Biomedical subjects

Norman S Miller

Publications and source records attributed to Norman S Miller.

5 recordsLinked to original sources

PubMed2004

Prescription opiate medications: medical uses and consequences, laws and controls.

The proposed analysis and evaluation of the data elements in the OPP and other similar regulatory programs will support the following potential impact on the patients and physicians in Michigan and other states: Reduced rates of addictive use of prescriptions of Schedule II medications. Reduced rates of addictive patterns of prescribing of Schedule II medications. Improved the prescribing of Schedule II medication for pain disorders. Improved the prescribing of Schedule II medications in addictive disorders. Establish the need and direction for development of curriculum for Schedule II drugs for undergraduate medical education and continuing medical education. Establish the need and direction for development of curriculum for use of Schedule II medications in patients with addictive and pain disorders. Explore the need and direction for development of the monitoring system medical curriculum for Schedule III, IV, and V drugs. Demonstrate link between diversion and adverse effects on health caused by an addictive pattern of use and prescribing of Schedule II drugs

Diagnostic and Statistical Manual of Mental Disord↗

PubMed2004

Addictive disorders.

In conclusion, complex medical and psychiatric comorbidity is com-mon in individuals with substance use disorders. It is important to assess comorbidity because of the implications for prevention and treatment. Studies of the neurobiology of substance use and psychiatric disorders are accumulating rapidly and informing treatment development. Information about the prevention and treatment of infectious diseases and other medical conditions associated with substance use disorders also is growing, and it is important that patients are able to benefit from this. The articles in this issue provide state-of-the-art information about several issues related to comorbidity in substance use disorders.

Behavior, Addictive↗

PubMedDate not supplied

Patient characteristics and risks factors for development of dependence on hydrocodone and oxycodone.

The purpose of the study was to document the substantial increase in problematic use of hydrocodone and oxycodone in an addiction treatment population. Our study consisted of a retrospective review of medical records from all patients admitted and discharged in 2000 from Sparrow/St. Lawrence Addiction Detoxification Unit (N = 534). A literature review was conducted in medical journals, governmental groups, and reports including Drug Abuse Warning Network, Pharmacy Times, and National Household Survey on Drug Abuse. More than 144 patients (27%) were dependent on prescription opiate medications. The most frequently mentioned medication was Vicodin (hydrocodone) (53% of the users) followed by OxyContin (oxycodone) (19%). Physicians commonly prescribed these medications (75% of the cases). Predictors of dependence on opiate medications included substance-related diagnoses, positive toxicology for opiates, and other medical diagnoses. Patients under the care of physicians who have other drug dependence diagnoses and medical complaints appear at risk of developing dependence on prescription opiate medications. Proper evaluation and intervention can limit adverse consequences of prescription opiate medications.

Adult↗

PubMedDate not supplied

Failure of enforcement controlled substance laws in health policy for prescribing opiate medications: a painful assessment of morbidity and mortality.

Controlled substances can be used for legitimate medical purposes to relieve pain and suffering, and allow management of medical and surgical conditions, whether acute or chronic in duration. However, because these are attractive, addicting drugs, diversion from sources such as physicians and pharmacists can lead to serious health problems. Of importance is that addiction to opiate medications can interfere with treatment of the original pain condition, and can lead to life threatening states because of poor judgment and depressed mood in the users. Consequently, the public has a vested interest in protecting the medical uses of these medications on the one hand, although reducing the morbidity and mortality from their diversion and addictive use. The controlled substance laws contain 3 sources of policy framework that governs the medical use and diversion of controlled substances: (1) international treaties, (2) federal laws and regulations, and (3) state laws and regulations. These laws are aimed at balancing the need to controlling use with adverse consequences against the therapeutic benefits opiate medications provide the public.

Analgesics, Opioid↗

PubMedDate not supplied

Effects of opioid prescription medication dependence and detoxification on pain perceptions and self-reports.

The purpose of this work is to document whether prescription opioid medications used for pain enhanced or worsened pain syndromes from medical conditions in patients who received a diagnosis of prescription opioid dependence as determined by a diagnosis by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. Further, whether detoxification improved or worsened pain perceptions and self-reports in patients who chronically administered prescription opioid medications. Our study consisted of a retrospective sample of patients taken from the Addiction Treatment Unit at St Lawrence Hospital in Lansing, MI. Patients were selected from those who voluntarily sought detoxification from opioid medications in an inpatient setting. Selection criteria for the study consisted of a DSM-IV diagnosis of opioid prescription medication dependence, willingness to undergo medical detoxification, cooperation with self-report scales, and abstinence from opioid medications. Study patients were randomly selected from discharges in patient census for the years 2001 to 2003. The significant findings were that self-reported pain scores improved during the detoxification from admission to discharge, from a mean of 5.5 at admission to mean of 3.4 at discharge (0 is no pain and 10 is the most pain). The detoxification period extended to an average of 5 days. Whereas oxycodone CR (OxyContin) produced higher levels of self-reported pain at admission than at discharge, and these patients experienced significant levels of pain reduction with decremental opioid doses as with other opioid medications. Patients with a DSM-IV diagnosis of prescription opioid dependence reported (self) less pain with detoxification and abstinence from the opioid medications.

Adult↗