Browsing by Subject "Prescription"

Now showing 1 - 5 of 5
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    The Impact of Substance Use on the Developing Brain
    (The Center for Health Policy, 2017-07-01) Kooreman, Harold E.
    Most peoples’ first exposure to alcohol, tobacco, and other drugs typically occurs during adolescence, a time when the brain changes rather dramatically. The maturation process of the adolescent brain is reflected in a greater propensity to take part in risky activities such as unprotected sex, reckless driving, and substance use. Alcohol, nicotine, and marijuana, the most commonly used substances by teens, have all been tied to disruptions in normal brain development. These structural changes are associated with higher rates of cognitive impairments and academic difficulties, higher rates of future substance use and substance use disorders, and higher rates of mood and psychotic disorders.
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    Medicated-Assisted Treatment in Indiana
    (The Center for Health Policy, 2019-03-01) Kooreman, Harold
    Opioid misuse and addiction continues to affect many Americans. Medication-assisted treatment (MAT) using methadone, buprenorphine, or extended-release naltrexone in combination with behavioral therapy is the most effective intervention for opioid use disorders (OUDs). Despite its effectiveness, methadone to treat OUDs is not widely available. Buprenorphine is more accessible, as it can be prescribed by medical doctors, nurse practitioners, and physician assistants who have received specialized training and obtained a waiver from the DEA. Naltrexone is a non-narcotic and can be prescribed by any healthcare professional who has prescription privileges.
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    Polypharmacy Among Prescription Drug Users
    (The Center for Health Policy, 2017-08-01) Omenka, Issac; Greene, Marion S.
    Polypharmacy, i.e., the misuse of multiple prescription drugs or prescription medication with other substances, is highly problematic. Whether unintentional or deliberate, misuse of multiple drugs can lead to adverse effects including addiction; drug-drug interactions; and overdose, potentially resulting in death. Polypharmacy is not uncommon; almost 84 percent of prescription drug misusers receiving substance abuse treatment in Indiana reported using at least one additional substance, most commonly alcohol or marijuana.
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    Substance Abuse in Indiana: An Urban-Rural Perspective
    (The Center for Health Policy, 2017-06-01) Kooreman, Harold E.; Greene, Marion S.
    The use of alcohol and drugs is a significant public health problem in the United States. Indiana, like many other states in the nation, is lacking in substance abuse treatment services and rural areas are particularly underserved. Rural residents may encounter additional barriers to receiving substance abuse treatment, including stigma, fear that they may know their treatment providers, a lack of access to specialized services, inferior quality of care, and having to pay more for treatment.
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    What happens next?: a claims database study of second-line pharmacotherapy in patients with major depressive disorder (MDD) who initiate selective serotonin reuptake inhibitor (SSRI) treatment
    (Springer Nature, 2014-03-19) Ball, Susan; Classi, Peter; Dennehy, Ellen B.; Psychiatry, School of Medicine
    Background: The objective of this research was to examine treatment patterns and health-care costs associated with second-step pharmacotherapy in patients with major depressive disorder (MDD) who initiated monotherapy with a selective serotonin reuptake inhibitor (SSRI) in 2010. Methods: This claims database study analyzed patients diagnosed with MDD who were prescribed a monotherapy SSRI, with the first prescription identified as the index date. Patients were required to be ≥18 years old, to have continuous insurance coverage from 1 year prior (pre-index) through 1 year post (post-index) from the index date, and to have not received an antidepressant in the pre-index period. The analyses are descriptive of the patient characteristics, initial SSRI prescribed, most commonly prescribed second-step therapies, and annualized health-care costs. Results: The identified patients (N = 5,012) were predominantly female (65.2%) with a mean age of 41.9 years. The most frequent index SSRIs were citalopram (30.1%) and sertraline (27.5%), and 52.9% of patients were prescribed a second-step pharmacotherapy during the post-index period. Add-on therapy occurred twice more frequently than switching treatments, with either anxiolytics (40.2%) or antidepressants (37.1%) as the most common classes of add-on pharmacological therapies. Patients who added a second medication or switched therapies had higher annualized medical costs compared with patients who continued their index SSRI or discontinued treatment. Conclusions: For patients who were initially treated with an SSRI therapy, approximately half were prescribed a second-step treatment. In this comprehensive claims analysis, many of these patients experienced the addition of second medication, rather than switching to a new therapy. Given the type of medications used, it is possible that second-step interventions were targeted toward resolution of residual symptoms; however, this work is limited by the use of claims data without information on dosing or clinical symptoms, side effects, or response. Findings from this study set the expectation that physicians and patients will most likely need to partner for additional interventions in order to achieve remission.