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https://www.readbyqxmd.com/read/28530896/use-and-misuse-of-opioid-agonists-in-opioid-addiction
#1
REVIEW
Vania Modesto-Lowe, Katie Swiezbin, Margaret Chaplin, Gabriela Hoefer
Although methadone (an opioid agonist) and buprenorphine (a partial opioid agonist) have evidence to support their use in treating opioid use disorder, they remain misunderstood and underutilized. In this article, we outline the risks and benefits of using these drugs as maintenance therapy in opioid-dependent patients.
May 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28526967/update-on-barriers-to-pharmacotherapy-for-opioid-use-disorders
#2
REVIEW
Anjalee Sharma, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Robert P Schwartz
PURPOSE OF REVIEW: The recent heroin and prescription opioid misuse epidemic has led to a sharp increase in the number of opioid overdose deaths in the USA. Notwithstanding the availability of three FDA-approved medications (methadone, buprenorphine, and naltrexone) to treat opioid use disorder, these medications are underutilized. This paper provides an update from the recent peer-reviewed literature on barriers to the use of these medications. FINDINGS: These barriers are interrelated and can be categorized as financial, regulatory, geographic, attitudinal, and logistic...
June 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28511053/opioid-analgesics-and-heroin-examining-drug-misuse-trends-among-a-sample-of-drug-treatment-clients-in-kentucky
#3
Grant A Victor, Robert Walker, Jennifer Cole, T K Logan
BACKGROUND: In an effort to mitigate Kentucky's prescription drug misuse, legislative intervention efforts were introduced in 2012 and 2013 to better regulate pain clinics, prescribed use of opioid analgesics, and to expand the monitoring of opioid prescriptions. The focus of this paper is primarily on opioid analgesics and heroin and the relationship of use/misuse patterns of these drugs to state drug policy initiatives. METHODS: A secondary data analysis of drug treatment clients (N=52,360) was conducted to project illicit drug use trends in Kentucky...
May 13, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#4
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28501383/intentional-misuse-and-abuse-of-loperamide-a-new-look-at-a-drug-with-low-abuse-potential
#5
Stephen W Borron, Susan H Watts, Jonathan Tull, Salvador Baeza, Stephanie Diebold, Alison Barrow
BACKGROUND: Despite its opioid properties, loperamide has long been thought to have low abuse potential due to its poor absorption from the gastrointestinal tract and limited potential to cross the blood-brain barrier. A recent patient reportedly taking loperamide to avoid heroin withdrawal symptoms, at doses approximately 100 times those recommended, directed our attention to this issue. OBJECTIVES: 1) Investigate number of cases of intentional loperamide abuse and misuse reported to poison centers between 2009 and 2015; 2) Compile reports of clinical effects of loperamide abuse; and 3) Search for evidence of increasing Internet interest in the central opioid effects of loperamide...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28496354/factors-associated-with-prescription-opioid-misuse-in-a-cross-sectional-cohort-of-patients-with-chronic-non-cancer-pain
#6
Jennifer M Hah, John A Sturgeon, Jennifer Zocca, Yasamin Sharifzadeh, Sean C Mackey
OBJECTIVE: To examine demographic features, psychosocial characteristics, pain-specific behavioral factors, substance abuse history, sleep, and indicators of overall physical function as predictors of opioid misuse in patients presenting for new patient evaluation at a tertiary pain clinic. METHODS: Overall, 625 patients with chronic non-cancer pain prospectively completed the Collaborative Health Outcomes Information Registry, assessing pain catastrophizing, National Institutes of Health Patient-Reported Outcomes Measurement Information System standardized measures (pain intensity, pain behavior, pain interference, physical function, sleep disturbance, sleep-related impairment, anger, depression, anxiety, and fatigue), and substance use history...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28493425/law-enforcement-derived-data-on-gabapentin-diversion-and-misuse-2002-2015-diversion-rates-and-qualitative-research-findings
#7
Mance E Buttram, Steven P Kurtz, Richard C Dart, Zachary R Margolin
PURPOSE: Recent limited epidemiologic and case reports suggest that gabapentin is being misused, especially among prescription opioid misusers. However, no apparent studies have reported data from law enforcement on the diversion and misuse of gabapentin. METHODS: Case report data are drawn from a quarterly survey of prescription drug diversion completed by a national sample of law enforcement and regulatory agencies who engage in drug diversion investigations. Rates of gabapentin diversion per 100 000 population were calculated for each quarter from 2002 through 2015...
