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Drug overdose has become the leading cause of death in the United States, and the majority of overdose fatalities involve opioids. Both legal (by doctor prescription) and illicit opioids are implicated in the current public health epidemic. The vast majority (80%) of heroin addicts started off using prescription opioids, showing that the healthcare and pharmaceutical industries are in large part culpable for fueling the crisis. Opioids do have a role to play in providing pain relief in extreme cases, but this powerful class of drugs needs to be pushed to the periphery of options available for patients in need of pain relief. Exploration of alternative options for pain relief is one of many strategies that can be used to address and mitigate the opioid epidemic. Other necessary interventions include the re-education of healthcare staff and the bringing to justice of the pharmaceutical industry.
It is hard to believe…… [Read More]
What Can be Done to Stop the Opioid Crisis in the United States Today?
Today, a veritable public health crisis exists with respect to the widespread use of prescription and illicit opioids such as heroin, pain relievers and synthetic opioids such as fentanyl by American consumers. In fact, opioid overdoses claim more than 130 Americans each day, and there are no signs this ugly trend will reverse itself in the foreseeable future (Opioid overdose crisis, 2019). Moreover, the social and economic costs that are related to the tens of millions of people who are currently addicted to opioids is estimated to exceed $78.5 billion annually, a figure that includes that costs of lost productivity, healthcare and addiction treatment as well as adjudication of criminal cases by the law enforcement community (Opioid overdose crisis, 2019). The purpose of this paper is to review the relevant literature to provide a concise…… [Read More]
Article 1: McCauley, J.L., Back, S.E. & Brady, K.T. (2013). Pilot of a brief, web-based educational intervention targeting safe storage and disposal of prescription opioids. Addictive Behaviors 38(2013): 2230-2235.
In this article, McCauley, Back & Brady (2013) report on the results of an open pilot trial focusing on increasing patient knowledge of safe use of prescription opioids. Participants were 62 outpatients at a chronic pain management clinic or dental clinic who were prescribed opioids. All participants received informed consent and then completed the Script Safety intervention, which is an online information service containing information specific to the medication each participant was taking. Telephone interviews were conducted one week and one month following the intervention to assess knowledge retention and comprehension, misuse behaviors, and overall satisfaction. Results showed that satisfaction rates were high, knowledge comprehension and retention rates were also high, and that some self-reported misuse behaviors had decreased at the…… [Read More]
Financial and Economic Impact of Worker's Compensation egulations And Compliance
The program and concept of Workers' Compensation might appear to be a product of a civilized society and the modern era, but nothing could be further from the truth. In fact, Workers' Compensation has essentially been around for as long as people have been completing task for payment of some form of another, because people have always been getting hurt in some way, on the job. "The history of compensation for bodily injury begins shortly after the advent of written history itself1. The Nippur Tablet No. 3191 from ancient Sumeria in the Fertile Crescent outlines the law of Ur-Nammu, king of the city-state of Ur. It dates to approximately 2050 B.C.2. The law of Ur provided monetary compensation for specific injury to workers' body parts, including fractures. The code of Hammurabi from 1750 B.C. provided a similar set of rewards…… [Read More]
The initial step starts with self-assessment. Various territories of self information are imperative in establishing a framework for a career plan. I initially need to comprehend my particular identity e.g. Am I active or bashful, latent or forceful, mindful or passionate. What's more, I should be clear about my mentalities toward life and work. For instance, an inspirational state of mind about work characterizes who I am and may turn me toward a career that gives the chance to take part in a driving enthusiasm however it would not intrigue somebody for whom work is just a fundamental malevolence to give stability and salary. (Andolsen, 2008).
Using the MTI personality type analysis, I can determine 4 levels of my personality; namely introversion, sensing Or sensitivity, thinking ability and perception. this can then allow me to determine whether I am logical, practical, adaptable l, observer or a problem-solver, leader or…… [Read More]
legislation on PA SB 1299
The General Assembly of Pennsylvania
Senate Bill No. 1299
Session of 2014
Introduced by: Ward, Pileggi, Erickson, Schwank, Washington, White and Baker.
The significance of PA SB 1299 Bill
The deaths from overdose on opioids have been a common occurrence across the nation with many of the people falling victims to either ignorance or intentional negligence by the people around then when they suffer the overdose symptoms to death. Initially, there were rampant incidences of the arrest and prosecution of the volunteers who called the law enforcement and the first responders to the scene since they too were often found to have used the drugs. The first responders were also not allowed to administer opioid antagonist at the scene to the person suffering obvious signs of overdose on the opioids hence the death rates from the overdose kept increasing even amidst the knowledge that…… [Read More]
Some patients knowingly abuse the healthcare system to obtain drugs and substances, which only adds to the complexities of the substance misuse relationship with the medical community. In 2008, the National Survey on Drug Use and Health reported approximately 4.7 million Americans used pain medications for non-medical use within the last month (Fishbain et al., 2010). This statistic is only one indication of the substance misuse prevalence and its inherent demand on the medical community.
The medical community not only combats substance misuse in adult patients, but must also address misuse among adolescents. The years of adolescence are widely regarded as an age defined by curiosity and experimentation (Crome, 2004). Adolescents are continuously trying to identify with their world and engage in new experiences. Within this context, taking drugs and experimenting with such substances as alcohol and tobacco can be understood within a setting of normal behavior. The time of…… [Read More]
Croop et al. (1997).
The overall safety profile of naltrexone is good; however, care must be taken in prescribing the drug to certain patient populations; e.g., naltrexone shows a dose-dependent hepatotoxicity (package insert) and is therefore contraindicated in patients with significant hepatic impairment, which is frequently encountered in alcohol-dependent populations.
The clinical trials of naltrexone have typically been conducted in patients without significant impairment in hepatic function. Another consequence of the hepatic impact of naltrexone is the possibility of drug-drug interactions.
