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https://www.readbyqxmd.com/read/29168404/impact-of-a-chronic-pain-management-pathway-on-opioid-administration-and-prescribing-in-an-emergency-department
#1
Caroline Pace, Sneha Shah, Amy X Zhang, Amy E Zosel
CONTEXT: Prescription opioid abuse and misuse is a significant public health crisis. In 2012, an opioid prescribing pathway for patients with chronic pain presenting to the Emergency Department (ED) was implemented. The objective of this study is to determine the impact of the pathway for administration of opioids in the ED as well as the prescribing of opioids for home use after discharge. METHODS: Retrospective pre- and post-intervention time series study of consecutive patients presenting to the ED with acute and chronic pain complaints before and after implementation of the pathway...
November 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29153783/patterns-and-correlates-of-medical-cannabis-use-for-pain-among-patients-prescribed-long-term-opioid-therapy
#2
Shannon M Nugent, Bobbi Jo Yarborough, Ning X Smith, Steven K Dobscha, Richard A Deyo, Carla A Green, Benjamin J Morasco
OBJECTIVE: Little is known about co-occurring long-term opioid therapy (LTOT) and medical cannabis use. We compared characteristics of patients prescribed LTOT who endorsed using medical cannabis for pain to patients who did not report cannabis use. METHOD: Participants (n=371) prescribed LTOT completed self-report measures about pain, substance use, and mental health. RESULTS: Eighteen percent of participants endorsed using medical cannabis for pain...
November 8, 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29150151/evaluating-short-and-long-term-impacts-of-a-medicaid-lock-in-program-on-opioid-and-benzodiazepine-prescriptions-dispensed-to-beneficiaries
#3
Rebecca B Naumann, Stephen W Marshall, Jennifer L Lund, Nisha C Gottfredson, Christopher L Ringwalt, Asheley C Skinner
BACKGROUND: Insurance-based "lock-in" programs (LIPs) have become a popular strategy to address controlled substance (CS) (e.g., opioid) misuse. However, little is known about their impacts. We examined changes in CS dispensing to beneficiaries in the 12-month North Carolina Medicaid LIP. METHODS: We analyzed Medicaid claims linked to Prescription Drug Monitoring Program (PDMP) records for beneficiaries enrolled in the LIP between October 2010 and September 2012 (n=2702)...
November 6, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29149148/current-impact-and-application-of-abuse-deterrent-opioid-formulations-in-clinical-practice
#4
Ya-Han Lee, Daniel L Brown, Hsiang-Yin Chen
BACKGROUND: Abuse-deterrent formulations (ADFs) represent one novel strategy for curbing the potential of opioid abuse. OBJECTIVE: We aim to compare and contrast the characteristics and applications of current abuse-deterrent opioid products in clinical practice. METHODS: Literature searches were conducted in databases (Pubmed Medline, International Pharmaceutical Abstracts, Google Scholar) and official reports. Relevant data were screened and organized into: 1) epidemiology of opioid abuse, 2) mitigation strategies for reducing opioid abuse, 3) development of ADFs, and 4) clinical experience with these formulations...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149119/pain-management-strategies-for-screening-and-monitoring-patients-receiving-chronic-opioid-therapy%C3%A2
#5
Karen Hande
The current state of pain management within the oncology setting, effectiveness of opioids for the relief of pain, and limited alternatives for chronic pain management have produced reliance on opioid medications with an inherent risk for aberrant behavior. Although standardization is lacking among prescribers who manage cancer-related pain, advanced practice RNs must act according to the available evidence that suggests assessing and monitoring for abuse and misuse. 
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29146290/sustained-opioid-antagonism-modulates-striatal-sensitivity-to-baby-schema-in-opioid-use-disorder
#6
An-Li Wang, Steven B Lowen, Igor Elman, Zhenhao Shi, Victoria P Fairchild, Alexander Bouril, Ruben C Gur, Daniel D Langleben
BACKGROUND: Chronic opioid misuse is associated with reduced sensitivity to natural rewards and social motivation deficits that include impaired caregiving. The neurobiological mechanisms underlying these deficits and their response to treatment are not well understood. Baby schema (Kindchenschema) is a set of juvenile physical features, which is perceived as "cute" and triggers motivation for caregiving. Recent studies suggest that the "baby schema effect" is mediated by the brain "reward" network...
October 18, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29143401/assessment-of-risk-behaviors-in-patients-with-opioid-prescriptions-a-study-of-indiana-s-inspect-data
#7
Marion S Greene, Robert Andrew Chambers, Constantin T Yiannoutsos, Eric R Wright, Gregory K Steele, Terrell W Zollinger
BACKGROUND AND OBJECTIVES: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients' likelihood to engage in opioid-related risk behaviors. METHODS: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29141653/test-of-a-workforce-development-intervention-to-expand-opioid-use-disorder-treatment-pharmacotherapy-prescribers-protocol-for-a-cluster-randomized-trial
#8
Todd Molfenter, Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden
BACKGROUND: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations' efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications...
November 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29139482/opioid-misuse-in-gastroenterology-and-non-opioid-management-of-abdominal-pain
#9
REVIEW
Eva Szigethy, Mitchell Knisely, Douglas Drossman
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29135698/associations-between-early-care-decisions-and-the-risk-for-long-term-opioid-use-for-patients-with-low-back-pain-with-a-new-physician-consultation-and-initiation-of-opioid-therapy
#10
Julie M Fritz, Jordan B King, Carrie McAdams-Marx
OBJECTIVE: Identify associations between early care decisions and long-term opioid use in opioid-naïve patients with a new physician consultation for low back pain at which an opioid was prescribed. METHODS: Retrospective study of claims data was used to identify opioid-naïve low back pain patients who were prescribed opioids at the index physician visit. Early care variables captured included additional non-opioid medications prescribed within 14 days, and provider visits or diagnostic imaging within 30 days of the index visit...
