescriptions at all: “cant get doctors to help me for shit have to self medicate.”In some of these cases it is clear that the patients have already sought extensive care but still can’t get a prescription.“There's so much scaremongering about doctors overperscribing (sic) opiates, but I'm out here with a super fucked up back (dont want to get into specifics but its gnarly) and the xrays and MRIS to prove it and i still can't find a doctor to prescribe me anything stronger than naproxen.”“I've had a torn miniscus (sic) tendon for the past 7-8 years and none of the doctors I've been to will do anything about it. Doctors refuse to send me to pain management, their excuse is that I don't need it. I've taken it upon myself to medicate with the only pills that seem to work for it. (Oxy, Lortab)” For at least one patient, only mild or highly improbable solutions have been given.“every single doctor I've been to just gives me shitty NSAIDs and tells me to exercise”In some cases, doctors are cutting patients off their medications. One patient has been told that there is no cure and is therefore scared of being cut off their meds.“I’ve been told this “is it” for me, as after 6 years of treatment/surgeries there’s nothing left to do but treat symptoms, and I’m terrified I’ll be cut off my meds this year, it’s terrifying…..”This patient’s story shows a direct link between being cut off and buying on the black market.“I was prescribed quite a bit of opioids but I was cut off because it was just a general doctor and I had to go to the streets which eventually led me to suboxone [an opioid partial agonist used for withdrawal]” 

Umbrella Theme 2: Patients have issues with withdrawal/dependence/tolerance and the way interactions with doctors about these topics have gone.One patient was worried that trying to taper off legally with suboxone would affect other prescriptions, and was crowdsourcing information instead of telling the doctor their fears.“I’ve bought subutex [same as suboxone] before and managed to get myself off it but I can’t get it this time. Would a doctor allow you to be prescribed subs  while your already on other opioids prescribed?”Another patient is trying to crowdsource answers to their problem; they started off using legal kratom, but it wasn’t enough for the pain.“Now i tried to just come off morphine and jump on to kratom but my habit is too big and the kratom wasn't holding me plus it wasn't really putting a dent in my pain. I'm so fkn lost, i really don't know what to do at this point this seems insurmountable and i've just been crying all day.”One person feels they made a mistake telling their doctor. There are steep costs associated with suboxone for them, and they consider heroin to be more pleasant and cheaper.“Doctors refuse to help me. Even with my medical history , I made a horrible mistake of going for help in my most desperate moments of withdrawal, tried to get on subs [suboxone, an opioid partial agonist used for withdrawal], But said fuck it when I realized they wanted $16 every single day to dispense me a sub [suboxone] strip 6 days a week with only 1 take home for sundays. My dope [heroin] habit I could maintain on for only a little more money and it felt way better so why the fck would I get on maintenance?”Two patients likely weren’t given enough information about withdrawal. Withdrawal is seen as a “junkie” thing, so doctors don’t want to give their patients the impression they’ll get it (or don’t know much about it themselves), and patients don’t think it will happen to them so they don’t research it. (Rieder, 2017)“Only today it dawned on me what an odd coincidence it is I feel sick when I don't take it but I'm fine when I do. I've been using it continuously for the past couple days and today I woke up feeling like complete shit.”“Now my tolerance is so high I haven’t been taking as directed and taking the max dose. I ran out almost 3 days ago now. I am so tired, my legs and my arms hurt if I don’t move them, have the shits [diarrhea], headache, and all over feeling terrible [typical opioid withdrawal symptoms]. I’m assuming this is withdrawal but I feel so fucking awful.”

