Perception and Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration

Surmaitis, Ryan; Amaducci, Alexandra; Henry, Kathryn; Jong, Michael R.; Kiernan, Emily; Kincaid, Hope; Houck, Lindsay J.; Sabbatini, Sandra J.; Greenberg, Marna Rayl; Katz, Kenneth D.

doi:10.1016/j.clinthera.2018.01.001

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…The selected articles discuss the experience of pain, pain treatment, opioid prescribing patterns, and prevalence of opioid misuse in women and men. [20][21][22][23][24] Dr. McGregor continues to spotlight our efforts to inform our readership about sex and gender differences in presenting symptoms, use of services, and treatment outcomes. 25,26 In the late 1960s and 1970s, my colleagues and I studied links between the phases of the menstrual cycle and drug effects, binge drinking, and visits to emergency departments (EDs).…”

Section: This Month's Updatementioning

confidence: 99%

A Tribute to Gertrude Belle Elion on the 100th Anniversary of her Birth

Shader¹

2018

Clinical Therapeutics

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A Tribute to Gertrude Belle Elion on the 100th Anniversary of her Birth About 25 years ago, when I directed and taught in a course called Graduate Pharmacology, I would regularly ask students to tell me the names of scientists who deserve a place in the pantheon of great drug discoverers. At least four names were typically offered (the names varied a bit from year to year), and the most frequently mentioned names were Alexander Fleming for penicillin, Paul Ehrlich for Salvarsan (arsphenamine) and its use for syphilis, Friedrich Serturner for morphine, Felix Hoffmann for acetylsalicylic acid (aspirin), and Frederick Banting and Charles Best for insulin. I liked to point out that Nicolae Paulescu isolated insulin (he named it pancreine) before Banting and Best and that Arthur Eichengrun was the actual discoverer of aspirin but that he was denied credit because he was Jewish. I would next point out that there were no women's names suggested; I should note that at least 50% of our graduate students were women. Someone would usually ask, "What about Madam Marie Curie?" Someone else would add that her work on radiation had nothing to do with drug discovery. I would point out that it was her separation of pure radium chloride from pitchblende (uraninite) that made its therapeutic uses possible. Whenever Curie's name came up, it would be an opportune segue to talk about laboratory safety and good laboratory practice by reminding them that Curie died of aplastic anemia secondary to radiation exposure. 1 I would add that Karen Wetterhahn, whose work on heavy metals our students had studied, died of exposure to dimethylmercury in her own laboratory; this liquid organic mercury form accidentally penetrated her latex gloves. Before 1991, I was unaware of any famous female pharmacologists. We have an annual lectureship at Tufts that was endowed by Sterling Drugs to honor Dr. Louis Lasagna, who was then the dean of the Sackler School for Graduate Biomedical Sciences at Tufts and a professor in our newly minted Department of Pharmacology and Experimental Therapeutics (DPET). In 1991, as DPET's first chair, I asked Dr. Lasagna to suggest a name for the Sterling Lectureship. Without hesitation, he suggested Gertrude Elion. When I did not recognize her name, he laughed and told me about her. I soon had the opportunity to meet with her at length and to talk with her at a dinner in her honor. What follows is short version of what I learned from her and from subsequent reading. 2-6 Gertrude Belle Elion was born in New York City 100 years ago (January 23, 1918). During her teenage years, her mother's father died of cancer. Having been close to him, she decided to devote her life to finding cures for cancer. She entered Hunter College in New York City and majored in chemistry, graduating summa cum laude at the age of 19. She then worked part time while working toward a master of science degree at New York University, which she received in 1941. Next, she worked as a chemist at several short-lived jobs at the Quaker Maid Company and John...

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Section: This Month's Updatementioning

confidence: 99%

A Tribute to Gertrude Belle Elion on the 100th Anniversary of her Birth

Shader¹

2018

Clinical Therapeutics

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“…Perception and Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration by Dr. Ryan Surmaitis and colleagues 10 aimed to determine the current attitudes, perceptions, and practices of emergency providers and registered nurses about the discharge of adult emergency patients after receiving opioid medications to treat pain. Developing discharge policies or guidelines to ensure patient safety was an overwhelmingly shared priority of surveyed providers.…”

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confidence: 99%

The Opioid Epidemic: Overcoming Challenges by Using a Sex and Gender Lens

McGregor

2018

Clinical Therapeutics

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The opioid epidemic is America's public health crisis. In 2015, 12.5 million people in the United States older than 12 years reported misusing prescription opioids and 2 million people reported having prescription opioid use disorder, up from 11.5 million and 1.9 million, respectively, in 2014. 1 No matter the causes for such a rapid rise, the enormous risk of morbidity and death associated with opioid use and abuse cannot be understated. Drug overdose is the leading cause of death for Americans younger than 50 years, killing more people than guns or motor vehicle accidents. 2 In 2015, 33,091 people-90 people per day-died of opioid overdose in the United States, and nearly onehalf of these deaths were attributed to overdose of prescribed opioids. 3,4 President Donald Trump has declared the opioid epidemic a national public health emergency, which anticipates enhanced efforts to identify those in need and to create effective treatment and prevention programs. 5 The accelerated use, abuse, and lethality associated with the opioid epidemic together with the national interest in ameliorating its deathly toll brings to light the need for understanding the who, how, and why of this epidemic. The knowledge that men and women have different reasons and patterns of substance use and abuse could be the critical, lifesaving key toward change. The medical and scientific research community is beginning to understand the vast impact patient sex and gender has on health and illness. The appreciation that men and women can differ in disease pathophysiology, symptom presentation, treatment response, and disease outcome can facilitate improved health outcomes through tailored treatments. A greater understanding of how men and women may differ in the sociocultural factors that contribute to drug use, predilection for the progression from initiation to addiction, opioid use disorder screening challenges, and responses to intervention will become valued pieces of the puzzle toward overcoming the challenges in designing effective strategies in prevention and treatment of opioid addiction. This Specialty Update in Clinical Therapeutics is dedicated to The Opioid Epidemic: Overcoming Challenges by Using a Sex and Gender Lens. We are pleased to highlight research that provides a deeper understanding of sexand gender-based differences that contribute to the epidemic of opioid use disorders. In their literature-based commentary, Dr. Andrew Koons and colleagues 6 emphasize the need to include women in research studies of pain experience and opioid abuse. The authors caution that most of our knowledge and understanding of the experience of pain and the factors that lead to opioid abuse have been generated through research dominated by male animal and human models. 7 Their thorough review of recent evidence underscores sex and gender differences in the experience of pain, rate and risk factors for opioid use disorder, and response to treatment that can assist health care providers in opioid prescribing stewardship. Gender Differences in Pain ...

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