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https://www.readbyqxmd.com/read/29238241/predictors-of-mortality-within-prison-and-after-release-among-persons-living-with-hiv-in-indonesia
#1
Gabriel J Culbert, Forrest W Crawford, Astia Murni, Agung Waluyo, Alexander R Bazazi, Junaiti Sahar, Frederick L Altice
Objectives: HIV-related mortality is increasing in Indonesia, where prisons house many people living with HIV and addiction. We examined all-cause mortality in HIV-infected Indonesian prisoners within prison and up to 24 months post-release. Materials and Methods: Randomly selected HIV-infected male prisoners (n=102) from two prisons in Jakarta, Indonesia completed surveys in prison and were followed up for 2 years (until study completion) or until they died or were lost to follow-up...
2017: Research and Reports in Tropical Medicine
https://www.readbyqxmd.com/read/29234968/a-cross-national-analysis-of-the-association-between-years-of-implementation-of-opioid-substitution-treatments-and-drug-related-deaths-in-europe-from-1995-to-2013
#2
Phillip L Marotta, Charlotte A McCullagh
Data at the individual-level provide evidence that opioid substitution treatment (OST) programs protect against mortality for opioid dependent populations. Prior research has not examined the merits of national implementation of opioid substitution programs for reducing mortality at the country-level. This study elucidates longitudinal associations between country-level implementation of opioid substitution treatment programs on mortality rates of drug related deaths (DRD) from 1995 to 2013 in 30 European nations...
December 12, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29224006/epigenetic-regulation-of-the-promotor-region-of-vascular-endothelial-growth-factor-a-and-nerve-growth-factor-in-opioid-maintained-patients
#3
Adrian Groh, Kirsten Jahn, Alexandra Burkert, Alexandra Neyazi, Laura Schares, Eva Janke, Marie Rehme, Rilana Schuster, Thomas Hillemacher, Stefan Bleich, Helge Frieling, Annemarie Heberlein
AIMS: The nerve growth factor (NGF) and the vascular endothelial growth factor-A (VEGF-A) may be of importance for psychiatric diseases including substance use disorders. The aim of the study was to identify differences in the regulation of both neuropeptides via the DNA-methylation status of the promotor regions of NGF and VEGF-A in different forms of maintenance therapy for opioid dependence and the related stress regulation via the hypothalamic-pituitary-adrenal axis. METHODS: We compared methylation levels of opioid-dependent patients receiving treatment with diamorphine (n = 28) or levomethadone (n = 54) and similar levels in a healthy control group (n = 72)...
December 8, 2017: European Addiction Research
https://www.readbyqxmd.com/read/29210063/opioid-induced-inhibition-of-the-human-serotonin-and-norepinephrine-transporters-in-vitro-link-to-clinical-reports-of-serotonin-syndrome
#4
Anna Rickli, Evangelia Liakoni, Marius C Hoener, Matthias E Liechti
BACKGROUND AND PURPOSE: Opioids may inhibit the serotonin and norepinephrine transporters (SERT and NET, respectively). NET inhibition may contribute to analgesia, and SERT inhibition or interactions with serotonin receptors may cause serotonergic toxicity. However, the effects of different opioids on the human SERT, NET, and serotonin receptors have not been sufficiently studied. EXPERIMENTAL APPROACH: We determined the potencies of different opioids to inhibit the SERT and NET in vitro using human transporter-transfected cells...
December 6, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29205946/surveillance-of-drug-abuse-in-hong-kong-by-hair-analysis-using-lc-ms-ms
#5
K Wing Leung, Zack C F Wong, Janet Y M Ho, Ada W S Yip, Jerry K H Cheung, Karen K L Ho, Ran Duan, Karl W K Tsim
The aim of this study is to reveal the habits of drug abusers in hair samples from drug rehabilitation units in Hong Kong. With the application of LC-MS/MS technology, a total of 1,771 hair samples were analyzed during the period (Jan 2012 to Mar 2016) of hair testing service provided to fourteen drug rehabilitation units including non-governmental organizations (NGOs), rehabilitation centers and medical clinics. Hair samples were analyzed for abused drugs and their metabolites simultaneously, including ketamine, norketamine, cocaine, benzoylecgonine, cocaethylene, norcocaine, codeine, MDMA, MDA, MDEA, amphetamine, methamphetamine, morphine, 6-acetylmorphine, phencyclidine and methadone...
December 4, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29181552/-nephrotic-syndrome-and-microhematuria-in-a-patient-with-nutcracker-syndrome-report-of-a-case-and-review-of-the-literature
#6
N Schöffel, R-M Liehr, C Bünger, K Krüger, D Rubin
We report about a 43-year-old woman with polyvalent drug addiction (i.e. alcohol, nicotine, methadone maintenance program with parallel consumption of heroin) who presented to the emergency department with peripheral edema, generalized weakness, and arthralgia. Laboratory findings revealed, among others, proteinuria, hyperlipoproteinemia and hypoproteinemia defining nephrotic syndrome. Computed tomography of the abdomen and iliocavography further revealed compression of left renal vein between aorta and superior mesenteric artery with distention of left ovarian vein as a possible cause of nephrotic syndrome (i...