Umbrella Theme 3: Patients are not consulting with doctors about pain and opioid use.Patients were often found to be deliberately withholding information from their doctors for various reasons:“Like I said I hid it from my doctors, so I never really got to find out exactly what that pain was”At least one patient was scared that doctors would think they were lying for a prescription.“I tried to hide it from everyone. I was scared that doctors would think I was phishing [committing fraud/lying] for pain pills, and/or that my family would doubt my sobriety because of my behavior.”Rehab facilities often don’t let patients take any psychoactive drugs, and this person was rightfully worried that if she entered rehab, her meds could be taken from her.“She says she can't go to treatment because they'll take her meds for her illness (she collects SSI for her disability) and they could fuck with that as well.”There are often lengthy processes associated with trying to get specialists that put people off.“I've been thinking of trying to get a referral by my regular doctor to the nearest chronic pain center, to see a specialist and psychiatrist for specific pain-related treatment. In this country the doc has to write up my medical history, explain the current condition in a referral letter, mail it to the pain specialist, and if he deems it legit he'll mail me a form to fill to evaluate my pain levels. Which I have to mail back to expect a call back about a first appointment. You can understand that this is so convoluted it doesn't even make me wanna do it.” Doctors are often wary if a patient asks for a specific opiate, thinking they are trying to commit fraud.“As of now I have been to two docs who pushed me aside giving me 800mg Tylenol, it didn't do shit but I remember I had gotten a script of trammadol (sic) for a root canal and it made everything painless and easy but as soon as I said that to the doctor he immediately wrote another 800mg Tylenol script without hesitation and sent me on my way.”Many patients were scared of being marked as addicts due to withdrawal symptoms, other prescriptions, or being honest about recreational drug use. “Doctors see the addict mark on my history and treat me like a piece of garbage.”One patient regrets honesty with their doctor, who won’t prescribe to a heavy drinker. Although alcohol and opioids are synergistic, this patient is still in a lot of pain. (Cushman, 1987)“I went to the doc my sister goes too (sic) and told him about my drinking habits and the pain, he told me he won't prescribe any opiates for "fear of additional addictions" occurring.”Here, the patient knows they are labeled dependent, so they are scared that the “addict mark” will not let them request extra of their prescription.“And when I go in for my next appointment, if I mention that the 10mg dose is preferable do you think I'll run into any trouble for suggesting that now that I have been labelled as dependent?”The patient feels they can’t be honest about illicit use without fear of being cut off from their meds.“If I go to my doctor and come clean that I’m using oxy’s {Oxycontin] and heroin will the (sic) blacklist me from the prescription I’m on?”This poster is worried that coming clean about their opioid usage will cause their psychiatrist to stop giving them benzodiazepines.“I have no intentions of telling my psychiatrist because knowing her, she'd most likely just take away my benzo [benzodiazepine] prescription away and think the problem is solved. I'm almost 100% if I tried telling anyone else I wouldn't get taken seriously either, just like with all my other both physical and mental health issues, and it's not that dangerous of a drug anyway. I don't want to make the situation even worse for myself, like it's always happened before when I mistakenly trusted people, despite it being their job to help me”This poster is worried that if suboxone is on their record, they will be blacklisted from future pain medication prescription and is wanting to try to self-medicate withdrawal with kratom instead.“I’m thinking about using kratom as a substitute for suboxone. I don’t want to take subs [suboxone] because 1. i don’t want my family to know 2. i don’t want that on my health record as i struggle with chronic pain and it would hinder some medical treatment for sure”In this case, a doctor’s beliefs about marijuana use are getting in the way of evidence-based care; the patient has essentially been cut off after admitting to marijuana use and exhibiting vague symptoms.“Now when it comes to my doctor. I feel like the stigma behind my marijuana use has greatly affected my care. He thinks I’m addicted to marijuana which is absolutely ridiculous. I’ve had panic attacks before in the hospital (I’ve dealt with anxiety far longer than I’ve been using marijuana) and he attributes them to “marijuana withdrawals” like wtf. And more recently he’s completely cut out any opiate use in my care. I’ve had multiple times where I have bad chest pain episodes and I need to go to the ER but the only thing they will give is toradol and Tylenol which does jack shit. This has forced me to start going to my local hospital ER whenever I have bad pain cause I know it can be treated there properly then I could be transferred to my normal hospital.”

Umbrella Theme 4: Guidelines for prescribing opioids aren’t serving patients.In this case, the patient is unsure but thinks state or healthcare company regulations are applying a rule that results in insufficient care.“Idk if doctors in California specifically at kaiser [Kaiser Permanente, a healthcare company] can even still prescribe monthly pain meds I don’t care about being high anymore I want this pain to end.”Here, a GP is prescribing an insufficient dose because of fear of crossing guidelines, which could impact their licensure.“My doctor (not pain management doc, normal GP) won't go over 50 MME [morphine milligram equivalents] a day because they're scared of the 2016 CDC Opioid guidelines bullshit.”Many practices have pain contracts, which require opioid-receiving patients to give their word to do certain things to keep getting their prescription (Payne et al., 2010). Here, a patient is scared that because they will have six less than needed if they didn’t use extra, at their next count they or their doctor will get penalized.“My doctor does pill counts now, the amount I’m supposed to be coming in with is 12 and if I’ll only be left with 6, am I gonna be fucked [low counts might look like abuse or dealing]? I’m not abusing them in any way, and I’m scared that I’ll look like I am and fuck up my prescription or get my doctors narcotic license taken away or something. I’ve only failed one drug screening when I wasn’t taking my medication because (TMI sorry) I hadn’t shit in a week.”

