...indicators of patient performance in recovery. In doing so, I have developed and used an integrated Therapeutic Drug Monitoring (TDM) and Behavioural Contingency Management framework as the experimental study intervention and contrasted outcomes with the treatment as usual. Primary outcomes measured by both percentage negative of any opioid screens (i.e. tramadol and morphine/heroin) and imputing missed appointments as positive screens were significantly higher in TDM treatment condition (76.71%)...
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...treatment of drug. The first article is “Do drug treatment variables predict cognitive performance in multidrug-treated opioid-dependent patients? A regression analysis study” by Pekka Rapeli, Carola Fabritius, Hely Kalska and Hannu Alho. This article was taken from an open access article under Substance Abuse Treatment, Prevention, and Policy 2012, at http://www.substanceabusepolicy.com/content/7/1/45. The second article entitled “Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety” by Redonna K. Chandler, Bennett W. Fletcher and Nora D. Volkow. It was taken from a public access journal under National Institute of Health: JAMA. 2009 January 14; 301(2): 183–190. doi:10.1001/jama.2008.976. The purpose of the first article was to examine the predictive power of drug treatment variables on specific cognitive performance measures in multidrug-treated opioid dependent patients. Also, the researchers interested in finding out which of the possible significant associations turn out as hypothesized. On the other hand, the purpose of the second article was to summarize relevant neuroscientific findings and evidence-based principles of addiction treatment that, if implemented in the criminal justice system, could help improve public health and reduce criminal behaviour. For methodologies, the first research involved 104 Opioid-Dependent Patients who were treated either with buprenorphine (52 patients) or methadone (52 patients) were given...
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...4/24/2015 4/24/2015 Lefebvre, Joseph Bentley University Lefebvre, Joseph Bentley University Over the Counter, Over Prescribed Prescription Drug Abuse Over the Counter, Over Prescribed Prescription Drug Abuse When describing a drug addict, the stereotypical description is usually someone who has no job, steals to get their fix, and is living their life in poverty because of their crippling addiction. The drug of choice for these “junkies” is typically black tar heroin. However in recent years this has not been the case. The age of prescription drugs is beginning and people are dying from prescription drug overdoses at an alarming rate. According to the National Institute of Drug Abuse (NIDA), as seen in Figure 1 found in the Appendix, in 2010 there were 8.76 million prescription drug abusers (Drug Facts: Prescription and Over-the-Counter Medications). Prescription drug abuse has become an epidemic in America and it is not isolated to the stereotypical addict, as doctors and emergency response teams are seeing more and more overdoses and individuals seeking medical attention who are in the upper middle class and lead a fairly “normal” life besides their addiction. The NIDA found that there are around 5.1 million people in the US suffer from substance abuse disorders related to prescription pain relievers (Figure 1, Appendix). Although pain killer abuse gets a lot of the prescription drug abuse headlines, there are other medications that are being abused namely stimulants...
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...Written Critique of Group Project Seven: Rebecca Pratiti Group Number: 4 Email Address: prebecca0155@gmail.com Name of the Group Project: Prescription Opioid Misuse (POM) among Rural U.S. Adolescents Group Number: 7 Summary of the Problem: The problem being addressed is the Prescription Opioid Misuse (POM) among U.S. adolescents in rural areas and its association with the risk of heroin use, overdose and deaths. 1-3 Additional indirect indicators affected by POM are emergency department visits and hospital admissions for opioid use and overdose.4,5 Main Argument: The committee’s main argument is that by implementing evidence based school education program there would be a significant decrease in the prevalence...
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...Treatment Types for Oncologic Pain James Skelton Mercy College of Health Sciences Treatment Types for Oncologic Pain Nearly all those who are diagnosed with cancer will have some kind of pain associated with the disease process. This pain may be visceral, neuropathic, procedural, or psychological in nature. This paper is a discussion of the different procedural guidelines that are currently used by the World Health Organization in the treatment of oncologic pain. This is also a look at alternative therapies that may be used in conjunction with the previously accepted pharmacological treatment of Western medicine. Article Summary One The article written by Fielding, Sanford, and Davis (2013) is a review of the current step-by-step guidelines the WHO has had in place for some time along with a comprehensive assessment of pain, the use of opioids and their adverse affects, the role of adjuvants, and non-pharmacological means of cancer pain treatment. The WHO bases its algorhythm on simplistic, broad categories such as mild, moderate, and severe pain. The article itself is geared towards nurses because they have a unique role in advocating for the patient. The WHO has had a three step analgesic ladder that it has used as a basis for cancer pain treatment for nearly 30 years now. Fielding, et al. (2013), stated that health professionals need to go beyond this three step ladder that focuses primarily on physical pain. Cancer pain is not just a physical but a biopsychosocial...
