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Showing results for tags 'Substance / Drug abuse'.
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Content ArticleDespite widespread efforts to combat the opioid epidemic, post-operative opioid overprescribing by doctors remains an ongoing contributor to opioid misuse. This US study aimed to evaluate the impact of a low-cost, reproducible “just in time” intervention on opioid prescribing in dialysis access operations. Standardised opioid prescribing guidelines were emailed to residents on the vascular service on the first day of the rotation. Opioid prescriptions were reviewed for four years before and one year after this intervention. The results showed a decrease in patients discharged with opioids following the intervention, from 58% to 36%. For patients prescribed opioids, the median quantity decreased from 90 to 45 oral morphine equivalents.
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News ArticleCodeine linctus, an oral solution or syrup licensed to treat dry cough in adults, is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced. Codeine linctus is an opioid medicine which has previously been available to buy in pharmacies under the supervision of a pharmacist but will now only be available on prescription following an assessment by a healthcare professional. Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’. The decision to reclassify the medicine has been made following a consultation with independent experts, healthcare professionals and patients. 992 responses were received. The consultation was launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant. Dr Alison Cave, MHRA Chief Safety Officer, said: "Patient safety is our top priority. Codeine linctus is an effective medicine for long term dry cough, but as it is an opioid, its misuse and abuse can have major health consequences." Alternative non-prescription cough medicines are available for short-term coughs to sooth an irritated throat, including honey and lemon mixtures and cough suppressants. Patients are urged to speak to a pharmacist for advice and not to buy codeine linctus from an unregistered website as it could be dangerous. Read full story Source: MHRA, 20 February 2024
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Content ArticleHealth-compromising behaviours such as cigarette smoking and poor dietary habits are difficult to change. Most social-cognitive theories assume that the intention to change is the best predictor of actual change, but people often do not behave in accordance with their intentions. Unforeseen barriers emerge, or people give in to temptations. Therefore, intentions should be supplemented by more proximal predictors that might facilitate the translation of intentions into action. Some self-regulatory mediators have been identified, such as perceived self-efficacy and strategic planning. They help to bridge the intention-behavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (1) a preintentional motivation process that leads to a behavioural intention and (2) a postintentional volition process that facilitates the adoption and maintenance of health behaviours. In this article, two studies are reported that examine mediators between intentions and two behaviours. One behaviour is smoking reduction in young adults, the other is dietary restraint in overweight patients with chronic disease. A structural equation model, specified in terms of the HAPA, was in line with both data sets but it explained more variance of dietary behaviours among middle-aged or older individuals with a health condition whereas variance of smoking reduction in healthy young adults was less well accounted for. The findings contribute to the elucidation of psychological mechanisms in health behaviour change and point to the particular role of mediator variables.
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News Article
People buying opioids and sedatives online face deadly fakes, expert warns
Patient Safety Learning posted a news article in News
People trying to buy illicit synthetic opioids and sedatives online to treat pain, anxiety and insomnia increasingly risk taking a different drug that has caused dozens of deaths among heroin users, a leading expert has warned. Nitazenes – synthetic and extremely powerful drugs implicated in fatalities of chronic powdered heroin users in Birmingham, Bristol and London in recent months – have been detected in illicit supplies of tablets being sold as diazepam and codeine that appeal to a wider market. New figures released to the Guardian by the National Crime Agency reveal 65 people have died from taking nitazenes in the past six months – more than two a week, while detections in drug supplies have increased more than fivefold in the last two years. “[Nitazenes] are being mixed into heroin but it is also in fake diazepam, fake codeine and the person buying the tablets online is a very different kind of user to a heroin user,” Dr Caroline Copeland, the director of the National Programme on Substance Abuse Deaths said. “It means the risk is much wider.” Read full story Source: The Guardian, 17 January 2024 -
News ArticleThousands of lives could be saved if safe rooms were set up in UK cities where people could be supervised while they get high, the world’s largest review of the effectiveness of drug-consumption rooms and overdose-prevention centres (OPCs) has found. The part-government-funded study published on Thursday also found the facilities could slash the transmission of fatal diseases, as well as reduce drug litter, the pressure on ambulance callouts and the burden on hospitals. Similar facilities already operate in France, the US, Germany, the Netherlands, Canada, Australia, Denmark, Greece, Belgium, Spain, Portugal, Norway, Luxembourg, Switzerland, Mexico, Iceland and Colombia. Each unit hosts from 20 to 400 users a day and is supposed to provide somewhere for people to take drugs in the presence of trained health workers who intervene if an overdose occurs. They also mean people don’t have to rush their drug taking, can access clean needles, and get help with other health issues, from testing for hepatitis B and HIV to accessing mental-health support. But none has yet been deployed officially in the UK, and the report warns the absence “costs lives”. Read full story Source: The Guardian, 11 January 2023
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Content ArticleThe opioid epidemic has been declared a public health emergency in the US, with major news outlets calling operating rooms “unintended gateways.” In response to this emergency, a team from Thomas Jefferson University sought to decrease their organisation's contribution to the potential diversion pool—the opioids surgeons prescribe to patients which go unused. This article in the journal Patient Safety looks at the research and improvement work undertaken by the team, who concluded that surgical departments can develop opioid reduction toolkits aimed at reducing the potential diversion pool of opioids in communities.
