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NLM Director’s Comments Transcript
Treating Prescription Opioid Overdose: 06/09/2014

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

I’m Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine, for Donald Lindberg, M.D, the Director of the National Library of Medicine.

Here is what’s new this week in MedlinePlus.

Physicians need to be more aware of an alarming trend of opioid prescription overdoses — and treatment medications need to be used more frequently, finds a commentary recently published in the New England Journal of Medicine.

Four leading addiction specialists (including the Director of the National Institute on Drug Abuse) note deaths from overdoses of prescription opioids more than quadrupled between 1999-2008.

The Patient Page of the Journal of the American Medical Association reports prescription opioids include: codeine, morphine, oxycodone, and fentanyl. A link to JAMA’s patient page is provided in the ‘specific conditions’ section of MedlinePlus.gov’s prescription drug abuse health topic page. Prescription opioids are among the medications that are popularly referred to as ‘narcotic painkillers.’

The commentary’s authors explain the recent rate of death from prescription opioid overdoses significantly exceeds the death toll from non-prescription drugs, such as cocaine and heroin.

The authors add the increase in prescription opioid deaths is tantamount to a national epidemic. For example, the authors note there were about 16,700 deaths from prescription opioid overdoses in 2010 compared to about 3000 deaths from a heroin overdose. The authors add about 82 percent of the deaths caused by prescription opioids are classified as unintentional.

The authors find the rates of emergency department rates and substance-abuse treatment admission related to prescription opioid use was about $72.5 billion in 2007, which is a cost similar to treatments for chronic diseases, such as asthma and HIV infection.

The authors explain substance use and abuse disorders underlie the increase in prescription opioid overdoses and deaths. They continue (and we quote): ‘expanding access to addiction-treatment services is an essential component of a comprehensive response’ (end of quote). Yet, the authors counter the medication therapies to treat patients with opioid addition are underutilized.

The authors find some of the available medications to treat opioid addiction include: methadone, buprenorphine, and naltrexone. The authors explain a recent survey suggests among the 2.5 million Americans who abused or became dependent on prescription opioids in 2012 – fewer than one million patients received available counter medications.

The authors note there is a need for more treatment prescribers and add it would help if health care providers were more skeptical of a widespread belief that using counter medications replaces one addition with another.

The authors explain a few changes in policy and regulations might boost the use of available medications. They explain some other reforms in physician recommendations for patients to take prescription opioids also might help reverse recent trends.

The authors conclude (and we quote): ‘Essential steps for physicians will be to reduce unnecessary or excessive opioid prescribing, routinely check data from prescription-drug-monitoring programs to identify patients who may be misusing opioids, and take full advantage of effective (available medications) for people with opioid addiction’ (end of quote).

Meanwhile, the U.S. Substance Abuse and Mental Health Services Administration (SAMSHA) provides specific webpages about buprenorphine and naltrexone in the ‘treatment’ section of MedlinePlus.gov’s prescription drug abuse health topic page.

The National Institute on Drug Abuse provides a website about fentanyl that is available within the ‘specific conditions’ section of MedlinePlus.gov’s prescription drug abuse health topic page.

Information about all these as well as the other medications mentioned in this podcast are available alphabetically in the ‘drugs & supplements’ section within MedlinePlus.gov. The drugs & supplements section is accessible on MedlinePlus.gov’s homepage.

MedlinePlus.gov’s prescription drug abuse health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about prescription drug abuse as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s prescription drug abuse health topic page type ‘prescription drug abuse’ in the search box on MedlinePlus.gov’s home page, then, click on ‘prescription drug abuse (National Library of Medicine).’ MedlinePlus.gov also has a comprehensive health topic page on substance abuse problems.

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

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A written transcript of recent podcasts is available by typing 'Director's comments' in the search box on MedlinePlus.gov's home page.

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.