Kim et al. (2001) potentially clinically significant interaction has been reported between naltrexone and nonsteroidal anti-inflammatory drugs; these researchers found elevated liver function tests in study participants receiving both medications, although the doses of naltrexone used in this study were higher than the typical 50 mg daily dose.
Naltrexone is not appropriate for use with patients taking prescribed or illicit opioid drugs. Antagonism of the effects of these drugs…… [Read More]
Animal models of addiction do not generalize well to substance dependence in humans as there are different criteria involved. For example, in animals "addiction" has been traditionally defined by a caged laboratory animal's tendency to press a lever for a reinforcing substance, whereas in humans the criteria for dependence (the clinical term for addiction) include a number of behavioral criteria and consequences that could never exist in laboratory animals (American Psychiatric Association [APA], 2000). These criteria include: tolerance, withdrawal, taking more of a substance than originally intended, a history of unsuccessful attempts to quit, inordinate amounts of time spent in using and seeking the substance, a reduction in activities (occupational, social, or education) due to use, continued usage despite adverse consequences (APA, 2000). Interestingly, only three of these criteria need to be met in a year, so one need not demonstrate significant physical signs such as tolerance and…… [Read More]
Mexico faces an array of drug-related problems ranging from production and transshipment of illicit drugs to corruption, violence, and increased internal drug abuse. Powerful and well-organized Mexican organizations control drug production and trafficking in and through Mexico, as well as the laundering of drug proceeds. These organizations also have made a concerted effort to corrupt and intimidate Mexican law enforcement and public officials. In addition, the geographic proximity of Mexico to the United States and the voluminous cross-border traffic between the countries provide ample opportunities for drug smugglers to deliver their illicit products to U.S. markets. The purpose of this study was to develop informed and timely answers to the following research questions: (a) How serious is the trade in illicit drugs between Mexico and the United States today and what have been recent trends? (b) How does drug trafficking fund terrorist organizations in general and trade between Mexico and…… [Read More]
Heroin Impact on Caucasian Family?
A large number of Caucasian families are plagued with the issue of heroin use, mostly consumed via injections. This is a major public health issue. Viral hepatitis, HIV and other dangers associated with heroin dependence, as well as social harm resulting from accompanying poverty and crime, exceed those of almost all other drugs used. A majority of Caucasian households are indirectly as well as directly impacted by the aforementioned diseases.
Increased pureness and decreased drug costs are potential factors contributing to the trend of decreased age of first-time consumption and increased initiation into habitual consumption in the Caucasian population. As heroin dependence can be successfully cured, primary care providers need to check their patients for this problem.
This paper serves two purposes. Firstly, it attempts to study substance abuse's socio-economic effects on Caucasian people. Secondly, depending on this analysis, it attempts to provide recommendations on…… [Read More]
Drug addiction is not merely a failure of will or weakness in character, however having this 'brain disease' does not absolve the addict of responsibility for his or her behavior, but it does explain why an addict feels compelled to continue using drugs (Leshner 2001). Environmental cues that surround an individual's initial drug use and development of the addiction, actually become "conditioned" to the drug use and thus are critical to the problem of addiction (Leshner 2001).
Therefore, when those cues are present at a later time, "they elicit anticipation of a drug experience and thus generate tremendous drug craving" (Leshner 2001). This type of cue-induces craving is one of the most frequent causes of drug use relapses, independently of whether drugs are available and even after years of abstinence (Leshner 2001).
In March 2006, it was reported that researchers from Liverpool, England discovered a gene that directly affects the…… [Read More]
Offered under the same roof are "consultative, diagnostic, and treatment services" which are stated to be provided "by board-certified practitioners in the fields of pulmonary medicine, otolarngology, family medicine and more." (2006)
Smith reports that the laboratories experiencing the most dramatic growth are two which are located the "farthest from the Hillsboro flagship" as they are located in two areas that were "formerly underserved." (2006) Smith additionally reports that the demand is stronger in the areas where the two fastest growing centers are located which supplies "plenty of fuel for expansion."
Smith states that the Sleep Health & Wellness NW is attempting to "fill a gap so that patients who previously were overlooked or not being reached or who fell through the cracks no longer are," she says. "We have no plans to open centers in areas where there are already quality sleep services programs. We only want to go…… [Read More]
Gonadectomy alters the magnitude of CCS and ICS analgesia and alters the relationship between the gender-specific effects observed in sham-treated rats. Castration significantly decreased the magnitude of CCS analgesia on the tail-flick and jump tests, and the magnitude of ICS analgesia on the jump test. Indeed castration reduced the magnitude of CCS and ICS analgesia in males to that observed for sham-treated female rats.
Given the multitude of CNS substrates and systems underlying both opioid and stress analgesia, and the likelihood that only a little differ amid sexes, we could rationally expect to come across sex differences in opioid analgesic efficacy in some occasions, depending solely on the nature of the ache incentive and opioid involved, as outlined earlier. It is important to also note that sex differences are no defined to opioid drugs in analgesia. Furthermore, commencement of endogenous pain inhibitory mechanisms in reaction to stress also produces…… [Read More]
Public Hearing -- Heroin Epidemic
The hearing attended for this paper was on Tuesday, August 26, from 9:30 A.M. To twelve noon. It was held at the Penn State Schuylkill, which is a campus that is part of Pennsylvania State University in Schuylkill Haven, Pennsylvania. Schuylkill Haven is located in Schuylkill County in Pennsylvania.
The purpose of the hearing was to present a formal, public discussion on a serious and growing drug problem in the county. Specifically, the hearing was focused on the serious problem in the community of heroin and opioid addiction, and what can be done about it. Also the hearing was held to discuss not just the problems of addiction -- and evidence to support that issue -- but also to bring to the audience's attention preventative measures that can be taken, or are being taken, whether adequate or not in the present context.
