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https://www.readbyqxmd.com/read/28642642/access-to-and-payment-for-office-based-buprenorphine-treatment-in-ohio
#1
Theodore V Parran, Joseph Z Muller, Elina Chernyak, Chris Adelman, Christina M Delos Reyes, Douglas Rowland, Mykola Kolganov
IMPORTANCE: Office-based opiate agonist therapy has dramatically expanded access to medication-assisted treatment over the past decade but has also led to increased buprenorphine diversion. OBJECTIVE: Our study sought to characterize physicians who participate in office-based therapy (OBT) to assess patient access to OBT in Ohio 10 years after its introduction. DESIGN/SETTING/PARTICIPANTS: Cross-sectional telephone survey of Drug Addiction Treatment Act-waivered physicians in Ohio listed by the Center for Substance Abuse Treatment (CSAT)...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/28629236/advances-in-new-psychoactive-substances-identification-the-u-r-i-to-n-consortium
#2
Elisabetta Bertol, Fabio Vaiano, Francesco Mari, Maria Grazia Di Milia, Silvia Bua, Claudiu T Supuran, Fabrizio Carta
Identification of new psychoactive substances (NPS) in biological and non-biological samples represents a hard challenge for forensic toxicologists. Their great chemical variety and the speed with which new NPS are synthesised and spread make stringent the need of advanced tools for their detection based on multidisciplinary approaches. For this reason, in August 2016, the "Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction" (U.R.I.To.N.) was founded by the Forensic Toxicology Division of the University of Florence...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28571505/buprenorphine-implants-in-medical-treatment-of-opioid-addiction
#3
Steven Chavoustie, Michael Frost, Ole Snyder, Joel Owen, Mona Darwish, Ryan Dammerman, Victoria Sanjurjo
Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations...
June 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28562310/mental-health-services-utilization-and-expenditures-among-children-enrolled-in-employer-sponsored-health-plans
#4
Angela Wangari Walter, Yiyang Yuan, Howard J Cabral
BACKGROUND AND OBJECTIVES: Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. METHODS: Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28554597/why-aren-t-physicians-prescribing-more-buprenorphine
#5
Andrew S Huhn, Kelly E Dunn
BACKGROUND & OBJECTIVE: Buprenorphine is an underutilized pharmacotherapy that can play a key role in combating the opioid epidemic. Individuals with opioid use disorder (OUD) often struggle to find physicians that prescribe buprenorphine. Many physicians do not have the waiver to prescribe buprenorphine, and a large proportion of physicians that are waivered do not prescribe to capacity. This study aimed to quantitatively understand why physicians do not utilize buprenorphine for the treatment of OUD more frequently...
July 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28543648/making-the-choices-necessary-to-make-a-difference-the-responsibility-of-national-bioethics-commissions
#6
Christine Grady
In this essay, I offer some reflections on how the topics were identified and approached by the Presidential Commission for the Study of Bioethical Issues, on which I had the honor to serve, in the hope that the reflections may be useful to future national bioethics commissions. In the executive order that established the bioethics commission, President Obama explicitly recognized the ethical imperative to responsibly pursue science, innovation, and advances in biomedical research and health care, and the importance of national attention to these issues...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28486877/effects-of-the-mental-health-parity-and-addictions-equality-act-on-depression-treatment-choice-in-primary-care-facilities
#7
Daniel M Goldberg, Hsien-Chang Lin
Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians' choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007-2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients...
January 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28459476/an-osteopathic-approach-to-chronic-pain-management
#8
John A Jerome
Chronic pain reduces quality of life and productivity, costing billions in health care dollars and lost revenue. Physicians routinely prescribe opioids, which has led to opioid addiction and overdose. The US surgeon general recommends nonpharmacologic treatment for patients with chronic pain. A paradigm shift is necessary for patients to partner with physicians to take control of their own health. This article outlines the cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies that osteopathic physicians can integrate in their treatment of patients with chronic pain...
May 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#9
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28394437/access-to-treatment-for-opioid-use-disorders-medical-student-preparation
#10
Elinore F McCance-Katz, Paul George, Nicole Alexander Scott, Richard Dollase, Allan R Tunkel, James McDonald
The current opioid epidemic requires new approaches to increasing access to treatment for patients with opioid use disorders and to improve availability of medication assisted treatment. We propose a model where medical students complete the necessary training to be eligible for the waiver to prescribe opioid medications to treat these disorders by the time of medical school graduation. This plan would increase the number of Drug Abuse Treatment Act of 2000 (DATA 2000) waivered physicians who could gain additional experience in treating substance use disorders during residency and provide the access to clinical care needed for individuals suffering with opioid use disorder...
June 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28379862/vermont-hub-and-spoke-model-of-care-for-opioid-use-disorder-development-implementation-and-impact
#11
John R Brooklyn, Stacey C Sigmon
BACKGROUND: Opioid use disorders (OUDs) are reaching epidemic proportions in the United States, and many geographic areas struggle with a persistent shortage in availability of opioid agonist treatment. Over the past 5 years, Vermont addiction medicine physicians and public health leaders have responded to these challenges by developing an integrated hub-and-spoke opioid treatment network. METHODS: In the present report, we review the development, implementation, and impact of this novel hub-and-spoke model for expanding OUD treatment in Vermont...