Discussion In analysis of these posts, the most common overarching theme was patients feeling disconnected from doctors, from not being able to convey their level of pain and having it met, to being prescribed medications they don’t understand, to not sharing issues with their doctors for fear of judgment or non-prescription.. All four themes — insufficient prescription, withdrawal issues, patients not consulting with doctors, and prescription guidelines — often come down to issues with the medical institution or individual doctors. However, this is such a widespread problem among individual doctors that change must be made on the systemic level, for instance, during education.Insufficient prescription stories in the data can be narrowed down to three categories: patients with prescriptions who experience more pain than their prescription can help, patients who cannot obtain a prescription for opioids, and patients who are cut off from their prescriptions. In all of these sub-categories, there is a common theme of frustration with doctors not meeting patient needs. There is also a theme in the already-prescribed sub-category of using other strategies to make a prescription have more power, some of which are risky. Using other substances to potentiate the drugs, especially benzodiazepines and alcohol, can lead to overdose, and doubling up on doses to then run out can lead to a cycle of withdrawal (Knopf, 2020). In the never-prescribed subcategory, it is becoming clear that many patients who are seeking extensive medical attention are not getting the medications they need. In the cut-off category, getting cut off or tapered down without permission can precipitate withdrawal. In all, this umbrella category shows a pattern of denial of a patient’s agency in their own pain management process, and doctors should find better ways to monitor people’s pain and not assume the least effective methods will do the trick.Multiple issues come up with withdrawal precipitated by running out of opioids and self-precipitated withdrawal due to the desire to taper off. For instance, it is hard to obtain suboxone and when people do, it can be quite expensive (Hswen, 2020). Kratom can also run quite expensive, and oftentimes does not treat withdrawal symptoms effectively (Eastlack et al., 2020). In a lot of cases, patients aren’t able to utilize detox programs because they would have to be free from opiates, but either doctors aren’t providing helpful ways to get patients off opioids, or patients don’t feel comfortable approaching the subject with their doctors (Timko et al., 2016). Additionally, many patients are not adequately educated on withdrawal; it can take a while for them to catch on to the fact that they don’t have a nasty flu, they are instead in withdrawal from the prescribed opiates they take (Kearney et al., 2018). This would imply  that in long-term opiate prescriptions, doctors need to do a better job of describing the near-inevitability of withdrawal, the signs and symptoms, and when to seek help.Patients are also often scared to seek help from their doctors, often preferring to seek answers from nonprofessionals on sites such as Reddit instead. There is fear that doctors would think they are lying. This is especially true when patients want to ask for a specific opiate, as this often makes doctors wary (Lagisetty et al., 2019). Instead, self-research about medications should be encouraged and not seen by doctors as grounds for a scam. Additionally, strict rehab policies and lengthy processes to get specialists are turning patients off (Mehrotra et al., 2011). The specialist issue is not unique to pain management, but should still be improved (Mehrotra et al., 2011). Rehabs or other drug treatment centers should also have less all-or-nothing, more harm-reduction centered approaches, especially ones that match the reasons why a person might be taking a specific drug.There is also a heavy stigma against drug users of all kinds in the medical profession (Ahern et al., 2007). Although it can be understood that a provider would be wary to prescribe an opioid to a self-disclosed drinker or benzodiazepine user, as these can cause dangerous combinations, there has to be some way to balance this. Otherwise, we have a system where patients lie to their doctors about their drug and alcohol use and therefore are not properly counseled and can succumb to these consequences. Doctors should take extra care if there is a Substance Use Disorder (SUD), but still prescribe, maybe with mandatory counseling, as more than anyone, people with SUDs can find these drugs on their own. In this system, posters are reporting lying so they won’t be cut off any prescriptions and even withdrawing by themselves so they are not marked as an addict by records.In the wake of the 2000s “opiate epidemic,” doctors were given more stringent prescription guidelines. In many cases, patients aren’t aware whether they are being affected, unless their doctors told them directly, but patients are aware that some great changes have been made, either from their past medical experiences or that of the people they know. Private practices have also instituted blanket rules against prescription, mandatory pain contracts, drug urinalysis, and pill counts, which can lead for one “slip-up” or double dose in a patient’s pain regimen to get them in trouble (Tobin et al., 2016). These policies should be reexamined as they are mostly working just to deter and punish chronic pain patients (Tobin et al., 2016). State and federal guidelines also need to be loosened, as doctors should have more freedom over their prescription choices, making patients’ lives better.

Hope you like this and feel free to share!

[mariacallous]

Editor's Note: This blog post is part of the USC-Brookings Schaeffer Initiative for Health Policy, which is a partnership between Economic Studies at Brookings and the University of Southern California Schaeffer Center for Health Policy & Economics. The Initiative aims to inform the national health care debate with rigorous, evidence-based analysis leading to practical recommendations using the collaborative strengths of USC and Brookings. We gratefully acknowledge support from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse. 

There is strong evidence that the opioid epidemic has reduced labor force participation in the United States. While use of prescription opioids aimed at pain management for some individuals may enhance their ability to work, the widespread misuse of opioids has resulted in an epidemic of opioid use disorders (OUD), labor supply disruptions, and unprecedented deaths. Opioid misuse can compromise labor supply in a variety of ways, including absenteeism, increased workplace accidents, and withdrawal from the labor force due to disability, incarceration, or death.

Overview of the issue

The opioid epidemic has been widely characterized as having three distinct waves of overdose deaths: the first wave beginning in the 1990s with increases in deaths involving prescription opioids; the second wave beginning in 2010 with increases in deaths involving heroin; and the third wave beginning in 2013 with increases in deaths involving synthetic opioids such as fentanyl. Several researchers have investigated the effects of elevated prescription opioid misuse, which began during the first wave of the epidemic, on labor supply. Though one study found small positive effects of prescription opioids on labor force participation for women, the majority of studies on this relationship have found that regions with higher exposure to opioid prescriptions experienced significant declines in labor force participation. In a 2016 survey of men aged 25-54 who were not in the labor force, nearly half of respondents reported taking pain medications on a daily basis, two-thirds of whom were taking prescription pain medications. In a follow-up survey of women in the same age group who were not in the labor force, 54% of respondents reported taking pain medications daily, half of whom were taking prescription medications.

The rise in illicit opioid use during the second and third waves of the opioid epidemic also reduced labor force participation, decreased employment, and increased applications for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Incarceration for offenses related to illicit opioids likely also contributes to the decrease in labor force participation caused by the opioid epidemic.

Altogether, the effects of the opioid epidemic on labor force participation have been significant. One estimate suggests the opioid epidemic accounts for 43% of the decline in men’s labor force participation rate between 1999 and 2015, and 25% of the decline for women.

Beyond its effects on labor force participation, the opioid epidemic also has implications for the working population. An estimated 12.6% of the U.S. workforce receives an opioid prescription each year, and 75% of employers surveyed by the National Safety Council report that they have been directly affected by opioids. OUD can impact workers’ labor market outcomes: workers with substance use disorders take nearly 50% more days of unscheduled leave than other workers, have an average turnover rate 44% higher than that for the workforce as a whole, and are more likely to experience occupational injuries that result in time away from work.

While the opioid epidemic has had significant impacts across the labor market, its effects have been particularly pronounced in specific occupations and industries. A CDC analysis of mortality data from 21 states concluded that unintentional and undetermined overdose deaths accounted for a disproportionate share of all deaths in the following six occupational groups: construction, extraction (e.g., mining), food preparation and serving, health care practitioners, health care support, and personal care and service. These fatalities are particularly concentrated in construction and extraction: an analysis by the Massachusetts Department of Public Health found that individuals employed in construction and extraction accounted for over 24% of all overdose deaths in the state’s working population.

