Hydromorphone Research Paper

Opioid use in the US has increased over the years, and this has led to an increase in substance abuse. Substance abuse is not only associated with use of illicit drugs but also prescription drugs. In 2015, of the 20.5 million reported cases of substance abuse, 2 million had an abuse disorder related to prescription pain relievers and 591,000 associated with heroin.1 The increase in substance abuse disorder has led to an increase in opioid related death. In 2015 drug overdose was the leading cause of accidental death in the US with 52, 404 lethal drug overdoses.2

The use of opioids and other drugs continues to gradually increase in the United State. According to Centers for Disease Control and Prevention (CDC), the number of overdose deaths involving opioids has quadrupled since 1999” (CDC website). Individuals are abusing prescription opioids such as oxycodone, hydrocodone, and methadone. Prescriptions opioids that are supposed to be used as pain relievers, cough suppressants and for withdrawal symptoms are being use by individuals in order to feel relaxed or for the overwhelming effect of euphoria. These types of drugs are to be taken orally, but people are snorting, smoking, and injecting them in order to get a better high. I have personal encounters with opioid drugs and opioid abuser on a regular

"The toxicology studies on blood reveal the presence alprazolam, and amphetamine at levels likely consistent with the therapeutic range, a metabolite of buproprion and a high level of fentanyl. Phenylpropranolamine and amphetamine are present in the urine. When fentanyl and alprazolam are taken together there may be a synergistic central nervous system depressive effect. Based on the history and circumstances, s currently known, the manner of death is accident."

Opioid drugs are some of the most widespread pain medications that we have in this country; indeed, the fact is that opioid analgesic prescriptions have increased by over 300% from 1999 to 2010 (Mitch 989). Consequently, the number of deaths from overdose increased from 4000 to 16,600 a year in the same time frame (Mitch 989). This fact becomes even more frightening when you think about today; the annual number of fatal drug overdoses in the Unites States now surpasses that of motor vehicle deaths (Alexander 1865). Even worse, overdose deaths caused by opioids specifically exceed those attributed to both cocaine and heroin combined (Alexander 1865).

The guideline named opioid cumulative dosing override allows for an override for an opioid product equal to or exceeding the hard-stop threshold (60mg morphine equivalent dose) and a 7 day supply. An override will be provided for patients with one of the following conditions: diagnosis of cancer, palliative care, or sickle cell disease, patients enrolled in hospice care, or patients taking an opiate tapering regimen following an orthopedic procedure with an end date not to exceed 21 days. For all other patients, the prescriber must be aware that all of the following criteria must be met: the diagnosis for use of the opiate and reason for continued use are documented, previous trials of non-drug and/or non-opiate use are documented, the patient does not have concurrent use of benzodiazepines

The United States is currently in the midst of an Opioid overdose epidemic. Deaths from overdoses of prescription drugs continue to be the leading cause of unintentional death for Americans. Last year, 47,055 people died from drug overdoses - 1.5 times greater than the number killed in car crashes. Overdose is an excessive and very dangerous dose of a drug. Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically, they are primarily used for pain relief. The most commonly prescribed opioid medications are Vicodin, OxyContin, and Percocet. Drug overdoses can be either accidental or intentional. They occur when a person takes more than the medically recommended dose. Treatments for overdose include medications

Naloxone, better known by its brand name Narcan, is an opiate antagonist that has the ability to reverse opiate overdoses. Due to the opiate epidemic, Narcan is being distributed in communities where opiate abuse is prevalent, and individuals in these communities are now administering the drug. However, administering the drug to someone with a suspected opiate overdose can be dangerous whether they are a skilled professional or civilian: “Administering narcan can be a wild experience the first time you do it because it's one of very few drugs that works very very rapidly and causes a very dramatic effect in a very short period of time especially depending on the dose.There's been a bad habit of people in the past to give very large amounts of naloxone very quickly and that can cause a patient to go from completely unconscious barely breathing or sometimes not even breathing at all and then within in a matter of seconds they can be awake alert breathing, One of the side effects is extreme agitation so these patients can become extremely like I said agitated or sometimes even combative or violent. So now we are learning as providers it's better to give it in more measured doses give smaller amounts at a time to prevent that sort of effect from happening.” said Sean McMullen a paramedic with Gila River EMS (McMullen). Since individuals can become combative and

Unlike the other complications, this one can be deadly. Most of the opioid overdose deaths that occurs happen when someone has just gone through the withdrawal process. Since this process reduces a person’s tolerance to opioids, people can overdose on a much smaller dose than they used to take. It is a tragic situation, and the best way to prevent it is to with medical intervention and caring support during the process of recovering from opioid use.

