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Journal of Opioid Management

Maurizio Coppola, Raffaella Mondola
No abstract text is available yet for this article.
July 2017: Journal of Opioid Management
Shawn E Fellows, Alexander J Coppola, Mona A Gandhi
The effectiveness and safety of naloxone for the reversal of opioid toxicity are reviewed. A literature search was performed using PubMed, the Cochrane Library, CINAHL, and Medline. Clinical trials comparing either the clinical efficacy or pharmacokinetic/pharmacodynamic properties displayed by intravenous, intramuscular, intranasal, subcutaneous, and nebulized naloxone were included; however, trials with primary endpoints evaluating oral or endotracheal naloxone were excluded. Naloxone was shown to be clinically effective via all routes of administration, when compared to either baseline or control...
July 2017: Journal of Opioid Management
Maryam Zahmatkesh, Mehri Kadkhodaee, Ali Salarian, Behjat Seifi, Soheila Adeli
BACKGROUND: Opioids produce reactive oxygen species (ROS) which are highly reactive molecules that damage cells and tissues, and are suggested to contribute to the opioid use disorders. Thus, antioxidant supplementation might improve the disturbance in redox (oxidation-reduction) homeostasis. However, randomized trials on antioxidant therapy have not shown beneficial effects. OBJECTIVES: The purpose of this review is to shed lights on the oxidative changes resulting from opioid use and to highlight the unanswered questions regarding oxidative profile in an effort to provide a comprehensive view of different aspects of an efficient antioxidant therapy in clinical settings...
July 2017: Journal of Opioid Management
Elyse Phillips, Julie Gazmararian
OBJECTIVES: To determine whether specific state legislation has an effect on opioid overdose mortality rates compared to states without those types of legislation. DESIGN: Ecological study estimating opioid-related mortality in states with and without a prescription drug monitoring program (PDMP) and/or medical cannabis legislation. SETTING AND PARTICIPANTS: Opioid-related mortality rates for 50 states and Washington DC from 2011 to 2014 were obtained from CDC WONDER...
July 2017: Journal of Opioid Management
Cyrus Motamed, Juliette Audibert, Aline Albi-Feldzer, Gaelle Bouroche, Christian Jayr
BACKGROUND: Opioid dependency is becoming increasingly common among surgical patients with cancer, and can lead to inadequate pain relief during the initial postoperative period. No guidelines are currently available for the management of perioperative and postoperative morphine administration in these patients. As a first approach, the authors assessed the opioid requirements of these patients during the early postoperative period. METHODS: A group of 35 consecutive surgical patients with cancer on opioid therapy (opioid-dependent group) for cancer pain were compared to a matched group of 44 surgical opioid-naive patients (control group)...
July 2017: Journal of Opioid Management
Bernd A Wollschlaeger, Tina M Willson, Leslie B Montejano, Naoko A Ronquest, Vijay R Nadipelli
OBJECTIVE: To identify the demographic and clinical characteristics of commercially insured and Medicaid patients with a diagnosis of opioid dependence or abuse and to describe the pharmacological and nonpharmacological treatments received by these patients. DESIGN: This was a retrospective observational study using de-identified administrative claims data. SETTING: The analysis included commercially insured and Medicaid patient data extracted from the Truven Health MarketScan® Commercial and Medicaid Databases...
July 2017: Journal of Opioid Management
Jamaluddin Nimah, Alexander Chen, Kelly N Gable, Alan R Felthous
A variety of medications, most notably tricyclic antidepressants, and other antidepressants including venlafaxine have been reported to have triggered manic episodes in patients with bipolar disorder. The synthetic opioid tramadol has also been associated with mania activation. This report describes an unusual case of tramadol-associated mania in a patient without a charted diagnosis of bipolar disorder. However, she had a history of two prior episodes of mania following administration of tramadol that were also believed to be related to medication-induced mood disorder rather than underlying bipolar disorder...
