This activity is for pharmacists and is sponsored by Postgraduate Healthcare Education, LLC (PHE).
Credits: 3.0 hours (0.30 ceu)
Published: February 21, 2017
Updated: February 22, 2019
Expires: February 21, 2020
Type of Activity: Knowledge
Fee Information: $6.97
To understand West Virginia's prescription drug abuse problem–often described as epidemic in proportion and exploding in magnitude–pharmacists need to understand specific trends and realities both at the national level and in West Virginia (WV). Epidemiologists noted sharp increases in nonmedical use of opioid analgesics between 2002 and 2011. Recreational drug users and addicts often use benzodiazepines as companion drugs when they misuse opioids, so they are part of the problem.1 Although the problem seems to have stabilized or declined in some areas, it is still a public health crisis.
EPIDEMIOLOGY OF CHRONIC PAIN AND OPIOID ABUSE
In 2012, opioid prescribing reached a peak in the United States, with American physicians writing more than 255 million prescriptions for these agents, a prescribing rate of 81.3 per 100 persons. This has since declined to 191 million (58.7 prescriptions per 100 persons), according to 2017 data. West Virginia ranked third in the country in 2012 in prescribed opioid usage, with 137.6 prescriptions per 100 persons. By 2017, this rate had declined to 81.3 opioid prescriptions per 100 persons; while still above the national average and in the top 10 states in terms of usage, the decline showed substantial progress in addressing the opioid crisis in West Virginia. However, this rate fails to capture the use of illicit opioids, a problem that has worsened during this time period.
The sharply increasing rates in opioid analgesic nonmedical use, overdose deaths, and treatment-seeking during 2002–11 have been followed by declining or stable rates nationwide and in West Virginia during subsequent years. Accounting for this trend is abuser migration from opioid analgesics to heroin following introduction of tamper- resistant opioid analgesic formulations, and greater use of state PDMPs. More difficult to measure is impact from other recently implemented risk reduction strategies.
Which of the following is NOT a change made in the current American Psychiatric Association's Diagnostic and Statistical Manual (DSM) 2013?
A) It merged the criteria for “substance dependence” and “substance abuse.”
B) It eliminated physiologic dependence as a diagnostic criterion.
C) It refers to substance abuse and dependence as substance use disorder (SUD).
D) It ignores combined opioid abuse and dependence.
Select the statement that is TRUE about discontinuing long-term opioid therapy:
A) All opioids doses are decreased in exactly the same way.
B) Patients usually accept that they will experience pain.
C) Prescribers should make decisions about tapering therapy on an individual basis.
D) A dose of 30 mg/day is a “magic number”; below 30 mg/day, patients can stop the opioid with no untoward effects.
Three patients arrive in the pharmacy within several minutes of each other. They all have prescriptions for oxycodone written by the same prescriber whose office is at some distance from your location. Each of them also has prescriptions for benzodiazepines. What should you suspect?
A) These are forged prescriptions
B) This physician's office has relocated
C) Your pharmacy's advertising is effective
D) These prescriptions were not issued for a legitimate use
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