This was an…… [Read More]
NLM (2012). Substance abuse treatment of women. Chapter 4. National Library of Medicine: National Institutes of Health. Retrieved on December 9, 2012 from http://www.ncbi.nlm.nih.gov/books/NK83257
- Screening and assessment. http://www.ncbi.nlm.nih.gov/books.NK83253
rauser, D (2010), Sublingual buprenorphine relieves symptoms of neonatal opioid abstinence syndrome, Medscape: Medscape LLC. Retrieved on December 9, 2012
Fisher, P.A. et al. (2011). The combined effects of prenatal drug exposure and early adversity on neurobehavioral dis-inhibition in childhood and adolescence,
Developmental Psychopathology. Retrieved on December 9, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335443
Hamdan, a.H. (2012). Neonatal abstinence syndrome, Medscape: Medscape LLC.
Retrieved on December 9, 2012 from http://www.emedicine.medscape.com/article/978763-clinical
Johnson, K et al. (2003). Treatment of neonatal abstinence syndrome, Archive of Disease
in Childhood. Retrieved on December 9, 2012 from http://www.bmj.com/content/88/1/F.2.2.ful
Johnson, K and Leff, M (1999). Children of substance abusers. Pediatrics. American Academy of Pediatrics. Retrieved on December 9, 2012 from http://www.pediatrics.aappublications.org/content/103/Supplement_2/1085.long
Kraft, W.K. et al. (2010). Future trends…… [Read More]
Veterinary Nursing Anesthesia and Analgesia Case Journal
The objective of this study is to address anesthesia needs in two specific cases with the first being a 12-week-old Jack Russell puppy and the second being a 12-year-old geriatric cat.
12-Week-old Jack Russell Puppy
This 12-week-old Jack Russell Puppy has eaten a babies dummy. This case study will highlight the anesthesia requirements and protocol and highlight the relevance of effect on renal function, speed of recovery, analgesia, emphasis on knowledge and understanding. Even at 12-weeks of age, this puppy is considered a pediatric patient according to the work of Gleed and Seymour (1991). This means that the patient has a higher oxygen requirement that the adult. The tongue of this patient due to his age is large and the airway is small in diameter. As well, there is a lower functional renal capacity in this age patient all of which make the…… [Read More]
Health Sciences 101
The Health Impact of Acetaminophen Overdose
Acetaminophen (APAP) is a common over-the-counter (OTC), antipyretic, anti-inflammatory, analgesic that is more commonly known as Tylenol®, a product of Johnson & Johnson1. Overseas the drug is called paracetamol and is manufactured and sold by countless generic drug makers.
A number of concerns regarding the safety of APAP have arisen over the past several years, including liver and kidney toxicity and adverse cardiovascular and cardiopulmonary effects. This essay will provide an overview of APAP, its uses, and safety issues, with an emphasis on the cardiopulmonary system.
Mechanisms of APAP Activity
The analgesic and antipyretic activity of APAP was thought to be similar to other non-steroidal anti-inflammatory medications because it was believed to inhibit prostaglandin (PGE2) synthesis2,3. This assumption has not withstood the test of time, for either APAP or other popular OTC non-steroidal anti-inflammatory drugs (NSAIDs). The main evidence…… [Read More]
120). Together these chemicals control and boost the sexual experience. It should be noted, that while dopamine dominates the desires of wanting to have sex it is another group of chemicals that govern enjoyment. Opioids are the brains equivalent of morphine and endorphins. Dopamine may propel the behavior but the opioids are necessary for experiencing orgasm.
During orgasm, opioids boost the reward circuit to add to the effect of dopamine. In the orgasmic phase, the body releases a shot of dopamine. However, after orgasm dopamine, levels fall precipitously and individuals lose interest in sexual encounters of a time. As levels of dopamine fall, prolactin and oxytocin levels increase. Oxytocin levels increase for a short period after orgasm and produces the bonding effect (Allchin, 2011). Prolactin functions as a dopamine suppressor. It halts the action of dopamine and brings the body back to a normal level. This marks the beginning of…… [Read More]
In 2012, there were nearly 800 million doses of opioids prescribed in Ohio alone -- a figure which equates to roughly 70 pills for every individual in the state. The prescriptions were for 20% of the state's populace (Semuels, 2017). What's more is that these prescriptions are not helping people; on the contrary, as Katz (2017) reports, "drug overdoses are now the leading cause of death among Americans under 50." It is so bad that the country is now essentially addicted to pills and it is literally killing us.
The causes of the opioid crisis are directly related to the Sackler brothers who pioneered the art of Big Pharma's role in advertising and making relationships with physicians in prescribing drugs to patients (Mariani, 2015). The Sacklers pushed OxyContin onto the market and turned the country into a drug-dependent nation. This was purely a profit before people type of…… [Read More]
When the nation was founded, hemp was a regular crop that the Founding Fathers all harvested. Cannabis was literally part of the fabric of the American Way: hemp was used for a variety of functions, from tea to textiles. As Robert Deitch notes, “we know colonial Americans were aware of the medicinal properties of cannabis. It was one of the few medicines they had, and they used it as commonly as we use aspirin today” (25). If cannabis was good enough for the first Americans, surely it stands some much warranted consideration—particularly in the light of the recent opioid epidemic that has claimed the lives of so many young in today’s day and age (Nelson, Juurlink, Perrone). People looking for a little relief are chasing after dangerous drugs that can kill. Marijuana, however, has never really been associated with overdosing and death. Just as the early Americans found, cannabis…… [Read More]
This allows the client to place their level of behavior on the continuum and assess the levels of risk associated with their behaviors. The continuum also allows the client to assess the ways in which their behaviors over time, by examining the ways in which their behaviors are now different to past behaviors. This may allow clients to recognize that they have already made some progress toward less harmful behaviors, or may allow them to identify specific events which led to developing more risky behaviors. The harm reduction model allows the client to assess their current situation and plan the actions which they wish to take to change their future behaviors.
