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https://www.readbyqxmd.com/read/28727661/comparison-of-post-cesarean-section-opioid-analgesic-requirements-in-women-with-opioid-use-disorder-treated-with-methadone-or-buprenorphine
#1
Annmarie L Vilkins, Sarah M Bagley, Kristen A Hahn, Florencia Rojas-Miguez, Elisha M Wachman, Kelley Saia, Daniel P Alford
OBJECTIVE: Buprenorphine is a highly effective treatment for opioid use disorders, but its continuation in the perioperative setting remains controversial, unlike the accepted practice of perioperative methadone continuation. METHODS: We conducted a retrospective cohort study from 2006 to 2014 comparing post-cesarean section opioid analgesic requirements of women with opioid use disorders treated with methadone or buprenorphine. Preoperative, intraoperative, and postoperative opioid requirements (morphine equivalent dose [MED]), postoperative complications, and length of stay were compared between the methadone and buprenorphine groups...
July 19, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28723731/the-combined-effect-of-cyp2b6-genotype-and-other-candidate-genes-on-a-steady-state-serum-concentration-of-methadone-in-opioid-maintenance-treatment
#2
Marianne K Kringen, Fatemeh Chalabianloo, Jean-Paul Bernard, Jørgen G Bramness, Espen Molden, Gudrun Høiseth
BACKGROUND: A considerable inter-individual variability in methadone pharmacokinetics is seen in patients on methadone maintenance treatment. The aim of this study was to clarify the impact of the reduced function CYP2B6*6 variant allele together with variants in other candidate genes on a steady-state methadone concentration in a naturalistic setting. METHODS: Information of methadone serum concentration, dose, age, gender and CYP2C9, CYP2C19, and CYP2D6 genotypes were collected from a routine therapeutic drug monitoring (TDM) database while variant alleles in CYP2B6 and CYP3A5 were retrospectively genotyped...
July 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#3
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721344/exploring-patient-characteristics-and-barriers-to-hepatitis-c-treatment-in-patients-on-opioid-substitution-treatment-attending-a-community-based-fibro-scanning-clinic
#4
Des Crowley, Walter Cullen, Eamon Laird, John S Lambert, Tina Mc Hugh, Carol Murphy, Marie Claire Van Hout
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is a major public health issue. There is substandard uptake in HCV assessment and treatment among people who inject drugs (PWID). Community fibroscanning is used to assess disease severity and target treatment. METHODS: A survey was administered to a cohort of chronically HCV infected patients attending a community fibroscanning clinic. Questions targeted diagnosis of HCV, suitability, willingness and barriers to engagement in treatment...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28719082/determination-of-seven-drugs-of-abuse-and-their-metabolites-in-surface-and-waste-water-using-solid-phase-extraction-coupled-to-liquid-chromatography-with-high-resolution-mass-spectrometry
#5
Helena Prosen, Núria Fontanals, Francesc Borrull, Rosa Maria Marcé
A method based on liquid chromatography with electrospray ionization high-resolution mass spectrometry (Exactive Orbitrap) combined with solid-phase extraction using a strong cationic exchange mixed-mode sorbent has been developed for the determination of seven drugs of abuse, including two synthetic cathinones, as well as some of their metabolites in environmental water samples. The method provides low detection limits and a high confirmation power thanks to the diagnostic and two fragment ions monitored for each compound in high-resolution mass spectrometry, providing six identification points for each analyte...
July 18, 2017: Journal of Separation Science
https://www.readbyqxmd.com/read/28716045/barriers-to-accessing-and-using-health-insurance-cards-among-methadone-maintenance-treatment-patients-in-northern-vietnam
#6
Bach Xuan Tran, Victoria L Boggiano, Cuong Tat Nguyen, Long Hoang Nguyen, Anh Tuan Le Nguyen, Carl A Latkin
BACKGROUND: Methadone maintenance treatment (MMT) patients face unique costs associated with their healthcare expenditures. As such, it is important that these patients have access to health insurance (HI) to help them pay for both routine and unforeseen health services. In this study, we explored factors related to health insurance enrollment and utilization among MMT patients, to move Vietnam closer to universal coverage among this patient population. METHODS: A cross-sectional study was conducted with 1003 patients enrolled in MMT in five clinics in Hanoi and Nam Dinh provinces...