[a-shared-experience]

Almost immediately upon arrival I started craving a cigarette. It’s an intense primal urge that gnaws away at me and leaves me on edge. My body rarely lets me forget that I’ve smoked in every single place here since I was 12. It’s nice that I don’t have to sneak outside at night where the earwigs and mosquitos roam or pay $23 for a pack of smokes but the urge remains.

It makes my heart beat faster. People will talk to me and I’m sort of once removed from being with them because it’s all I can think about.

I sneak one at a friends house and feel relieved but only really for a few minutes before I want another. I discipline myself but still it’s there… persistent within. I think about it over coffee, when I’m driving on the highway, after dinner and before bed. I feel deprived or unsatisfied in ways I thought would subside considering it’s been nearly 4 months.

That’s the weird thing about addiction… it’s embedded in memories , entangled in our experiences and habitual even without the chemical hook.

My brain knows this will soothe me just as much as it knows it will harm me.

I’m a week deep into vacation but can’t disassociate myself from my old behaviours even though I have incredible willpower.

When I was young smoking was cool or sexy.

It was marketed and portrayed as such. I remember adverts in all the fashion magazines selling us death. The warning label reminded us “ this product is addictive”. Still… it was a product that was displayed next to designer clothing worn by women battling eating disorders or food addictions.

Addiction is everywhere.

I try and relax knowing that soon I’ll be returning to an astronomical opioid crisis. I can’t help but look at the emails that keep pouring in. I think 6 clients died just this afternoon and the unfathomable number of substance poisonings remains just as high as when I’d left. My neighbourhood is now listed as one of the top hotspots with over 100 ems calls in the past week. I would be lying in bed in my condo hearing nonstop sirens and think , “ another one” with despair in my heart. Then I’d try to be rational and think … the ambulance gets called for a variety of emergencies and the sirens are simply triggering old ptsd responses.

I gaslit myself more or less. If you go on YouTube and type in the word fentanyl you’ll see hundreds, if not thousands of videos come up where cities have declared states of emergency, personal stories being shared in hopes of advocacy for change and ending stigma, as well as , great political divide as if being conservative or liberal or what have you means you somehow get to decide who’s life is of value.

It’s all so frustrating to listen to people who demonize the drug because it’s a pharmaceutical drug which has purpose. Epidurals are usually fentanyl and I doubt there’s a crisis of young mothers ditching their families at the ER to become immersed in opioid use. The fact is , we need pain killers, we have pain.

Why aren’t we studying the pain.

When we demonize the substance we seek blame instead of change. We create fear instead of providing evidence based facts. We begin to demonize the people who use the substance and forget that addiction isn’t a choice , at least not entirely.

I guess I don’t have the right words to explain it. I wish I did because I truly understand it. Nicotine is a habit forming substance. I did the “commendable” thing and quit before I turned 40 years old. It’s July and I’m battling cravings for the thing I didn’t even really like. I just remember it served a purpose. My body remembers. My mind remembers. I’m not a monster because I “ relapsed” and had a cancer stick on my friends porch. I just was tired of being on edge. Luckily my vice kills a little slower but ultimately there’s nothing that will save me.

I don’t have a disease , I just remember.

When I go back , I’ll be in the place where I victoriously quit and the cravings will go away but for now it’s like quitting all over again. I have to train my brain to be this new me in this old place.

Cravings are not moral failure , it’s literally the human mind working the way it’s supposed to. Such a delicate and resilient little thing.

I think someday we’ll understand it all and look back at how many people died because we were debating on ideologies and we’ll feel shame and sorrow which ultimately … lead to addiction

Sigh.

I wish I could save the world

I don’t know how.

[ecoamerica]

Watch the 2024 American Climate Leadership Awards for High School Students now: https://youtu.be/5C-bb9PoRLc

The recording is now available on ecoAmerica's YouTube channel for viewers to be inspired by student climate leaders! Join Aishah-Nyeta Brown & Jerome Foster II and be inspired by student climate leaders as we recognize the High School Student finalists. Watch now to find out which student received the $25,000 grand prize and top recognition!

[lifewithchronicpain]

Dopesick, the eight-part Hulu series on the opioid epidemic – sorry, the OxyContin epidemic -- has been nominated for 14 Emmy awards. Based on the best-selling book of the same name by Beth Macy, most of the nominations are well-earned, from the excellent acting of Michael Keaton (nominated for Outstanding Lead Actor) to the breakout performance of Kaitlyn Dever (nominated for Outstanding Supporting Actress) as an addicted patient.

As entertainment, Dopesick is an achievement, but the awards should only be given if the admission is made that the Hulu series is almost entirely fictional. So far, the series’ makers have failed to do so, with Executive Producer Danny Strong claiming that robust research was carried out to make the series as realistic as possible.

“I had done a ton of research, conceived and sold the show before I even knew the book Dopesick existed,” Strong told The Hollywood Reporter. "I read the book, and I loved it. I thought it was a beautiful book, incredibly well done.”

The problems with the Hulu series are many-fold, mostly arising from errors, conflations and under-examinations that are littered throughout Macy’s book, as well as the fact/fiction transition necessary in the baton pass from page to screen.

Strong took many elements of Macy’s dubiously factual text at face value, picking up on the well-established narrative that Purdue Pharma’s marketing of OxyContin was the root cause of the opioid epidemic.

As a result, the series was almost literally bound to fail as an adequate representation of the true origins and spread of opioid use disorder. (Read more at link)

Long article but worth the read.

[knifefightscene]

Hi there friend. I’m not sure how old you are, or what your life experiences have been thus far, so if this information isn’t helpful to you feel free to disregard.