Applications of the model
The harm reduction model has been applied predominantly to drug misuse issues, however it is also appropriate to apply the model for a wide range of social and health behavior changes. The model has been…… [Read More]
Substance Abuse in the Elderly
The increase in substance abuse among people over 60 years of age is understandable from several perspectives. The boomer generation grew up in a society that was experimenting with controlled substances, and in -- or on the margins of -- a culture that viewed the use of drugs as normative. Indeed, much of the rhetoric about drugs and alcohol was that these substances could enhance life experiences, provide deeper insights into one's life -- transcendence, if you will -- and ease the suffering brought about by life transitions and quotidian pressures. This generation found self-medicating for personal angst and genuine disorders such as depression or post-traumatic syndrome was acceptable.
While many life challenges are universal and do not occur in higher percentages according to particular demographics, other challenges are linked to demographics. People in their 60s and beyond do experience an uptick of physical and…… [Read More]
Substance / Alcohol Abuse among the Elderly
Substance/alcohol abuse among the elderly 60 years and older
Alcohol and substance abuse among the elderly is a significant social problem, not only because people in this age group tend to have very permissive attitudes towards social drug and alcohol usage but also because the stressors that accompany aging may result in increases in drug or alcohol usage to problematic levels. While people may begin experiencing age-related problems in their 40s and 50s, it is not generally until their 60s that most people begin to experience significant physical or emotional challenges related to age. These challenges are often accompanied by major life changes, such as retirement, the death of a spouse or friends, relocation, and diminished physical and intellectual capabilities. These changes may mean a lack of access to the coping mechanisms that have traditionally served the individual, leading to a rise in…… [Read More]
Alternatives to Pain Medication
Given the growing concerns over opioid addictions in recent years and the potential for tolerance, clinicians continue to search for efficacious alternatives to convention pain medications (Moore & Anderson, 2016). Fortunately, a number of alternatives to conventional pan medication are readily available, including cannabis, yoga, hypnosis, mind-body meditation, therapeutic touch, herbal remedies, acupuncture, biofeedback, massage therapy, homeopathic practices (Tan & Craine, 2007) and aromatherapy (Esposito & Bystrek, 2014). To learn more about these alternatives, this paper provides an initial reference list of ten relevant peer-reviewed and scholarly sources concerning pain medication alternatives, followed by a description of clinical guidelines and an implementation plan for these alternatives. A discussion concerning the manner in which the implementation of the intervention should be tested is followed by an assessment of potential barriers and strategies intended to gain cooperation from individuals who will be implementing the change. Finally, a timeline…… [Read More]
[Narayan, (2010)]. The review also showed that patients from culture might feel disinclined to take opioid medications due to cultural ban. For instance, in a study conducted by Sandy Lowering (2006) in a multicultural clinical setting in a Saudi Arabia, including patients form Irish, African, Asian, Filipino and Tswana, it was found that the use of narcotics was unacceptable for African, Saudi Arabian and Tswana patients due to cultural taboo on the use of sedatives and addictive substances. [Sandy Lovering, (2006)]
In these cases it is incumbent upon the nurses to establish good rapport and help the patients shed the cultural patterns that are hindering effective pain management. y skillful explanations and effective culturally sensitive communication the nurse should explain that the traditional beliefs should be abandoned in cases where they tend to compromise care. This could only be achieved by establishing culturally competent communication with the patient and educating…… [Read More]
A "drug" is any substance, other than food, that affects our bodies or minds. Since not all drugs are bad, the book uses "substance" to clarify the issue. Substance abuse can cause temporary or long-term problems for the abuser. Dependence, tolerance or addiction can develop.
Depressants: slow the central nervous system (CNS) down. Alcohol is a CNS depressant.
Alcohol: nearly 6% of the U.S. population are heavy drinkers, some as young as 11. Men outnumber women 3:1. Ethyl alcohol is quickly absorbed in stomach and intestine. First it depresses the areas of the brain that control judgments and curbs on behavior. Next, motor control is affected. Alcohol can also interfere with both vision and hearing. As the liver metabolizes the alcohol, the blood levels drop and function gradually returns. Patterns of alcoholism vary among socio-cultural groups and by age. Alcoholism can destroy family life, sink a career, and…… [Read More]
The authors state: "The amphetamines occasioned dose-related increases in d- amphetamine-appropriate responding, whereas hydromorphone did not. Amphetamines also occasioned dose-related increases in reports of the drug being most like "speed," whereas hydromorphone did not. However, both amphetamines and hydromorphone occasioned dose-related increases in reports of drug liking and in three scales of the ARCI. Thus, some self-report measures were well correlated with responding on the drug-appropriate lever and some were not. Lamb and Henningfield (1994) suggest that self-reports are complexly controlled by both the private event and the subject's history of experience with the drug. Some of the self-reports they observed (e.g., feels like speed) are probably occasioned by a relatively narrow range of stimuli because in the subject's experience with drug administration, these reports have been more selectively reinforced by the verbal community relative to other reports (e.g., drug liking). They also suggest that these results imply…… [Read More]
The bulk of the Cuban community in exile in Miami focuses on its white contingency. Afro-Cubans have a second-class status there, and their patterns of migration have been much different than they have for white Cuban refugees and immigrants. As Newby & Dowling (2007) note, recent Afro-Cuban immigrants have settled in various other places in the United States including the Southwest, where there are already entrenched Chicano communities and African-American communities. Afro-Cubans do not fit into the Chicano communities, the communities with other white Latinos, or the African-American communities. Language presents one of the most significant cultural barriers and identity markers distinguishing the AfroCubans from the African-Americans. Although they share some common ethnic heritage and ancestral experiences of racism, slavery, and political oppression, centuries have passed since their cultures demonstrated divergent trajectories. With regards to white Latinos in the Southwest such as Austin and Albuquerque, race raises serious…… [Read More]
Overall, the findings of Shields and colleagues (2007) suggest that religious patients entering a substance abuse treatment program will tend to seek out treatment programs that are more religious. This grouping effect will then have a positive effect on retention rates and commitment to establishing a drug-free lifestyle.
