Question

Since there is currently a coronavirus epidemic, why is it a good time to clear up the issues on opioid abuse?

Answer 1

Strategies to Prevent Opioid Abuse, and Diversion that may Also possible at home.

1. Implementing approaches that will encourage the use of safe practices (universal precautions) in pain management by providers can reduce the risk for abuse and misuse associated with chronic pain medications, especially opioids. These approaches include, but are not limited to, extensive physician and patient education regarding these medications and their associated risks for abuse; the development of prescription monitoring programs to detect physician or pharmacy shopping; the detection of inappropriate prescribing and medical errors; the use of physician-patient contracts concerning opioid treatment; the requirement of presenting a photo identification to pick up an opioid prescription at the pharmacy; urine drug toxicology screening; provisions for safe disposal of unused opioids; referrals to pain and addiction specialists; and potentially encouraging the use of opioid formulations aimed at reducing abuse.

2. opioid maintenance treatment or detoxification

Most dependent individuals engage in both, likely multiple times, during the course of their drug-using careers. Agonist and partial agonist medications are commonly utilized for both maintenance and detoxification purposes; alpha-2-adrenergic agonist medications are primarily used to enhance detoxification outcomes. Antagonist medications are used to accelerate the detoxification process and prescribed post-detoxification to assist in preventing relapse. Success of the various treatment approaches and combinations of treatments is assessed in a number of ways with the primary outcomes of interest being retention in treatment, and opioid and other drug use. Secondarily, HIV risk behaviors, legal/crime involvement, psychiatric symptoms, and morbidity are also used as indicators of treatment success. With regard to detoxification, there are undoubtedly differences between individuals withdrawing from illicit opioid use and those withdrawing from methadone or buprenorphine maintenance and the contexts in which these occur, however, due to limited prospective, comparative data this distinction is not highlighted for purposes of this review. The review of pharmacotherapy options for opioid dependence derives from Medline, Pubmed, and systematic reviews from the Cochrane Databases.

3. MEDICATIONS FOR OPIOID

• Methadone is a full mu-opioid receptor agonist, typically used as a replacement therapy for heroin or other opioid dependence.
• Methadone’s slow onset of action when taken orally and long elimination half-life (24–36 hours) allows it to be used as a maintenance therapy .

4 .Educating providers and patients on these drugs can minimize opioid abuse; current approaches include prescription monitoring programs, preventing prescription/medical errors, checking patient identification at the pharmacy, referral to pain specialists, and the use of abuse-deterrent opioid formulations.

5.There is growing interest in using buprenorphine as a way of managing opioid withdrawal. Because of the partial agonist properties, buprenorphine is expected to produce fewer withdrawal symptoms as it is withdrawn, relative to full agonist therapies 46. As with methadone, detoxification outcomes are likely dependent on a complex interaction of factors including dependence severity, opioid used, dose taken, duration of use, taper schedule, social/environmental circumstances, and psychological factors such as fear of withdrawal, depression.

Thus all way also possible at this time to reduce opidid abus