Call Today: 248.624.9800
Fax: 248.624.9825
  M-F 8am to 5pm | Sat & Sun 8am to 12pm
Call Today: 248.624.9800
M-F 8am to 5pm | Sat & Sun 8am to 12pm

What Will the Opioid Crisis Look Like in Five Years?

Posts Tagged ‘healthcare’

What Will the Opioid Crisis Look Like in Five Years?

Posted on: November 20th, 2019 by Access Computer No Comments

As an Infectious Disease physician, Dr. Bruce E. Ruben is always learning more about how current issues affect his patients’ healthcare. This article by Jirka Taylor and Peter Reuter originally appeared in the Concord Monitor in New Hampshire last week. Dr. Ruben found this commentary on what the opioid crisis will look like in five years to be a fascinating look at this world-wide problem and thinks his patients should read it too.

Few people had ever heard of fentanyl five years ago. By 2018 this synthetic opioid was implicated in more than 30,000 fatal overdoses in the United States. The next stage of the fast-changing opioid crisis may well depend on how the illegal drug markets morph in the years to come.

In the corners of Europe that have been dealing with fentanyl as long or longer than the United States, each illegal market for opioids took distinct turns. In some, heroin disappeared. In others, opioid nasal sprays arrived. Online sales became the norm. Any of these things could happen here.

What Will the Opioid Crisis Look Like in Five Years?

It’s Estonia where heroin practically disappeared. In the early 2000s, the Taliban’s prohibition on growing poppies in Afghanistan had a ripple effect in Europe constricting the heroin supply. Fentanyl smuggled from or through Russia took its place. Today, tiny Estonia (population about 1.3 million) has the only “mature” fentanyl market in the world.

The replacement of heroin with fentanyl in its drug market was devastating: By 2012, Estonia had one of the highest per capita rates of fatal overdoses in the world. Two other observations, however, offer a bit more reassurance. First, fentanyl does not seem to attract new users: The number of opioid users in Estonia began declining in the 1990s and has continued on that trend. Second, although fentanyl is much cheaper than heroin to produce and ship, drug traffickers do not appear to have lowered street prices, also limiting its spread.

Nearby Latvia underwent a different shift, essentially skipping the fentanyl stage. Stronger variations of the fentanyl molecule, called analogs, started appearing in large quantities around 2014. Until very recently, the most common was carfentanil. One gram of pure carfentanil represents thousands of lethal doses for those without opioid tolerance.

Despite this dangerous potency, Latvian health statistics don’t show a substantial increase in overdose deaths. This suggests that Latvian users and dealers have found comparatively safer ways of consuming synthetic opioids and that overdose death levels don’t inevitably have to skyrocket like they did in Estonia. (Some certainly go unrecorded, but the undercount would have to be enormous for Latvia’s fatal overdose rate to approach Estonia’s.)

Sweden, unlike every other country, developed parallel opioid markets: one for heroin and another for fentanyl analogs. Around 2014, dealers started selling fentanyl analogs online, offering direct-mail delivery. After a period of experimentation, these online dealers settled on an analog nasal spray—a popular alternative for people who preferred not to inject drugs.

Some, though not all, of these facets—the disappearance of heroin, direct online sales, nasal sprays, potent analogs—have begun to pop up in distinct pockets of the United States. None have become widespread in North America yet—but there is no reason why they couldn’t.

Sweden, Latvia and Estonia are, to be sure, much smaller than the United States. But it is useful to think of them as equivalent to a city or small state with a comparatively concentrated supply chain. That also shows us regions just a few hundred miles apart might be affected by fentanyl in completely different ways. The areas of North America that have suffered the most in the opioid crisis—New England, the Midwest, Appalachia, British Columbia—are likely to confront fentanyl in localized ways as well. That will have ramifications for prevention, provision of treatment and other services, and law enforcement efforts.

Despite the variations, there is an overarching commonality to the European cases, too: Once a synthetic opioid like fentanyl becomes dominant, it stays that way. The United States should prepare for fentanyl and other synthetic opioids as a lasting phenomenon, and learning from other countries’ experiences is an important part of that effort.

Jirka Taylor is a policy analyst at the nonpartisan, nonprofit RAND Corporation. Peter Reuter is a professor in the School of Public Policy and Department of Criminology at the University of Maryland. Both are authors of “The Future of Fentanyl and Other Synthetic Opioids.”

 

Telehealth Can Give Patients Better Care | Support Solutions

Posted on: May 1st, 2014 by Mindy Ruben No Comments

See on Scoop.itNutrition

Telehealth is more likely to achieve better and faster health outcomes, and gives patients more responsibility over their health.

(more…)

Remember Mumps?

Posted on: April 3rd, 2014 by Access Computer No Comments

Mumps is a virus–Encompass HealthCare and Wound Medicine[/caption]

After the recent mumps outbreak at the Ohio State University and its subsequent spread beyond campus and into the community, it’s a good time to review what you can do to avoid contracting the infection, and what you can do if you become infected.

According to the Centers for Disease Control and Prevention (CDC), mumps is a serious disease caused by a virus. Symptoms include fever, headache, and swollen glands. Mumps infection can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and, rarely, death.

Children should receive their first vaccine for measles, mumps and rubella at 12 to 15 months, and the second dose at 4 to 6 years.

Mumps is a highly infectious disease that spreads the same way as a cold or flu does — through respiratory droplets when someone coughs or sneezes. It’s recommended that patients have five days of isolation after diagnosis. That’s the time period when the disease is most infectious.

Two doses of the mumps vaccine offers immunity from the disease, Encompass HealthCare & Wound Medicine, West Bloomfield, Michigan.

Two doses of the mumps vaccine offers immunity from the disease.

It’s difficult to isolate any disease within a crowded university setting, which may be one of the reasons why the OHU outbreak was so widespread. Plus, in one-third of cases, there are no symptoms. So the disease can be spread unknowingly.

There is no specific treatment; it’s a virus, so it doesn’t respond to antibiotics. Simply, it just has to run its course and generally resolves in one to two weeks.

During that time, patients should:

  1. Wash their hands frequently
  2. Cover their cough
  3. Stay at home if they’re sick to prevent spreading the disease.

Avoiding this infection is a function of when were you vaccinated, how many doses of the vaccine you received and whether you ever had an outbreak of this virus. Having two doses of the vaccine is the best way to prevent contracting the illness.

According to the CDC, all adults born during or after 1957 should have documentation of one dose of the vaccine. Adults at higher risk, such as university students, health care personnel, international travelers and persons with potential mumps outbreak exposure should have documentation of two doses of mumps vaccine or other proof of immunity to mumps.

In general, you’re considered to be immune to mumps if you’ve previously had the infection, or if you’ve been two-dose immunized against the disease. However, in the case of an outbreak, the CDC has issued guidance for considerations for use of a third dose in specifically identified target populations such as schools, colleges and healthcare settings.

 

 

Featured Video

 

 

Loading Quotes...

 

 

© 2019 Encompass HealthCare | Designed by Access Technology

2300 Haggerty Road, Suite 1190 | West Bloomfield, Michigan 48323 | 248-624-9800