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The United Nations Office on Drugs and Crime (UNODC) confirmed in February 2022 that opium
manufacturing in Afghanistan increased by 8 percent in 2021, despite the fact that the
floor space underneath poppy cultivation withered. You probably have ever
tried suicide, overdosed on medication or alcohol, or change into addicted to
either. On the social and growth aspect, an lively Drug Abuse and Awareness program led by the United Nations Association of Pakistan (UNAP) addresses a spread of aspirations from reducing demand to a reduction of drug related crime and violence,
and reduction of drug-related well being and social costs.
It’s referred to as social prescribing - a comparatively new scheme
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well being advantages. They're a number of occasions more highly effective than morphine and, like different opiates and opioids, have a big potential for addiction. It
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With a considerable Uzbek population, Shymkent is close to Tashkent and, like Osh, is
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There is a new group gathering political support for a say in the way the Drug Enforcement Administration runs the "war on drugs".
Although there is no doubt of the need for firm action to
reduce the availability of addictive drugs on the streets, the latest DEA
crackdown does little more than penalize large numbers
of ordinary people in pain. This April sees a Senate panel taking evidence from the owners and operators of
nursing homes, doctors, nurse practitioners, and pharmacists.
There is great concern at the new rules requiring pharmacies to wait for a prescription signed by a licensed doctor
before dispensing the more powerful of painkillers.
In hospitals and nursing homes, the standard practice used to allow nursing staff to place orders for drugs orally, with the prescriptions being written up later.
This smoothed the treatment regime, ensuring a continuous supply of medication without any delays caused by missing paperwork.
That practice is now prohibited in nursing homes.
Why should this matter? The answer lies in the numbers.
Nationally, there are about 16,000 nursing homes and they are literally "home" for some
two million patients. An average of about 60% of these people
have problems with chronic pain. They are vulnerable.
Many are old or confined to bed. They cannot fend for themselves by going to see a doctor and getting a prescription filled
by a pharmacy. They depend on the medical staff to supply the drugs
they need to manage the pain. In fact, many are left for days in acute pain without relief because the paperwork in the hands of the pharmacy does not match
DEA requirements.
In fact, the DEA has stepped up enforcement with recent prosecutions in Ohio, Michigan, Virginia and
Wisconsin. This action is justified in two ways. First, there is a need to prevent the
diversion of drugs from hospitals, clinics and nursing
homes. If drugs are dispensed without paperwork, hospital
staff could sell them on for street distribution. Secondly, some powerful meds are used by lazy nursing staff to dope any patient thought
disruptive. This abuse of the vulnerable is made less likely if
all dispensing is supervised by the attending physicians. But
strict enforcement ignores the reality of life in nursing homes.
Unlike hospitals, there are fewer doctors around and more day-to-day responsibility falls
on the nursing practitioners. If nurses cannot be considered the
agent of the supervising doctors, there can be serious delays in getting
any prescription signed.
All systems are set up with checks and balances.
In this case, there are real problems to be addressed on both sides and it will be
interesting to see where the Senate panel draws the
line. If we were talking only about the less addictive painkillers like tramadol, there would be less cause
to worry. Drugs which are not habit-forming should be made available with
the minimum of formality within the nursing home environment.
This gives relief for the majority of people.
Where the level of pain goes beyond tramadol's limits, doctors should be more
closely monitoring their patients' health. The balance of benefits and costs in the use of
the more powerful drugs changes as people age and their health deteriorates.
It might be reasonable to use the opiates for a person dying
of cancer. Here, you want the maximum pain relief to make the person's
last days more comfortable. In other cases, the use of stronger drugs should be careful monitored.
Richard Stallings is always ready to share his professional
point of view on a topic. To see what Richard Stallings has written about other things visit
website Home Patients Suffer
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