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Richard C Dart - One of the best experts on this subject based on the ideXlab platform.
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detecting signals of opioid analgesic Abuse application of a spatial mixed effect poisson regression model using data from a network of poison control centers
Pharmacoepidemiology and Drug Safety, 2008Co-Authors: Meredith Y Smith, William Irish, David J Haddox, Jianmin Wang, Richard C DartAbstract:Purpose The recent rise in the non-medical use of opioid analgesics in the US has underscored the importance of comprehensive post-marketing surveillance of these products. To assist pharmacovigilance efforts, we developed a methodology for detecting geo-specific “signals” of potential outbreaks of Prescription Drug Abuse by 3-digit ZIP (3DZ) code. Methods The number of intentional exposure calls involving nine specific opioid analgesics were obtained from eight regional poison control centers between first quarter 2003 and fourth quarter 2004. The unit of analysis was a combination of Drug–quarter/year–3DZ. We fitted an empirical Bayes mixed effects Poisson–Gamma regression model that adjusted for differences across 3DZs in opioid analgesic exposure. A relative report rate (RR) ≥3 at a probability of >0.95 was the signal threshold criterion. Results A total of 15 769 valid Drug–time–3DZ combinations were identified. Of these, 1.9% (n = 294) met the signal threshold criterion. The number of signals generated per Drug–quarter/year–3DZ combination ranged from 0 to 13. The largest number of signals were those involving methadone (n = 71), hydrocodone (n = 57), and branded oxycodone extended-release (n = 45). Signals for methadone and branded oxycodone extended-release were predominantly clustered in Appalachia. Hydrocodone-related signals showed less geographic clustering with approximately 26% reported from California, and the remainder from other regions in the US. Conclusions Our results show marked regional differences in reported Abuse of specific opioid analgesics. Additional research is needed to determine the sensitivity and specificity of signals obtained using this spatial mixed effect Poisson regression model. Copyright © 2008 John Wiley & Sons, Ltd.
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the development of a comprehensive risk management program for Prescription opioid analgesics researched Abuse diversion and addiction related surveillance radars
Pain Medicine, 2007Co-Authors: Theodore J Cicero, Richard C Dart, Sidney H Schnoll, James A Inciardi, George E Woody, Alvaro MunozAbstract:Bloomberg School of Public Health, Baltimore, Maryland, USA ABSTRACT Objective. Beginning in the late 1990's a marked increase in Abuse of OxyContin ® emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize Abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS ® ) System. The main goal of RADARS ® was to develop proactive, timely and geograph- ically sensitive methods to assess the Abuse and diversion of OxyContin ® , along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of Abuse of OxyContin ® and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems. Methods. The detection systems selected were: (1) Quarterly-surveys of Drug Abuse experts who are knowledgeable about cases of Prescription Drug Abuse; (2) Surveys of law enforcement agencies that detect diversion of Prescription Drugs; and (3) Poison Control Center reports of intentional misuse or Abuse of Prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes. Results. Preliminary results indicate that Prescription Drug Abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely Abused Drugs in the country, but the Abuse of all Prescription opioids seems to have grown over the 14 quarters since the inception of RADARS ® . Conclusion. The next step in these studies is to develop regionally specific, risk-minimization- strategies, which is the goal of all risk-management programs. If successful, RADARS ® will serve as a prototype of such programs for any new Drug approved thathas measurable Abuse potential.
