Trends in Opioid Abuse: Prescription Abuse and Resurgence of Heroin (Feat. Dr. Cicero)

Trends in Opioid Abuse: Prescription Abuse and Resurgence of Heroin
Authors: Cicero, TJ1, Yee A2
Published: March 6, 2018

AUTHOR INFORMATION
1 Department of Psychiatry, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Abuse of prescription opioids leaves patients vulnerable to overdose and death as heroin becomes more widely available. Theodore Cicero speaks on his 50-year experience as an endowed professor in psychiatry researching drug abuse. In this video lecture, Cicero provides the historical context from which the opioid epidemic emerges. He also explains the reasons for opioid addiction by telling several personal patient stories of abuse. Cicero discusses significant opioid sources, which includes doctor shopping, prescription theft, and forgery, and its impact on the current state of health. He also explains gender considerations and the importance of patient history, with respect to previous substance abuse and psychopathology. He documents current efforts for confronting the opioid epidemic and the importance of resolving fundamental psychiatric issues in patients as heroin abuse emerges. Overdose deaths from heroin is a significant national issue as the opioid becomes the first drug of abuse.

TABLE OF CONTENTS
00:00 Introduction
00:45 THE PRESCRIPTION OPIOID EPIDEMIC
01:11 Joint Commission Classification of Pain as a Vital Sign
02:04 Introduction of Extended Release Oxycodone
03:20 The Epidemic Emerges
04:26 OVERVIEW
04:30 Why Prescription Opioids?
05:48 Patients’ Perceptions of Prescription Opioids
06:52 Source of Drugs
08:35 The Relevance of Age in Sourcing
10:47 Current State of Health and Effect of Opioid Abuse
12:28 Gender Considerations on Chronic Pain, First Opioid Use, and Psychopathology
16:13 Previous Substance Abuse
16:56 Specific Types of Drug Use Before Opioid Abuse
18:16 Initial Opioid Exposure and Its Unanticipated Benefits
19:19 Psychiatric Statistics of Opioid Abusers and Personal Stories
22:53 CONFRONTING THE EPIDEMIC
23:20 Supply-side Efforts
24:32 Have Those Efforts Worked?
24:36 The Resurgence of Heroin
26:31 Issues with Heroin
27:08 Why Has Heroin Use Grown So Rapidly?
27:17 Trends of Reduced Stigma and the Changing Demographics of Heroin Users
29:13 Heroin as the First Opioid of Abuse
31:20 Summary and the Importance of Psychiatric Issues
32:11 Credits