Located throughout the body, the main G-protein-coupled opioid receptors, mu-opioid receptors (MOR), delta opioid receptors (DOR), and kappa opioid receptors (KOR), respond to endogenous and exogenous opioids and suppress the HPA axis. Better guidance for diagnosis and treatment is urgently needed, particularly in light of the fact that 5% of the United States population has a prescription for chronic opioid therapy. OIAI can be treated and for patients who must continue opioid therapy, it can be clinically managed. This may be dangerous, as OIAI can lead to a potentially life-threatening adrenal crisis. OIAI can be diagnosed by a variety of tests, such as the morning cortisol test, but cutoff values are not well established and it is estimated that only about 10% of patients with OIAI will ever be properly diagnosed. Beyond chronic opioid use, risk factors for OIAI are not well known. OIAI is secondary to long-term opioid use and differs from primary adrenal insufficiency. Among several opioid-associated endocrinopathies, opioid-associated adrenal insufficiency (OIAI) is both common and not well understood by most clinicians, particularly those outside of endocrine specialization.
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We are asking residents to join us in becoming water wise. A community that is more informed and prepared will have a greater opportunity to rebound quickly from weather and climate-related events. Every improvement made, from the individual level to the state level will ensure the success and protection of Oklahoma resources, residents and resiliency. To meet these challenges, we have to employ methods of water conservation and reuse during drought and stormwater management during heavy rain events. When there is an abundance of rain, these conditions also result in considerable losses in the same areas. When there is not enough rain, drought conditions result in cosiderable losses to the environment, the economy and the safety of citizens. We have to be prepared to handle both situations. In Oklahoma, we go through periods of not enough water and then too much water. 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