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active surveillance of Abused and misused Prescription opioids using poison center data a pilot study and descriptive comparison
Clinical Toxicology, 2007Co-Authors: Alice Hughes, Gregory M Bogdan, Richard C DartAbstract:Background. Prescription opioids are Abused throughout the United States. Several monitoring programs are in existence, however, none of these systems provide up-to-date information on Prescription opioid Abuse. This article describes the use of poison centers as a real-time, geographically specific, surveillance system for Prescription opioid Abuse and compares our system with an existing Prescription Drug Abuse monitoring program, the Drug Abuse Warning Network (DAWN). Methods. Data were collected from eight geographically dispersed poison centers for a period of twelve months. Any call involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone was considered a case. Any case coded as intentional exposure (Abuse, intentional misuse, suicide, or intentional unknown) was regarded as misuse and Abuse. Comparative data were obtained from DAWN. Results. Poison center rates of Abuse and misuse were highest for hydrocodone at 3.75 per 100,000 population, followed by oxycodone at 1.81 per 100,000 population. DAWN emergency department (ED) data illustrate a similar pattern of Abuse with most mentions involving hydrocodone and oxycodone. Poison center data indicate that people aged 18 to 25 had the highest rates of Abuse. DAWN reported the majority of ED mentions among 35 to 44-year-olds. Geographically, Kentucky had the uppermost rates of Abuse and misuse for all opioids combined at 20.69 per 100,000 population. Conclusions. Comparing poison center data to DAWN yielded mostly comparable results, including hydrocodone as the most commonly mentioned Drug. Our results suggest poison center data can be used as an indicator for Prescription opioid Abuse and misuse and can provide timely, geographically specific information on Prescription Drug Abuse.
Alvaro Munoz - One of the best experts on this subject based on the ideXlab platform.
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relationship between therapeutic use and Abuse of opioid analgesics in rural suburban and urban locations in the united states
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Theodore J Cicero, Hilary L Surratt, James A Inciardi, Alvaro MunozAbstract:SUMMARY Purpose The goal of these studies was to determine the relationship between prescribed use of opioid analgesics and their non-medically related use (Abuse) at a regional level across the country. Methods To gather information about Prescription Drug Abuse, we asked 233 Drug Abuse treatment specialists to provide us Quarterly reports on the number of cases of Prescription opioid analgesic Abusers who used opioid analgesics to get high in the past 30 days. Results and Conclusions We found that there was a very strong correlation between therapeutic exposure to opioid analgesics, as measured by Prescriptions filled, and their Abuse. There were, however, geographical loci that represented outliers in which Abusewas disproportionately high relative to therapeutic use (>95th percentile), most of which were invery small urban, suburban, and rural areas. The rank order of Abuse shows that buprenorphine products, extended release (ER) oxycodone and methadone are the most intensely Abused Prescription opioid analgesics, with hydrocodone the least Abused, when the data are corrected for degree of exposure, i.e., cases/1000 persons filling a Prescription. If, on the other hand, one uses the number of cases/100000 population, hydrocodone ranked as high as ER oxycodone and all other Drugs grouped together at very low levels of Abuse. Since the latter conclusion ignores therapeutic exposure, we conclude that the rate of Abuse of highly efficacious opioid analgesics is best expressed as cases of Abuse/1000 persons filling a Prescription, which yields the best possible estimate of the risk-benefit ratio of these Drugs. Copyright # 2007 John Wiley & Sons, Ltd. key words—risk management; risk-benefit; post-marketing surveillance; Drug Abuse; Drug diversion; opioid analgesics;
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the development of a comprehensive risk management program for Prescription opioid analgesics researched Abuse diversion and addiction related surveillance radars
Pain Medicine, 2007Co-Authors: Theodore J Cicero, Richard C Dart, Sidney H Schnoll, James A Inciardi, George E Woody, Alvaro MunozAbstract:Bloomberg School of Public Health, Baltimore, Maryland, USA ABSTRACT Objective. Beginning in the late 1990's a marked increase in Abuse of OxyContin ® emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize Abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS ® ) System. The main goal of RADARS ® was to develop proactive, timely and geograph- ically sensitive methods to assess the Abuse and diversion of OxyContin ® , along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of Abuse of OxyContin ® and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems. Methods. The detection systems selected were: (1) Quarterly-surveys of Drug Abuse experts who are knowledgeable about cases of Prescription Drug Abuse; (2) Surveys of law enforcement agencies that detect diversion of Prescription Drugs; and (3) Poison Control Center reports of intentional misuse or Abuse of Prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes. Results. Preliminary results indicate that Prescription Drug Abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely Abused Drugs in the country, but the Abuse of all Prescription opioids seems to have grown over the 14 quarters since the inception of RADARS ® . Conclusion. The next step in these studies is to develop regionally specific, risk-minimization- strategies, which is the goal of all risk-management programs. If successful, RADARS ® will serve as a prototype of such programs for any new Drug approved thathas measurable Abuse potential.