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...the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana.3 In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.4 Although a number of classes of prescription drugs are currently being abused, this action plan primarily focuses on the growing and often deadly problem of prescription opioid abuse. The number of prescrip tions filled for opioid pain relievers—some of the most powerful medications available—has increased dramatically in recent years. From 1997 to 2007, the milligram per person use of prescription opioids in the U.S. increased from 74 milligrams to 369 milligrams, an increase of 402 percent.5 In addition, in 2000, retail pharmacies dispensed 174 million prescriptions for opioids; by 2009, 257 million prescrip tions were dispensed, an increase of 48 percent.6 Further, opiate overdoses, once almost always due to heroin use, are now increasingly due to abuse of prescription...
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...COOPERATION AND ASSISTANCE SCIENTIFIC REPORT OF EFSA Review of the potential health impact of β-casomorphins and related peptides 1 Report of the DATEX Working Group on β-casomorphins (Question N° EFSA-Q-2008-379) Issued on 29 January 2009 WORKING GROUP MEMBERS Ivano De Noni, Richard J. FitzGerald, Hannu J. T. Korhonen, Yves Le Roux, Chris T. Livesey, Inga Thorsdottir, Daniel Tomé, Renger Witkamp. 1 For citation purposes: Scientific Report of EFSA prepared by a DATEX Working Group on the potential health impact of β-casomorphins and related peptides. EFSA Scientific Report (2009) 231, 1-107 © European Food Safety Authority, 2009 Review of the potential health impact of β-casomorphins and related peptides SUMMARY Proteins are a very diverse family of large organic compounds involved in many important biological processes. Following their enzymatic hydrolysis during food processing or digestion, proteins may release fragments from their primary amino acid sequence. These fragments are called peptides, and many of them are known to be physiologically active. The possible beneficial effects of bioactive peptides have attracted increasing interest in recent years. On the other hand, there are also reports suggesting that some food-derived peptides might adversely affect human health. Among these, β-casomorphin-7 (BCM7), a peptide sequence present in the milk protein β-casein, has been suggested to contribute to an increased risk for certain non-communicable...
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...Integrating Values - The Legality, Morality, and Social Responsibility of the George Brothers & the Largest Pill Mills in South Florida Abstract This paper examines the legality and ethics of the George brother’s pain medication clinics in South Florida. It explains the legality of the pain medication supply that is available for consumers that medically need it and how its source can also be an easy access to addicts. Although it is considered legal, is it ethical? In this paper we study different theories in ethics, including Kantian and Utilitarian ethical models. These models provide clear analyses that guide us in deciding if pain medication distribution from pain clinics is ethical. Finally, we review and conclude if the George brother’s pain medication clinics were acting socially responsible within their communities. Given the rise of pain medication abuse and illegal reselling, pain clinics in South Florida should adhere to strict rules to provide services to those that need it and not turn their businesses into pill mills. Introduction Purposes of Paper The intent of this paper is to provide a detailed and analytical examination of the George brother’s pain medication clinics. Throughout this paper all approaches will be examined such as the legality and ethics of the case, and how social responsibility plays a role. In the past few years in South Florida, there has been a rise of pain medication addiction and the reselling of these narcotics. Pain...
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...Location | New York City | Effective | 8 August 1975 [1] | Condition | 40 ratifications | Parties | 185[1] | Depositary | Secretary-General of the United Nations | Languages | Chinese, English, French, Russian and Spanish | Single Convention on Narcotic Drugs at Wikisource | The Single Convention on Narcotic Drugs of 1961 is an international treaty to prohibit production and supply of specific (nominally narcotic) drugs and of drugs with similar effects except under licence for specific purposes, such as medical treatment and research. As noted below, its major effects included updating the Paris Convention of 13 July 1931 to include the vast number of synthetic opioids invented in the intervening thirty years and a mechanism for more easily including new ones. From 1931 to 1961, most of the families of synthetic opioids had been developed, including drugs in whatever way related to methadone, pethidine, morphinans and dextromoramide and related drugs; research on fentanyls and piritramide was also nearing fruition at that point. Earlier treaties had only controlled opium, coca, and derivatives such as morphine, heroin and cocaine. The Single Convention, adopted in 1961, consolidated those treaties and...
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...Physical Exercise Submitted by Reshma Gupte XII – E Physical ExercisePhysical exercise is any bodily activity that enhances or maintains physical fitness and overall health or wellness. It is performed for various reasons. These include strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance and for enjoyment. Frequent and regular physical exercise boosts the immune system, and helps prevent the "diseases of affluence" such as heart disease, cardiovascular disease, Type 2 diabetes and obesity. It also improves mental health, helps prevent depression, helps to promote or maintain positive self-esteem, and can even augment an individual's sex appeal or body image, which again is also linked with higher levels of self-esteem. Childhood obesity is a growing global concern and physical exercise may help decrease the effects of childhood obesity in developed countries. Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system. Exercise also reduces levels of cortisol. Cortisol is a stress hormone that builds fat in the abdominal region, making weight loss difficult. Cortisol causes many health problems, both physical and mental. Frequent and regular aerobic exercise has been shown...