November 10, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29133312/exploring-perceptions-and-experiences-of-patients-who-have-chronic-pain-as-state-prescription-opioid-policies-change-a-qualitative-study-in-indiana
#11
Morhaf Al Achkar, Debra Revere, Barbara Dennis, Palmer MacKie, Sumedha Gupta, Shaun Grannis
OBJECTIVES: The misuse and abuse of prescription opioids (POs) is an epidemic in the USA today. Many states have implemented legislation to curb the use of POs resulting from inappropriate prescribing. Indiana legislated opioid prescribing rules that went into effect in December 2013. The rules changed how chronic pain is managed by healthcare providers. This qualitative study aims to evaluate the impact of Indiana's opioid prescription legislation on the patient experiences around pain management...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29130474/interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#12
REVIEW
Christopher Eccleston, Emma Fisher, Kyla H Thomas, Leslie Hearn, Sheena Derry, Cathy Stannard, Roger Knaggs, R Andrew Moore
BACKGROUND: This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29124080/demographic-and-mental-health-characteristics-of-individuals-who-present-to-community-health-clinics-with-substance-misuse
#13
Praise O Iyiewuare, Colleen McCullough, Allison Ober, Kirsten Becker, Karen Osilla, Katherine E Watkins
Introduction: Community health clinics (CHCs) are an opportune setting to identify and treat substance misuse. This study assessed the characteristics of patients who presented to a CHC with substance misuse. Methods: Personnel at a large CHC administered a 5-question screener to patients between June 3, 2014, and January 15, 2016, to assess past 3-month alcohol use, prescription opioid misuse, or illicit drug use. We stratified screen-positive patients into 4 diagnostic groups: (1) probable alcohol use disorder (AUD) and no comorbid opioid use disorder (OUD); (2) probable heroin use disorder; (3) probable prescription OUD, with or without comorbid AUD; and (4) no probable substance use disorder...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29122425/analgesic-consumption-following-outpatient-carpal-tunnel-release
#14
Blair Peters, Arash Izadpanah, Avinash Islur
PURPOSE: Few studies have examined the consumption of prescribed opioid medications after elective outpatient surgery. A better understanding of opioid consumption after elective upper-extremity surgery may lead to improved prescribing practices, decreased costs, and less leftover medication available for potential misuse. The goal of this study was to evaluate pain control and quantify the amount of leftover pain medication after outpatient carpal tunnel release. METHODS: We performed a prospective study of patients scheduled for outpatient carpal tunnel surgery...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122159/opioid-analgesic-drugs-misuse-toxicity-and-hypersensitivity
#15
EDITORIAL
Brian A Baldo
No abstract text is available yet for this article.
November 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#16
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29116878/evaluation-of-methadone-treatment-in-malaysia-findings-from-the-malaysian-methadone-treatment-outcome-study-mytos
#17
Norsiah Ali, Salina Abd Aziz, Salmah Nordin, Norliza Che Mi, Norni Abdullah, V Paranthaman, Maimunah Mahmud, Anne Yee, Mahmoud Danaee
BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005. OBJECTIVE: To evaluate the effectiveness of MMT. METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20...
November 8, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29091525/measurement-of-chronic-pain-and-opioid-use-evaluation-in-community-based-persons-with-serious-illnesses
#18
Kathleen Puntillo, Ramana K Naidu
BACKGROUND: Chronic pain associated with serious illnesses is having a major impact on population health in the United States. Accountability for high quality care for community-dwelling patients with serious illnesses requires selection of metrics that capture the burden of chronic pain whose treatment may be enhanced or complicated by opioid use. OBJECTIVE: Our aim was to evaluate options for assessing pain in seriously ill community dwelling adults, to discuss the use/abuse of opioids in individuals with chronic pain, and to suggest pain and opioid use metrics that can be considered for screening and evaluation of patient responses and quality care...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29084121/promoting-health-department-opioid-prescribing-guidelines-for-new-york-city-emergency-departments-a-qualitative-evaluation
#19
Frederick W Nagel, Jessica A Kattan, Shivani Mantha, Lewis S Nelson, Hillary V Kunins, Denise Paone
To address the epidemic of opioid misuse and overdose, the New York City Department of Health and Mental Hygiene partnered with an expert panel of emergency medicine physicians to develop voluntary guidelines for judicious prescribing of opioids upon discharge from an emergency department. A qualitative evaluation of the guidelines was conducted using semistructured interviews with emergency department directors and providers. The guidelines were widely supported by respondents and cited as helpful in easing difficult negotiations with patients requesting opioids...
October 27, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29070156/born-into-addiction-neonatal-abstinence-syndrome-and-pediatric-dentistry
#20
Jennifer L Cully
Drug overdose and opioid-involved deaths continue to increase across the United States. An end-condition related to opioid abuse is neonatal abstinence syndrome (NAS). The implications for pregnant or post-partum women using an opioid, whether prescribed or illicit, can have significant effects on their infant. First described in the 1970s, NAS is defined as a postnatal drug withdrawal syndrome that primarily occurs in opioid-exposed infants. There are no nationally accepted, evidence-based treatment protocols for these infants...
September 15, 2017: Pediatric Dentistry
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