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Journal of Opioid Management

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https://www.readbyqxmd.com/read/29199399/the-effect-of-toothpicks-containing-flavoring-and-flavoring-plus-jambu-extract-spilanthol-to-promote-salivation-in-patients-diagnosed-with-opioid-induced-dry-mouth-xerostomia
#1
Bennet Davis, Kathy Davis, Sandy Bigelow, Patricia Healey
OBJECTIVE: To determine if the use of toothpicks infused with flavoring and flavoring plus the food additive spilanthol (Xerosticks™) improve saliva flow in people with opioid-induced dry mouth. DESIGN: Time series, nonrandomized, double-blind within-subject design. SETTING: Private practice/academic multidisciplinary pain and palliative care clinic. PARTICIPANTS: Ten subjects with opioid-induced dry mouth were recruited, and all finished the study...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199398/tramadol-for-maintenance-in-opioid-dependence-a-retrospective-chart-review
#2
Siddharth Sarkar, Rakesh Lal, Mohit Varshney, Yatan Pal Singh Balhara
BACKGROUND AND AIMS: Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of individuals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months. METHODS: Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199397/opioid-tolerance-and-urine-drug-testing-among-initiates-of-extended-release-or-long-acting-opioids-in-food-and-drug-administration-s-sentinel-system
#3
Marc R Larochelle, Noelle M Cocoros, Jennifer Popovic, Elizabeth C Dee, Cynthia Kornegay, Jing Ju, Judith A Racoosin
OBJECTIVE: A risk evaluation and mitigation strategy for extended-release and long-acting (ER/LA) opioid analgesics was approved by the Food and Drug Administration in 2012. Our objective was to assess frequency of opioid tolerance and urine drug testing for individuals initiating ER/LA opioid analgesics. DESIGN: Retrospective cohort study. SETTING: Sentinel, a distributed database with electronic healthcare data on >190 million predominantly commercially insured members...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199396/educational-intervention-for-physicians-to-address-the-risk-of-opioid-abuse
#4
Margaret K Pasquale, Richard L Sheer, Jack Mardekian, Elizabeth T Masters, Nick C Patel, Amy R Hurwitch, Jennifer J Weber, Anamaria Jorga, Carl L Roland
OBJECTIVE: To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse. SETTING, DESIGN AND PATIENTS, PARTICIPANTS: Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199395/projecting-the-cost-utilization-and-patient-care-impact-of-prescribing-extended-release-non-abuse-deterrent-opioids-to-chronic-pain-patients
#5
Mihran Ara Yenikomshian, Alan G White, Michael E Carson, Louis P Garrison, Gary M Oderda, Joseph E Biskupiak, Patrick R Hlavacek, Carl L Roland
OBJECTIVES: To estimate healthcare resource utilization, associated costs, and number needed to harm (NNH) from a physician's decision to prescribe extended-release (ER) non-abuse-deterrent opioids (non-ADO) as compared to ER ADOs in a chronic pain population. DESIGN: A 12-month probabilistic simulation model was developed to estimate the reduction of misuse and/or abuse from a physician's prescribing decisions for 10,000 patients. Model inputs included probabilities for opioid misuse and/or abuse-related events, opioid discontinuation, and switching from ADO to non-ADO...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199394/trends-in-florida-s-prescription-drug-monitoring-program-registration-and-utilization-implications-for-increasing-voluntary-use
#6
Chris Delcher, Yanning Wang, Henry W Young, Bruce A Goldberger, Siegfried Schmidt, Gary M Reisfield
OBJECTIVE: Effective use of state prescription drug monitoring programs (PDMPs) to track controlled substance prescribing and dispensing may help mitigate the current opioid crisis. Our objective was to examine trends in registration for and use of Florida's PDMP by physicians and pharmacists, from 2013 to 2016. We discuss implications for PDMP uptake and policy. DESIGN: Key measures, such as cumulative number of registrants per license type and monthly utilization intensity, are presented...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29199393/a-public-health-outbreak-management-framework-applied-to-surges-in-opioid-overdoses
#7
Kieran Moore, Maximilien Boulet, Julia Lew, Nicholas Papadomanolakis-Pakis
Over the past decade, Canada and the United States have been facing an epidemic of harms from prescription opioids. More recently, opioid-naïve individuals have been exposed to illicit opioids through adulterated combination products. This has resulted in sudden surges of opioid-related mortality. A proactive public health solution is needed to prevent further death. We propose examining these surges in opioid overdoses as outbreaks and investigating them in a similar way to an outbreak of an infectious disease...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28983886/opioid-receptor-antagonists-in-the-treatment-of-pathological-gambling
#8
Maurizio Coppola, Raffaella Mondola
No abstract text is available yet for this article.
July 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28953317/comparing-methods-of-naloxone-administration-a-narrative-review
#9
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
https://www.readbyqxmd.com/read/28953316/impact-of-opioids-on-oxidative-status-and-related-signaling-pathways-an-integrated-view
#10
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
https://www.readbyqxmd.com/read/28953315/implications-of-prescription-drug-monitoring-and-medical-cannabis-legislation-on-opioid-overdose-mortality
#11
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
https://www.readbyqxmd.com/read/28953314/postoperative-pain-scores-and-opioid-consumption-in-opioid-dependent-patients-with-cancer-after-intraoperative-remifentanil-analgesia-a-prospective-case-controlled-study
#12
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
https://www.readbyqxmd.com/read/28953313/characteristics-and-treatment-patterns-of-us-commercially-insured-and-medicaid-patients-with-opioid-dependence-or-abuse
#13
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
https://www.readbyqxmd.com/read/28829520/tramadol-associated-mania-a-case-report
#14
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
https://www.readbyqxmd.com/read/28829519/looking-both-ways-before-crossing-the-street-assessing-the-benefits-and-risk-of-opioids-in-treating-patients-at-risk-of-sleep-disordered-breathing-for-pain-and-dyspnea
#15
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
https://www.readbyqxmd.com/read/28829518/cost-of-opioid-treated-chronic-low-back-pain-findings-from-a-pilot-randomized-controlled-trial-of-mindfulness-meditation-based-intervention
#16
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
https://www.readbyqxmd.com/read/28829517/assessing-the-impact-of-the-extended-release-long-acting-opioid-an-algesics-risk-evaluation-and-mitigation-strategies-on-opioid-prescrip-tion-volume
#17
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
https://www.readbyqxmd.com/read/28829516/opioid-management-strategy-decreases-admissions-in-high-utilizing-adults-with-sickle-cell-disease
#18
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
https://www.readbyqxmd.com/read/28829515/oxycodone-induced-neurotoxicity-secondary-to-concurrent-voriconazole-use-in-a-patient-with-cancer
#19
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
https://www.readbyqxmd.com/read/28829527/does-caffeine-improve-respiratory-rate-during-remifentanil-target-controlled-infusion-sedation-a-case-report-in-endoscopic-sedation
#20
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
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