{"id":1066,"date":"2014-10-13T11:06:15","date_gmt":"2014-10-13T18:06:15","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=1066"},"modified":"2014-10-13T11:06:50","modified_gmt":"2014-10-13T18:06:50","slug":"the-dose-makes-the-poison-paracelsus","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=1066","title":{"rendered":"The dose makes the poison &#8211; Paracelsus"},"content":{"rendered":"<p>The <a href=\"http:\/\/www.cdc.gov\/mmwr\/pdf\/wk\/mm6340.pdf\">MMWR<\/a> recently reported that in the current problem with the abuse of prescription drugs, alcohol plays a significant role in ED department visits, including opioid pain reliever (OPR) and benzodiazepine (BZP) drug-related deaths. Using the <!--more-->SAMHSA Drug Abuse Warning Network, data was analyzed from 237 hospitals on ED visits as well as other data on drug-related deaths in 13 states.<\/p>\n<p>It was estimated that in the U.S. in 2010 there were 438,718 ED visits related to OPRs and 408,021 related to BZP use. Among those visits, an estimated 18.5% and 27.2% also involved alcohol, respectively. Of the total ED visits, concomitant alcohol-OPR use was highest in the 30-54 year-old age group. Concomitant alcohol-BZP use was highest among the 45-54 year-old age group and was more common among men than among women.<\/p>\n<p>Of the 3,883 OPR deaths in the 13-state survey in 2010, 22.1% involved alcohol and for BZP related deaths 21.4% involved alcohol. Among the OPR deaths, persons aged 40-59 had the highest percentage and for BZP deaths the highest percentage was among persons &gt; 60 years of age.<\/p>\n<p>Alcohol use and risk for abuse should be a part of the screening process when considering prescribing opioids or benzodiazepines to patients.<\/p>\n<p>The use of <a href=\"http:\/\/www.integration.samhsa.gov\/clinical-practice\/SBIRT\">SBIRT<\/a>, Screening, Brief Intervention and Referral for Treatment, provides a tool for alcohol risk screening and is a benefit of Medi-Cal and PHC that is reimbursed outside of capitation.<\/p>\n<p>Marshall Kubota, MD<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The MMWR recently reported that in the current problem with the abuse of prescription drugs, alcohol plays a significant role in ED department visits, including opioid pain reliever (OPR) and benzodiazepine (BZP) drug-related deaths. Using the<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19,15,9],"tags":[],"class_list":["post-1066","post","type-post","status-publish","format-standard","hentry","category-drug-and-substance-abuse","category-medical-practice","category-phc-services"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/1066","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1066"}],"version-history":[{"count":4,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/1066\/revisions"}],"predecessor-version":[{"id":1070,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/1066\/revisions\/1070"}],"wp:attachment":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1066"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1066"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}