1. Todd Davis, MD, MMM EVP & CMO, CaroMont Health
The Opioid Epidemic
Todd Davis, MD, MMM
EVP & CMO, CaroMont Health

2. History and Pharmacology of Opioids

3. Poppy First Cultivated in Mesopotamia around 4000 BC
Poppy seed pod scratched and resulting fluid dried into Opium
Ancients used opium for analgesia (pain killer) and to alter mood

4. Morphine first extracted from opium in 1805, Germany
Morpheus
Morphine first extracted from opium in 1805, Germany
Morphine was commercialized and sold as a panacea, widely available in markets

5. Commercially available opioids used widely in late 1800’s and early 1900’s for all types of maladies

6. Opioid Pharmacology
Opioids are chemicals that bond to specific receptors in the brain
Opioids are similar in action to endogenously produced chemicals called “Endorphins”
Synthetic opioids are much more powerful and long acting than natural endorphins

7. Signs and symptoms that occur with cessation of the drug
Tolerance
Decreased subjective and objective effects to the same amount of drug over time requiring increasing the amount to achieve the same effect
Dependence
Signs and symptoms that occur with cessation of the drug
Addiction
A CHRONIC DISEASE of the brain manifested by compulsive substance use despite harmful consequences. 75% of people with addiction have a Mental Illness

8. Addiction Is a Chronic Disease Is NOT a Choice
Requires Life-long treatment
Brain’s “wiring” or neurochemistry is altered
Judgment, decision making, learning, memory, behavioral control ALL changed
Any person can develop an addiction if vulnerable and stressed

9. Risks for Addiction
Family History of any substance abuse - including alcohol
Personal history of substance abuse
Age less than 45 years
History of preadolescent sexual abuse
Psychological Disorders including: ADD, ADHD, OCD, Bipolar disease
Depression
Stress: Emotional, Financial, Pain, Injury
No-one wants aspires or plans to be a heroin addict

10. Withdrawal
Withdrawal is a condition opposite of the effects of the drug and addicted state
Acute Withdrawal - 5 to 7 days
Chronic/Sub-Acute Withdrawal - Months to years
Permanent Rewiring - Depression, Stress Response, Craving

11. Opioid Epidemic
US uses 80% of world’s opioids (4.4% of the world population)
US life expectancy has dropped due to opioid overdoses
Opioid overdose deaths have quadrupled since 2000 and are the leading cause of accidental death
130 people die daily from opioids

12. Hope - Your Community