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trends in Abuse of oxycontin and other opioid analgesics in the united states 2002 2004
The Journal of Pain, 2005Co-Authors: Theodore J Cicero, James A Inciardi, Alvaro MunozAbstract:OxyContin® (Purdue Pharma L.P., Stamford, Conn) was approved by the Food and Drug Administration (FDA) in 1995 as a sustained-release preparation of oxycodone hydrochloride and was thought to have much lower Abuse potential than immediate-release oxycodone because of its slow-release properties. However, beginning in 2000, widespread reports of OxyContin® Abuse surfaced. In response, Purdue Pharma L.P. sponsored the development of a proactive Abuse surveil- lance program, named the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) system. In this paper, we describe results obtained from one aspect of RADARS—the use of Drug Abuse experts (ie, key informants)—as a source of data on the prevalence and magnitude of Abuse of Prescription Drugs. The results indicate that Prescription Drug Abuse has become prevalent, with cases reported in 60% of the zip codes surveyed. The prevalence of Abuse was rank ordered as follows: OxyContin > hydrocodone > other oxycodone > methadone > morphine > hydromorphone > fentanyl > buprenorphine. In terms of the magnitude of Abuse (>5 cases/100,000 persons in a 3-digit zip code), modest growth was seen with all analgesics over the 10 calendar quarters we monitored, but was most pronounced with OxyContin and hydrocodone. These results indicate that OxyContin Abuse is a pervasive problem in this country, but that it needs to be considered in the context of a general pattern of increasing Prescription Drug Abuse. Perspective: Over the past 5 years, there have been reports, frequently anecdotal, that opioid analgesic Abuse has evolved into a national epidemic. In this study, we report systematic data to indicate that opioid analgesic Abuse has in fact increased among street and recreational Drug users, with OxyContin and hydrocodone products the most frequently Abused. Steps need to be taken to reduce Prescription Drug Abuse, but very great care needs to be exercised in the nature of these actions so the legitimate and appropriate use of these Drugs in the treatment of pain is not compromised as a result.
Theodore J Cicero - One of the best experts on this subject based on the ideXlab platform.
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black beauties gorilla pills footballs and hillbilly heroin some reflections on Prescription Drug Abuse and diversion research over the past 40 years
Journal of Drug Issues, 2009Co-Authors: James A Inciardi, Theodore J CiceroAbstract:Although the problem of Prescription Drug Abuse has endured for well over two centuries, research into the Abuse and diversion of these Drugs has been relatively recent. The first general population survey to document the Abuse of Prescription medications occurred in 1970, and subsequent studies demonstrated that the Abuse and diversion of amphetamines, opioids, and sedatives has continued to be widespread. During the 1980s and much of the 1990s, Prescription Drug Abuse took a back seat to other more pressing concerns: “freebase” and powder cocaine, the cocaine wars, crack and sex-for-crack exchanges, rising rates of Drug-related street crime, and HIV/AIDS among injection and non-injection Drug users. However, recent surveys suggest that the current outbreak of Prescription Drug Abuse began during the early to mid-1990s. Although the Abuse and diversion of Prescription Drugs was clearly an evolving problem, what seemed to galvanize the attention of the media, the government, and the public at large was Ox...