For this article, the researchers have assessed that there has been a substantial increase in unintentional overdose events occurring with the rise of sales of prescription opioids within the past 2 decades. There is concern that the therapeutic use of the opioids has had an affect of the number of overdose injury. After assessing the information gathered, the researchers formed an objective. This is similar to the next step in the nursing process, which is forming a diagnosis using clinical judgment. The researcher’s objective was to examine and determine, “whether the risk of unintentional overdose injury is associated with the duration of opioid action (ie, long-acting vs short-acting formulations,” (Miller et al., 2015). In nursing, judgment is based from actual or potential conditions that the patient is vulnerable to. In the research the objective created, the patients are open to a potential condition. The researchers have distinguished that there is a risk of unintentional overdose injury related to the duration of opioid

The world of opioids can be divided into two categories: (1) illicit opioids and (2) prescription opioids. Illicit opioids include substances like heroin that people abuse to reach a euphoric and relaxed state. In contrast, prescription opioids are commonly used by doctors in a medical setting to treat pain. Some of these powerful painkillers include codeine, oxycodone, hydrocodone, morphine, and methadone. While these prescription medications provide pain relief for patients who are recovering from surgery or injuries, they also pose serious risks when they are misused. Among these risks are addiction, overdose, and death.

As the war on drugs continues, more and more lives are being lost to opiate overdoses. Opiates are drugs that contain or are derived from the opium poppy plant. They can be legally prescribed pain medications such as OxyContin or Vicodin or illegal street drugs such as heroin. Whether these drugs are used legally or illegally, there is always the chance of an overdose if not used correctly. According to a 2014 press release from the Center for Disease Control (CDC), “in 2013 more than 16,000 deaths in the United States involved prescription opioids, and more than 8,000 others were related to heroin.”

B’s tolerance to opiates not considered, Mr. B.’s clinical situation not considered (i.e., Mr. B’s age and renal function), and knowledge deficit of opiates. Drilling down the data to identify the root cause of Mr. B’s death is the fifth step in conducting a RCA on Mr. B’s sentinel event. Upon analyzing the data, causative factors, and events leading to Mr. B’s sentinel event, the RCA team determined that the root cause of Mr. B’s death is a medication error. Mr. B was given an overdose of hydromorphone. The final step in a root cause analysis is to implement changes that will mitigate the root cause. Changes include educating the nursing staff about hydromorphone, such as side effects and adverse reactions,

Methaqualone, is also referred to as Disco Biscuits, Down And Dirties, Jekyll-and-Hyde, Joe Fridays, Lemmon 714, Lemons, Lennon's, Lovers, Ludes, Mandies, Mandrake, Q, Qua, Quack, Quad, Quaaludes, Soaper, Supper, Vitamin Q, The Love Drug, Wallbangers, Whore Pills, and Sopor. This list of street names for the drug goes on and on.

While narcotics are most commonly used to treat acute pain, opioids, one subgroup of narcotics, are being used most commonly to treat chronic pain. The number of opioid prescriptions has been on the rise over the past 25 years, increasing from “76 million prescriptions in 1991 to nearly 207 million in 2013” (Volkow, 2014, p. 1). This has no doubt contributed to the increasing number of unintentional overdose deaths seen in recent years. The United States has seen their unintentional overdose rates quadruple since 1999, which may be explained by the fact that the United States is responsible for the use of nearly all of the word’s hydrocodone (Volkow, 2014).

Toxic effects are the most dangerous effect and can result in death. If the patient is experiencing a toxic effect, the medication must be stopped immediately and measures should be put in place to stop the toxic effect occurring on the patient.