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https://www.readbyqxmd.com/read/29789018/pain-clinic-definitions-in-the-medical-literature-and-u-s-state-laws-an-integrative-systematic-review-and-comparison
#1
REVIEW
Barbara Andraka-Christou, Joshua B Rager, Brittany Brown-Podgorski, Ross D Silverman, Dennis P Watson
BACKGROUND: In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice...
May 22, 2018: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29786898/adults-with-comorbid-posttraumatic-stress-disorder-alcohol-use-disorder-and-opioid-use-disorder-the-effectiveness-of-modified-prolonged-exposure
#2
Kelly R Peck, Julie A Schumacher, Paul R Stasiewicz, Scott F Coffey
Opioid use disorders (OUDs) are a growing problem in the United States. When OUDs co-occur with problematic drinking and posttraumatic stress disorder (PTSD), negative drug-related mental and physical health outcomes may be exacerbated. Thus, it is important to establish whether PTSD treatments with established efficacy for dually diagnosed individuals also demonstrate efficacy in individuals who engage in problematic drinking and concurrent opioid misuse. Adults who met DSM-IV-TR criteria for PTSD and alcohol dependence were recruited from a substance use treatment facility and were randomly assigned to receive either modified prolonged exposure (mPE) therapy for PTSD or a non-trauma-focused comparison treatment...
May 22, 2018: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29781284/opioid-prescription-among-sinus-surgeons
#3
Khashayar Arianpour, Brandon Nguyen, Brian Yuhan, Peter F Svider, Jean Anderson Eloy, Adam J Folbe
Background Misuse and diversion of opioids have contributed to the U.S. opioid crisis, making an understanding of specialty-specific and procedure-specific trends essential. Objective The objective of this analysis was to evaluate nationwide trends in opioid prescribing patterns among sinus surgeons performing functional endoscopic sinus surgery and maxillary sinus balloon dilation, specifically examining factors associated with variations. Methods High-volume sinus surgeons were identified through the Centers for Medicare and Medicaid Services database and cross-referenced against prescriptions to Medicare Part D beneficiaries during 2013 through 2015...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29771745/national-institute-on-drug-abuse-international-program-improving-opioid-use-disorder-treatment-through-international-research-training
#4
Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29758355/alcohol-and-opioid-use-in-chronic-pain-a-cross-sectional-examination-of-differences-in-functioning-based-on-misuse-status
#5
Kevin E Vowles, Katie Witkiewitz, Melissa Pielech, Karlyn A Edwards, Mindy L McEntee, Robert W Bailey, Lena Bolling, Mark D Sullivan
Opioid misuse is regularly associated with disrupted functioning in those with chronic pain. Less work has examined whether alcohol misuse may also interfere with functioning. This study examined frequency of opioid and alcohol misuse in 131 individuals (61.1% female) prescribed opioids for the treatment of chronic pain. Participants completed an anonymous survey online, consisting of measures of pain, functioning, and opioid and alcohol misuse. Cut-scores were used to categorize individuals according to substance misuse status; individuals were categorized as follows: 35...
May 11, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29754428/tapering-off-long-term-opioid-therapy-in-chronic-non-cancer-pain-patients-a-randomized-clinical-trial
#6
Geana Paula Kurita, Jette Højsted, Per Sjøgren
BACKGROUND: The indications for initiating long-term opioid treatment (L-TOT) for chronic non-cancer pain (CNCP) are often unclear and associated with problematic use. This study aimed at evaluating the efficacy of stabilizing opioid therapy followed by a sequential opioid tapering off program in CNCP patients. METHODS: A randomized clinical trial with a medications stabilization period (Phase 1) followed by a opioid tapering off program (Phase 2). In Phase 2, patients were randomized to Control Group (stable treatment) or Taper off Group (sequential opioid dose reduction) and assessed at baseline, after stabilization and up to six months...
May 13, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29754031/dispositional-mindfulness-and-prescription-opioid-misuse-among-chronic-pain-patients-craving-and-attention-to-positive-information-as-mediating-mechanisms
#7
Sarah E Priddy, Adam W Hanley, Michael R Riquino, Keith A Platt, Anne K Baker, Eric L Garland
OBJECTIVES: Opioid-treated chronic pain patients may be at risk for prescription opioid misuse due to heightened opioid craving coupled with deficits in attention to naturally rewarding, positive stimuli. Conversely, dispositional mindfulness, which is associated with reduced craving and increased responsiveness to natural rewards, may serve as a protective factor and buffer opioid misuse risk. The current investigation aimed to examine the association between mindfulness and opioid misuse, and to test opioid craving and attention to positive information as mediators of this relationship...
