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CALL TODAY With fast turnaround time, easy, convenient web-based interface and clear and understandable reporting we provide you the opportunity of better patient care. Zenith Hope Center is staffed by professional qualified personnel who ar motivat d and compassionate about provi ing optimal services for individuals in need.

508 Eastway Drive - Suite A Charlotte, NC 28205

704-248-0246

www.zenithhopecenter.com

704.248.0246

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It’s time to discover a new form of yourself— a new path for yourself— one that reaches well past the impulse of the moment. It’s time to wake up in a world of self-made character — of self-determination.

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Call toDAY TO speak with one of our specialists Don’tGetHungUp on Prescription Medications

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Trial evaluated effectiveness for common injuries

Four Groups of Patients The patients were randomly assigned to one of four groups. One group received a pill for their acute pain that contained a combination of ibu- profen and acetaminophen, the ingredients in Advil and Tylenol. The other groups were given a pill for their pain that contained a prescription opioid as well as acetaminophen, either oxyco- done and acetaminophen (Percocet), hydroco- done and acetaminophen (Vicodin), or codeine and acetaminophen (Tylenol No. 3). All the patients were asked to rate their pain immediately before taking the pain medication and again both one and two hours afterward (before they left the emergency department). The assessments were done using an 11-point scale (0 = no pain; 10 = worst possible pain). The study found that the intensity of pain was similar among all four groups before they took the medication, with a mean score of 8.7 on the scale. The pain then declined over time in all

As the over prescribing of opioid pain medications has become a major public health concern, health care providers have been paying more attention to over-the count- er-drugs that could be used instead, without the risk of addiction. A recent study published in the Journal of the American Medical Association (JAMA) has confirmed that OTC meds ibuprofen and acet- aminophen are just as effective as prescription opioids at reducing acute pain caused by com- mon injuries.It is one of the few “real world” studies that has made the comparison. A team of researchers led by Andrew Chang, M.D. of Albany Medical College, studied 411 patients (aged 21 to 64) who had sought med- ical care at two urban emergency departments after having sprained, strained or broken an arm or leg. (About 20 percent of the patients had fractures.)

individuals can become addicted even after only taking opioid pain meds for a few days. One study found that one in five people given a 10-day supply of opioid painkillers became long-term users. More M.D. Education Needed Don Teater, M.D., medical adviser of the non-profit National Safety Council, says doctors need more education to understand the draw- backs of prescribing opioids. “Doctors get a lot of training in the physical aspects of health, but not the mental aspects,” says Teater, a family physician in North Carolina whose practice focuses on treatment of pain and the treatment of opioid use disorder. “We don’t get training in addiction. Often, a doctor will start a patient on opioid pain med- ication and continue it for awhile. Then if the doctor feels the patient is asking for too much medication, the doctor will cut them off, and abandon them. There needs to be a greater understanding of the emotional component to pain. We also need to have a better under- standing of the disease of addiction.” According to a white paper from the Council, there is little evidence that opioids are helpful when used for chronic pain.

four groups – and by similar levels: 4.3 points in the ibuprofen/acetaminophen group, 4.4 points in the oxycodone/acetaminophen group, 3.5 in the hydrocodone/acetaminophen group and 3.9 in the codeine/acetaminophen group. The researchers said the major limitation of the study is that it had the patients assess their pain only while they were in the emergency department. The study did not evaluate how the ibuprofen/acetaminophen combination would work in comparison to opioids once the patients went home. Also, the participants had a specific type of acute pain – from sprained or broken arms and legs. “Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sus- tained treatment to patients already addicted to opioids, in whom it may take many years to achieve recovery,” Demetrio Kyriacou, M.D., a senior editor at JAMA and a professor of emer- gency medicine at Northwestern University, wrote in an accompanying editorial. Yet, as Kyriacou also acknowledges, “stemming the opioid addiction crisis will … require reex- amination of the long-standing assumptions that opioids are superior to

non-opioids in most clinical situations requiring man- agement of moderate to severe pain.” Studies have shown that nearly one-third of adult patients seeking care at U.S. hospital emergency departments are given prescriptions for opioid painkillers, even if their visit was not pain-relat- ed. That is a dangerous practice, since some

“In fact, some evidence shows they may be detri- mental and increase risk of addiction and premature death,” the paper says.

There is little evidence that opioids are helpful when used for chronic pain.

On October 24, 2018... President Trump signed a new, bipartisan bill to combat the opioid addiction epidemic. Politicians are hailing it as a major step forward, while addiction and treatment experts say it falls far short of

A package of more than 70 bills introduced targeting the opioid crisis, the Support for Patients & Communities Act:

• Reauthorizes funding from the Cures Act, which put $500 million a year toward the opioid crisis, and makes some policy changes intended to give states more • Creates a grant program for “Comprehensive Opioid Recovery Centers,” which will attempt to serve the addiction treatment and recovery needs of their communities (in part by using what’s known as an ECHO model). • Removes restrictions on medications for opioid addiction, allowing more types of health care practitioners to prescribe the drugs.