May 2017: Journal of Opioid Management
Mellar P Davis, Bertrand Behm, Diwakar Balachandran
Opioids adversely influence respiration in five distinct ways. Opioids reduce the respiratory rate, tidal volume, amplitude, reflex responses to hypercapnia and hypoxia, and arousability related necessary for respiratory adaptive responses. Opioids cause impairment of upper pharyngeal dilator muscles leading to obstructive apnea. Opioids cause complex sleep disordered breathing (SDB) consisting of central sleep apnea and obstructive sleep apnea. Clinically opioids worsen pre-existing SDB. Recent studies have shown increased morbidity and mortality in patients receiving opioids for chronic noncancer pain and chronic obstructive pulmonary disease, which appear to be related to cardiovascular events, not overdose...
May 2017: Journal of Opioid Management
Aleksandra E Zgierska, James Ircink, Cindy A Burzinski, Marlon P Mundt
OBJECTIVE: Opioid-treated chronic low back pain (CLBP) is debilitating, costly, and often refractory to existing treatments. This secondary analysis aims to pilot-test the hypothesis that mindfulness meditation (MM) can reduce economic burden related to opioid-treated CLBP. DESIGN: Twenty-six-week unblinded pilot randomized controlled trial, comparing MM, adjunctive to usual-care, to usual care alone. SETTING: Outpatient. PARTICIPANTS: Thirty-five adults with opioid-treated CLBP (≥30 morphine-equivalent mg/day) for 3 + months enrolled; none withdrew...
May 2017: Journal of Opioid Management
Victoria Divino, Soledad Cepeda, Paul Coplan, Jean-Yves Maziere, Yingli Yuan, Rolin L Wade
OBJECTIVE: The Food and Drug Administration approved the extended-release/long-acting (ER/LA) opioid analgesics risk evaluation and mitigation strategies (REMS) in July 2012 to educate healthcare providers and patients about safe and appropriate opioid analgesic use. The authors evaluated the impact of the REMS on ER/LA opioid analgesic utilization, overall and stratified by patient characteristics and prescriber type associated with greater expected need for analgesia. DESIGN: Retrospective repeated cross-sectional study...
May 2017: Journal of Opioid Management
Amy Mager, Kristin Pelot, Kathryn Koch, Lawrence Miller, Collin Hubler, Anisah Ndifor, Canice Coan, Cynthia Leonard, Joshua J Field
BACKGROUND: A subset of adults with sickle cell disease (SCD) heavily utilizes the emergency department (ED) and hospital. The objective of our study was to determine the efficacy of a multidisciplinary strategy to address unmet needs in highly utilizing adults with SCD. METHODS: In a prospective study, adults with SCD with ≥10 admissions per year were assessed by a multidisciplinary team for gaps in medical, social, and psychological care. Thereafter, the team decided upon the subject's predominant domain that drove admissions and instituted an interventional plan...
May 2017: Journal of Opioid Management
Lana Alghothani, Jillian Gustin
Chronic pain is common in patients with underlying malignancy with prevalence of up to 70 percent in those with advanced disease. Opioids are often used for those with both active disease and chronic cancer-related pain. In high-risk patients with hematologic malignancies and pneumonia, the Infectious Diseases Society of America recommends empiric antifungal therapy, often with voriconazole or another similar azole agent. Thus, patients with cancer are commonly on medications, such as antifungals, that have the potential to interact with opioids, causing adverse effects...
May 2017: Journal of Opioid Management
Fabio Sbaraglia, Mariella De Riso, Maria Elena Riccioni, Guido Costamagna, Maria Sammartino
Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc)...