May 3, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29747875/young-adults-opioid-use-trajectories-from-nonmedical-prescription-opioid-use-to-heroin-drug-injection-drug-treatment-and-overdose
#8
Honoria Guarino, Pedro Mateu-Gelabert, Jennifer Teubl, Elizabeth Goodbody
INTRODUCTION: Recent research has begun to explore the transition from nonmedical use of prescription opioids (POs) to heroin and injection drug use, adding to earlier literature identifying factors that influence the transition from intranasal to injection use of heroin. However, little research has explored how these transitions are embedded within young people's broader opioid use trajectories - individual pathways that may also include experiences of nonfatal overdose and drug treatment...
May 1, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29743233/re-predicting-risk-for-opioid-misuse-in-chronic-pain-with-a-single-item-measure-of-catastrophic-thinking
#9
Ayodeji Otufowora
No abstract text is available yet for this article.
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29740351/pain-therapy-guided-by-purpose-and-perspective-in-light-of-the-opioid-epidemic
#10
REVIEW
Amie L Severino, Arash Shadfar, Joshua K Hakimian, Oliver Crane, Ganeev Singh, Keith Heinzerling, Wendy M Walwyn
Prescription opioid misuse is an ongoing and escalating epidemic. Although these pharmacological agents are highly effective analgesics prescribed for different types of pain, opioids also induce euphoria, leading to increasing diversion and misuse. Opioid use and related mortalities have developed in spite of initial claims that OxyContin, one of the first opioids prescribed in the USA, was not addictive in the presence of pain. These claims allayed the fears of clinicians and contributed to an increase in the number of prescriptions, quantity of drugs manufactured, and the unforeseen diversion of these drugs for non-medical uses...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29735625/how-did-we-get-here-heroin-and-fentanyl-trafficking-trends-a-law-enforcement-perspective
#11
Leslie Cooley Dismukes
Illicit heroin and fentanyl are infecting North Carolina's communities, and causing an increasing number of overdose deaths. These trends in drug trafficking and opioid misuse represent a dramatic shift, necessitating a new and coordinated law enforcement response. The North Carolina Attorney General's Office is committed to working toward increased enforcement, prevention, and treatment to address this epidemic.
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29735614/emergency-providers-opioid-prescribing-behaviors-among-medicare-part-d-beneficiaries-in-north-carolina-2013-2014-medication-utilization-and-costs
#12
Brittany Williams, Geoffrey Mospan, Rebecca Seabock, Chris Gillette, Michelle DeGeeter
BACKGROUND This study sought to quantify utilization and costs associated with opioid prescribing by emergency providers for Medicare Part D beneficiaries in North Carolina and the United States from 2013 to 2014. METHODS This was a retrospective examination of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013-2014. The main variables of interest were total number of prescription claims and total Medicare Part D medication costs for opioid analgesic medications. Generalized estimating equations were used to analyze the data...
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29733097/the-effects-on-patient-retention-after-opioid-weaning-in-an-internal-medicine-residency-clinic
#13
Charles P Opperman, Melissa M Butler, Andrew K Stroud, Michael R Sun
A retrospective, cross-sectional study was completed on 220 patients to determine the effects of implementation of an aggressive policy to curb opioid misuse/abuse in an internal medicine residency clinic. Our findings suggest that the development of a clear and consistent protocol for approaching patients on chronic controlled substances, as well as the initiation of regular didactic sessions addressing chronic pain and pain management, led to a dramatic reduction in the number or opioid prescriptions written by our resident providers without much reduction in patient volume...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29731244/engagement-in-online-pain-self-management-improves-pain-in-adults-on-medication-assisted-behavioral-treatment-for-opioid-use-disorders
#14
Marian Wilson, Myles Finlay, Michael Orr, Celestina Barbosa-Leiker, Naghmana Sherazi, Mary Lee A Roberts, Matthew Layton, John M Roll
INTRODUCTION: Persistent pain has been recognized as an important motivator that can lead individuals to misuse opioids. New approaches are needed to test pain treatments that can improve outcomes for people with persistent pain in medication-assisted behavioral treatment for opioid use disorder. This study piloted an online pain self-management program to explore acceptability and treatment effects. METHODS: A sample of 60 adults diagnosed with chronic non-cancer pain and receiving medication-assisted behavioral treatment at one of two clinics were randomized into either treatment group with access to an online pain management program or waitlist attention control...