The diversity of individual religious practices is one of the main impediments to researchers attempting to define it efficacy in treatment programs (reviewed by Puffer, Skalski, and Meade, 2012). For example, the eligious Coping Scale (COPE) instrument is intended to bring some measure of standardization to the research being conducted in this area by discriminating between positive and negative religious beliefs. A positive religious coping practice would be the belief in a benevolent Higher Power and finding meaning in personal suffering. Negative religious coping, on the other hand, would be to believe personal suffering is God's punishment for past wrongs.
When…… [Read More]
In addition to the therapeutic armamentarium, CAM reported to have a great role to treat interstitial cystitis (IC). It is multimodal and individualized and includes various treatment methods including: Neuromodulation, dietary modification, acupuncture, surgical methods, medications etc. The objective of this literature review is to discuss the possible causes of the IC, diagnosis, prevalence, the symptoms, and CAM treatment options.
Interstitial cystitis (IC) also called as painful bladder syndrome is an inflammatory disease of the bladder wall with typical ulceration of the urothelium. The interstitial cystitis (IC) is generally regarded as an elusive disease picture with inadequate therapeutic options. Critical to improving the prospects for therapy is the early diagnosis of the disease, which may involve only a careful history taking and clinical examination. CAM suggests multimodal treatment strategies in the early stage of disease (Abrams, Cardozo, & Fall, 2002).
Due to definition similarity, IC is often referred…… [Read More]
As a new graduate of six months working night shift on a small cancer unit, I am faced with a dilemma. Mr. V has been in and out of the unit several times over the last few months. He has liver cancer and has gone through several episodes of chemotherapy. His wife has been staying with him since his admission. There are two RN's on this unit.
Mr.V recently joined the hospice program. His current admission is for pain control with orders to start a morphine drip to be regulated for pain control.
The only set parameters indicated by hospital policy are to decrease the drip when respirations are less than twelve breaths per minute. Mr. V has requested that the drip be increased several times during my shift. Even though he does not appear to be in any discomfort, I increase the drip. On my final round of…… [Read More]
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction.
The role of the anesthesiologist in cardiac surgery is to as much extent as possible, to reduce the stress response that results form cardiac surgery. Stress response can be mitigated by a variety of anesthetic technique, including use of opioids and epidural anesthesia. These ideas are explored in greater detail below.
Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique
INTRODUCTION stress response may…… [Read More]
Prescription Drug Abuse
The overall point of conversation when speaking of prescription drugs in the public and political sphere has usually focused on cost and/or ease of access among all Americans. The overall points of conversation relating to drug has often centered on drugs like heroin, cocaine, crack and marijuana. However, as time and trends have shifted, the primary focus of both overall topics has centered on the use and abuse of prescription drugs, usually certain classes of drugs such as sedatives, opiates and anti-anxiety drugs. Common drugs focused on include Xanax, any narcotic-based painkiller such as Oxycontin and sedatives or muscle relaxers such as Valium and Soma. While prescription drugs are very important to have at the ready, the likelihood and propensity towards abuse of the drugs and other legal behavior is significant and this is even true among people who obtain the drugs legally at the onset.
Analysis…… [Read More]
Future of Marijuana in America:
Marijuana or cannabis was first identified by the Chinese in c. 2737 BCE and has since been used for medicinal purposes for millennia. The introduction or arrival of medicinal cannabis in America was characterized with an amazingly colorful and checkered history. Medicinal cannabis was characterized with initial robust use in the United States, which faded after the development of aspirin and opioids. The decreased used culminated in the criminalization of cannabis in America in 1937 despite of the contradictory advice of the American Medical Association, which was submitted on record to Congress. However, the use of marijuana has emerged as a major issue in the past few decades because of the renewed interest in medicinal cannabis. Actually, several stakeholders in the health care sector including the American College of Physicians, the Institute of Medicine, and the National Institutes of Health have supported further research and…… [Read More]
Drugs and Differences between Them
There are various types of drugs that have considerable effects on the brain and are used by individuals for various reasons. These types of drugs are classified into different categories i.e. stimulants, depressants, and hallucinogens. As the name suggests, stimulants are drugs that speed up an individual and can be dangerous while depressants are drugs that slow down an individual and can be dangerous by causing vomiting, unconsciousness, and even death. On the contrary, hallucinogens are drugs that make a person see and hear strange things or things that are not actually in existence. Similar to stimulants and depressants, hallucinogens can be dangerous because of their effect on a person's brain. Some examples of depressants, stimulants, and hallucinogens are oxycodone, nicotine, and mescaline. These drugs differ with regards to the composition, physical and psychological effects, manufacture or cultivation, how they are used, and individual's motivation…… [Read More]
Substance Abuse in America
The objective of this study is to apply change theory and the Transtheoretical Model of ehavior Change to health promotion activities in the health care environment and examine how the 'readiness to change' factor impact the success of a change in behavior.
Substance abuse in America is a prevalent problem and a challenge faced by health care provides in terms of identifying and applying effective modes of treatment to bring about behavior change in those with substance abuse problems.