I can’t in good conscience not share some of my knowledge based on recent posts you’ve made. I work on a drug for Opioid Use Disorder (OUD) and I just want to caution you on the TYPE of painkillers you use. The danger of opioid addiction is how it changes your body to a volatile state at high risk for death. Maybe you lose access to the meds for a few days and your body craves them violently. So the next time you have meds you take a normal dose, and your body can’t handle it the same way it could even a few days ago. Overdose deaths are rising right now, it’s really a terrible crisis. And since it’s hard to get a reliable stream of painkillers from legal channels, cravings can send people to the black market where you’re more likely to encounter fentanyl which horrendously increases the chance for death.

Please just be safe. Even over the counter meds can start fucking with your liver and organs after excessive use, but I completely understand weighing the odds if you deal with severe and/or chronic pain (I know I use pot to mitigate chronic back pain flare-ups). You’re not a bad person for wanting relief and painkiller addictions come from a very logical place. This stranger just asks that you protect yourself ❤️

Oh thank you i only use over counter painkillers that don’t contain opioids because I don’t get often intense pain like i used to so i take the pharmaceutical recommend doses only and i only take it when it’s unbearable bc i do fear my body will develop a tolerance.

[wainswright]

Going through my random pile of medical journals. psychologist.

substance used disorders are treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments and health, social function and control over substance use. It is a cluster of cognitive behavioral and physiological symptoms, indicating that the individual continues using the substance despite harmful consequences these disorder, range and severity and can affect people of any race, gender, income level or social class.

 research has shown the genetic factors play a strong role in whether a person developed a substance used disorder accounting for 40% to 60% of the risk in fact, family transmission of substance use disorder particularly alcohol. Use disorder has been well established individuals have relatives with substance use disorder are 3 to 5 times greater risk of developing substance use disorder than the general population. The presence of substance use disorder and one or both biological parents are most more important than the presence of substance used disorder and one or both adoptive parents, the genetic risk increases with the number of relatives with substance use disorder and the closeness of the genetic relationship. However, most children of parents substance use disorder do not develop disorders and some children from families were substance uses not a problem develop disorders when they get older.

if a child is genetically predisposed to substances disorders, these environmental factors may further increase the tendency. (excerpt)

 environmental stimuli the expected drug affect in the setting of use context of administration, play important roles in the social learning of drug use opioids and other drugs that increase dopamine turnover lead to conditional responses and may become conditioned to the activities of daily living as a result, environmental stimuli can become powerfully associated with substance use, which can trigger cravings for the drug visibility of pharmaceutical marketing, and advertising a medication‘s may also play a role by changing the attitude towards ingestion of these agents for youth, a social learning aspect to drug uses, likely based off the modeling of drug use by adults and their families and social networks

 diagnosis as noted the DSM five TR defined substance used disorder as a problematic pattern of substance use leading to clinically significant impairment or distress. The components are generally the same regardless of substance used. The diagnosis of substance use disorder is made by meeting two or more criteria in a one year period, one substance taken in larger amounts are over a longer period than intended to persistent desire, unsuccessful efforts to cut down or control use three excessive time spent to obtain use or recover from using the substance for craving an intense urge to use five substance use interferes with obligations six continue used despite life disruption, seven reduction or elimination of important activities due to use eight recurrent use and physically hazardous situations nine continue use despite physical or psychological problems 10 tolerance need for increased doses of the substance for the desired effect or a market diminished effect with the continued use of the same amount 11 withdrawal

in the case of opioid use disorder, the criteria for tolerance and withdrawal are not considered to be met for those taking opioids solely under appropriate medical supervision

substance use disorder, treatment all substance use disorder. Treatment plan should reflect the patients most important goals, and establish measurable and achievable steps towards achieving those goals as such all treatment plans will be individualized and creating collaboration with the patient. The recovery roadmap also requires the clinicians communicate with clear non stigmatized language regarding the patient’s condition and options.

 treatment of substance use independence with psychosocial or behavioral therapy is based on the assumption that addictive behavior is developed and maintained by specific mechanisms one expect expectancies and modeling to reinforce properties of the drug three secondary social reinforcement. The goal of these types of treatments is to modify drugs, seeking and other behavioral aspect of drug dependency psychosocial therapy and Pharma therapy are not mutually exclusive and fax some drug therapies for substance use abuse are considered useless without a psychosocial behavioral component.

 psychosocial therapies for substance use disorders can be divided into two broad categories. The first category consist of therapies that were originally developed for patients with anxiety and depression and modified for use with patients with substance use disorders. This group of therapeutic approaches includes cognitive behavioral therapy, the behavioral therapy and interpersonal therapy. The second group of psychosocial therapies was developed, explicitly for patients with substance used disorders and includes motivational interviewing and motivation enhancement therapy. All psychotherapies are intended to be delivered in a supportive empathetic matters that minimize confrontation.

 for patients with alcohol use disorder the department of veteran affairs, work group and recommends one offering one or more of the following interventions considering patient preference and provider training or competence behavioral couples therapy for alcohol use disorder. Cognitive behavioral therapy for substance use disorders. Community reinforcement approach. Motivational enhancement therapy. 12 step facilitation.

[wellnessmedicalclinic]

Opioid Addiction is a Serious Health Disorder! Stay Wary of it

Did you know that over 10 million people are entrapped in Opioid addiction in the US alone? You must think that they’re usual drug addicts, and what is so surprising about it? However, that’s not the complete picture. You must be well aware of the pain-relief medication usage of Opioid that made them gain popularity among physicians and doctors. But it is also a fact that Opioids are highly addictive in nature, and if their usage is prolonged, they will certainly cause serious harmful effects.