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relationship between therapeutic use and Abuse of opioid analgesics in rural suburban and urban locations in the united states
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Theodore J Cicero, Hilary L Surratt, James A Inciardi, Alvaro MunozAbstract:SUMMARY Purpose The goal of these studies was to determine the relationship between prescribed use of opioid analgesics and their non-medically related use (Abuse) at a regional level across the country. Methods To gather information about Prescription Drug Abuse, we asked 233 Drug Abuse treatment specialists to provide us Quarterly reports on the number of cases of Prescription opioid analgesic Abusers who used opioid analgesics to get high in the past 30 days. Results and Conclusions We found that there was a very strong correlation between therapeutic exposure to opioid analgesics, as measured by Prescriptions filled, and their Abuse. There were, however, geographical loci that represented outliers in which Abusewas disproportionately high relative to therapeutic use (>95th percentile), most of which were invery small urban, suburban, and rural areas. The rank order of Abuse shows that buprenorphine products, extended release (ER) oxycodone and methadone are the most intensely Abused Prescription opioid analgesics, with hydrocodone the least Abused, when the data are corrected for degree of exposure, i.e., cases/1000 persons filling a Prescription. If, on the other hand, one uses the number of cases/100000 population, hydrocodone ranked as high as ER oxycodone and all other Drugs grouped together at very low levels of Abuse. Since the latter conclusion ignores therapeutic exposure, we conclude that the rate of Abuse of highly efficacious opioid analgesics is best expressed as cases of Abuse/1000 persons filling a Prescription, which yields the best possible estimate of the risk-benefit ratio of these Drugs. Copyright # 2007 John Wiley & Sons, Ltd. key words—risk management; risk-benefit; post-marketing surveillance; Drug Abuse; Drug diversion; opioid analgesics;
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the development of a comprehensive risk management program for Prescription opioid analgesics researched Abuse diversion and addiction related surveillance radars
Pain Medicine, 2007Co-Authors: Theodore J Cicero, Richard C Dart, Sidney H Schnoll, James A Inciardi, George E Woody, Alvaro MunozAbstract:Bloomberg School of Public Health, Baltimore, Maryland, USA ABSTRACT Objective. Beginning in the late 1990's a marked increase in Abuse of OxyContin ® emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize Abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS ® ) System. The main goal of RADARS ® was to develop proactive, timely and geograph- ically sensitive methods to assess the Abuse and diversion of OxyContin ® , along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of Abuse of OxyContin ® and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems. Methods. The detection systems selected were: (1) Quarterly-surveys of Drug Abuse experts who are knowledgeable about cases of Prescription Drug Abuse; (2) Surveys of law enforcement agencies that detect diversion of Prescription Drugs; and (3) Poison Control Center reports of intentional misuse or Abuse of Prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes. Results. Preliminary results indicate that Prescription Drug Abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely Abused Drugs in the country, but the Abuse of all Prescription opioids seems to have grown over the 14 quarters since the inception of RADARS ® . Conclusion. The next step in these studies is to develop regionally specific, risk-minimization- strategies, which is the goal of all risk-management programs. If successful, RADARS ® will serve as a prototype of such programs for any new Drug approved thathas measurable Abuse potential.
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trends in Abuse of oxycontin and other opioid analgesics in the united states 2002 2004
The Journal of Pain, 2005Co-Authors: Theodore J Cicero, James A Inciardi, Alvaro MunozAbstract:OxyContin® (Purdue Pharma L.P., Stamford, Conn) was approved by the Food and Drug Administration (FDA) in 1995 as a sustained-release preparation of oxycodone hydrochloride and was thought to have much lower Abuse potential than immediate-release oxycodone because of its slow-release properties. However, beginning in 2000, widespread reports of OxyContin® Abuse surfaced. In response, Purdue Pharma L.P. sponsored the development of a proactive Abuse surveil- lance program, named the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) system. In this paper, we describe results obtained from one aspect of RADARS—the use of Drug Abuse experts (ie, key informants)—as a source of data on the prevalence and magnitude of Abuse of Prescription Drugs. The results indicate that Prescription Drug Abuse has become prevalent, with cases reported in 60% of the zip codes surveyed. The prevalence of Abuse was rank ordered as follows: OxyContin > hydrocodone > other oxycodone > methadone > morphine > hydromorphone > fentanyl > buprenorphine. In terms of the magnitude of Abuse (>5 cases/100,000 persons in a 3-digit zip code), modest growth was seen with all analgesics over the 10 calendar quarters we monitored, but was most pronounced with OxyContin and hydrocodone. These results indicate that OxyContin Abuse is a pervasive problem in this country, but that it needs to be considered in the context of a general pattern of increasing Prescription Drug Abuse. Perspective: Over the past 5 years, there have been reports, frequently anecdotal, that opioid analgesic Abuse has evolved into a national epidemic. In this study, we report systematic data to indicate that opioid analgesic Abuse has in fact increased among street and recreational Drug users, with OxyContin and hydrocodone products the most frequently Abused. Steps need to be taken to reduce Prescription Drug Abuse, but very great care needs to be exercised in the nature of these actions so the legitimate and appropriate use of these Drugs in the treatment of pain is not compromised as a result.