May 10, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28492129/codeine-misuse-and-dependence-in-south-africa-perspectives-of-addiction-treatment-providers
#8
Charles D H Parry, Eileen Rich, Marie Claire Van Hout, Paolo Deluca
BACKGROUND: General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. OBJECTIVES: To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. METHOD: Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28489491/risk-factors-for-symptoms-of-prescription-opioid-misuse-do-older-adults-differ-from-younger-adult-patients
#9
Gerald Cochran, Daniel Rosen, Rebecca M McCarthy, Rafael J Engel
Limited research is available regarding the health risks associated with opioid medication misuse among middle age (50-64 years) and older adults (65 and older). Understanding the misuse symptom risk profiles of these populations has potential to advance the national opioid epidemic response. A survey was conducted in four community pharmacies in southwestern Pennsylvania among adult, non-cancer patients filling opioid medications (N = 318) regarding opioid medication misuse symptoms and misuse risk factors...
May 10, 2017: Journal of Gerontological Social Work
https://www.readbyqxmd.com/read/28488993/physician-guide-to-appropriate-opioid-prescribing-for-noncancer-pain
#10
Timothy Munzing
Prescription opioid use for relief of noncancer pain has risen dramatically in the last 15 years, contributing to a quadrupling of opioid overdoses and prescription opioid-related deaths. This crisis is resulting in heightened attention by health care professionals and organizations, law enforcement, and the government. In this article, I highlight key topics in the management of patients using opioids (or potentially needing opioids) in outpatient clinical practice; federal and state law enforcement actions regarding physicians' illegal prescribing of opioids; multimodal approaches to pain control; nonmedication management of pain; response strategies when suspecting a patient of diverting or misusing opioids; and warning signs for abuse or diversion...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28484399/biochemical-benefits-diagnosis-and-clinical-risks-evaluation-of-kratom
#11
REVIEW
Dimy Fluyau, Neelambika Revadigar
BACKGROUND: Kratom (Mitragyna speciosa) is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28476275/beliefs-about-the-consequences-of-using-benzodiazepines-among-persons-with-opioid-use-disorder
#12
Michael D Stein, Bradley J Anderson, Shannon R Kenney, Genie L Bailey
BACKGROUND: Patients admitted to addiction treatment programs report high rates of concurrent opioid and benzodiazepine (BZD) use. This combination places individuals at high risk for accidental overdose and other serious consequences. However, little is known about the beliefs opioid users have about the consequences of BZD use. METHODS: We surveyed consecutive persons initiating inpatient opioid detoxification (N=476; 95.0% enrollment) and identified 245 who reported BZD use in the past 30days and/or had a positive toxicology...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476268/past-year-prevalence-of-prescription-opioid-misuse-among-those-11-to-30years-of-age-in-the-united-states-a-systematic-review-and-meta-analysis
#13
Ashly E Jordan, Natalie A Blackburn, Don C Des Jarlais, Holly Hagan
BACKGROUND: There are high levels of prescription and consumption of prescription opioids in the US. Misuse of prescription opioids has been shown to be highly correlated with prescription opioid-related morbidity and mortality including fatal and non-fatal overdose. We characterized the past-year prevalence of prescription opioid misuse among those 11-30years of age in the US. METHODS: A systematic review and meta-analysis were carried out following a published protocol and PRISMA guidelines...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28474345/impact-of-pharmacists-assisting-with-prescribing-and-undertaking-medication-review-on-oxycodone-prescribing-and-supply-for-patients-discharged-from-surgical-wards
#14
T Tran, S E Taylor, A Hardidge, D Findakly, P Aminian, R A Elliott
WHAT IS KNOWN AND OBJECTIVES: Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. METHODS: A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study...