You won’t find pharmaceutical companies mentioning that in their marketing campaigns. Therefore, it is extremely necessary to check your Opioid intake and possibly eliminate its usage. Those who are struggling with high Opioid usage must consult a professional medical wellness Suboxone clinic to help them get rid of it.

Comprehensive treatment is necessary

Excessive and prolonged opioid usage is a widely recognized disorder, especially among patients experiencing excruciating pain due to accidents. Suddenly cutting off the intake of opioids would only welcome extensive withdrawal symptoms and very often would not produce positive results. Therefore, comprehensive treatment programs that include medications like Suboxone and Modvellum, along with supervised therapy and support services, are the only correct measures.

Keep a check on these symptoms to identify Opioid addiction

If you or your close one is medicated with Opioid drugs, then you must certainly observe these possible symptoms of possible opioid addiction. Excessive usage, i.e., more than the prescribed dosage, resorting to Opioids in stressful situations, prioritizing being in the effect of the medication over essential work, and obvious withdrawal symptoms are definite indicators of Opioid addiction.

Opt for the experienced medical wellness clinic only

Since opioids are meant to curtail opioid receptors in the brain to provide pain relief, only expert wellness professionals must be trusted to overcome this serious disorder. Experienced medical wellness professionals offer comprehensive, medically assisted treatment along with personalized therapy sessions. They assess and manage your medication accurately to keep you clear of any possible withdrawal symptoms. Moreover, you must ensure that you connect with support groups that will provide valuable support throughout the journey.

About Wellness Medical Clinic:

Wellness Medical Clinic is a health wellness center operating in Tallahassee and Thomasville that specializes in mental health wellness medication and therapy along with aesthetics and anti-aging services such as Skinbetter Sciences. It aims to provide its clients with comprehensive treatments and assistance for maintaining and improving physical and mental health. In the case of opioid addiction disorder, it is the only therapy you must trust.

Visit https://tallyclinics.com/ for more information.

Original Source: https://bit.ly/3UNGdGL

[health-views-updates]

Opioid Use Disorder Market Detail Analysis focusing on Application, Types and Regional Outlook

The opioid crisis has long been a significant public health concern, and its economic impact is profound. The Opioid Use Disorder market has been witnessing substantial growth in recent years, driven by various factors such as increased awareness, advancements in treatment options, and evolving regulatory landscapes. According to recent market research, the Opioid Use Disorder market size was valued at USD 3.13 billion in 2022 and is projected to reach USD 6.15 billion by 2030, with a remarkable Compound Annual Growth Rate (CAGR) of 8.8% during the forecast period from 2023 to 2030.

Emerging Trends and Opportunities:

Telemedicine and Digital Therapeutics: With the rise of telehealth, there's a growing trend towards utilizing telemedicine platforms and digital therapeutics for the management and treatment of OUD. These technologies offer convenience, accessibility, and personalized interventions, potentially improving patient outcomes and engagement.

Integration of Behavioral Health Services: There's an increasing recognition of the importance of integrating behavioral health services into primary care settings. This integrated approach aims to address the complex needs of individuals with OUD comprehensively, including mental health support, addiction treatment, and social services.

Novel Treatment Modalities: Researchers and pharmaceutical companies are actively exploring novel treatment modalities for OUD, including medication-assisted therapies, non-opioid medications, and gene therapies. These innovations hold the promise of improving treatment efficacy, reducing withdrawal symptoms, and minimizing the risk of relapse.

Download Free Sample Report: https://www.snsinsider.com/sample-request/3018

Key Drivers Propelling Growth:

Rising Incidence of Opioid Abuse: The prevalence of opioid abuse and addiction continues to escalate globally, driving the demand for effective treatment options and supportive services.

Government Initiatives and Funding: Governments and healthcare organizations are ramping up efforts to combat the opioid crisis by allocating resources towards prevention, treatment, and recovery programs. This increased funding contributes to the growth of the OUD market.

Advancements in Pharmacotherapy: The development of new pharmacological agents and formulations for the management of OUD, coupled with expanded access to existing medications such as buprenorphine and naltrexone, is expanding the treatment landscape and driving market growth.

Challenges and Considerations:

Stigma and Access Barriers: Stigma surrounding substance use disorders often prevents individuals from seeking treatment or accessing care. Addressing stigma and reducing access barriers, particularly in underserved communities, remains a significant challenge.

Treatment Adherence and Compliance: Ensuring treatment adherence and compliance among individuals with OUD can be challenging due to various factors, including the chronic nature of the disorder, co-occurring mental health conditions, and socioeconomic factors.

Regulatory Hurdles: Regulatory frameworks governing the prescription and distribution of opioid agonist and antagonist medications vary across regions, posing challenges for market expansion and access to treatment options.

Key Takeaways from the Market:

The Opioid Use Disorder market is poised for substantial growth, driven by increasing awareness, technological advancements, and government initiatives.

Telemedicine, integrated care models, and novel treatment modalities are emerging as key trends, offering new opportunities for stakeholders in the OUD ecosystem.

Addressing stigma, improving treatment adherence, and navigating regulatory complexities are critical considerations for fostering market growth and enhancing patient outcomes.

In conclusion, the Opioid Use Disorder market presents significant opportunities for innovation and growth, fueled by evolving trends, supportive policies, and advancements in treatment modalities. However, addressing the complex challenges associated with OUD requires a multifaceted approach involving collaboration among stakeholders, including healthcare providers, policymakers, pharmaceutical companies, and community organizations.