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Content ArticleThe World Health Organization (WHO) has published the third edition of the Mental Health Gap Action Programme (mhGAP) guideline which includes important new, and updated, recommendations for the treatment and care of mental, neurological and substance use (MNS) disorders. MNS disorders are major contributors to morbidity and premature mortality in all regions of the world. Yet it is estimated that over 75% of people with MNS disorders are unable to access the treatment or care they need. The mhGAP guideline supports countries to strengthen capacity to deal with the growing burden of these conditions. It is intended for use by doctors, nurses, other health workers working in non-specialist settings at primary health care level, as well as health planners and managers.
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News Article
Vapes '95% safer' than cigarettes messaging backfired
Patient Safety Learning posted a news article in News
The message that vaping is 95% safer than smoking has backfired, encouraging some children to vape, says a top health expert. Dr Mike McKean treats children with lung conditions and is vice-president for policy at the Royal College of Paediatrics and Child Health. He says the 2015 public messaging should have been clearer - vapes are only for adults addicted to cigarettes. Evidence on the possible health risks of vaping is still being gathered. In an exclusive interview with the BBC, Dr McKean said: "Vaping is not for children and young people. In fact it could be very bad for you," although he stresses that it is not making lots of children very sick, and serious complications are rare. "Vaping is only a tool for adults who are addicted to cigarettes." He says the 95% safe messaging was "a very unwise thing to have done and it's opened the door to significant chaos". "There are many children, young people who have taken up vaping who never intended to smoke and are now likely addicted to vaping. And I think it's absolutely shocking that we've allowed that to happen." Read full story Source: BBC News, 26 September 2023 -
News ArticleHundreds of people across England with drug and alcohol dependencies who have been prescribed Valium long-term, will have their cases reviewed following an Ombudsman investigation. The Local Government and Social Care Ombudsman has found that Change Grow Live (CGL), on behalf of Cambridgeshire County Council, has been prescribing benzodiazepines to people long-term, against national guidance. The company also provides drug and alcohol services for 50 other councils. Benzodiazepines – including diazepam (Valium) - are a class of medicines that can relieve nervousness, tension and other symptoms of anxiety and should usually only be prescribed short-term. CGL’s policy explains people use them for anxiety, insomnia, to enhance opiate effects, to deal with mental health issues, improve confidence and to reduce psychotic symptoms like hearing voices. However, if they are prescribed for too long, they can have significant negative effects including dependence, withdrawal symptoms and drug-seeking behaviour. People on these medicines should have their prescriptions reviewed regularly, and those reviews should consider the benefits and risks of continuing with the current dose, reducing or stopping it, with a management plan put in place after each review. However, the Ombudsman’s investigation found CGL were either not reviewing people’s prescriptions regularly enough or not keeping proper records of those reviews. Nigel Ellis, Local Government and Social Care Ombudsman Chief Executive, said: “Clinicians need to weigh up the benefits and risks for patients who are taking these medicines long-term and should have a clear rationale for continuing to prescribe. “I am pleased that patients in these vulnerable groups will now have their cases reviewed more regularly and comprehensively following my investigation. “Both CGL and the council have co-operated fully with our investigation, and I welcome their ready acceptance of our recommendations.” Read full story Source: Local Government and Social Care Ombudsman, 23 August 2023
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News Article
Addiction treatment eludes more than half of Americans in need
Patient-Safety-Learning posted a news article in News
Roughly three in 10 adults have been addicted to opioids or have a family member who has been, and less than half of those with a substance use disorder have received treatment, according to a new survey conducted by KFF, a health policy research group. The survey, which polled more than 1,300 adults in July, underscores the broad and often harmful influence of opioid addiction across the nation, which recorded around 110,000 fatal drug overdoses last year alone. And the findings suggest that some proven medications for helping curb drug cravings, such as buprenorphine and methadone, are still not getting to those who need them. Only 25 percent of participants in the poll who said they or someone in their family had an opioid addiction reported receiving medication for themselves or family members. Mollyann Brodie, the executive director of KFF’s polling program, said that the numbers might be an undercount, as some survey participants might have