November 27, 2017: Der Internist
https://www.readbyqxmd.com/read/29180560/dysrhythmias-with-loperamide-used-for-opioid-withdrawal
#7
Nicki D Vithalani, Christopher Heron, Ravishankar E Rao, Anthony F Cardell, Mark B Stephens
The antidiarrheal loperamide has had a recent, drastic increase in off-label use as an alternative treatment for symptoms of opioid withdrawal. The concept of this is easily discovered on the Internet and social media, where there are multiple blogs and forums promoting loperamide use at doses of 70 to 200 mg per day. Unfortunately, the serious side effects are not well recognized. Multiple cases of cardiac dysrhythmias contributing to death have been highlighted in recent literature. In November 2016, the US Food & Drug Administration released a statement highlighting the potential heart effects and risk of death with high doses of loperamide...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29172963/effect-of-administration-rate-on-propofol-requirement-in-cats
#8
Renato Ls Oliveira, Clarissa Mr Moreira, Myla Cb Barcellos, Camile Pp Silva, Jorge Gc Teixeira, Heloisa Jm Souza
Objectives The objective of this study was to determine the effect of administration rate on propofol dose for induction of anesthesia and the effect of methadone on this dose. Methods This was a prospective, randomized, blinded clinical study. Forty male cats (mean ± SD age 1.5 ± 0.8 years) were admitted for orchiectomy. Cats were randomly allocated to receive acepromazine (0.05 mg/kg) with either methadone (MET; 0.3 mg/kg) or saline (SAL; 0.03 ml/kg). Each premedication group then received anesthetic induction with propofol at 5 (F) or 1...
March 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29155916/a-novel-strategy-to-address-unmeasured-confounding-when-comparing-opioid-agonist-therapies-in-pregnancy
#9
Lara S Lemon
Opioid addiction in pregnancy is a growing concern that has recently received a lot of attention. When comparing recommended opioid agonist therapies, many currently published studies guiding practice may be impacted by unmeasured confounding by indication. Populations of women who receive methadone are generally different from those treated with buprenorphine. Women treated with methadone frequently have more severe and uncontrolled addiction compared with buprenorphine treated patients; however, these factors are typically unmeasured or unavailable in large observational data sets...
November 16, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29145698/illicit-drug-use-illicit-drug-use-disorders-and-drug-overdose-deaths-in-metropolitan-and-nonmetropolitan-areas-united-states
#10
EDITORIAL
Karin A Mack, Christopher M Jones, Michael F Ballesteros
PROBLEM/CONDITION: Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. REPORTING PERIOD: Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015...
December 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29120275/ethnic-differences-in-psychosocial-factors-in-methadone-maintenance-hmong-versus-non-hmong
#11
Gavin Bart
Little is known about the characteristics of U.S.-based Asian populations undergoing methadone maintenance treatment for opioid use disorders. We evaluated psychosocial factors in 76 Hmong and 130 non-Hmong on methadone maintenance for at least two months in a single urban methadone maintenance clinic. Assessments included the Addiction Severity Index 5th Edition, the Symptom Checklist-90, and the Structured Clinical Interview for DSM-IV Axis I Disorders. The Hmong were older, predominately male, and on lower doses of methadone than the non-Hmong...
November 9, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/29112519/methadone-versus-buprenorphine-for-opioid-use-dependence-and-risk-of-neonatal-abstinence-syndrome
#12
Lara S Lemon, Steve N Caritis, Raman Venkataramanan, Robert W Platt, Lisa M Bodnar
BACKGROUND: Our objective was to estimate the association between methadone and neonatal abstinence syndrome compared with buprenorphine using a probabilistic bias analysis to account for unmeasured confounding by severity of addiction. METHODS: We used a cohort of live-born infants exposed in utero to methadone or buprenorphine for maternal opioid maintenance therapy at Magee-Womens Hospital in Pittsburgh, PA from 2013-2015 (n=716). We determined exposure and outcome status using pharmacy billing claims...