[clarkelawpa]

Suing for Kratom Overdose and Death (Copy) (Copy)

Kratom is an extract from the leaves of a plant, mitragyna speciosa, that is native to Southeast Asia. In recent years, kratom  has become quite popular in the United States as a dietary supplement.   Kratom has several psychoactive compounds and acts as a stimulant at low doses and a sedative agent at higher doses.  Its distributors ascribe many extraordinary health benefits to the plant : curing opioid addiction, easing withdrawal from opiods, and alleviating depression and anxiety.  The limited studies on kratom’s physiologic effects indicate that it may provide analgesia and improvements in mood, but it can also cause addiction, dependence, and death.

Regulation of Kratom in the United States

       Due to the paucity of research on kratom’s physiologic effects, The FDA has discouraged the sale and consumption of kratom.  It has also stated that it is illegal to market kratom as a dietary supplement.   Due to concerns regarding kratom’s adverse health effects, import of kratom into the United States for medical purposes has been banned.  Nonetheless, it is legal to buy kratom as a botanical extract. A burgeoning industry of kratom growers and distributors has emerged in the last 15 years that generates billions of dollars in revenue yearly.  The FDA estimates that there are now over 5 million people who regularly consume kratom products in the United States.  The FDA has initiated a few enforcement actions against kratom manufacturers who were marketing kratom products to treat opioid use disorders and withdrawal symptoms.  However, the FDA has thus far failed to enforce its ban against kratom manufacturers who market their products as extracts rather than supplements (though all of these products are in fact  designed to be consumed like drugs).

A Tide of Kratom related Overdoses and Deaths

A 2019 report from the American Association of Poison Control Centers (AAPCC) noted that there was a 52-fold increase in kratom use, based on reports of intoxication,  between the years 2011 to 2017.  As kratom use has increased,  many consumers have paid the ultimate price.  Over 18 months in 2016 and 2017, 152 overdose deaths involving kratom were reported in the United States, with kratom as the primary overdose agent in 91 of the deaths.

 Wrongful Death Litigation Against Kratom Manufacturers

 There have been an increasing number of wrongful death cases filed against kratom manufacturers in recent years as kratom overdose deaths have risen.  These cases tend to assert claims that the relevant manufacturers and retailers are negligent in how they market their products, and/or are strictly liable for failure to warn consumers of their dangers.

- In 2022, the Estate of Krystal Talavera won a judgment of $11,000,000 against Sean Michael Harder, owner and operator of the Kratom Distro after Krystal died from a kratom overdose on Father’s Day 2021.

 In August 2023, a Seattle jury awarded $2.5 million to a Castle Rock family in a wrongful death lawsuit after a man with back pain died after ingesting kratom. 

 If you or a family member have been injured by the use of kratom products, call personal injury attorney John Clarke at (305)467-5560 for a free consultation!

[dogmetaph0r]

Sic ‘Em and Mental Health

Now that we’re getting into the real action with this story, I think it’s worthwhile to expand on the warnings for mental health issues because some of the coming content may be particularly triggering, both to watch externally and to experience through a character’s POV. These themes are prominent and drive many plot points. In true PB fashion, none of these conditions are diagnosed or professionally treated, so a number of them are going to be sort of up in the air in terms of modern diagnostic categories. Mental health and neurological health are not well-categorized, even today!

Serious spoilers below for those who are more bothered by that than the potential content warnings

Tommy’s conditions are all pretty much known and canon, but I have a couple headcanons to impose on y’all fjdjcjsbsjd. Firstly I think Tommy has OCD centered around decision-making rituals (the coin toss, etc), harm anxiety, and reassurance. Secondly, I am attributing his seizures and hallucinations to epilepsy caused by his severe brain injury (the cracked skull scene). Third, I know that Tommy canonically exhibits disordered eating, but I wanted to warn you guys that it is a future topic of emotionally-charged conversation because I know it’s especially triggering for many people.

For Sam, I want to go right ahead and say that he is on the psychotic spectrum. This is largely traumagenic but is exacerbated by other factors such as substance use, stress, genetics, and brain injury. It doesn’t play a prominent role the entire time but it does make some sections potentially disturbing to anyone who’s prone to delusion, specifically Cotard delusion. He is also affected by substance abuse disorder. This is mainly in regards to opioid abuse common in PB, but also extends to a temporary reliance on cocaine and an anesthetic liquid called ether, which is a historical depressant marketed as an alternative to alcohol. It is not physically addictive but difficult to quit due to the dopamine rush. He drinks alcohol often, like most of the cast, but not to the extent where it’s damaging his life. He’s more into ether because it’s stronger.

Traumatic brain injury is a major career interest of mine as well as something I have personal experience in, so please do forgive it playing a prominent role! I definitely don’t take it as lightly as our characters here. Sam ofc has his concussion, but I also subscribe to the theory that shellshock is a form of compounded PTSD and TBI, and it plays a role in his cognition later on. On that note, it is established that Sam has PTSD flashbacks and nightmares, which are lived firsthand through Sam’s POV. They do get more graphic from here. He is also passively suicidal, whereas Tommy presents with risk-taking suicidality through things like Russian roulette and intentionally high-stakes decision making. Sam more just sorta accepts it when he’s in mortal danger and has sort of a learned helplessness response to fear.

For Fia, it’s pretty evident by now that she has some serious anxiety issues. She ruminates, double-checks, and frequently fixates on the worst outcome. Later on, this will worsen. She will also, at some point, go through postpartum depression. It will result in her being somewhat emotionally distant from her child, which has lasting effects on their relationship.

As a side note, this child does develop difficulties with socializing, but as the author I want to say right away that I do not condone the way people treat them because of this, and I don’t think a lack of social connection skills means anyone is bad or evil. This is more of a parental attachment issue for this kid, which is handled poorly due to limited understanding of mental health and developmental psychology in the time period.

