Charles Ruetsch

Bio: Charles Ruetsch is an academic researcher from Bendix Corporation. The author has contributed to research in topics: Medicine & Buprenorphine. The author has an hindex of 10, co-authored 32 publications receiving 441 citations.

Compliance with buprenorphine medication-assisted treatment and relapse to opioid use.

Abstract: Opioid dependence (OD), often characterized as a chronic relapsing disorder, affects millions of people worldwide. The purpose of this study was to examine the effect of compliance with buprenorphine on reducing relapse among a sample of patients in treatment for OD. Patients new to buprenorphine (N = 703) completed the Addiction Severity Index (ASI) at baseline, and at 1, 2, and 3 months postbaseline. The ASI is a semistructured interview designed to measure problem severity in seven functional areas known to be affected by alcohol and drug dependence. Compliance was defined as taking buprenorphine medication on at least 22 of the past 28 days (80%), while relapse classification was based on resumed use of opioids during the follow-up period (months 2 and 3). Relapse was regressed onto demographic indicators, baseline ASI composite scores, and compliance with buprenorphine. Noncompliant patients were over 10 times more likely to relapse than those who were compliant (exp β= 10.55; p .05). Compliance with medication-assisted treatment supports abstinence, essential for patient recovery. Understanding the factors that drive treatment compliance and noncompliance may assist providers in supporting patient compliance and recovery. (Am J Addict 2011;21:55–62)

Opioid dependence treatment and guidelines.

Abstract: BACKGROUND: In response to the growing incidence of opioid dependence, guidelines have been created, and new treatments are being developed to assist physicians in treating dependence and withdrawal of opioids. OBJECTIVE: To review treatment modalities and guidelines utilized in opioid dependence. SUMMARY: Guidelines for the treatment of opioid dependence have been developed by organizations such as the American Society of Interventional Pain Physicians (ASIPP) and the American Psychiatric Association (APA). Current guidelines recommend comprehensive treatment with pharmacological agents such as methadone, buprenorphine, or buprenorphine combined with naloxone as well as psychosocial therapy. These guidelines stress the need for an integrated approach to treatment. Office-based opioid treatment is currently being utilized to treat opioid dependent patients in a physician's office setting with buprenorphine/naloxone replacement therapy as an alternative to entering patients into a methadone clinic. These o...

Empirical view of opioid dependence.

Abstract: BACKGROUND: The impact of opioid dependence on employers, managed care, and society is significant. Inappropriate use of narcotic analgesics leads to uncontrolled pain management, dependence, and may lead to patient deaths, creating a tremendous cost burden to the health care system. OBJECTIVE: To provide an overview of the clinical and economic impact of treating opioid dependence on managed care, employers, and society. SUMMARY: An estimated 6% to 15% of people in the United States abuse drugs, and approximately 20% of Americans report using prescription opioids for nonmedical use. This is associated with an annual cost of nearly half a trillion dollars, taking into account the medical, economic, social, and criminal impact of this abuse. A recent study showed that patients who abuse opioids generate mean annual direct health care costs 8.7 times higher than nonabusers. The National Survey on Drug Use and Health (NSDUH), conducted by the Substance Abuse and Mental Health Services Administration (SAM HSA...

Out of the Crisis

Abstract: According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Abstract: Objective:To revise the “Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult” published in Critical Care Medicine in 2002.Methods:The American College of Critical Care Medicine assembled a 20-person, multidisciplinary, multi-institutional task f

National Survey on Drug Use and Health

Abstract: 8 FAQ Page https://nsduhweb.rti.org/ No. Restricted data is only available to those directly involved with the NSDUH; however, most of the data is available within the public use data. The National Survey on Drug Use and Health (NSDUH) (formerly, National Household Survey of Drug Abuse) is an annual national survey that provides information on prevalence and correlates of drug use within the United States. The NSDUH measures illicit drug use, alcohol, and tobacco, and contains questions on age of first use, lifetime use, past year use, and past month use of marijuana, cocaine (and crack), hallucinogens, heroin, inhalants, alcohol, tobacco, and nonmedical or prescription drugs among respondents aged 12 and older. The study also covers substance abuse treatment, mental health issues, health access, police contact, and problems as a result of substance use. In 2002, the NSDUH introduced questions on "youth experiences" that cover topics such as neighborhood environment, illegal activities, gang involvement, drug use by friends, social support, extracurricular activities, exposure to substance abuse prevention and education programs, and perceived adult attitudes toward drug use and activities such as school work. (Summary provided--in part--by the Office of Applied Studies via ICPSR).

Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States

Abstract: Objectives The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States Methods Costs were grouped into three categories: health care, workplace, and criminal justice Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries Other data/information were derived from publicly available survey and other secondary sources Results Total US societal costs of prescription opioid abuse were estimated at $557 billion in 2007 (USD in 2009) Workplace costs accounted for $256 billion (46%), health care costs accounted for $250 billion (45%), and criminal justice costs accounted for $51 billion (9%) Workplace costs were driven by lost earnings from premature death ($112 billion) and reduced compensation/lost employment ($79 billion) Health care costs consisted primarily of excess medical and prescription costs ($237 billion) Criminal justice costs were largely comprised of correctional facility ($23 billion) and police costs ($15 billion) Conclusions The costs of prescription opioid abuse represent a substantial and growing economic burden for the society The increasing prevalence of abuse suggests an even greater societal burden in the future