Rick Dart - One of the best experts on this subject based on the ideXlab platform.
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characterization of adolescent Prescription Drug Abuse and misuse using the researched Abuse diversion and addiction related surveillance radars system
Journal of the American Academy of Child and Adolescent Psychiatry, 2013Co-Authors: Amy Zosel, Becki Bucher Bartelson, Elise Bailey, Steven R Lowenstein, Rick DartAbstract:Objective To describe the characteristics and health effects of adolescent (age 13–19 years) Prescription Drug Abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS ® ) System. Method Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent Prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. Results A total of 16,209 intentional adolescent exposures to Prescription Drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD±1.7 years). Slightly more than half (52.4%) of Drug mentions involved females. The five most frequently misused or Abused Drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38% were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to Prescription Drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Conclusions Prescription Drug misuse and Abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent Prescription Drug Abuse and misuse by adolescents.
James A Inciardi - One of the best experts on this subject based on the ideXlab platform.
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Prescription Drug Abuse diversion role of the pain clinic
Journal of Drug Issues, 2010Co-Authors: Khary K Rigg, Samantha J March, James A InciardiAbstract:The goal of this research is to better understand the role that South Florida pain management clinics may be playing in the Abuse and diversion of Prescription Drugs. This study explores 1) the characteristics and practices of pain clinics that may be facilitating the Drug-seeking endeavors of Prescription Drug Abusers and 2) the Drug-seeking behaviors of Prescription Drug Abusers who use pain clinics as a primary source for Drugs. Thirty in-depth interviews were conducted with Prescription Drug Abusers in South Florida. Interviews were transcribed verbatim and codes were generated based on thematic analyses of the data. Using grounded theory strategies, the analysis revealed six main themes: "pill mills", on-site pharmacies, liberal prescribing habits, "sponsoring" Drug diversion, pain doctor/pharmacy shopping, and faking symptoms/documentation. These findings should provide insights for law enforcement, regulatory agencies, and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices.
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black beauties gorilla pills footballs and hillbilly heroin some reflections on Prescription Drug Abuse and diversion research over the past 40 years
Journal of Drug Issues, 2009Co-Authors: James A Inciardi, Theodore J CiceroAbstract:Although the problem of Prescription Drug Abuse has endured for well over two centuries, research into the Abuse and diversion of these Drugs has been relatively recent. The first general population survey to document the Abuse of Prescription medications occurred in 1970, and subsequent studies demonstrated that the Abuse and diversion of amphetamines, opioids, and sedatives has continued to be widespread. During the 1980s and much of the 1990s, Prescription Drug Abuse took a back seat to other more pressing concerns: “freebase” and powder cocaine, the cocaine wars, crack and sex-for-crack exchanges, rising rates of Drug-related street crime, and HIV/AIDS among injection and non-injection Drug users. However, recent surveys suggest that the current outbreak of Prescription Drug Abuse began during the early to mid-1990s. Although the Abuse and diversion of Prescription Drugs was clearly an evolving problem, what seemed to galvanize the attention of the media, the government, and the public at large was Ox...