Transtheoretical Model Stages of Change
The Transtheoretical Model Stages of Change was developed at the University of Rhode Island by James O. Prochaska in the latter part of the 1970s and is comprised by four components: (1) stages of change; (2) processes of change; (3) decisional balance; and (4) self-efficacy. (Inspire Malibu, 2015, p. 1) The reason for the name 'Transtheoretical" being assigned to this model is…… [Read More]
ecovery can be a difficult journey for many. The reality of having to change old habits for new ones can take a lifetime. The recovery approach/model realizes the struggle of change and transformation and makes it so that way emphasis is not placed on the destination, but rather the journey. Although other approaches like the disease/medical model aim to treat one aspect of recovery from addiction, the recovery model encompasses all aspects making it one of the most advantageous models to adopt to fight addiction.
The recovery approach/model to addiction and/or mental disorder places a strong emphasis on a support for an individual's potential for recovery. ecovery means a person undergoing a personal journey instead of determining and setting an outcome. This personal journey involves the development of hope, a sense of self, a secure base, social inclusion, meaning, empowerment, and coping skills that will take that person past the…… [Read More]
Drug Abuse in Long Island, New York
With more than seven and a half million residents, Long Island, New York is a major center of commerce and education, but like many other densely populated large urban centers, this city also has a significant drug abuse problem. To determine the facts about the problem, this paper reviews the relevant literature to provide epidemiological evidence concerning the incidence of drug abuse in Long Island, and what community-based resources are available to its resident. Finally, a review of a recent research study article concerning these issues is followed by a summary of the research and important findings concerning drug abuse in Long Island in the conclusion.
eview and Analysis
Epidemiological evidence concerning drug abuse in Long Island
Like many other major American urban centers, all types of drugs are abuse in Long Island, but heroin abuse in particular has become a serious problem…… [Read More]
There is a need to legalize marijuana and allow people an alternative source of health care to that which is provided by the pharmaceutical industry. Big Pharma is responsible for the opioid epidemic devastating lives today. Marijuana is a naturally occurring plant that people have used responsibly for thousands of years. It is time to take back control of the lives of people and legalize marijuana. This proposal explains why that would be beneficial and how the government can take action now.
Introduction (Purpose and Problem)
Marijuana has been legalized by many different states in recent years. However, it still remains a schedule 1 narcotic according to the federal government, which means under federal law it is considered a substance as dangerous as heroin and cocaine (DEA). The history of marijuana usage in the U.S. shows that the plant was always legal up until the era of Prohibition and…… [Read More]
An addiction can be considered a physical and psychological incapability to avoid the consumption of drugs, chemicals, substances, or even taking part in an activity even when doing so causes both physical and psychological harm (Nutt, 2018). The Addiction term is not only applicable when it comes to cocaine and heroin use. Any person who cannot function normally without taking some specific chemical or drug is considered to be substance dependent (Nutt, 2018). The obsession with some activities such as working, eating, and gambling is considered an addiction (Clark & Limbrick-Oldfield, 2013). This type of addiction is commonly referred to as behavioral addiction. As stated by Robbins and Clark (2015) behavioral addictions have gradually become a recognized psychiatric disorder. Recently pathological gambling has been allocated to the DSM-5 category (American Psychiatric Association, 2013).
There are several other disorders that have been suggested as being part of the behavioral addiction category…… [Read More]
The inclusion of alcohol and drug education is a vital component of most drug and alcohol abuse interventions, for both the users and non-user. (Montagne et al., 1992). This education can be offered as a preventive measure to beginners of abuse of substances of to the vulnerable group to save the future generations from the menace and the whole society from the drug's association with crime. Alternatively, it should be offered to be taught as part of the educational curriculum in schools
ecent literature reviews have not found enough evidence to convince many researchers that drug and alcohol awareness programs have great impact on changing substance and drug use, attitude and behavior (Eliany et al., 1993). Although it is of great effort, it has been observed that education alone is not enough to change the actual behavior of alcohol and drug use (Tobler et al1976), in the actual examination of…… [Read More]
When processed by a transglutaminase enzyme, it can interact with immunological cells and produce cytotoxic inflammation. In autism, it is believed that peptides from gluten and casein cross the intestinal microvillus barrier and enter the blood stream. They also cross the blood-brain barrier. In the brain, certain amino acid sequences of these peptides compete with natural peptides, which bind to opioid receptors. These receptors are G-protein receptors in cell membrane surfaces of neurons. inding to these receptors disturbs the neuronal function and ultimately leads to or contributes to autism (Department of Pediatrics Staff).
Limited Reliable Scientific Evidence
UK researchers investigated more than 30 scientific articles on the effectiveness of the gluten-free, casein-free diet on autistic children (astian, 2004). They found one, which provided reliable scientific evidence that the diet works. The particular study, however, was conducted on only 20 children aged 5-10 who had high levels of protein in their…… [Read More]
Teen Drug Abuse - Prescription or Not
Differences between nonalcoholic offspring of alcoholics (family history positive, FHP) and matched offspring of nonalcoholics (family history negative, FHN) have been identified on a variety of behavioral, cognitive, and neurological measures. Compared to FHN teens, FHP adolescents and young adults demonstrate more disturbed school careers, impulsivity, rebelliousness, and nonconformity (National Survey on Drug Use and Health, 2006); poorer neuropsychological performance (Worden & Slater, 2009); and significantly lower amplitude in P300 brain waves, which are believed to measure selective attention (Cicero, et al. 2005). Further, following ingestion of alcohol, sons of alcoholics report less body sway and less subjective intoxication (Grant, et al., 2005), higher levels of flushing (McBride, 2011), and decreased P300 amplitudes when performing difficult tasks (Foster, et al., 2009).
Not all individuals with a family history of alcohol dependence become alcohol and/or drug abusers, however, and genetics alone cannot account for…… [Read More]
This is vital because medical personnel could administer something that causes life threatening symptoms if taken with an anticoagulant.
