Opioid Overdose Crisis: Medications Prevent Subsequent Overdoses

by Yale School of Medicine

Newswise — Drug overdose is the number one cause of accidental death in Connecticut, where someone is more likely to die from a drug overdose than from a car accident.

Researchers are seeking to understand how to best prevent overdoses. A new Yale-led retrospective cohort study published in Drug and Alcohol Dependence examined the efficacy of a range of treatments for patients who survived an opioid overdose and identified treatments that are most successful in preventing subsequent overdoses.

The investigators examined data of over 4,000 overdose survivors spanning a 19-month period, homing in on treatment modalities like medication and inpatient rehabilitation. The analysis found that people who took methadone or buprenorphine had a lower risk of further overdoses compared to those who did not take the medications.

This real-world experience confirms what we see in clinical trials. Medications are shown to improve a range of outcomes like treatment retention, drug use, criminalized behavior, and even employment.

Benjamin Howell, MD, MPH

“This real-world experience confirms what we see in clinical trials,” says Benjamin Howell, MD, MPH, assistant professor of medicine (general medicine) and lead author of the study. “Medications are shown to improve a range of outcomes like treatment retention, drug use, criminalized behavior, and even employment.”

Methadone and buprenorphine are controlled substances, and are available by prescription only. These medications are used to curb opioid withdrawal symptoms and on-going treatment.

“Our access to a unique combination of state-level datasets allowed us to consider multiple treatments in our statistical models and draw meaningful conclusions about people’s risk for overdose,” says Anne C. Black, PhD, associate professor of medicine (general medicine) and co-author.

The research team also found no statistical differences between inpatient treatment, such as rehabilitation or detox, and receiving no treatment. This means inpatient treatment has no independent effect on subsequent overdoses. The finding, Howell notes, highlights the need for medications to be provided in conjunction with inpatient treatment.

“These medications are the gold standard for the treatment of opioid use disorder by the NIH and other authoritative bodies, and they are effective because they prevent withdrawal and decrease craving,” says David Fiellin, MD, professor of medicine (general medicine), emergency medicine and public health, and co-author.

The study emphasizes the need for public health awareness on the importance of the use of medications to treat patients with OUD. Researchers hope the data will inform public policy and regulations at the local, state, and federal level.

Medications prevent overdoses and ultimately save lives. So it follows that we should continue to pursue efforts to reduce barriers to accessing them.

William Becker, MD

“Medications prevent overdoses and ultimately save lives. So it follows that we should continue to pursue efforts to reduce barriers to accessing them,” adds William Becker, MD, professor of medicine (general medicine).

Yale School of Medicine (YSM) and Yale School of Public Health (YSPH) faculty partnered with several agencies for the study, including The Department of Mental Health and Addiction Services (DMHAS); U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER); Office of Surveillance and Epidemiology (OSE) of FDA.

The research reported in this news article was supported by Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) (award U01FD005938) and National Institute on Drug Abuse (NIDA) (award #5K12DA033312). The content is solely the responsibility of the authors and does not necessarily represent the official views of FDA, HHS, or NIDA.

The Yale Program in Addiction Medicine works to expand access to and improve effectiveness of diagnosis, prevention, treatment, and harm reduction services for substance use. Our efforts span clinical practice, research, education, and policy. We provide evidence-based clinical care, conduct rigorous and innovative research, train the next generation of addiction specialists, and engage in policy and advocacy initiatives at the local, state, and national levels. Learn more about how you can support this and other practice-changing work.

Source: Newswise

Life Expectancy of IBC Totes

Intermediate Bulk Containers (IBC totes) are versatile storage and transportation solutions widely used across various industries for liquids, semi-liquids, and granulated materials. Understanding their lifespan is crucial for businesses and individuals to maximize their investment and ensure safe usage over time.