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relationship between therapeutic use and Abuse of opioid analgesics in rural suburban and urban locations in the united states
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Theodore J Cicero, Hilary L Surratt, James A Inciardi, Alvaro MunozAbstract:SUMMARY Purpose The goal of these studies was to determine the relationship between prescribed use of opioid analgesics and their non-medically related use (Abuse) at a regional level across the country. Methods To gather information about Prescription Drug Abuse, we asked 233 Drug Abuse treatment specialists to provide us Quarterly reports on the number of cases of Prescription opioid analgesic Abusers who used opioid analgesics to get high in the past 30 days. Results and Conclusions We found that there was a very strong correlation between therapeutic exposure to opioid analgesics, as measured by Prescriptions filled, and their Abuse. There were, however, geographical loci that represented outliers in which Abusewas disproportionately high relative to therapeutic use (>95th percentile), most of which were invery small urban, suburban, and rural areas. The rank order of Abuse shows that buprenorphine products, extended release (ER) oxycodone and methadone are the most intensely Abused Prescription opioid analgesics, with hydrocodone the least Abused, when the data are corrected for degree of exposure, i.e., cases/1000 persons filling a Prescription. If, on the other hand, one uses the number of cases/100000 population, hydrocodone ranked as high as ER oxycodone and all other Drugs grouped together at very low levels of Abuse. Since the latter conclusion ignores therapeutic exposure, we conclude that the rate of Abuse of highly efficacious opioid analgesics is best expressed as cases of Abuse/1000 persons filling a Prescription, which yields the best possible estimate of the risk-benefit ratio of these Drugs. Copyright # 2007 John Wiley & Sons, Ltd. key words—risk management; risk-benefit; post-marketing surveillance; Drug Abuse; Drug diversion; opioid analgesics;
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the development of a comprehensive risk management program for Prescription opioid analgesics researched Abuse diversion and addiction related surveillance radars
Pain Medicine, 2007Co-Authors: Theodore J Cicero, Richard C Dart, Sidney H Schnoll, James A Inciardi, George E Woody, Alvaro MunozAbstract:Bloomberg School of Public Health, Baltimore, Maryland, USA ABSTRACT Objective. Beginning in the late 1990's a marked increase in Abuse of OxyContin ® emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize Abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS ® ) System. The main goal of RADARS ® was to develop proactive, timely and geograph- ically sensitive methods to assess the Abuse and diversion of OxyContin ® , along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of Abuse of OxyContin ® and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems. Methods. The detection systems selected were: (1) Quarterly-surveys of Drug Abuse experts who are knowledgeable about cases of Prescription Drug Abuse; (2) Surveys of law enforcement agencies that detect diversion of Prescription Drugs; and (3) Poison Control Center reports of intentional misuse or Abuse of Prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes. Results. Preliminary results indicate that Prescription Drug Abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely Abused Drugs in the country, but the Abuse of all Prescription opioids seems to have grown over the 14 quarters since the inception of RADARS ® . Conclusion. The next step in these studies is to develop regionally specific, risk-minimization- strategies, which is the goal of all risk-management programs. If successful, RADARS ® will serve as a prototype of such programs for any new Drug approved thathas measurable Abuse potential.
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trends in Abuse of oxycontin and other opioid analgesics in the united states 2002 2004
The Journal of Pain, 2005Co-Authors: Theodore J Cicero, James A Inciardi, Alvaro MunozAbstract:OxyContin® (Purdue Pharma L.P., Stamford, Conn) was approved by the Food and Drug Administration (FDA) in 1995 as a sustained-release preparation of oxycodone hydrochloride and was thought to have much lower Abuse potential than immediate-release oxycodone because of its slow-release properties. However, beginning in 2000, widespread reports of OxyContin® Abuse surfaced. In response, Purdue Pharma L.P. sponsored the development of a proactive Abuse surveil- lance program, named the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) system. In this paper, we describe results obtained from one aspect of RADARS—the use of Drug Abuse experts (ie, key informants)—as a source of data on the prevalence and magnitude of Abuse of Prescription Drugs. The results indicate that Prescription Drug Abuse has become prevalent, with cases reported in 60% of the zip codes surveyed. The prevalence of Abuse was rank ordered as follows: OxyContin > hydrocodone > other oxycodone > methadone > morphine > hydromorphone > fentanyl > buprenorphine. In terms of the magnitude of Abuse (>5 cases/100,000 persons in a 3-digit zip code), modest growth was seen with all analgesics over the 10 calendar quarters we monitored, but was most pronounced with OxyContin and hydrocodone. These results indicate that OxyContin Abuse is a pervasive problem in this country, but that it needs to be considered in the context of a general pattern of increasing Prescription Drug Abuse. Perspective: Over the past 5 years, there have been reports, frequently anecdotal, that opioid analgesic Abuse has evolved into a national epidemic. In this study, we report systematic data to indicate that opioid analgesic Abuse has in fact increased among street and recreational Drug users, with OxyContin and hydrocodone products the most frequently Abused. Steps need to be taken to reduce Prescription Drug Abuse, but very great care needs to be exercised in the nature of these actions so the legitimate and appropriate use of these Drugs in the treatment of pain is not compromised as a result.