July 17, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#7
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28704148/-i-was-not-sick-and-i-didn-t-need-to-recover-methadone-maintenance-treatment-mmt-as-a-refuge-from-criminalization
#8
David Frank
BACKGROUND: Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences, or meet the needs of people who use drugs (PWUD), many of whom who use the program as a pragmatic means of reducing harms associated with criminalization...
July 13, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28699845/development-and-implementation-of-an-alcohol-withdrawal-protocol-using-a-5-item-brief-alcohol-withdrawal-scale-baws
#9
Darius A Rastegar, Dinah Applewhite, Anika A H Alvanzo, Christopher Welsh, Timothy Niessen, Edward S Chen
BACKGROUND: The standard of care for management of alcohol withdrawal is symptom-triggered treatment using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Many items of this 10-question scale rely on subjective assessments of withdrawal symptoms, making it time-consuming and cumbersome to use. Therefore, there is interest in shorter and more objective methods to assess alcohol withdrawal symptoms. METHODS: We initially piloted a 6-item withdrawal scale developed at another institution...
July 12, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28699698/reduced-dosing-and-liability-in-methadone-maintenance-treatment-by-targeting-oestrogen-signal-for-morphine-addiction
#10
Yao-Chang Chiang, Ruey-Yun Wang, Chieh-Liang Huang, Shue-Hwa Chen, Wen-Jing Ho, Hsien-Yuan Lane, Ing-Kang Ho, Hwei-Ting Yang, Wen-Lung Ma
Methadone maintenance treatment (MMT) is the major tapering therapy for morphine addictive patients. There have gender differences reported in response to MMT. This study discovered that the estrogen-response element single nucleotide polymorphism (ERE-SNP; rs16974799, C/T) of cytochrome 2B6 gene (cyp2b6; methadone catabolic enzyme) responded differently to MMT dosing. Oestradiol was associated with high MMT dosing, high enantiomer (R- or S-) of 2-ethylidene-1,5-dimethyl-3,3-dipheny-pyrrolidine (EDDP; methadone metabolite) to methadone ratio and increased drug-seeking behaviour, implicating oestradiol-CYP-EDDP/methadone axis decreasing MMT efficacy...
July 12, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28695388/measuring-acceptability-and-preferences-for-implementation-of-pre-exposure-prophylaxis-prep-using-conjoint-analysis-an-application-to-primary-hiv-prevention-among-high-risk-drug-users
#11
Roman Shrestha, Pramila Karki, Frederick L Altice, Oleksandr Dubov, Liana Fraenkel, Tania Huedo-Medina, Michael Copenhaver
Although people who use drugs (PWUD) are one of the key risk populations who could benefit from the use of pre-exposure prophylaxis (PrEP), to date, little attention has been given to incorporating PrEP into HIV prevention approaches targeting this underserved group. This study investigated the acceptability of PrEP based on a number of known PrEP attributes among high-risk PWUD in a drug treatment setting. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors were recruited from a methadone clinic to complete a stated preference (full-profile conjoint) survey...
July 10, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28693573/a-qualitative-assessment-of-an-abstinence-oriented-therapeutic-community-for-prisoners-with-substance-use-disorders-in-kyrgyzstan
#12
Lyuba Azbel, Julia Rozanova, Ingo Michels, Frederick L Altice, Heino Stöver
BACKGROUND: Kyrgyzstan, where HIV is concentrated in prisons and driven by injection drug use, provides a prison-based methadone maintenance therapy program as well as abstinence-oriented therapeutic community based on the 12-step model called the "Clean Zone." We aimed to qualitatively assess how prisoners navigate between these treatment options to understand the persistence of the Clean Zone despite a lack of evidence to support its effectiveness in treating opioid use disorders. METHODS: We conducted an analysis of policy documents and over 60 h of participant observation in February 2016, which included focus groups with a convenience sample of 20 therapeutic community staff members, 110 prisoners across three male and one female prisons, and qualitative interviews with two former Clean Zone participants...
