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https://www.readbyqxmd.com/read/27898458/smoking-status-and-opioid-related-problems-and-concerns-among-men-and-women-on-chronic-opioid-therapy
#1
Kelly C Young-Wolff, Daniella Klebaner, Constance Weisner, Michael Von Korff, Cynthia I Campbell
OBJECTIVES: Smokers on chronic opioid therapy for non-cancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to non-smokers. The current study aims to assess whether smoking is associated with problems and concerns with chronic opioid therapy from the perspective of the patient. METHODS: In a large sample (N=972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with chronic opioid therapy using regression analyses, adjusting for covariates...
November 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#2
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897918/buprenorphine-shared-medical-appointments-for-the-treatment-of-opioid-dependence-in-a-homeless-clinic
#3
Sara L Doorley, Cheryl J Ho, Elizabeth Echeverria, Charles Preston, Huy Ngo, Ahmad Kamal, Chinazo O Cunningham
BACKGROUND: Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. We describe and preliminarily evaluate a unique delivery system that provides buprenorphine treatment via a shared medical appointment. METHODS: We conducted a retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010-2012...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#4
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27882841/association-of-a-controlled-substance-scoring-algorithm-with-health-care-costs-and-hospitalizations-a-cohort-study
#5
Catherine I Starner, Yang Qiu, Pinar Karaca-Mandic, Patrick P Gleason
BACKGROUND: Patients often misuse a combination of prescription drugs including opioids; however, the relationship between a controlled substance (CS) score and health outcomes is unknown. OBJECTIVE: To examine the association between a CS scoring algorithm and health care use, specifically total cost of care, hospitalizations, and emergency room (ER) visits. METHODS: This analysis was a retrospective cohort study using administrative claims data from a large U...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27880633/diversion-alert-1-year-evaluation-across-northern-new-england-2013-2014
#6
Sarah Levin Martin, Clare Desrosiers
This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert's impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients' care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert...
November 23, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/27876595/behavioral-mental-and-physical-health-characteristics-and-opioid-medication-misuse-among-community-pharmacy-patients-a-latent-class-analysis
#7
Gerald Cochran, Valerie Hruschak, Jennifer L Bacci, Kenneth C Hohmeier, Ralph Tarter
BACKGROUND: Community pharmacists are well-positioned to address the US opioid medication crisis, which has created a need to detect misuse risk in order to provide optimal patient care. OBJECTIVES: This study sought to identify community pharmacy patient subgroups at risk for opioid medication misuse. METHODS: This study was a cross-sectional survey that examined behavioral, mental, and physical health characteristics among patients filling opioid pain medications...
November 15, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27873179/oxycodone-deterx-%C3%A2-a-novel-abuse-deterrent-extended-release-analgesic-option-for-the-treatment-of-patients-with-chronic-pain
#8
REVIEW
Jeff Gudin
BACKGROUND: Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx(®) (Xtampza(®) ER, Collegium Pharmaceutical, Inc...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27873121/challenges-to-treatment-of-chronic-pain-and-addiction-during-the-opioid-crisis
#9
REVIEW
Daniel Krashin, Natalia Murinova, Mark Sullivan
Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society...
December 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27872581/a-trigger-for-opioid-misuse-chronic-pain-and-stress-dysregulate-the-mesolimbic-pathway-and-kappa-opioid-system
#10
REVIEW
Nicolas Massaly, Jose A Morón, Ream Al-Hasani
Pain and stress are protective mechanisms essential in avoiding harmful or threatening stimuli and ensuring survival. Despite these beneficial roles, chronic exposure to either pain or stress can lead to maladaptive hormonal and neuronal modulations that can result in chronic pain and a wide spectrum of stress-related disorders including anxiety and depression. By inducing allostatic changes in the mesolimbic dopaminergic pathway, both chronic pain and stress disorders affect the rewarding values of both natural reinforcers, such as food or social interaction, and drugs of abuse...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27871180/prescription-opioid-prescribing-use-misuse-harms-and-treatment-among-aboriginal-people-in-canada-a-narrative-review-of-available-data-and-indicators
#11
Cayley Russell, Michelle Firestone, Len Kelly, Christopher Mushquash, Benedikt Fischer
INTRODUCTION: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS: A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27865152/psychoactive-medications-and-disengagement-from-office-based-opioid-treatment-obot-with-buprenorphine
#12
Zoe M Weinstein, Debbie M Cheng, Emily Quinn, David Hui, Hyunjoong Kim, Gabriela Gryczynski, Jeffrey H Samet
BACKGROUND: The prevalence of psychoactive medications (PAMs) use in patients enrolled in Office Based Opioid Treatment (OBOT) and its association with engagement in this care is largely unknown. OBJECTIVE: To describe the use of PAMs, including those medications with emerging evidence of misuse ("emerging PAMs" - gabapentin, clonidine and promethazine) among patients on buprenorphine, and its association with disengagement from OBOT. METHODS: This is a retrospective cohort study of adults on buprenorphine from January 2002 to February 2014...