• Expands an existing program

• Advances new initiatives to educate and raise awareness about proper pain treatment among health care providers. • Attempts to improve coordination between different federal agencies to stop illicit drugs like fentanyl at the border, and gives agencies more tools to improve detection and testing at border checks. • Increases penalties for drug manufacturers and distributors related to the over-prescribing of opioids.

responders, such as police and

naloxone, a medication that reverses opioid overdoses.

• Allows federal agencies to pursue more research projects related to addiction and pain. • Makes several changes to Medicare and Medicaid to attempt to limit the over-prescription of opioid painkillers within the programs and expand access to addiction treatment, including lifting some of the current restrictions that make it harder for Medicare and Medicaid to pay for addiction treatment.

It also authorizes HHS to develop grants to support people who are in recovery transition to independent living and jobs, as well as develop a pilot program to provide temporary housing for those recovering from substance abuse. of the bill provides measures to prevent synthetic opioids like fentanyl from entering the U.S. According to the Centers for Disease Control, total opioid deaths did not increase in 2017, but deaths due to fentanyl overdoses did. Data shows the drug, which is about 50 times more potent than heroin, caused nearly 30,000 fatal overdoses last year. access to medication-assisted treatment. It removes the cap on the number of patients to whom drugs like buprenorphine, a drug cravings and easing withdrawal, from 100 to 275, and expands a grant program allowing medication-assisted treatments.

strengthen the federal government’s response to the opioid crisis,” Sen. Rob Portman (R-OH), who helped put together the legislation, said in a statement after the Senate vote. “Importantly, this bill will increase access to long-term treatment and recovery while also like fentanyl from being shipped into the United States through our own Postal Service.” On the other side of the debate, Leana Wen, M.D., the former health commissioner of Baltimore (and incoming president of Planned Parenthood), said that the legislation “is simply tinkering around the edges.” Daniel Raymond, director of policy and planning for the Harm a bad thing, but I do think to some degree it’s a political document,” Raymond told the Washington Post. “When you drill down into it, it’s not that there aren’t good ideas, but it doesn’t reach the level of, this is what our nation needs right now.” and Mental Health Services Administration (SAMHSA) to allow organizations to develop opioid recovery centers in a community. It also requires the Department of Health and Human Services to determine best practices and then create a grant program implementing those policies or procedures, such as the use of recovery coaches, which has

Discrimination, whether based on race, gender, or sexual orientation, has long been thought to be a contributor to substance abuse. Now a new study has confirmed the relationship between discrimination and addiction, but it’s also brought up many more questions that still need to be answered in order to improve treatment outcomes. Researchers at the University of Iowa recently completed a peer review study in which they looked at 97 previous studies on discrimination and alcohol use. Their goal was to summarize the collective knowledge researchers have uncovered throughout the years, and what they found confirmed in more detail what many had previously suspected.

“Generally there is good scientific support, but the evidence is mixed for different groups

and for types of discrimination.” - Dr.Paul Gilbert, University of Iowa

overtly racist or sexist to another person. But less research has been done on what are known as micro-aggressions, small everyday occurrences that can rub a person the wrong way. That research is improving, but there are other factors that need to be more fully explored. While studies have looked at historical trauma in the African-American population, the concept has not been fully investigated with regards to Hispanic and Asian populations. “This notion of historic trauma could be really relevant to other groups, but it hasn't received much attention at all,” Dr. Gilbert says. “This is something we should pay attention to.” All of this adds up to the fact that treatment providers may be missing a key piece of the substance abuse puzzle.

The team found that discrimination did indeed lead to an increase in drinking frequency, quantity of alcohol consumed, and in the risk for alcohol use disorders. Researchers say drinking can represent a coping mechanism in response to the stress caused by discrimination, and several studies showed clients acknowledging this direct link themselves. But when looking at specific populations and types of discrimination, the picture becomes less clear. “The story is that generally there is good scientific support, but the evidence is mixed for different groups and for types of discrimination,” says Dr. Paul Gilbert, the study’s lead author. “We don’t really know comparing one type or one level to another.” For example, much research has been done on interpersonal discrimination where someone is

But just because the intricacies of how discrimination affects drinking aren’t yet fully understood, that doesn’t mean our current knowledge base can’t be helpful. Dr. Gilbert says simply knowing that experiences with discrimination can drive drinking could inform the way treatment providers interact with clients, opening new areas of their lives to explore during treatment. “It can serve as sort of an early warning or indicator,” Dr. Gilbert says. “For treatment providers, it’s worth looking at: is there something that may be keeping folks from accessing services or affecting outcomes?”