May 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28471275/trait-mindfulness-and-progression-to-injection-use-in-youth-with-opioid-addiction
#15
J Deanna Wilson, Hoa Vo, Pamela Matson, Hoover Adger, Gabriela Barnett, Marc Fishman
BACKGROUND: Many youth initiate opioid misuse with prescription opioids and transition over time to more severe substance-using behaviors, including injection. Trait mindfulness is a potentially protective factor. OBJECTIVES: This is a cross-sectional study characterizing a sample of opioid-using youth by level of mindfulness and examines the potential effect modification of emotion regulation on the relationship between mindfulness and progression to injection opioid use...
May 4, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28456473/continuing-links-between-substance-use-and-hiv-highlight-the-importance-of-nursing-roles
#16
Sherry Deren, Madeline Naegle, Holly Hagan, Danielle C Ompad
Links between HIV and substance use were identified early in the U.S. HIV epidemic. People who use drugs are at risk of HIV infection through shared injection equipment and risky sexual behaviors. In addition, substance use has negative health consequences for people living with HIV. The prescription opioid misuse epidemic, linked to injection drug use, hepatitis C infection, and HIV, poses a new threat to declining HIV rates. We reviewed evidence-based interventions that decrease HIV risk in people who use drugs (needle/syringe programs, medication-assisted treatment, engagement in HIV care, and preexposure prophylaxis/postexposure prophylaxis)...
March 24, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28448772/the-effect-of-a-federal-controlled-substance-act-schedule-change-on-hydrocodone-combination-products-claims-in-a-medicaid-population
#17
Stephanie Tran, Pavel Lavitas, Karen Stevens, Bonnie C Greenwood, Karen Clements, Caroline J Alper, Kimberly Lenz, Mylissa Price, Tasmina Hydery, Jennifer L Arnold, Mito Takeshita, Rachel Bacon, Justin P Peristere, Paul L Jeffrey
BACKGROUND: In 2012, hydrocodone combination products (HCPs) were the most prescribed medications in the United States. Under the Controlled Substance Act of 1970, hydrocodone alone was classified as a Schedule II drug, while HCPs were classified as Schedule III, indicating a lower risk for abuse and misuse. However, according to a Drug Enforcement Agency analysis, the addition of nonopioids has not been shown to diminish abuse potential of hydrocodone. In response to concerns for drug abuse and overdose, the Drug Enforcement Agency rescheduled HCPs to Schedule II in October 2014, with the intent of limiting overprescribing and increasing awareness of their abuse potential...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28445584/chronic-opioid-use-following-surgery-for-oral-cavity-cancer
#18
John Pang, Kathryn R Tringale, Viridiana J Tapia, William J Moss, Megan E May, Timothy Furnish, Linda Barnachea, Kevin T Brumund, Assuntina G Sacco, Robert A Weisman, Quyen T Nguyen, Jeffrey P Harris, Charles S Coffey, Joseph A Califano
Importance: Opioid misuse and overuse has become an epidemic. Chronic opioid use among oral cavity cancer patients after surgery has not been described. Objectives: To assess the prevalence of chronic opioid use in patients undergoing surgery for oral cavity cancer, and evaluate possible associated clinical factors; and the association between opioid use and survival. Design, Setting, and Participants: For this retrospective cohort study of patients undergoing surgery for oral cavity cancer a consecutive sample of 99 patients between January 1, 2011, and September 30, 2016, were identified through the institutional cancer registry from a single academic center...
April 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28430388/associations-between-childhood-maltreatment-and-non-medical-use-of-prescription-drugs-among-chinese-adolescents
#19
Lan Guo, Yan Xu, Jianxiong Deng, Xue Gao, Guoliang Huang, Jinghui Huang, Xueqing Deng, Wei-Hong Zhang, Ciyong Lu
AIMS: To test, among Chinese adolescents: (1) whether childhood maltreatment is associated with non-medical use of prescription drugs (NMUPD), (2) whether there are interaction effects of childhood maltreatment and depressive symptoms on NMUPD. DESIGN: A secondary analysis of the cross-sectional data collected from 7(th) and 12(th) graders who were sampled using a multistage, stratified cluster, random sampling method in the 2015 School-based Chinese Adolescents Health Survey (SCAHS)...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#20
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
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