November 5, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27861439/trends-in-tramadol-pharmacology-metabolism-and-misuse
#13
Karen Miotto, Arthur K Cho, Mohamed A Khalil, Kirsten Blanco, Jun D Sasaki, Richard Rawson
Tramadol is a unique analgesic medication, available in variety of formulations, with both monoaminergic reuptake inhibitory and opioid receptor agonist activity increasingly prescribed worldwide as an alternative for high-affinity opioid medication in the treatment of acute and chronic pain. It is a prodrug that is metabolized by cytochrome P450 (CYP) enzymes CYP2D6 and CYP3A4 to its more potent opioid analgesic metabolites, particularly the O-demethylation product M1. The opioid analgesic potency of a given dose of tramadol is influenced by an individual's CYP genetics, with poor metabolizers experiencing little conversion to the active M1 opioid metabolite and individuals with a high metabolic profile, or ultra-metabolizers, experiencing the greatest opioid analgesic effects...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27858590/turning-the-tide-or-riptide-the-changing-opioid-epidemic
#14
Stefan G Kertesz
The US opioid epidemic has changed profoundly in the last 3 years, in ways that require substantial recalibration of the US policy response. This report summarizes the changing nature of overdose deaths in Jefferson County (home to Birmingham, Alabama) using data updated through June 30, 2016. Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, while opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015...
November 18, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27849403/oversimplifying-opioid-misuse-disorder-confounds-the-issue
#15
Arthur G Lipman
No abstract text is available yet for this article.
November 16, 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27848217/pregabalin-for-the-treatment-of-drug-and-alcohol-withdrawal-symptoms-a-comprehensive-review
#16
REVIEW
Rainer Freynhagen, Miroslav Backonja, Stephan Schug, Gavin Lyndon, Bruce Parsons, Stephen Watt, Regina Behar
Treatments for physical dependence and associated withdrawal symptoms following the abrupt discontinuation of prescription drugs (such as opioids and benzodiazepines), nicotine, alcohol, and cannabinoids are available, but there is still a need for new and more effective therapies. This review examines evidence supporting the potential use of pregabalin, an α2δ voltage-gated calcium channel subunit ligand, for the treatment of physical dependence and associated withdrawal symptoms. A literature search of the MEDLINE and Cochrane Library databases up to and including 11 December 2015 was conducted...
November 16, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27844475/rhode-island-board-of-medical-licensure-and-discipline-illustration-of-the-disciplinary-process-as-it-pertains-to-cases-involving-opioid-prescribing
#17
James V McDonald
Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline.
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27832755/experience-of-the-use-of-ketamine-to-manage-opioid-withdrawal-in-an-addicted-woman-a-case-report
#18
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27832472/oxycodone-deterx-%C3%A2-er-capsules-a-review-in-severe-chronic-pain
#19
Yvette N Lamb, Karly P Garnock-Jones, Susan J Keam
Oxycodone DETERx (®) extended-release (ER) capsules (Xtampza(®) ER), an abuse-deterrent formulation of oxycodone as the myristate salt, are approved in the USA for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. This narrative review discusses the clinical efficacy and tolerability of the oxycodone DETERx (®) ER capsule formulation in the management of severe pain, and provides an overview of pharmacokinetics, abuse-deterrent properties and alternative administration options...
November 10, 2016: Drugs
https://www.readbyqxmd.com/read/27829785/chronic-pain-in-the-emergency-department-a-pilot-mixed-methods-cross-sectional-study-examining-patient-characteristics-and-reasons-for-presentations
#20
Patricia A Poulin, Jennifer Nelli, Steven Tremblay, Rebecca Small, Myka B Caluyong, Jeffrey Freeman, Heather Romanow, Yehudis Stokes, Tia Carpino, Amanda Carson, Yaadwinder Shergill, Ian G Stiell, Monica Taljaard, Howard Nathan, Catherine E Smyth
Background. Chronic pain (CP) accounts for 10-16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives. To describe patients with CP attending the ED and identify factors contributing to their visit. Methods. We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
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