Dr. Gilbert says treatment providers should continue to address discrimination as part of a holistic approach to recovery. He says it will be up to researchers to fill

in the gaps to find the precise ways that discrimination affects drinking behavior. “We’ve got good evidence on this level of interpersonal discrimination,” Dr. Gilbert says. “We’ve gotten the low-hanging fruit, now it’s time to start working on the stuff that’s a little further up the tree.”

“It can serve as sort of an early warning or indicator.”

New study looks to pinpoint transition from prescription opioids to heroin

Stopping heroin use before it begins may be the best remedy for the country’s growing epidemic. A new study looks to pinpoint the times and ways that young people rst use the dangerous drug in hopes of strengthening prevention efforts. For three years, researchers at Wright State University tracked nearly 400 18- to 23-year-olds in Columbus, Ohio, who used illicit prescription opioids but were not opioid-dependent. Of the 362 participants, 27 eventually transitioned to heroin, a rate of 7.5 percent. “We were surprised at the number of people who transitioned to heroin,” says Dr. Robert Carlson, the study’s lead researcher. “We had really no idea of what exactly we’d be able to predict.”

Predicting risk

Researchers found several predictors of increased risk of heroin use, starting with the ways in which the opioids were being used. Those who crushed or snorted the prescription drugs were far more likely to transition to heroin. “It increases the speed at which the drug is hitting the system and makes people much more liable to becoming dependent,” Dr. Carlson says. “If people can become aware that if they even think about starting to use via a non-oral route, they are heading off on a very dangerous path.”

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“We were surprised at the number of people who transitioned to heroin. ” - Dr. Robert Carlson, Wright State University

Racial divide

The new NIDA-funded study targeted 18- to 23-year-olds because they are arguably at the highest risk for substance abuse. The study did not look at other age groups. But when considering the factors that may move a person from prescription opioids to heroin, Dr. Carlson believes age is just a number. “I wouldn’t think the risk factors for transition to heroin would be much different regardless of age group,” Dr. Carlson says. While the risk factors may be the same across age groups, the most deadly effects of heroin use are not. Research has shown that those most at risk of a heroin-related overdose fall in the 25 to 44 age range. It’s important to keep in mind that the vast majority of prescription opioid users will not move on to heroin. And signicant research is still needed to determine the social, environmental and biological factors that contribute to a person transitioning to heroin. But Dr. Carlson says he’s encouraged by the progress being made and believes the groundwork has been laid to develop effective treatment and intervention programs. “The really exciting thing to come out of this is it really gives us a rm foundation of some variables that could be targeted to prevent transition to heroin and transition to dependence,” Dr. Carlson says. Targeted approach The study also saw a difference in race among those who eventually turned to heroin. Despite roughly half the participants being African-American or Hispanic, all of the individuals who ultimately used heroin were white. Although the study could not determine the reasons behind such a strong racial divide, Dr. Carlson suggests that social networks, generational use and other circumstances could be signicant factors. National data shows the heroin epidemic has increasingly hit white males the hardest. The Centers for Disease Control estimates that between 2002 and 2013, heroin use among non-Hispanic whites increased 114 percent. Age is just a number

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OPIATE + OPIOID ADDICITON What is the difference between Opiates and Opioids?

OPIATES

OPIOIDS

A Natural Pain RemedIES

SYNTHETIC PAIN MEDICATIONS

VS.

Opium

Oxycodone

Thebaine

Hydrocodone

Morphine

Oxymorphone

Codeine

Hydromorphone

Heroin

What Medications Treat Opiate & Opioid Addiction?

Naltrexone

These medications act directly upon the opioid receptors; more specically the mu receptors. Because the effects of these medications vary at the receptor level, there can be different clinical effects during treatment.

ReVia | Depade | Vivitrol

Methadone Dolophine

Buprenorphine Suboxone | Subutex

A FULL AGONIST binds to the receptor and activates it by changing its shape - inducing a full receptor response.

A PARTIAL AGONIST binds to the receptor and activates it with a smaller shape change in the receptor that includes a partial receptor response.

RECONNECTING. RESTORING. MOVING FORWARD.

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Zenith Hope Center provides treatment to individuals with substance abuse disorders, specifically seniors, adults, emancipated minors, military veterans, homeless and special needs populations.

508 Eastway Drive - Suite A Charlotte, NC 28205 704-248-0246

www.zenithhopecenter.com

ADDICTION

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508 Eastway Drive - Suite A Charlotte, NC 28205 704-248-0246

www.zenithhopecenter.com

www.zenithhopecenter.com Reconnecting. Restoring. moving forward.

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