July 10, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28683172/opioids-for-cancer-pain-an-overview-of-cochrane-reviews
#13
REVIEW
Philip J Wiffen, Bee Wee, Sheena Derry, Rae F Bell, R Andrew Moore
BACKGROUND: Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Opioid (morphine-like) drugs are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. The most commonly-used opioid drugs are buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, tramadol, and tapentadol...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28652072/evaluation-of-a-hepatitis-c-education-intervention-with-clients-enrolled-in-methadone-maintenance-and-needle-syringe-programs-in-malaysia
#14
Trena I Mukherjee, Veena Pillai, Siti Hafizah Ali, Frederick L Altice, Adeeba Kamarulzaman, Jeffrey A Wickersham
BACKGROUND: Approximately 40%-90% of people who inject drugs (PWID) in Malaysia have hepatitis C (HCV). PWID continue to be disproportionately affected by HCV due to their lack of knowledge, perceived risk and interest in HCV treatment. Education interventions may be an effective strategy for increasing HCV knowledge in PWID, and harm reduction services are uniquely positioned to implement and deploy such interventions. METHODS: We recruited 176 clients from methadone maintenance treatment (MMT: N=110) and needle/syringe programs (NSP: N=66) between November 2015 and August 2016...
June 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28651404/-correlation-between-insufficient-methadone-dosage-and-morphine-positive-urine-on-drop-out-of-treatment-in-patients-with-access-to-methadone-maintenance-treatment
#15
T Yao, D Feng, M H Pan, Y P Cheng, C X Li, J Wang, Y L Feng, J Shi, T Su, Q Chen, S Shi, S P Wang
Objective: To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Methods: Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. Results: The study included 1 031 participants, 40.6% of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage<100 mg/d group were 57...
May 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28650702/a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#16
Michael S Toce, Margaret A Stefater, David T Breault, Michele M Burns
BACKGROUND: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported. We present the case of an 11-month-old male who developed hypoketotic, hyperinsulinemic, hypoglycemia after an acute, unintentional methadone exposure. CASE DETAILS: The patient was a previously healthy 11-month-old male who presented in respiratory failure...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28650467/genome-wide-loss-of-function-genetic-screening-identifies-opioid-receptor-%C3%AE-1-as-a-key-regulator-of-l-asparaginase-resistance-in-pediatric-acute-lymphoblastic-leukemia
#17
S M Kang, J L Rosales, V Meier-Stephenson, S Kim, K Y Lee, A Narendran
L-asparaginase is a critical chemotherapeutic agent for acute lymphoblastic leukemia (ALL). It hydrolyzes plasma asparagine into aspartate and NH3, causing asparagine deficit and inhibition of protein synthesis and eventually, leukemic cell death. However, patient relapse often occurs due to development of resistance. The molecular mechanism by which ALL cells acquire resistance to L-asparaginase is unknown. Therefore, we sought to identify genes that are involved in L-asparaginase resistance in primary leukemic cells...
June 26, 2017: Oncogene
https://www.readbyqxmd.com/read/28648353/healthcare-contact-and-treatment-uptake-following-hepatitis-c-virus-screening-and-counseling-among-rural-appalachian-people-who-use-drugs
#18
Dustin B Stephens, April M Young, Jennifer R Havens
BACKGROUND: Hepatitis C virus (HCV) remains a major contributor to morbidity and mortality worldwide. Since 2009, Kentucky has led the United States in cases of acute HCV, driven largely by injection drug use in rural areas. Improved treatment regimens hold promise of mitigating the impact and transmission of HCV, but numerous barriers obstruct people who inject drugs (PWID) from receiving care, particularly in medically underserved settings. METHODS: 503 rural people who use drugs were recruited using respondent-driven sampling and received HCV screening and post-test counseling...
June 22, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#19
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28642082/clinical-trial-of-the-effects-of-vitamin-d-supplementation-on-psychological-symptoms-and-metabolic-profiles-in-maintenance-methadone-treatment-patients
#20
Amir Ghaderi, Hamid Reza Banafshe, Maryam Motmaen, Morad Rasouli-Azad, Fereshteh Bahmani, Zatollah Asemi
BACKGROUND: Vitamin D deficiency may be associated with some complications including nonspecific musculoskeletal pain and periodontal disease in maintenance methadone treatment (MMT) patients. This study was designed to determine the effect of vitamin D supplementation on psychological symptoms and metabolic profiles in MMT patients. METHODS: This randomized, double-blind, placebo-controlled, clinical trial was carried out among 68 MMT patients. Participants were randomly allocated to receive either 50,000IU vitamin D supplements (n=34) or placebo (n=34) every 2weeks for 12weeks...
June 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
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