April 27, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29729776/safe-opioid-use-management-of-opioid-related-adverse-effects-and-aberrant-behaviors
#15
REVIEW
Joseph Arthur, David Hui
Opioids are highly effective for cancer pain but are associated with multiple adverse effects and risk of addiction. This article provides a synopsis on the management of various opioid-related adverse effects and strategies to minimize aberrant opioid use in patients who have cancer. Many adverse effects can be effectively managed. Some patients on chronic opioid therapy may demonstrate aberrant behaviors suggestive of opioid misuse or diversion. Through intensive education, longitudinal monitoring, early identification, and timely management, clinicians can optimize the risk to benefit ratio to support safe opioid use...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29727755/are-patients-pejorative-representations-of-buprenorphine-associated-with-their-level-of-addiction-and-of-misuse
#16
Paul Vanderkam, Stéphanie Gagey, Pierre Ingrand, Marie-Christine Perault-Pochat, Yann Brabant, Clara Blanchard, Benoit Tudrej, Nassir Messaadi, Philippe Binder
BACKGROUND: In France, buprenorphine is at once the most widely prescribed and the most commonly misused opioid maintenance treatment (OMT). Unlike other medicines, it is seldom prescribed as a generic drug. Several studies have underlined the influence of the patient's representations when choosing brand-name rather than generic forms. We aim to prove a link between these pejorative representations and misuse, a higher degree of addiction and a preference for brand-name products. METHODS: An observational study carried out at 11 sites in France using self-assessment questionnaires filled out in dispensing pharmacies by patients having come to them for buprenorphine delivery...
April 27, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29722031/indirect-acting-strategy-of-opioid-action-instead-of-direct-receptor-activation-dual-acting-enkephalinase-inhibitors-denkis
#17
REVIEW
R B Raffa, J V Pergolizzi, R Taylor, M H Ossipov
WHAT IS KNOWN AND OBJECTIVE: Although pain is one of the most common afflictions, it is often inadequately managed because the available analgesic options are relatively limited due to insufficient efficacy, unacceptable adverse effects or the potential for misuse or abuse. However, recent publications suggest that an alternative approach-indirect enhancement of endogenous pain-relieving pathways-might be desirable. We review this approach, in particular the dual enkephalinase inhibitors (DENKIs)...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29713452/challenges-of-the-pharmacological-management-of-benzodiazepine-withdrawal-dependence-and-discontinuation
#18
REVIEW
Dimy Fluyau, Neelambika Revadigar, Brittany E Manobianco
Background: Benzodiazepines (BZDs) are among the most prescribed sedative hypnotics and among the most misused and abused medications by patients, in parallel with opioids. It is estimated that more than 100 million Benzodiazepine (BZD) prescriptions were written in the United States in 2009. While medically useful, BZDs are potentially dangerous. The co-occurring abuse of opioids and BZD, as well as increases in BZD abuse, tolerance, dependence, and short- and long-term side effects, have prompted a worldwide discussion about the challenging aspects of medically managing the discontinuation of BZDs...
May 2018: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/29708450/associations-between-pain-related-anxiety-gender-and-prescription-opioid-misuse-among-tobacco-smokers-living-with-hiv-aids
#19
Lisa R LaRowe, Lauren N Chilcott, Michael J Zvolensky, Peter A Vanable, Kelley Flood, Joseph W Ditre
BACKGROUND: People living with HIV/AIDS (PLWHA) who smoke cigarettes are vulnerable to greater pain and aberrant use of prescription pain medications. Prescription opioid misuse is highly prevalent among PLWHA and can lead to a variety of adverse outcomes. Pain-related anxiety, which has been implicated in the maintenance of both pain and tobacco dependence, may also play a role in prescription pain medication misuse. OBJECTIVES: This study aimed to test associations between pain-related anxiety and prescription opioid misuse...
April 30, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29700904/trajectories-of-dispensed-prescription-opioids-among-beneficiaries-enrolled-in-a-medicaid-controlled-substance-lock-in-program
#20
Rebecca B Naumann, Stephen W Marshall, Nisha C Gottfredson, Jennifer L Lund, Christopher L Ringwalt, Asheley C Skinner
PURPOSE: "Lock-in" programs (LIPs) are used by health insurers to address potential substance (eg, opioid) misuse among beneficiaries. We sought to (1) examine heterogeneity in trajectories of dispensed opioids (in average daily morphine milligram equivalents (MMEs)) over time: prior to, during, and following release from a LIP, and (2) assess associations between trajectory patterns and beneficiary characteristics. METHODS: Medicaid claims were linked to Prescription Drug Monitoring Program records for a cohort of beneficiaries enrolled in the North Carolina Medicaid LIP (n = 2701)...
April 26, 2018: Pharmacoepidemiology and Drug Safety
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