Drug diversion is defined as any transfer of a prescription drug from a lawful to an unlawful channel of distribution or use.
Often thought of as occurring in the outpatient setting – with doctor-shopping, “pill mills,” and family or friends taking medications not prescribed to them – drug diversion can occur in hospitals and other inpatient facilities. It is a very real and costly problem, with far-reaching effects, often referred to as a “multiple-victim” crime.
The opioid epidemic has become an all-too-familiar topic in hospital grand rounds, in political speeches, in daily news briefings, and in social media hashtags.
However, there is another epidemic, one that in many cases actually overlaps with, and exacerbates, the opioid crisis: benzodiazepine misuse.
I love Prince. My first job was at a movie theater that played Purple Rain for months.
I saw that movie hundreds of times, in five-minute bursts while I left the ticket booth unattended. My first concert was the Purple Rain tour – at the Capital Centre, outside of Washington, DC; one of the first albums I bought with my own money was Dirty Mind, on cassette, no less.
When it comes to addressing opiate addiction, it’s all beginning to come together.
Within mere days of each other, Massachusetts Gov. Charlie Baker signed a historic law holding great promise to curb the Commonwealth’s opioid epidemic; the Centers for Disease Control and Prevention (CDC) released new guidelines for prescribing opioids; and the U.S. Senate passed the Comprehensive Addiction and Recovery Act of 2016 (CARA) by a near-unanimous vote.
In February, President Obama proposed a FY17 budget that allocates $1.1B in new funding to address the opioid use disorder crisis in the United States.
Whatever one’s politics (or general anxieties about the 2016 election season), we all agree that something must change. Despite the best efforts of policymakers, health care professionals, and communities to combat this problem, opioid deaths continue to rise, prompting the question: Why is the epidemic so pervasive?
One of my all-time favorite films is A Beautiful Mind starring Russell Crowe as the great John Nash, the genius mathematician who died earlier this year in a car crash. John Nash won a Nobel Prize in 1994 for his revolutionary work on game theory. He also struggled throughout his life with delusions secondary to paranoid schizophrenia. However, with the support of his wife and colleagues, he was able to learn to live and function despite the vicious persistence of his underlying psychopathology. On average today, people have psychosis for one year and five months before being treated. This timeframe is six times longer than the World Health Organization guidelines for effective early onset intervention (less than three months). The…
In the news: Recent publication of the almost immediate resolution of treatment-resistant depression (TRD) following Ketamine infusion has sparked tremendous interest within the fields of clinical psychiatry and psychotropic drug development. It has also sparked the entrepreneurial development of specialized ketamine clinics, despite the lack of Federal Drug Administration (FDA) approval of ketamine for this purpose. And, of course, third-party payers are being asked to cover these services. Should they? After all, there is replicated evidence for ketamine’s rapid antidepressant effects.[i] Background: Ketamine was FDA-approved as an anesthetic agent in 1964 and was widely used for soldiers injured in the Vietnam War.[ii] Its legitimate role has expanded over the years to include pain management and veterinary surgery. Ketamine was also…
Has public opinion trumped the rigors of the scientific method – clinically sound research that supports or negates the efficacy of marijuana for medical use? A recent issue of the Journal of the American Medical Association (JAMA) devoted two extensive clinical reviews, a research letter, an editorial and a patient page to topics related to medical marijuana. The reviews lay bare what is at the heart of the medical marijuana debate for the health care industry: Has public opinion trumped the rigors of the scientific method – clinically sound research that supports or negates the efficacy of marijuana for medical use? There are downstream effects of the legalization of medical marijuana that are not specifically related to efficacy or safety….
Behavioral health is the least evidence-based area of health care today. The reality being there just isn’t a robust evidence base for much of what we deliver in behavioral health care, least of all for children and adolescents. A case in point is an article published by The New York Times several weeks ago. The article cites statistics suggesting one in four women in America now takes a psychiatric medication, compared to one in seven men. The most common antidepressants prescribed in the US are selective serotonin reuptake inhibitors (SSRIs), which enhance serotonin transmission and thus modulate mood. Such medication is not without side effects, including feeling agitated and/or experiencing gastrointestinal discomfort. While sadness and anxiety are undeniably common, it…