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https://www.readbyqxmd.com/read/28737989/incremental-effect-of-the-addition-of-prescriber-restrictions-on-a-state-medicaid-s-pharmacy-only-patient-review-and-restriction-program
#1
Shellie L Keast, Timothy Pham, Ashley Teel, Nancy J Nesser
BACKGROUND: Patient review and restriction programs (PRRPs), used by state Medicaid programs to limit potential abuse and misuse of opioids and related controlled medications, often restrict members to a single pharmacy for controlled medications. While most states use a restricted pharmacy access model, not all states include restricted prescriber access. Oklahoma Medicaid (MOK) added a restricted prescriber access feature to its PRRP in July 2014. OBJECTIVE: To evaluate the incremental effect that the addition of a prescriber restriction to MOK's pharmacy-only PRRP had on the pharmacy and resource utilization of the enrolled members...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28735077/opioid-medication-misuse-among-unhealthy-drinkers
#2
Gerald Cochran, Rebecca McCarthy, Adam J Gordon, Ralph E Tarter
BACKGROUND: Combining opioid medications and alcohol has serious implications for patient health, including overdose. Information regarding those who use/misuse opioid medications and engage in unhealthy alcohol use is limited to pharmacological and epidemiological descriptions. This study presents opioid medication misuse and behavioral, mental, and physical health characteristics of persons filling opioid medications that are engaged in unhealthy alcohol use. METHODS: We conducted a cross-sectional survey at 5 community pharmacies in Southwestern, Pennsylvania among patients filling opioid medications...
July 14, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28723312/alcohol-marijuana-and-opioid-use-disorders-5-year-patterns-and-characteristics-of-emergency-department-encounters
#3
Amber L Bahorik, Derek D Satre, Andrea H Kline-Simon, Constance M Weisner, Kelly C Young-Wolff, Cynthia I Campbell
BACKGROUND: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorder in an integrated health system. METHODS: In a retrospective design, electronic health record (EHR) data identified patients with ‚Č• 1 of three common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574)...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723248/reducing-opioid-misuse-among-adolescents-through-physician-education
#4
Nonie S Arora, Kayla M Marcotte, John A Hopper
Increased prescribing of opioids has been associated with an epidemic of nonmedical prescription opioid use in the United States; adolescents and young adults are particularly vulnerable to opioid misuse. The role of physicians as healthcare providers, educators, and confidants for their adolescent patients equips them to intervene in adolescent opioid misuse. We advocate for improving the education of physicians and residents regarding opioid use and misuse among adolescents. To achieve this, we can require residency education that includes opioid misuse and appropriate prescribing, widely disseminate existing resources on management of pain and opioid misuse, and develop pain management and addiction mentorship programs...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#5
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28697912/screening-brief-intervention-and-referral-to-treatment-for-opioid-and-other-substance-use-during-infertility-treatment
#6
REVIEW
Tricia E Wright
Opioid use and misuse have reached epidemic proportions in the United States, especially in women of childbearing age, some of whom seek infertility treatments. Substance use is much more common than many of the conditions routinely screened for during the preconception period, and it can have devastating consequences for the woman and her family. Substance use can worsen infertility, complicate pregnancy, increase medical problems, and lead to psychosocial difficulties for the woman and her family. The reproductive endocrinologist thus has an ethical and medical duty to screen for substance use, provide initial counseling, and refer to specialized treatment as needed...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28697909/women-and-the-opioid-crisis-historical-context-and-public-health-solutions
#7
REVIEW
Mishka Terplan
Driven by a legitimate but overly opioid-focused response to pain, the United States is currently experiencing an opioid crisis, a crisis with parallels to the first opioid epidemic at the turn of the 20th century. Women, particularly white reproductive-age women, are increasingly the face of the opioid crisis. Given the penetration of opioid misuse and addiction across all income and insurance strata, any provider who cares for women needs to be prepared to assess and evaluate opioid use, misuse, and addiction...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28689460/global-threats-from-preventable-injuries
#8
Jennan A Phillips
Preventable injuries kill thousands of the world's population every day and injure millions each year. Road traffic crashes and opioid drug misuse are major causes of these injuries. Increased efforts are needed to promote strong policies, develop new prevention strategies, and protect workers from these global public health threats.