been hesitant to share histories of opioid addiction. Addiction cuts across class, race and geography, the KFF researchers found. Rural and white Americans were the likeliest to report personal or family opioid addiction, but significant percentages of Black, Hispanic, urban and suburban families did, as well. White families were more likely than Black or Hispanic families to say that they had received treatment. Overdose fatality rates among Black Americans have climbed substantially in recent years, the Centers for Disease Control and Prevention found in a study last year. Dr. David Fiellin, an addiction physician at the Yale School of Medicine, said the survey showed the need for a stronger federal response to substance use disorders, akin to the one for AIDS. He said, “There’s often a misunderstanding of what treatment actually looks like and what it is—people often look to a quick fix,” he said, referring to a detox strategy. “Effective treatment tends to be much more long term and requires addressing the denial that can be part of the condition.” Read full story (paywalled) Source: New York Times, 15 August 2023 -
Community Post
Better use of data for medication safety in hospitals
Kenny Fraser posted a topic in Medicine management
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NHS hospital staff spend countless hours capturing data in electronic prescribing and medicines administration systems. Yet that data remains difficult to access and use to support patient care. This is a tremendous opportunity to improve patient safety, drive efficiencies and save time for frontline staff. I have just published a post about this challenge and Triscribe's solution. I would love to hear any comments or feedback on the topic... How could we use this information better? What are hospitals already doing? Where are the gaps? Thanks- Posted
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News Article
Cough syrups could be made prescription-only over addiction fears
Patient Safety Learning posted a news article in News
Concerns codeine-based cough syrup could be addictive and have serious health consequences have led the UK medicines safety regulator to consider stopping its sale over the counter. The Medicines and Healthcare products Regulatory Agency (MHRA) is asking the public for their views on changing codeine linctus - which is a syrup with the active ingredient codeine phosphate and is used to treat a dry cough - to a prescription-only medicine. This comes in the wake of multiple reports to the regulator that the medicine is instead being used recreationally for its opioid effects. Since 2018, the MHRA has received 116 reports of recreational drug abuse of, dependence on, and/or withdrawal from codeine medicines, including codeine linctus. Dr Alison Cave, MHRA Chief Safety Officer, said this can have a severe impact on people’s health. She said: “Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences.” Pharmacists are also “significantly” concerned, especially about the overdose risk. Read full story Source: The Independent, 18 July 2023 -
News Article
Rise in vulnerable women dying early in north-east England, report finds
Patient Safety Learning posted a news article in News
A growing number of disadvantaged and vulnerable women living in one of the poorest parts of England are dying prematurely because public services are not meeting their needs, according to a report. Research published on Monday calculates that in 2021, a woman in the north-east of England was 1.7 times more likely to die early as a result of suicide, addiction or domestic murder than women living in England and Wales as a whole. Laura McIntyre, the head of women and children’s services at Changing Lives, described the report as shocking. “But I’m more saddened,” she said. “To not reach your 40th birthday is just not right.” The report says the reasons for early and avoidable deaths are complicated, involving a patchwork of unaddressed issues including domestic abuse, debt, poverty, mental and physical ill-health, alcohol and substance misuse, and housing problems. But the conclusions are striking. “Put plainly, women living in the north-east are more likely to live shorter lives, to spend a larger proportion of time living in poor health and to die prematurely from preventable diseases,” the report states. Read full story Source: The Guardian, 10 July 2023 -
Content ArticleToo many women are dying from disadvantage in one of the poorest parts of England, according to ground breaking new research which serves as an urgent wake-up call for levelling up efforts. The report by Agenda Alliance and Changing Lives, Dismantling disadvantage has found that in 2021 a woman in the North East of England was 1.7 times more likely to die early as a result of suicide, addiction, or murder by a partner or family member than in the rest of England and Wales. Today’s new research was conducted to better understand the lives and needs of disadvantaged women in the North East, including Newcastle, coastal areas and Gateshead and Sunderland; some of the poorest regions in the country. Working with women with lived experience at every stage, the study involved 18 in-depth interviews, 47 survey responses; focus groups; data analysis and multiple meetings with affected women, practitioners and policy makers.
