Trends in Opioid Abuse: Prescription Abuse and Resurgence of Heroin 0 Cicero TJ1, Yee A2 March 6, 2018Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Abuse of prescription opioids leaves patients vulnerable to overdose and death as heroin becomes more widely available. Theodore Cicero speaks on his 50-year experience as an endowed professor in psychiatry researching drug abuse. In this video lecture, Cicero provides the historical context from which the opioid epidemic emerges. He also explains the reasons for opioid addiction by telling several personal patient stories of abuse. Cicero discusses significant opioid sources, which includes doctor shopping, prescription theft, and forgery, and its impact on the current state of health. He also explains gender considerations and the importance of patient history, with respect to previous substance abuse and psychopathology. He documents current efforts for confronting the opioid epidemic and the importance of resolving fundamental psychiatric issues in patients as heroin abuse emerges. Overdose deaths from heroin is a significant national issue as the opioid becomes the first drug of abuse.Keywords: psychiatric issuespain managementopioidsheroin abuseopioid epidemic Presentation Table of Contents00:00:00 - Introduction00:00:45 - THE PRESCRIPTION OPIOID EPIDEMIC00:01:11 - Joint Commission Classification of Pain as a Vital Sign00:02:04 - Introduction of Extended Release Oxycodone00:03:20 - The Epidemic Emerges00:04:26 - OVERVIEW00:04:30 - Why Prescription Opioids?00:05:48 - Patients' Perceptions of Prescription Opioids00:06:52 - Source of Drugs00:08:35 - The Relevance of Age in Sourcing00:10:47 - Current State of Health and Effect of Opioid Abuse00:12:28 - Gender Considerations on Chronic Pain, First Opioid Use, and Psychopathology00:16:13 - Previous Substance Abuse00:16:56 - Specific Types of Drug Use Before Opioid Abuse00:18:16 - Initial Opioid Exposure and Its Unanticipated Benefits00:19:19 - Psychiatric Statistics of Opioid Abusers and Personal Stories00:22:53 - CONFRONTING THE EPIDEMIC00:23:20 - Supply-side Efforts00:24:32 - Have Those Efforts Worked?00:24:36 - The Resurgence of Heroin00:26:31 - Issues with Heroin00:27:08 - Why Has Heroin Use Grown So Rapidly?00:27:17 - Trends of Reduced Stigma and the Changing Demographics of Heroin Users00:29:13 - Heroin as the First Opioid of Abuse00:31:20 - Summary and the Importance of Psychiatric Issues00:32:11 - Credits PreziREFERENCES Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States: Lessons Learned From OxyContin. JAMA Psychiatry. 2014 Jul 1;71(7):821-6. PMID: 24871348. Cicero TJ, Ellis MS. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2015 May;72(5):424-30. PMID: 25760692. Cicero TJ, Ellis MS, Harney J. Shifting Patterns of Prescription Opioid and Heroin Abuse in the United States. N Engl J Med. 2015 Oct 29;373(18):1789-90. PMID: 26510045. Cicero TJ, Ellis MS, Kasper ZA. A tale of 2 ADFs: differences in the effectiveness of abuse-deterrent formulations of oxymorphone and oxycodone extended-release drugs. Pain. 2016 Jun;157(6):1232-8. PMID: 27186712. Cicero TJ, Ellis MS, Kasper ZA. Psychoactive substance use prior to the development of iatrogenic opioid abuse: A descriptive analysis of treatment-seeking opioid abusers. Addict Behav. 2017 Feb;65:242-244. PMID: 27544696. Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav. 2017 Nov;74:63-66. PMID: 28582659. Leave a Comment Cancel replyYou must be logged in to post a comment.