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Global use of deadly opioid drugs has risen significantly, a new United Nations report reported on June 26, 2019, amid a growing synthetic drug crisis in the United States.


According to the latest World Drug Report, up to 53 million people are estimated to have used opioids globally in 2017, an increase of 56% year-on-year. Opioids include both heroin and legal pain relievers. The United Nations estimates up to 585,000 people died as a result of drug use in 2017, with the use of highly-addictive substances continuing to grow around the world. The report highlights an “ongoing crisis” in the United States and Canada around the use of synthetic opioid drugs, which led to more than 51,000 overdoses in 2017 alone.


There were no legal restrictions on the importation or use of Opioids until the early 1900s. In the United States, the unrestricted availability of narcotic, the influx of Opioid-smoking immigrants from East Asia, and the invention of the hypodermic needle contributed to the more severe variety of compulsive drug abuse seen at the turn of the 20th century. In those days, medicines often contained Opioids without any warning label. Today, there are state, federal, and international laws governing the production and distribution of narcotic substances.


Although Opioids is used in the form of paregoric to treat diarrhea, most opium imported into the United States is broken down into its alkaloid constituents.


These alkaloids are divided into two distinct chemical classes, phenanthrenes and isoquinolines. The principal phenanthrenes are morphine, codeine, and thebaine, while the isoquinolines have no significant central nervous system effects and are not regulated under the CSA.

Source: DEA


Guidelines have concluded that the risk of opioids is likely greater than their benefits when used for most non-cancer chronic conditions including headaches, back pain, and fibromyalgia. Thus they should be used cautiously in chronic non-cancer pain. In treating chronic pain, opioids are an option to be tried after other less risky pain relievers have been considered, including paracetamol/acetaminophen.


Some types of chronic pain, including the pain caused by fibromyalgia or a migraine, are preferentially treated with drugs other than opioids. The efficacy of using opioids to lessen chronic neuropathic pain is uncertain.


Opioids are contraindicated as a first-line treatment for a headache because they impair alertness, bring the risk of dependence, and increase the risk that episodic headaches will become chronic. Opioids can also cause heightened sensitivity to headache pain. When other treatments fail or are unavailable, opioids may be appropriate for treating headache if the patient can be monitored to prevent the development of a chronic headache.


Opioids are being used more frequently in the management of non-malignant chronic pain. This practice has now led to a new and growing problem with addiction and misuse of opioids. Because of various negative effects, the use of opioids for long-term management of chronic pain is not indicated unless other less risky pain relievers have been found ineffective. Chronic pain which occurs only periodically, such as that from nerve pain, migraines, and fibromyalgia, frequently is better treated with drugs other than opioids. Paracetamol and non-steroidal anti-inflammatory drugs including ibuprofen and naproxen are considered safer alternatives. They are frequently used combined with opioids, such as paracetamol combined with oxycodone (Percocet) and ibuprofen combined with hydrocodone (Vicoprofen), which boosts the pain relief but is also intended to deter recreational use.


Other Sources:

CDC Releases Guideline for Prescribing Opioids for Chronic …

www.cdc.gov/media/releases/2016/p0315-prescribing-opioids-guidelines.html
CDC Releases Guideline for Prescribing Opioids for Chronic Pain. Recommendations to improve patient care, safety, and help prevent opioid misuse and …

Overdose Prevention | Drug Overdose | CDC Injury Center

www.cdc.gov/drugoverdose/opioids/odprevention.html
The best way to prevent opioid overdose deaths is to improve opioid prescribing to reduce exposure to opioids, prevent abuse, and stop the addiction.

CDC – Prescription Opioid Abuse – CDC’s Primary Care and …

www.cdc.gov/primarycare/materials/opoidabuse/index.html
Balancing Pain Management and Prescription Opioid Abuse. Recommend on Facebook Tweet Share Compartir. Educational Module (Released October 24, 2012)


By Bob Hansen January 29, 2022
Zyprexa (Olanzapine) is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder. More information/images in the Prescription Drug Brochure. When you receive Zyprexa extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive Zyprexa extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility. A program has been set up to help people receive Zyprexa extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program. For people being treated with olanzapine extended-release injection or Zyprexa injection: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment. Olanzapine injection and olanzapine extended-release injection are not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is being treated with olanzapine injection or olanzapine extended-release injection. For more information visit the FDA website: http://www.fda.gov/Drugs Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with olanzapine extended-release injection and each time you receive an injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide. extended-release injection, the medication is usually released slowly into your blood over a period of time. However, when you receive olanzapine extended-release injection, there is a small chance that olanzapine may be released into your blood too quickly. If this happens, you may experience a serious problem called Post-injection Delirium Sedation Syndrome (PDSS). If you develop PDSS, you may experience dizziness, confusion, difficulty thinking clearly, anxiety, irritability, aggressive behavior, weakness, slurred speech, difficulty walking, muscle stiffness or shaking, seizures, drowsiness, and coma (loss of consciousness for a period of time). You are most likely to experience these symptoms during the first 3 hours after you receive the medication. You will receive olanzapine extended-release injection in a hospital, clinic, or another medical facility where you can receive emergency medical treatment if it is needed. You will need to remain in the facility for at least 3 hours after you receive the medication. While you are in the clinic, the medical staff will watch you closely for signs of PDSS. When you are ready to leave the facility, you will need a responsible person to be with you, and you should not drive a car or operate machinery for the rest of the day. Get emergency medical help right away if you experience any symptoms of PDSS after you leave the facility. A program has been set up to help people receive olanzapine extended-release injection safely. You will need to register and agree to the rules of this program before you receive olanzapine extended-release injection. Your doctor, the pharmacy that dispenses your medication, and the medical facility where you receive your medication will also need to register. Ask your doctor if you have any questions about this program. For people being treated with olanzapine extended-release injection or olanzapine injection: Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or mini-stroke during treatment. Olanzapine injection and olanzapine extended-release injection are not approved by the Food and Drug Administration (FDA) for the treatment of behavior disorders in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is being treated with olanzapine injection or olanzapine extended-release injection. For more information visit the FDA website: http://www.fda.gov/Drugs  Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with olanzapine extended-release injection and each time you receive an injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.
By Bob Hansen January 29, 2022
Zoloft (Sertraline) is included in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). This class of drugs is used to treat depression, anxiety, and other mood disorders.
By Bob Hansen January 29, 2022
Zanaflex (Tizanidine) is a short-acting muscle relaxer. Tizanidine is used to relieve the spasms and increased muscle tone caused by multiple sclerosis (MS, a disease in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscle coordination and problems with vision, speech, and bladder control), stroke, or brain or spinal injury. Tizanidine is in a class of medications called skeletal muscle relaxants. It works by slowing action in the brain and nervous system to allow the muscles to relax. Tizanidine comes as a tablet and a capsule to take by mouth. It is usually taken consistently either always with or always without food two or three times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tizanidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Tizanidine capsules may be opened and sprinkled on soft foods such as applesauce. Talk to your doctor before opening the capsules because the effects of the medication, when used in this manner, may be different than when swallowing the capsule whole. The medication in the capsule is absorbed differently by the body than the medication in the tablet, so one product cannot be substituted for the other. Each time you have your prescription filled, look at the tablets or capsules in the bottle and make sure that you have received the right product. If you think you received the wrong medication, talk to your doctor or pharmacist right away. Your doctor will probably start you on a low dose of tizanidine and gradually increase your dose, depending on your response to this medication.  Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will probably decrease your dose gradually.
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