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News Article
Vaping: BMA to review effects of “growing public health epidemic”
Patient Safety Learning posted a news article in News
The BMA will review the dangers posed by e-cigarettes, after its annual representative meeting passed a motion warning that vaping was a “growing public health epidemic.” The motion, which was passed by the meeting in Liverpool on 5 July, called on the BMA’s Board of Science to rereview the dangers of vaping, and discuss restrictions on marketing and cracking down on illegal sales to children. The BMA’s last position paper on vaping was published in 2017.1 The motion urged the board to consider whether doctors should include history of e-nicotine use as a “regular and essential” part of patient history and examination. Read full story (paywalled) Source: BMJ, 5 July 2023 -
News Article
All people in England who have smoked to be offered middle-age lung screening
Patient Safety Learning posted a news article in News
Everyone who has ever smoked in England is to be offered lung screening in middle age under plans to detect and treat cancer earlier. Lung cancer kills about 35,000 people every year, and is the most common cause of cancer death in the UK, accounting for one in five. It also has one of the worst cancer survival rates, which is largely attributed to diagnoses at a late stage when treatment is less likely to be effective. Millions of people will be invited for lung checks in an effort to improve survival rates. About a million screenings of people aged 55 to 74 will be carried out every year under the programme. It follows a successful pilot of the scheme in deprived areas of the country where people are four times more likely to smoke. It resulted in more than 2,000 people being detected as having cancer, 76% of them at an earlier stage compared with 29% outside the programme in 2019. “Identifying lung cancer early saves lives, and the expansion of the NHS’s targeted lung health check programme is another landmark step forward in our drive to find and treat more people living with this devastating disease at the earliest stage,” said the chief executive of NHS England, Amanda Pritchard. Read full story Source: The Guardian, 26 June 2023 -
News ArticleForty children were hospitalised for vaping last year, prompting NHS bosses to warn we risk “sleep-walking into a crisis”. Amanda Pritchard, NHS England boss, said it was "right" for paediatricians to call for action on vaping among young people, as the Royal College of Paediatrics and Child Health called for an outright ban on disposable vapes. She said the 40 children admitted to hospital in England in 2022 due to “vaping-related disorders” was up from 11 two years before. The RCPCH’s call for action comes as NHS data revealed one in five 15-year-olds said they used e-cigarettes in 2021, while charity Action on Smoking (ASH) reported the experimental use of e-cigarettes among 11 to 17-year-olds had risen by 50 per cent compared to last year. The college warned: “Youth vaping is fast becoming an epidemic among children, and I fear that if action is not taken, we will find ourselves sleep-walking into a crisis.” Read full story Source: The Independent, 16 June 2023
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Content ArticleThe public health grant is paid to local authorities from the Department for Health and Social Care (DHSC) budget. It is used to provide vital preventative services that help to support health. This includes smoking cessation, drug and alcohol services, children's health services and sexual health services, as well as broader public health support across local authorities and the NHS.
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News ArticleChildren's doctors are calling for a complete ban on disposable vapes because they are likely to damage young lungs and are bad for the environment. But an anti-smoking campaign group says a ban would make it harder for some adults to give up smoking and increase the trade in illegal vapes. UK governments are planning steps to reduce vaping among under-18s. Prime Minister Rishi Sunak recently said it was "ridiculous" that vapes were designed and promoted to appeal to children when they were supposed to be used by adults giving up smoking. A BBC investigation found unsafe levels of lead, nickel and chromium in vapes confiscated from a secondary school, which could end up being inhaled into children's lungs. Scientists analysing the vapes said they were the worst lab test results of their kind they had ever seen. The Royal College of Paediatrics and Child Health (RCPCH) now says the UK government should "without a doubt" ban disposable e-cigarettes. Read full story Source: BBC News, 6 June 2023
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Content ArticleThe opioid crisis in the United States (US) is one of the most high-profile public health scandals of the 21st century with millions of people unknowingly becoming dependent on opioids. The United Kingdom (UK) had the world’s highest rate of opioid consumption in 2019, and opiate-related drug poisoning deaths have increased by 388% since 1993 in England and Wales. This article, published in the British Journal of Pain, explores the epidemiological definitions of public health emergencies and epidemics in the context of opioid use, misuse, and mortality in England, to establish whether England is facing an opioid crisis.