Average Lifespan

The typical life expectancy of an IBC tote ranges from 5 to 10 years with proper care and maintenance. However, this timeframe can vary significantly based on several factors:

  • Some high-quality IBC totes can last up to 20 years when used and maintained correctly
  • Under good conditions, IBC totes for water storage last over 5 years
  • Industrial-grade IBC totes for chemical storage can vary in lifespan. This depends on the materials used and the types of substances they hold
  • An IBC tote usually lasts about five years. However, with good care, it can last much longer

Indirectly about their reliability perfectly speaks of a huge secondary market of used IBC totes and its size, as well as the state of such offers. So for example you can study the volume of offers in your state through the Repackify. On average, you can buy used versions of totes from $30. Which is much more profitable and cheaper than new versions that start at $200.

Factors Affecting Lifespan

Material Composition

The materials used in IBC tote construction significantly impact their durability and longevity:

HDPE (High-Density Polyethylene)

Most IBC tote products are made from high-density polyethylene. This strong plastic is famous for its strength. It can resist chemicals and weather damage. These containers resist UV rays and corrosion. They are FDA, ANSI, and NSF 61 certified for food use. With proper care, they can last 5 to 20 years.

Stainless Steel

Great for high-temperature or flammable uses. Grades 304 and 316L resist corrosion well. The key materials for making stainless steel are ferronickel, ferrochrome, and scrap steel.

Carbon Steel

Typically, it costs less than stainless steel. It has lower resistance to heat and corrosion. Yet, you can strengthen some properties through forging and heat treatment.

Galvanized Steel Components

The outer frame of caged IBCs uses galvanized steel. This design prevents rust and increases stability, strength and impact resistance.

Environmental Conditions

Environmental factors play a crucial role in determining how long an IBC tote will last:

Sunlight Exposure

IBC plastic can get brittle after years in the sun. The top of the tote usually degrades first since it gets more direct UV radiation. UV exposure often makes the top of an IBC tote brittle first. It usually gets the most sunlight and for the longest time.

Temperature Extremes

IBCs should not be exposed to temperatures over 120°F, inside or out. Also, keep contents from freezing in the tote. Both situations can harm the plastic. Most poly IBC totes can handle a maximum fill temperature of 140°F (60°C). They are rated for a constant temperature of 120°F (49°C).

Storage Location

Totes stored outside without any protection usually do not last as long as those in controlled environments. Some IBC totes have been known to last more than 5 years while sitting in the sun and storing water.

Contents and Chemical Compatibility

What you store in an IBC tote significantly affects its useful life:

Corrosive Chemicals

Can reduce the lifespan of containers, especially if the tote material isn’t fully resistant to what’s stored inside. The material(s) an IBC handles is probably the most important factor in its service life.

Water Storage

It’s usually less harmful to totes. This helps them last longer if you maintain them well. If the poly tote is carrying an inert cargo, such as water, this will not be a concern to the IBC’s lifespan.

Material Compatibility

It’s important to match the tote material with the chemical. For strong acids, use poly IBCs. For solvents and petroleum-based liquids, choose stainless steel.

Maintenance Requirements

Regular maintenance can significantly extend the life of IBC totes:

Inspection Schedule

External Visual Inspection

Check for cracks, damage, and proper function of components every 30 months (2.5 years). The U.S. government says all IBCs need inspection after they are made. Then, they must be inspected every 2.5 years.

Internal Inspection

It’s best to do this every five years. This checks thickness, markings, and any internal damage. After every five years, totes must be inspected internally to look for any damage to the liner.

Pressure Testing

Do this every 30 months. It ensures the tote keeps the right pressure levels, which is 2.9 PSIG for many uses. Stainless steel tote tanks certified to UN/DOT standards must be tested every 30 months. A metal thickness test is required every 60 months.

Cleaning and Care

Proper cleaning and handling practices help maximize IBC tote lifespan:

Professional Cleaning

Hire cleaning services for a deep clean of totes that contained hazardous materials. If you’re not sure how to clean an IBC tote, hire a pro. They can do it right for you.

Careful Handling

Train staff to move and transport totes safely to avoid damage. Use caution when moving or lifting totes.

UV Protection

Use UV-resistant covers, paint, or shading structures to protect totes from sun damage. Select a premium IBC product that includes UV inhibitors in the plastic from the start.