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...Running head: CASE STUDY LS Mental Health Case Study LS Nicole Castro College of Southern Nevada Division of Nursing Mental Health Nursing Clinical NURS 243C-S10 Micki Lin Mongogna-Alarcon, MA, BSN, RN October 18, 2010 Mental Health Case Study DM Demographic Data: LS is a 44 year-old female of African and Hispanic decent. She was born in California but moved to Las Vegas as a teenager. She stated that she attended Clark High School and went to a “stewardess college” in California. She worked as a stewardess for 4 years and quit in 1986. Her father was African-American and her mother is Hispanic. She has 4 brothers and 2 sisters. She is married and lives with her husband and his son in their private home. She has two children, fathered by her ex-husband, who are now in custody of LS’s mother. Her children were taken away from her, by the court, due to her abuse of drugs and alcohol. LS stated that her father abused alcohol and that all of her brothers and sisters abused drugs and were diagnosed with bipolar disorder. LS stated that she started noticing symptoms of what she thought was depression 6 years ago but was diagnosed with bipolar disorder in 2005. Her chart stated that she has had an 11 year history of bipolar disorder. Presenting Problem: LS stated that she had not been taking her medications for four days because her husband forgot to pick up her medications from the pharmacy. However, her chart stated that she was off of her medications...
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...pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend appropriate therapy. 9. Recommend appropriate analgesic therapy for older patients with osteoarthritis. 10. Discuss risks and benefits of medication classes used to treat rheumatoid arthritis. 2. Which of the following is the single most important intervention you can make to reduce her risk of falls? A. Suggest to J.T. that her neurologist reassess her Parkinson disease...
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...Chapter 14 Summary A substance-related disorder is a condition (such as intoxication, harmful use/abuse, dependence, withdrawal, and psychoses or amnesia associated with the use of the substance) associated with substance abuse, often involving maladaptive behaviors over a long period of time. In order to be diagnosed with substance dependence an individual must display at least three of the following for a 12 month period: development of tolerance to the substance, withdrawal symptoms, persistent desire/unsuccessful attempts to stop using the substance, ingestion of larger amounts of substance, declined life functioning, and persistent use of substance. Substance intoxication, substance withdrawal, substance abuse and substance dependence are the four substance-related conditions that are present in the DSM-IV-TR. Substance intoxication is a type of substance-induced disorder, consisting of reversible, substance-specific, maladaptive behavioral or psychological changes directly resulting from the physiologic effects on the central nervous system of recent ingestion of or exposure to a drug of abuse, medication, or toxin. Specific cases are named on the basis of etiology, e.g., alcohol intoxication. Substance withdrawal is physiologic and psychological readjustments made during discontinuation of use of a substance previously employed to induce intoxication. Substance abuse is a patterned use of a substance (drug) in which the user consumes the substance in amounts or...
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...alleviate the daily pressure to perform. The same reasons stand today. The National Institute on Drug Abuse (NIH) reveals that the most commonly abused drugs include tobacco, alcohol, cannabinoids, opioids, stimulants, club drugs, dissociative drugs, hallucinogens, prescription medications and other compounds (2011). In a 10 year study between 1993 and 2003, 12.8 was the average age for abusing substances (The DASIS Report, 2006). Reuters also revealed that there is less use of drugs but an increase in alcohol use among young athletes in high school (2011). Young athletes are still developing and can have insecurities about their bodies. This can be due to pressure among their peers, personal expectations and comparing themselves to others (Mayo Clinic, 2013). USA Today reports, “according to a survey by the Center for Disease Control and Prevention, steroid use among high school students more than doubled between 1991 and 2003. More than 6% of 15,000 students surveyed admitted trying steroid pills or injections. At the same time, less than 4% of the nation's high schools were testing for steroids, according to the National Federation of State High School Associations' survey of athletic directors (USA Today, 2005).” Banned substances are utilized by athletes due to the perceived benefits of increase in power, endurance, aggressiveness, acceleration, speed and concentration (Lajis, n.d.). There are consequences and health risks involved when using banned substances. Athletes...
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...Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO Ministry of Health & Family Welfare Government of India Assessment and Management of HIV-Infected Person No Is HIV infection confirmed? Send to ICTC for confirmation of HIV status Yes Perform history taking and physical examination (see p 9 ) Evaluate for signs and symptoms of HIV infection or OIs and WHO clinical staging (see p 10) Provide appropriate investigations/treatment of OIs (see p 13 ) If pregnant, refer to PPTCT Screen for TB Screen for STI Identify need for: CTX prophylaxis (see p 16 ) ART (see p 18 ) No Pre ART care (see p 15 ) Yes Give patient education on treatment and adherence (see p 54 ) Arrange psychosocial, nutrition and community support (see p 56) Start ART, (see p 19 ) Arrange follow-up + monitoring (see p 25 ) Assess adherence every visit Provide positive prevention advice and condoms Provide patient information sheet on the ART regimen prescribed (see annex 7, 8) Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO National AIDS Control organisation Ministry of Health and Family Welfare Government of India with support from CDC . Clinton Foundation . WHO TAble of T A b l e o f Acronyms and Abbreviations Introduction....... ..........................................................................................
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