March 2017: Journal of Opioid Management
Jeffrey M Dayno, Gwendolyn Niebler, John Lawler, Torben Elhauge, Karsten Lindhardt
OBJECTIVE: To characterize the pharmacokinetics (PK) and in vitro alcohol dissolution characteristics of extended-release (ER), injection-molded (IM) morphine tablets with abuse-deterrent (AD) features (morphine-ADER-IMT). DESIGN: In vivo, in vitro, and in silico studies were conducted. A randomized, two-cohort study evaluated the bioequivalence of morphine-ADER-IMT (60 mg) to morphine ER (60 mg; MS Contin®; Purdue Pharma LP, Stamford, CT) and characterized the effect of food on the PK profile of morphine-ADER-IMT...
March 2017: Journal of Opioid Management
Leah Sera, Micke Brown, Mary Lynn McPherson, Kathryn A Walker, Wendy Klein-Schwartz
OBJECTIVES: The purpose of the study was to evaluate states' experiences with abrupt changes in controlled substances (CS) prescribing, to determine whether states have action plans in place to manage such situations, and describe the components of any such plans. METHODS: A survey of executive directors of 51 medical boards was conducted to evaluate states' experiences with abrupt changes in CS prescribing, the extent of consumer complaints attributed to these events, and the types of plans in place to manage these situations...
March 2017: Journal of Opioid Management
Corey J Hayes, Jacob T Painter
Opioid analgesics are one of the most often prescribed medication classes, and their use has increased dramatically, with the number of prescriptions doubling between 1998 and 2010. Moreover, long-term use of opioids is becoming more prevalent. The complications arising from opioid use have been clearly documented; however, a relatively unknown complication potentially linked to opioid use is allodynia. This article outlines how research on opioid-induced hyperalgesia has led to the discovery of allodynia. Next, this article provides a detailed review of the current literature on allodynia, which includes animal studies, case reports, case series, and randomized controlled trials...
March 2017: Journal of Opioid Management
Stefano Cattaneo, Pablo Ingelmo, Luigia Scudeller, Manuela De Gregori, Dario Bugada, Marco Baciarello, Maurizio Marchesini, Giovanni Alberio, Marco Normanno, Gloria Saccani Jotti, Tiziana Meschi, Guido Fanelli, Allegri Massimo
OBJECTIVE: The sex of the patients has been shown to affect postoperative pain and morphine consumption; still a clear understanding able to explain the reasons behind this difference struggles to emerge. Our research aimed to investigate one specific aspect of the variability in morphine consumption between sexes. Previous studies have shown that circadian rhythm can influence opioid consumption. Furthermore, circadian rhythm is different between female and male. Our analysis investigated the presence of differences in daily rhythmicity of morphine consumption between males and females...
March 2017: Journal of Opioid Management
Michael A Grasso, Zachary D W Dezman, Clare T Grasso, David A Jerrard
OBJECTIVE: This study sought to characterize national patterns for opioid pain medication (OPM) prescriptions received during emergency medical encounters in the Veterans Health Administration (VA). DESIGN: The authors conducted a retrospective study of all emergency department (ED) visits by adults in the VA between January 2009 and June 2015. We examined demographics, comorbidities, utilization measures, diagnoses, and prescriptions. MAIN OUTCOME MEASURES: The percentage of ED visits that culminated in the receipt of a prescription for an OPM...
March 2017: Journal of Opioid Management
Scott G Weiner, Andrew R Joyce, Heather N Thomson
OBJECTIVES: The intranasal route of administration for naloxone delivery is one treatment for opioid overdose, but treatment failures with this modality have been documented. This study determines the incidence of obstructive nasal pathology in patients who experienced serious opioid-induced respiratory depression (OIRD). DESIGN: Retrospective analysis of the IMS LifeLink: Health Plan Claims Database to detect patients with at least one opioid pharmacy claim from 2009 to 2013 and who experienced serious OIRD...
March 2017: Journal of Opioid Management
Fisher Deborah, Suzanne W Ameringer
OBJECTIVE: The purpose of this study was to describe the current opioid tapering practice. DESIGN: Cross-sectional, online, survey research. PARTICIPANTS: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves. RESULTS: One hundred four participants responded to the survey...
January 2017: Journal of Opioid Management
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