Regulatory Considerations

IBC totes that carry regulated materials must follow specific testing and certification rules:

UN/DOT Certification

Stainless steel tote tanks must be tested every 30 months to meet UN/DOT standards. An IBC needs a valid test certificate to transport regulated products.

Recertification

Mark the date of the latest periodic retest on the tank. Place it near the metal serial number plate. If there’s a retest date, it must be marked on the container, near the metal certification plate.

Transportation Regulations

An IBC must not be filled or shipped if its inspection period has run out. If IBCs fail inspections or tests, they must be taken out of hazardous materials transport. They can only be used again once they are restored to their original design type.

Pressure Testing Standards

A hydrostatic pressure test is needed for all metal, rigid plastic, and composite IBC designs. This applies to IBCs that hold solids under pressure or contain liquids.

Food Grade Certification

Food-grade IBC totes must meet FDA and ANSI/NSF 61 standards. This ensures they are safe for drinking water and food use.

Extending IBC Tote Lifespan

Several strategies can help extend the useful life of IBC totes:

UV Protection Methods

  • Using UV-resistant covers to shield totes from UV radiation
  • Applying white paint to reflect more light and reduce UV radiation
  • Wrapping the IBC in insulative materials
  • Building DIY shading structures over or around the IBC tank
  • Using specialized UV hoods or hardtop spill containment pallets

Proper Storage

Store totes in a controlled area. Keep them away from extreme heat, cold, and direct sunlight.

Regular Maintenance

Following manufacturer guidelines for inspection, cleaning, and repair. Regular maintenance of an IBC is key to extending its plastic lifespan.

Correct Usage

Use the tote correctly. Make sure it fits the materials you store. Don’t exceed the recommended weight or pressure limits. IBCs are not designed to hold pressure, be pressurized, or serve as pressure vessels.

End-of-Life Considerations

When an IBC tote reaches the end of its useful life, several options exist:

Reconditioning

Replacing damaged components with new ones conforming to the original design specifications. Drum and IBC reconditioning is about restoring used containers. It offers a green and affordable choice for the market.

Remanufacturing

Adapting totes to new design types for continued use in different applications. By opting for remanufactured totes, industries take a step forward in reducing waste and promoting a circular economy.

Recycling

Properly disposing of totes that can no longer be reconditioned or remanufactured. The standard method for metal IBC totes is to melt the metal. Then, it is reformed into new products. For plastic IBCs, the process is different. They are shredded into small pieces, washed, and melted into pellets. These pellets are used to make new plastic products.

Market Growth

The reconditioning market is projected to hit $207.5 million by 2027. This shows a CAGR of about 4.5% from 2023 to 2027.

Advanced Applications and Industry Uses

IBC totes serve numerous industries and applications beyond basic storage:

Construction Industry

Plastic IBC totes are perfect for storing construction chemicals. They hold solvents, adhesives, and sealants. Also, they are great for water storage used in dust suppression and concrete mixing.

Agricultural Applications

IBCs are widely used in irrigation systems. They help collect rainwater and provide water for livestock. Also, they serve as garden beds for growing vegetables and herbs.

Aquaponics and Food Production

IBC totes are popular in aquaponics systems. They are also useful for composting organic waste.

Chemical and Industrial

Most IBC totes are made from high-density polyethylene (HDPE) or stainless steel. They come in sizes from 180 to 550 gallons. They hold almost every liquid, powder, or granulated product.

Cost-Effectiveness and Economic Benefits

IBC totes provide significant economic advantages:

Durability and Reusability

IBC tanks are tough. They handle transportation and storage well. With good care, they can last for many years.

Space Efficiency

IBC totes stack easily. This saves space and improves storage. It helps with logistics and cuts costs.

Cost Savings

Using IBC totes again and again can save a lot of money when compared to single-use packaging. Reconditioned totes are tested to meet industry standards. They are just as reliable as new ones, but cost much less.

Knowing the factors that affect IBC tote lifespan allows businesses to make better decisions. This includes when to buy, maintain, or replace totes. These choices improve their return on investment.