I also wanna talk about Sam’s parents. Oh, Sam’s parents. First off, Sam’s father, Henry Lovell, is kicked in the head by a horse as an adult. He survives but has lasting cognitive, physical, and emotional effects due to very severe brain damage. As a result he does require full-time care. His behavior may seem strange and upsetting at times if you’re not familiar with TBI, but this is a normal symptom (as normal as TBI can get considering how unpredictable it is) of a temporal lobe injury and shouldn’t be taken as an indicator of his dad’s underlying personality before the accident. He’s a good guy. Please be patient with him.

Sam’s mom is also a relatively good woman, but she’s under a lot of duress due to the number of unlucky tragic incidents that have occurred in their family. As such it’s fair to say that she has severe anxiety. She does have moments where she lashes out, and it’s implied that she is how Sam and the SamFia baby inherit some of their predisposition to mental health problems. This is meant to mirror Tommy’s relationship with his own parents, but in the inverse of mother and father personalities and ofc not abusive. But I wanted to give this warning about his parents because they ARE good people, they’re just dealing with extremely difficult circumstances even by modern standards.

But that’s pretty much it!! If there’s anything else, I’ll be sure to update this post!

[aimarketresearch]

Rapid Oral Fluid Screening Device Market Size, Share, Trends, Opportunities, Key Drivers and Growth Prospectus

Rapid Oral Fluid Screening Device Market report is an important manuscript for every market enthusiast, policymaker, investor, and market player. The market research and analysis conducted in this report assists clients in forecasting the investment in an emerging market, growth of market share or success of a new product. In addition, this business report endows with a delegate overview of the market where it identifies industry trends, determines brand awareness, potency and insights and provides competitive intelligence. Report contains strong and weak points of the competitors and analysis of their strategies with respect to product and  industry. Rapid Oral Fluid Screening Device Market is the most established tool and hence used widely to generate market research report.

With the complete understanding of business environment that is best suitable for the requirements of the client, Rapid Oral Fluid Screening Device Market business report has been generated. Businesses can also achieve insights into profit growth and sustainability programs with this market report. Market drivers and market restraints explained in this report gives idea about the rise or fall in the consumer demand for the particular product depending on several factors. This market document contains all the company profiles of the major players and brands. Each of the topics is properly elaborated with the in-depth research and analysis for generating an absolute Rapid Oral Fluid Screening Device Market survey report.

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Data Bridge Market Research analyses that the rapid oral fluid screening device market will exhibit a CAGR of around 14.54% for the forecast period of 2021-2028. Rising prevalence of oral disorders, increased focus on research and development proficiencies in regards to medical devices and on the adoption of advanced healthcare technologies, growing awareness amongst the people regarding the benefits of rapid drug screening and rising expenditure for the development of healthcare infrastructure especially in the developing economies are the major factors attributable to the growth of rapid oral fluid screening device market. Therefore, the rapid oral fluid screening device market value, which was USD 5,485,064.27 million by 2028 from USD 6,867.15 million in 2020.

Rapid Oral Fluid Screening Device Key Benefits over Global Competitors:

The report provides a qualitative and quantitative analysis of the Rapid Oral Fluid Screening Device Market trends, forecasts, and market size to determine new opportunities.

Porter’s Five Forces analysis highlights the potency of buyers and suppliers to enable stakeholders to make strategic business decisions and determine the level of competition in the industry.

Top impacting factors & major investment pockets are highlighted in the research.

The major countries in each region are analyzed and their revenue contribution is mentioned.

The market player positioning segment provides an understanding of the current position of the market players active in the Personal Care Ingredients

Table of Contents: Rapid Oral Fluid Screening Device Market

1 Introduction

2 Global Rapid Oral Fluid Screening Device Market Segmentation

3 Executive Summary

4 Premium Insight

5 Market Overview

6 Rapid Oral Fluid Screening Device Market, by Product Type

7 Rapid Oral Fluid Screening Device Market, by Modality

8 Rapid Oral Fluid Screening Device Market, by Type

9 Rapid Oral Fluid Screening Device Market, by Mode

10 Rapid Oral Fluid Screening Device Market, by End User

12 Rapid Oral Fluid Screening Device Market, by Geography

12 Rapid Oral Fluid Screening Device Market, Company Landscape

13 Swot Analysis

14 Company Profiles

Critical Insights Related to the Rapid Oral Fluid Screening Device Included in the Report:

Exclusive graphics and Illustrative Porter’s Five Forces analysis of some of the leading companies in this market

Value chain analysis of prominent players in the market

Current trends influencing the dynamics of this market across various geographies

Recent mergers, acquisitions, collaborations, and partnerships

Revenue growth of this industry over the forecast period

Marketing strategy study and growth trends

Growth-driven factor analysis

Emerging recess segments and region-wise market

An empirical evaluation of the curve of this market

Ancient, Present, and Probable scope of the market from both prospect value and volume

The major players covered in the rapid oral fluid screening device market report are Abbott., Thermo Fisher Scientific Inc., Drägerwerk AG & Co. KGaA, Laboratory Corporation of America Holdings., Quest Diagnostics Incorporated., OraSure Technologies, Inc., Omega Laboratories, Inc., F. Hoffmann-La Roche Ltd, Shimadzu Corporation, Oranoxis, Premier Biotech, Inc., UCP Biosciences, Inc., SCREEN ITALIA Srl, Securetec., MEDACX Ltd., AccuBioTech Co., Ltd., Premier Biotech, Inc., Psychemedics Corporation and American Bio Medica Corporation among other domestic and global players. Market share data is available for Global, North America, Europe, Asia-Pacific (APAC), Middle East and Africa (MEA) and South America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.

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Opioid Use Disorder (OUD) Market Overview, Competitive Analysis and Forecast 2031