July 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28688032/prescription-opioid-use-is-associated-with-virologic-failure-in-people-living-with-hiv
#9
John Flores, Yuanyuan Liang, Norma S Ketchum, Barbara J Turner, Delia Bullock, Roberto Villarreal, Jennifer S Potter, Barbara S Taylor
Prescription opioid misuse is a rising epidemic in the U.S., and people living with HIV are at increased risk. We assessed the association between prescription opioid use and virologic failure in HIV+ patients in the South Texas HIV Cohort. We found prescription opioid use was significantly associated with virologic failure, after adjustment for age, race, gender, insurance status, years living with HIV, reported HIV risk factor, chronic hepatitis C virus infection, current substance abuse, and care engagement...
July 7, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28684383/preventing-prescription-drug-misuse-in-work-settings-efficacy-of-a-brief-intervention-in-health-consciousness
#10
Gale Lucas, Michael Neeper, Brittany Linde, Joel Bennett
BACKGROUND: It is becoming more commonplace for employees to use prescription medication outside of intended use. Opioid and other prescription misuse has implications for the health and productivity of workers. Easy-to-access webinars that help employees learn about alternatives to prescription use may decrease risk. OBJECTIVE: The aim of this study was to examine the efficacy of an interactive but brief health consciousness and prescription drug intervention for a diverse sample of employees and show effectiveness via both Internet-delivered webinar and classroom delivery...
July 6, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28666699/perioperative-pain-management-an-update-for-obstetrician-gynecologists
#11
REVIEW
Georgine Lamvu, Jessica Feranec, Emily Blanton
The opioid epidemic in the United States is unprecedented and continues to worsen. Many opioid abusers obtain their pills through legitimate prescriptions, directly or indirectly, from a medical provider. While practitioners have a responsibility to treat pain, it is now becoming clear that aggressive opioid prescription practices contribute to an epidemic of abuse. The medical community has to balance the unintended consequences of opioid misuse and abuse with the need to provide adequate pain control. Additionally, providers are being held accountable by the legal system and professional organizations for their prescribing practices...
June 27, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28663389/an-epidemic-of-the-use-misuse-and-overdose-of-opioids-and-deaths-due-to-overdose-in-the-united-states-and-canada-is-europe-next
#12
REVIEW
G T T Helmerhorst, T Teunis, S J Janssen, D Ring
The United States and Canada are in the midst of an epidemic of the use, misuse and overdose of opioids, and deaths related to overdose. This is the direct result of overstatement of the benefits and understatement of the risks of using opioids by advocates and pharmaceutical companies. Massive amounts of prescription opioids entered the community and were often diverted and misused. Most other parts of the world achieve comparable pain relief using fewer opioids. The misconceptions about opioids that created this epidemic are finding their way around the world...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28655025/effect-of-buprenorphine-weekly-depot-cam2038-and-hydromorphone-blockade-in-individuals-with-opioid-use-disorder-a-randomized-clinical-trial
#13
Sharon L Walsh, Sandra D Comer, Michelle R Lofwall, Bradley Vince, Naama Levy-Cooperman, Debra Kelsh, Marion A Coe, Jermaine D Jones, Paul A Nuzzo, Fredrik Tiberg, Behshad Sheldon, Sonnie Kim
Importance: Buprenorphine is an efficacious, widely used treatment for opioid use disorder (OUD). Daily oral transmucosal formulations can be associated with misuse, diversion, and nonadherence; these limitations may be obviated by a sustained release formulation. Objective: To evaluate the ability of a novel, weekly, subcutaneous buprenorphine depot formulation, CAM2038, to block euphorigenic opioid effects and suppress opioid withdrawal in non-treatment-seeking individuals with OUD...