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News Article
Laughing gas users risk spine damage, say doctors
Patient Safety Learning posted a news article in News
Doctors at an east London hospital say they are seeing so many risky cases of laughing gas misuse that they have drawn up treatment guidelines for colleagues in the UK. Nitrous oxide, sold in metal canisters, is one of the most commonly used drugs by 16 to 24-year-olds. Heavy use can lead to a vitamin deficiency that damages nerves in the spinal cord. The Royal London Hospital team say medics need to be on alert. They have been seeing a new case almost every week. The guidelines, endorsed by the Association of British Neurologists and written with experts from Manchester, Birmingham, Nottingham and the Queen Mary University of London, warn doctors what to look for and how to treat. Read full story Source: BBC News, 23 February 2023 -
News Article
Workers fighting America’s overdose crisis are ‘hanging by a thread’
Patient Safety Learning posted a news article in News
President Biden has endorsed “harm reduction,” which aims to cut down on overdoses by encouraging safer drug use. But the organizations carrying out that strategy are severely underfunded. In his State of the Union address on Tuesday, Mr Biden, the first president to endorse the strategy, highlighted the federal government’s attention to some of the core features of harm reduction work, including a provision in a recently enacted spending package that makes it easier for doctors to prescribe buprenorphine, an effective addiction medication that Ms Krauss works to get to drug users. During his speech, Mr Biden recognised the father of a 20-year-old from New Hampshire who died from a fentanyl overdose, citing the more than 70,000 Americans dying each year from the potent synthetic opioid. But two years after Mr Biden took office, with the nation’s drug supply increasingly complex and deadly, the practice of harm reduction remains underfunded and partially outlawed in many states. Read full story (paywalled) Source: New York Times, 10 February 2023 -
News Article
Stockport hospital failed woman who took poisonous substance, inquest finds
Patient Safety Learning posted a news article in News
A private psychiatric hospital provided “inadequate care” for a woman who killed herself by swallowing a poisonous substance, a jury has found. Beth Matthews, a mental health blogger, was being treated as an NHS patient for a personality disorder at the Priory hospital Cheadle Royal in Stockport. The 26-year-old, originally from Cornwall, opened the substance, which she had ordered online, in close proximity to two members of staff and told them it was protein powder, BBC News reported. An inquest jury concluded she died from suicide contributed to by neglect, after hearing Matthews was considered a high suicide risk. She had a history of frequent suicide attempts, the inquest heard. A BBC News investigation also found that two other young women died at the Priory in Stockport in the two months before her death. A spokesperson for the Priory Group said: “We fully accept the jury’s findings and acknowledge that far greater attention should have been given to Beth’s care plan. Read full story Source: The Guardian, 19 January 2023 -
Content ArticleYoung people and expert mental healthcare staff say patients are unlikely to receive in-patient mental health care unless they “have attempted suicide multiple times”, according to a new report published by Look Ahead Care and Support. Launched in the House of Lords, the report – funded by Wates Family Enterprise Trust and produced by experts Care Research – argues Accident and Emergency departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill-equipped to offer the treatment required. Based on in-depth interviews with service users, parents and carers, and NHS and social care staff from across England, the findings from the Look Ahead Care and Support report draws on experience of treating depression, anxiety, self-harm, suicidal thoughts and suicide attempts, eating disorders, addiction and psychosis.
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News Article
Coffey’s ‘ultra-libertarian’ health stance risks lives, Tory ex-minister warns
Patient Safety Learning posted a news article in News
People could die because of Thérèse Coffey’s “ultra-libertarian ideological” reluctance to crack down on smoking and obesity, a Conservative ex-health minister has warned. The strongly worded criticism of the health secretary came from Dr Dan Poulter, a Tory MP and NHS doctor who served as a health minister in the coalition government from 2012 to 2015. Poulter claims Coffey’s “hostility to what the extreme right call ‘nanny statism’” is stopping her from taking firm action against the “major killers” of tobacco and bad diet. His intervention – in an opinion piece for the Guardian – was prompted by Coffey making clear that she opposed banning adults from smoking in cars containing children, even though the practice was outlawed in 2015 and is credited with reducing young people’s exposure to secondhand smoke. The government’s widely anticipated scrapping of measures to curb obesity such as the sugar tax and ditching of the tobacco control plan and health inequalities white paper – both of which previous health ministers had promised to publish – have led Poulter to brand Coffey’s stance “deeply alarming”. He writes: “More smoking and more obesity means more illness, more pressure on the NHS and shorter lives, particularly amongst the poorest in society. “I am acutely concerned that the health secretary’s ideological hostility to what history shows is government’s potentially very positive role in protecting us against these grave threats to our health will exacerbate the problems they already pose. “At its worst such a radically different approach to public health could cost lives, as it will inevitably lead to more people smoking and becoming dangerously overweight.” Read full story Source: The Guardian, 18 October 2022