The Evolution of Global Payroll: Managing Remote Teams Across Borders

In 2024, the traditional office has become a concept of the past for many businesses. With 72% of companies now embracing remote work arrangements, the challenge of managing global payroll has moved from a niche concern to a mainstream business imperative. Welcome to the new era of borderless business operations!

The Remote Work Revolution: By the Numbers

The landscape is shifting dramatically:

  • 67% of companies report increased cross-border hiring since 2020
  • Teams spanning an average of 4.2 time zones
  • 42% reduction in operational costs for companies embracing remote work
  • Managing payroll across an average of 3.8 countries per organization

The Current Global Payroll Landscape

Traditional vs. Modern Approaches

Remember the days when “international payroll” meant a stack of papers and endless phone calls with foreign banks? Those days are thankfully behind us. Today’s global payroll landscape looks radically different:

  1. Traditional Approach:
    • Manual currency conversions
    • Individual country processors
    • Fragmented reporting
    • Limited visibility
  2. Modern Approach:
    • Automated currency management
    • Unified global platforms
    • Real-time reporting
    • Complete transparency

Mastering Multi-Currency Management

One of the most complex aspects of global payroll is managing multiple currencies effectively. For businesses expanding into Eastern Europe, polish payroll services have become a crucial component of successful operations, offering specialized knowledge of local regulations while maintaining international standards.

Key Currency Considerations:

  • Exchange rate timing
  • Banking fees optimization
  • Payment scheduling
  • Local tax implications

Pro Tip“Lock in exchange rates at the beginning of each pay period to avoid currency fluctuation risks,” suggests Maria Kowalski, International Payroll Director at Global Pay Solutions.

Building a Robust Compliance Framework

Country-Specific Regulations

Every country brings its own regulatory puzzle:

Region

Key Compliance Areas

Update Frequency

EU

GDPR, Working Time

Quarterly

Asia

Data Privacy, Labor Laws

Bi-annual

Americas

Tax Treaties, Benefits

Annual

Africa

Currency Controls, Labor

Quarterly

Documentation Essentials:

  1. Employee contracts in local languages
  2. Tax registration certificates
  3. Social security documentation
  4. Work permits and visas
  5. Benefits enrollment forms

Technology Solutions: The Great Enabler

Modern global payroll technology has become the backbone of efficient operations. Here’s what to look for:

Essential Platform Features

  • Multi-currency processing
    • Real-time exchange rates
    • Banking integration
    • Fee optimization
  • Compliance Management
    • Automatic updates
    • Document storage
    • Audit trails
  • Reporting Capabilities
    • Cross-border analytics
    • Custom report builders
    • Real-time dashboards

Security Measures

  1. Data encryption at rest and in transit
  2. Multi-factor authentication
  3. Regular security audits
  4. Compliance certifications
  5. Disaster recovery plans

Best Practices for Success

Implementation Strategy

  1. Start Small
    • Begin with core markets
    • Test processes thoroughly
    • Document learnings
  2. Scale Gradually
    • Add countries strategically
    • Build on successes
    • Maintain flexibility
  3. Focus on Integration
    • Connect with existing systems
    • Streamline data flow
    • Eliminate redundancies

Future Trends to Watch

The global payroll landscape continues to evolve. Here are the trends shaping the future:

  • Blockchain Integration
    • Smart contracts for payments
    • Enhanced security
    • Reduced processing times
  • AI and Machine Learning
    • Predictive analytics
    • Automated compliance
    • Error detection
  • Enhanced Employee Experience
    • Mobile-first solutions
    • Self-service options
    • Real-time access

Implementation Checklist

Ready to transform your global payroll? Start here:

  • Audit current processes
  • Identify priority markets
  • Evaluate technology solutions
  • Develop compliance framework
  • Create training program
  • Plan phased rollout
  • Establish success metrics

Conclusion

Managing global payroll isn’t just about paying people – it’s about building a foundation for international growth and success. As we move further into 2024, the organizations that embrace modern solutions and best practices will find themselves at a significant advantage.