June 22, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28652805/provider-confidence-in-opioid-prescribing-and-chronic-pain-management-results-of-the-opioid-therapy-provider-survey
#14
Amy Cs Pearson, Rajat N Moman, Susan M Moeschler, Jason S Eldrige, W Michael Hooten
INTRODUCTION: Many providers report lack of confidence in managing patients with chronic pain. Thus, the primary aim of this study was to investigate the associations of provider confidence in managing chronic pain with their practice behaviors and demographics. MATERIALS AND METHODS: The primary outcome measure was the results of the Opioid Therapy Provider Survey, which was administered to clinicians attending a pain-focused continuing medical education conference...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28652205/opioid-analgesics-administered-for-pain-on-the-inpatient-pediatric-setting
#15
Gary A Walco, Nancy Gove, Jennifer Phillips, Steven J Weisman
This study aimed to describe utilization of opioid medications among infants, children, and adolescents on the inpatient setting. These data are needed to guide clinical trials and improve research methodologies, as well as to inform more about possible sources of opioid misuse in the United States. A retrospective chart review was conducted covering a span of one year, with a special focus on the prescription of opioids for long-term treatment of chronic pain. Opioid medications were prescribed for less than 5 days in the overwhelming majority (75%) of patients...
June 23, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28647680/a-retrospective-review-of-unintentional-opioid-overdose-risk-and-mitigating-factors-among-acutely-injured-trauma-patients
#16
Jannette Baird, Mark Faul, Traci C Green, Jonathan Howland, Charles A Adams, Ann George, Michael J Mello
BACKGROUND: Opioid medication to treat acutely injured patients is usual care in trauma settings. A higher prevalence of alcohol and other substance misuse in this population compared to the general population increases the vulnerability of such patients to both misuse of their prescribed opioids, and also unintentional opioid overdose. The primary purpose of this study was to assess the prevalence of substance use and unintentional opioid overdose risk among acutely injured trauma patients, and to examine the frequency and predictors of high opioid dose at discharge...
June 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#17
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/28645137/-to-take-or-not-to-take-the-association-between-perceived-addiction-risk-expected-analgesic-response-and-likelihood-of-trying-novel-pain-relievers-in-self-identified-chronic-pain-patients
#18
D Andrew Tompkins, Andrew S Huhn, Patrick S Johnson, Michael T Smith, Eric C Strain, Robert R Edwards, Matthew W Johnson
BACKGROUND AND AIMS: Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity, and previous opioid experience would be positively associated with likelihood of risky medication use. DESIGN: This cross-sectional online study determined state/trait associations with addiction-related medication decisions in CPP...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28639058/geospatial-analysis-of-drug-poisoning-deaths-involving-heroin-in-the-usa-2000-2014
#19
Kathleen Stewart, Yanjia Cao, Margaret H Hsu, Eleanor Artigiani, Eric Wish
We investigate the geographic patterns of drug poisoning deaths involving heroin by county for the USA from 2000 to 2014. The county-level patterns of mortality are examined with respect to age-adjusted rates of death for different classes of urbanization and racial and ethnic groups, while rates based on raw counts of drug poisoning deaths involving heroin are estimated for different age groups and by gender. To account for possible underestimations in these rates due to small areas or small numbers, spatial empirical Baye's estimation techniques have been used to smooth the rates of death and alleviate underestimation when analyzing spatial patterns for these different groups...
June 21, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28633638/evaluating-the-impact-of-prescription-drug-monitoring-program-implementation-a-scoping-review
#20
Erin P Finley, Ashley Garcia, Kristen Rosen, Don McGeary, Mary Jo Pugh, Jennifer Sharpe Potter
BACKGROUND: Prescription drug monitoring programs (PDMPs) have been implemented in 49 out of 50 states in an effort to reduce opioid-related misuse, abuse, and mortality, yet the literature evaluating the impact of PDMP implementation remains limited. We conducted a scoping review to: (1) describe available evidence regarding impact of PDMPs in the U.S.; and (2) propose a conceptual model to inform future PDMP implementation and evaluation efforts. METHODS: Scoping systematic review following Arksey and O'Malley's (2005) methodology...
June 20, 2017: BMC Health Services Research
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