The final educational area that needs to be covered are the changes that must take place in the daily life of the patient. The patient must be careful not to cut himself or herself, In addition the patient must be careful not to take part in activities that might cause injury as injury can cause the patient to hemorrhage.
Three common GI problems include heartburn, ulcers and irritable bowel syndrome. Each of these conditions can cause stomach upset. Heartburn can be treated with over the counter medications, including Zantac. Ulcers require a specific antibiotic and a stomach acid reducer and IBS is often treated with stomach acid reducers. In addition all three conditions respond favorably to changes in diet.
The medications for heartburn can be purchased over the counter,…… [Read More]
For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.
The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."
Clearly this specific case study has important and practical implications to the practice…… [Read More]
In year 1799 anesthetic properties of Nitric Oxide were discovered by Humphery Davy (1778-1829) he advised that the by using nitric oxide, pain and shock of the surgical procedure can be negated. Third person who continue with Morton and ells philosophy was Charles T. Jackson. The Fourth man who contributed to anesthetics was Thomas Mortan (Blatner, 2009). In the year 1848 James Simpson used chloroform in obstetric surgery, he used diethyl ether to anesthetize a women with a pelvic deformity for delivery (kodali, 2009) and in year 1853 John Snow did a successful induction of chloroform to her Majesty Queen Victoria at the time of Prince Leopold's Birth and also on Fenny Longfellow who wrote to her poet brother that this use of ether is certainly the greatest blessing of this era (Longfellow, 1956). In the year 1885-illiam Halsted introduced the nerve block. In 1891 Heinrich Quincke demonstrated the process…… [Read More]
ATTACTION, SEX, LOVE, & ELATIONSHIPS
Attraction, love, sex, and relationships are fundamental to human condition. Each individual human is separate and distinct from every other one, yet there are numerous aspects to the human experience that every human shares -- attraction, love, sex, and relationships are prime examples of commonalities shared among the human race. Science(s) have demonstrated that sexual attraction and the desire for close relationships form and manifest in humans very early on their development, often before children have reached school age. With reference to several psychological, academic resources, the paper aims to explain some of the key components of sex, love, attraction, and relationships.
Key Components to Attraction, Sex, Love, & elationships
While attraction, love, sex, and relationships remains quite a substantial mystery to many people, there are professional and researchers in areas such as psychology where they are making headway toward a comprehensive understanding of…… [Read More]
military has a number of jurisdictional and operational issues associated with what it will do with personnel involved with the use of medical marijuana. Though it claims that there is no ambiguity -- that its Directives (DOD 1010.1) are clear -- in reality it now finds itself facing a "Don't Ask, Don't Smoke" problem. What is happening inside and outside of the armed services is mystifying how the rules are actually enforced and understood by its legal structure.
In general, the rules are clear. Law enforcement and command personnel inside of the services say the same as those on the outside who advice people about this issue:
The fact that your state has decriminalized marijuana use is not relevant to military law. The military is a federal institution, governed by federal laws. Drug use is a crime under the Uniform Code of Military Justice (UCMJ) Article 112a, 10…… [Read More]
Ropivacaine in Epidural Pregnancies
hen it comes time for a woman to have her baby, women worry with the different options and what kind of anesthetic she wants to block the pain during the delivery, who go to the hospital once they start going in to labor, will have already decided that they would like to have an epidural. Therefore, at a certain point in her delivery, the anesthesiologist will be notified, and they will come to the birthing unit room that the mother is in to perform the procedure right there while she is either laying on her side or sitting up while the mother is curled tightly over her belly. This position allows the anesthesiologist to have the best view of her spine so he can make sure that he is putting the needle in between the vertebrae and right outside of the membrane outside the spinal nerves…… [Read More]
Drug addiction has been the scourge of our times. Heroin and cocaine especially are the leading cause of imprisonment in the civilized world. (Johnson, 1973) The anti-drug lobbies aver with statistics that show that marijuana users often fall prey to more potent narcotics -- especially those that are seeking that perennial "high."
This essay will present a comprehensive picture of the factors -- physical, pharmacological, societal and epidemiological -- that surround heroin in Australia. (Hirst, 1979)
Heroin (Hulburd, 1952). Pharmacologically, heroin belongs to a class of drugs called depressants. This is because heroin use slows down the brain and central nervous system.
Heroin usually comes in powder form. In its pure form, heroin is white. ut depending on how it is "cut" or diluted, it can have different colors. In some third world countries, users are familiar with "brown sugar" (severely cut heroin, occasionally even with rat poison). (Charles,…… [Read More]
Care of Patients With Cancer
Diagnosis and Staging of Cancer
Because cancer is a complex disorder that often progresses over long periods of time -- including long periods before an actual diagnosis can be made -- it is very useful to medical practitioners to identify various stages in the progression of the disease. Diagnosis may occur as the result of presenting complaints that cause a patient to seek medical help, or diagnosis may occur when routine check-ups lead to a suspicion by a physician or a laboratory specialist that a more thorough investigation is indicated. Indeed, one of the reasons why certain procedures are included in routine annual physicals is because these tests result in a diagnosis at sufficiently high rates to make them worth conducting. As medical technology advances, the procedures are modified accordingly -- and sometimes the frequency standards for these procedures are modified, as well.
The nomenclature…… [Read More]
The Management of Constipation in Palliative Patients
hich strategy is considered the best when nurses must intervene with a patient suffering from constipation? The PubMed publication put out by the National Institutes of Health and the U.S. National Library of Medicine explains that there is some uncertainty within the healthcare field about the choice between managing constipation with drugs (pharmacologically) or with other various clinical programs in palliative care settings (Clemens, et al., 2013).