November 6, 2017: Epidemiology
https://www.readbyqxmd.com/read/29108376/pain-of-methadone-maintained-heroin-addicts-lonelier-individuals-feel-more-intense-pain
#13
Fu Li, Yan-Min Xu, Jun-Hong Zhu, Jin Lu, Bao-Liang Zhong
Managing pain in patients with heroin addiction is challenging, because most pain medications are addictive. A promising way to relieve pain of heroin addicts is to identify and address modifiable psychosocial factors associated with pain. This study examined the association between loneliness and pain intensity in Chinese heroin addicts receiving methadone maintenance treatment (MMT). A consecutive sample of 603 heroin addicts were recruited from three MMT clinics in Wuhan, China. Loneliness was assessed with a single question, and socio-demographic and clinical data were collected with a standardized questionnaire...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29105663/exacerbated-craving-in-the-presence-of-stress-and-drug-cues-in-drug-dependent-patients
#14
Kenzie L Preston, William J Kowalczyk, Karran A Phillips, Michelle L Jobes, Massoud Vahabzadeh, Jia-Ling Lin, Mustapha Mezghanni, David H Epstein
In addiction, risk factors for craving and use include stress and drug-related cues. Stress and cues have additive or more-than-additive effects on drug seeking in laboratory animals, but, surprisingly, seem to compete with one another (ie, exert less-than-additive effects) in human laboratory studies of craving. We sought heretofore elusive evidence that human drug users could show additive (or more-than-additive) effects of stress and cues on craving, using ecological momentary assessment (EMA). Outpatients (N=182) maintained on daily buprenorphine or methadone provided self-reports of stress, craving, mood, and behavior on electronic diaries for up to 16 weeks...
November 6, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29096016/opioid-use-disorders-medication-assisted-treatment-and-the-role-of-the-laboratory
#15
Roger L Bertholf, Gary M Reisfield
Urine drug testing is an essential component in the evaluation and management of individuals with opioid use disorders, including those on buprenorphine or methadone maintenance therapies. Notwithstanding its centrality in adherence monitoring, studies have shown that clinicians have important knowledge deficiencies regarding the ordering and interpretation of drug tests. In this review, we discuss the scope and frequency of testing, the advantages and disadvantages of immunoassay- (presumptive) and liquid chromatograph-mass spectrometry- (definitive) based techniques, indications for definitive testing, medical necessity, and other considerations...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29095804/deaths-involving-fentanyl-fentanyl-analogs-and-u-47700-10-states-july-december-2016
#16
Julie K O'Donnell, John Halpin, Christine L Mattson, Bruce A Goldberger, R Matthew Gladden
Preliminary estimates of U.S. drug overdose deaths exceeded 60,000 in 2016 and were partially driven by a fivefold increase in overdose deaths involving synthetic opioids (excluding methadone), from 3,105 in 2013 to approximately 20,000 in 2016 (1,2). Illicitly manufactured fentanyl, a synthetic opioid 50-100 times more potent than morphine, is primarily responsible for this rapid increase (3,4). In addition, fentanyl analogs such as acetylfentanyl, furanylfentanyl, and carfentanil are being detected increasingly in overdose deaths (5,6) and the illicit opioid drug supply (7)...
November 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29090834/computer-simulation-and-enantioselective-capillary-electrophoresis-to-characterize-isomer-mixtures-of-sulfated-%C3%AE-cyclodextrins
#17
Saara Mikkonen, Jitka Caslavska, Vlastimil Hruška, Wolfgang Thormann
The enantiomeric separation of methadone in the presence of multiple isomer mixtures of sulfated β-cyclodextrin (S-β-CD) was studied experimentally with CZE and theoretically using computer simulation. Experiments were performed over many years with several lots of S-β-CD from the same manufacturer with a specified degree of substitution of 7-11. Large differences in the migration patterns were observed between certain lots and it was concluded that the extent of labelling in lots released after a transition time was higher than originally specified...
November 1, 2017: Electrophoresis
https://www.readbyqxmd.com/read/29089014/methadone-maintenance-treatment-for-older-adults-cost-and-logistical-considerations
#18
Brandi P Cotton, William Culbertson Bryson, Martha L Bruce
In a demographic shift, older adults now comprise an increasing proportion of those receiving methadone maintenance treatment (MMT) for opioid use disorder. A study of MMT recipients in New York City suggests that 13% of the population is over 60 years of age. Adults ages 50-59 are among the largest age demographic, evidence that the number of older adults receiving MMT will continue to increase. Because medical comorbidities, cognitive impairment, and neurobehavioral changes often accumulate with age, older adults on MMT become increasingly vulnerable...
November 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29084357/adverse-events-associated-with-medium-and-long-term-use-of-opioids-for-chronic-non-cancer-pain-an-overview-of-cochrane-reviews
#19
REVIEW
Charl Els, Tanya D Jackson, Diane Kunyk, Vernon G Lappi, Barend Sonnenberg, Reidar Hagtvedt, Sangita Sharma, Fariba Kolahdooz, Sebastian Straube
BACKGROUND: Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. OBJECTIVES: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29073515/high-risk-of-misinterpreting-hair-analysis-results-for-children-tested-for-methadone
#20
Pascal Kintz, Audrey Farrugia, Alice Ameline, Aude Eibel, Jean-Sébastien Raul
The major problem after testing the hair of a child for drugs is the interpretation of the findings. In 2016, the laboratory received several hair specimens with the request to verify if there was any evidence of previous methadone exposure by the donor of the sample. Case 1 was a child admitted to the Emergency Unit for intense sedation and breathing difficulties. Cases 2-4 involved children found dead at home. In all cases, methadone and EDDP, its metabolite, were found in blood. After decontamination, the hair was analysed with LC-MS/MS for methadone and EDDP...
November 2017: Forensic Science International
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