April 4, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28376444/discussing-opioid-risks-with-patients-to-reduce-misuse-and-abuse-evidence-from-2-surveys
#12
Joachim O Hero, Caitlin McMurtry, John Benson, Robert Blendon
We used 2 population-representative surveys to evaluate the recommendation from recent clinical guidelines for prescribing opioid analgesics that physicians discuss the risk of long-term use disorders with patients. In nationally representative data we observed a 60% lower rate, after adjustment for covariates, in a self-reported saving of pills among respondents who say they talked with their physicians about the risks of prescription painkiller addiction (67% lower rate without adjustment). These findings suggest patient education efforts, as currently practiced in the United States, may have positive behavioral consequences that could lower the risks of prescription painkiller abuse...
November 2016: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376226/urinary-concentrations-of-topically-administered-pain-medications
#13
Michele A Glinn, Andrew J Lickteig, Luke Weber, Sherri Recer, Matthew Salske, Audrey Harvey, Brian Rappold, Julie Stensland, Patrick Bell
A common treatment for chronic pain is prescription of analgesics, but their long-term use entails risk of morbidity, addiction and misuse. One way to reduce the risk of abuse is prescribing of analgesics in a topical form. Physicians are urged to perform urine drug testing to ensure that patients are compliant with their medication regimens. However, there is little data on the efficiency of transdermal delivery for many analgesic drugs, and no data on expected urine drug levels. This study includes data from over 29,000 specimens tested for gabapentin, ketamine, cyclobenzaprine or amitriptyline used orally or topically...
March 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28375881/institutional-substance-use-disorder-intervention-improves-general-internist-preparedness-attitudes-and-clinical-practice
#14
Sarah E Wakeman, Genevieve Pham Kanter, Karen Donelan
OBJECTIVE: To assess the impact of hospital substance use disorder (SUD) initiative, which, beginning in October 2014, implemented an inpatient addiction consult team, a postdischarge addiction clinic, recovery coaches, and SUD treatment within primary care on general internists' attitudes, clinical practice, and preparedness to care for SUD. METHODS: Pre and postintervention survey of general internal medicine physicians at Massachusetts General Hospital, in Boston, Massachusetts, in September 2014 (n = 290) and 2015 (n = 296) was conducted...
April 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28375414/proceedings-from-bridging-health-disparities-to-address-the-opioid-epidemic-a-symposium-at-the-warren-alpert-medical-school-of-brown-university
#15
Luba Dumenco, Kristina Monteiro, Michael Mello, Sally Collins, Don Operario, Karen Scanlan, Richard Dollase, Paul George
OBJECTIVE/BACKGROUND: In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28373756/attitudes-towards-pain-management-in-hospitalized-cancer-patients-and-their-influencing-factors
#16
Fangli Lou, Shaomei Shang
OBJECTIVE: To investigate patients' attitudes towards cancer pain management and analyze the factors influencing these attitudes. METHODS: The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form (BQT), and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China. RESULTS: The average patient score for attitudes towards pain management was 2...
February 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28371881/from-opiophobia-to-overprescribing-a-critical-scoping-review-of-medical-education-training-for-chronic-pain
#17
Fiona Webster, Samantha Bremner, Eric Oosenbrug, Steve Durant, Colin J McCartney, Joel Katz
Background.:  Chronic pain is a significant health problem strongly associated with a wide range of physical and mental health problems, including addiction. The widespread prevalence of pain and the increasing rate of opioid prescriptions have led to a focus on how physicians are educated about chronic pain. This critical scoping review describes the current literature in this important area, identifying gaps and suggesting avenues for further research starting from patients' standpoint...
March 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28371816/evaluation-of-an-integrated-multidisciplinary-program-to-address-unsafe-use-of-opioids-prescribed-for-pain
#18
William C Becker, Sara N Edmond, Dana J Cervone, Ajay Manhapra, John J Sellinger, Brent A Moore, Ellen L Edens
Objectives. : Unsafe use of opioids prescribed for pain is a common challenge in primary care. We aimed to describe a novel clinical program designed to address this issue-the Opioid Reassessment Clinic-and evaluate preliminary efficacy. Methods. : The Opioid Reassessment Clinic is a multidisciplinary care team staffed by an internist, addiction psychiatrist, advanced practice nurse, and health psychologist designed to perform enhanced assessment and longitudinal treatment of patients with unsafe use of opioids prescribed for pain...
March 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28367351/predicting-inpatient-detoxification-outcome-of-alcohol-and-drug-dependent-patients-the-influence-of-sociodemographic-environment-motivation-impulsivity-and-medical-comorbidities
#19
Yvonne Sofin, Heidi Danker-Hopfe, Tina Gooren, Peter Neu
Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients. Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined...
2017: Journal of Addiction
https://www.readbyqxmd.com/read/28357832/prevalence-of-consumption-of-addictive-substances-amongst-moroccan-fishermen
#20
Omar Laraqui, Salwa Laraqui, Nadia Manar, Tarik Ghailan, Frederic Deschamps, Chakib H Laraqui
BACKGROUND: The prevalence of toxic habits is constantly increasing in developing countries and all professional sectors are concerned. Seafarers are a particular target because of the dangerousness and complexity of their work. However, few studies have investigated toxic habits in this population. The aim of the study was to determine the prevalence of the use and misuse of addictive substances in seafarers and to appreciate poly-consumptions according to socio-demographic and occupational characteristics...
2017: International Maritime Health
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