A section in the Oxford Textbook of Palliative Nursing dedicated to bowel management -- written by researcher Denice Caraccia Economou -- explains that there is no absolute rule as to what intervention is best (220).
Pharmacological Management: The use of opioids is not always recommended for constipated patients, because they increase electrolyte and water absorption in both intestines which can lead to dehydration and dry, hard stools, according to Economou (221). Also morphine is not…… [Read More]
Patient is a Hispanic male, aged 31. He is the father of one son, aged 10. The patient is Puerto ican, and was born and spent his childhood in Puerto ico. He came to live in the U.S. at age 11. He now lives in Brooklyn, New York. The patient is separated from the mother of his son. His son lives with his mother. The patient currently lives alone and is unemployed.
The chief complaint of the patient is that he is "feeling down and alone recently," and that he also feels separated from his family: "I also haven't seen my son for a while." Clearly he is depressed about his living situation, his prospects, and his health.
History of Present Illness
The patient's present illness is related to drug abuse, of which the patient has a considerable history. Essentially, the patient reports that over the past…… [Read More]
Biopsychosocial Approach to Treating Self-Injurious Child and Adolescent Psychiatric Nursing
My initial thoughts/feelings on the topics were: (This section contains your general feelings on the topic and NOT what the readings have informed you.
Initially, I did not have much knowledge about self-injurious behavior (SIB). Though I had from time to time heard about the behavior, it never actually crossed my mind that it is a behavior that could warrant significant medical attention. In my life, I have actually not encountered an individual with the behavior. I have not even heard many people mention or talk about it. I thought that people who would perhaps contemplate harming themselves are suicidal people, substance abusers, or insane people. In fact, I thought the behavior was more relatable with non-human animals as opposed to humans. I did not even think the behavior was evident in children. I also viewed it as some…… [Read More]
Mass Incarceration in Arizona: Trends and History
Mass incarceration is an example of one of the more profound injustices of our time. Arizona is one of the states in America that currently struggles with mass incarceration, as its penal system has spiraled out of control, becoming a factor of injustice, rather than a necessary and notable part of the justice system. This paper will look at how the penal system has changed—in Arizona and in America as a whole, and discuss how Arizona has also gotten on the corrupt bandwagon of for-profit prisons, something that does a tremendous disservice to all the citizens of the nation. Finally, this paper will examine the race relations in Arizona from a more historical perspective, ultimately demonstrating that mass incarceration impacts black and brown men more than white men, and is ultimately a form of segregation revived. This paper seeks to prove the undeniable…… [Read More]
The U.S. Healthcare Systems
The U.S. healthcare system is fragmented by the fact that incentives do not align with the actual goal of healthcare (Enthoven, 2009). For instance, healthcare facilities are incentivized to “treat” patients rather than to help them lead healthier lives. As Goldhill (2009) points out, healthcare treatments are subsidized by taxpayer dollars—and there are powerful lobbies in the healthcare field that promote the use of pharmaceuticals or new health technology (like hip replacements, which could end up leaking cobalt into one’s body). Moreover, care providers are encouraged to perform tests on patients even though there is no real need for them and they may in fact lead to overdiagnosis and to a deterioration of the patient’s quality of life, as the patient becomes obsessed with every minor health problem (Lichtenfeld, 2011).
Fragmentation impacts patient care in a negative way because it leads to the patient being…… [Read More]
PONV was not seen at 24 hours significantly lower rates of PONV at four and eight hours were found in the septoplasty group in which pharyngeal packing was not used
Habib, et al. (2010)
prospective, double-blind, randomized study
104 Patients undergoing craniotomy
Patients were randomized to receive oral aprepitant 40 mg (or matching placebo) 1 to 3 hours before induction of anesthesia or ondansetron 4 mg IV (or placebo) within 30 minutes of the end of surgery.
Data were collected at regular intervals by blinded personnel for 48 hours after surgery. Statistical analysis was performed using Wilcoxon's ranked sum test and ?(2) test. P < 0.05 was considered statistically significant.
cumulative incidence of vomiting at 48 hours was 16% in the aprepitant group and 38% in the ondansetron group (P = 0.0149). The incidence of vomiting was also decreased in the aprepitant group at 2 hours…… [Read More]
However, recently, anesthesiologists have suggest a low to mid thoracic epidural combined with adequate general anesthesia. This anesthetic technique will allow for adequate inter-operative monitoring. After the operation, the anesthesiologist must continue to monitor the patient for either hypertension, hypotension and hypoglycemia. The presence of either of these conditions may alter the course of the medication given to the patient once the patient is removed from the anesthesia.
Neurofibroma can cause systemic problems within the various components of the Respiratory System. As has already been presented, Neurofibromas can cause partial blockages within upper parts of the trachea. However, Neurofibromas can also pose challenges or the anesthesiologist when dealing with nasal, sinus or maxilofacial cavities with Neurofibromas present within. One example of how devastatingly complex the Neurofibroma can become is seen when a benign neurofibroma can cause a superior vena cava compression. Such was the case of a 21-year-old…… [Read More]
, 2006). The evidence reflects only a low level weight loss but is still worthwhile to consider in controlling weight at roughly 0.007 kg per week. It is useful for individual weight loss programs. Losing 0.2 kg per week requires a decrease of 220 kilocalories per day. Achieving a 32% reduction requires a sacrifice of 330 kilocalories a day from sucrose by substituting aspartame. Using aspartame replaces 70 g of sucrose or roughly two cans of soft drinks every day (Hunty et al.). This means less expense.
200 Times Sweeter and Cheaper
On the average, aspartame is 200 times sweeter than sucrose (Hu et al., 2008). Not only does it mean less calories but also less cost. The taste difference between them is that the sweetness of aspartame is detected by the taste buds longer than sucrose. This can, however, be resolved by adding acesulfame potassium. Aspartame also has limited…… [Read More]