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https://www.readbyqxmd.com/read/28090165/challenges-and-solutions-in-reducing-opioid-misuse-and-abuse
#1
Peter Sonnenreich, Linda Geisler
We present some of the approaches to and challenges of the opioid crisis that emerged from thought-leaders at an Academy of Managed Care Pharmacy symposium.
January 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28088084/correlates-of-anti-hepatitis-c-positivity-and-use-of-harm-reduction-services-among-people-who-inject-drugs-in-two-cities-in-croatia
#2
Senad Handanagic, Sandra Sevic, Jelena Barbaric, Zoran Dominkovic, Oktavija Dakovic Rode, Josip Begovac, Ivana Bozicevic
BACKGROUND: We assessed correlates of anti-hepatitis C (anti-HCV) positivity and utilization of needle and syringe exchange programs (NSEP) and opioid agonist treatment (OAT) among people who inject drugs (PWID) in two Croatian cities. METHODS: We conducted a cross-sectional study using respondent-driven (RDS) sampling among PWID in Rijeka (N=255) and Split (N=399). We used RDS-weighted population estimates and multivariable logistic regression to explore correlates of anti-HCV positivity and NSEP and OAT utilization...
December 7, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#3
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28073687/adverse-event-detection-using-the-fda-post-marketing-drug-safety-surveillance-system-cardiotoxicity-associated-with-loperamide-abuse-and-misuse
#4
Kimberley A Swank, Eileen Wu, Cindy Kortepeter, Jana McAninch, Robert L Levin
OBJECTIVE: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use. METHODS: We searched the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database for post-marketing reports of serious cardiac adverse events associated with loperamide use from December 28, 1976 (U.S. drug approval date), through December 14, 2015. We also conducted a Pubmed and Google Scholar search to identify additional published reports of cardiotoxicity associated with loperamide in the medical literature through February 11, 2016...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28072811/evaluation-of-the-ototoxicity-potential-of-once-daily-single-entity-hydrocodone-in-patients-with-chronic-pain-results-of-two-phase-3-clinical-studies
#5
Kathleen Campbell, J Walter Kutz, Angela Shoup, Warren Wen, Shau Yu Lynch, Ellie He, Steven R Ripa
BACKGROUND: Use/misuse of the opioid combination hydrocodone-acetaminophen has been associated with permanent hearing loss. Although reports have been rare, this potential effect can have significant detrimental effect on patients' overall quality of life. To date, the ototoxic effect of hydrocodone alone has not been systematically investigated. OBJECTIVE: In this report, we aimed to evaluate the potential ototoxicity of a novel, single-entity, once-daily, extended-release hydrocodone tablet (Hysingla® ER; HYD)...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28068563/a-review-fentanyl-and-non-pharmaceutical-fentanyls
#6
REVIEW
Joji Suzuki, Saria El-Haddad
BACKGROUND: Fentanyl and non-pharmaceutical fentanyls (NPFs) have been responsible for numerous outbreaks of overdoses all over the United States since the 1970s. However, there has been a growing concern in recent years that NPFs are contributing to an alarming rise in the number of opioid-related overdoses. METHODS: The authors conducted a narrative review of the published and grey literature on fentanyl and NPFs in PubMed, Google Scholar, and Google using the following search terms: "fentanyl", "non-pharmaceutical fentanyl", "fentanyl analogs", "fentanyl laced heroin" and "fentanyl overdose"...
December 16, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28061909/opioid-overdose-prevention-and-naloxone-rescue-kits-what-we-know-and-what-we-don-t-know
#7
REVIEW
Todd Kerensky, Alexander Y Walley
The opioid use and overdose crisis is persistent and dynamic. Opioid overdoses were initially driven in the 1990s and 2000s by the increasing availability and misuse of prescription opioids. More recently, opioid overdoses are increasing at alarming rates due to wider use of heroin, which in some places is mixed with fentanyl or fentanyl derivatives. Naloxone access for opioid overdose rescue is one of the US Department of Health and Human Services' three priority areas for responding to the opioid crisis. This article summarizes the known benefits of naloxone access and details unanswered questions about overdose education and naloxone rescue kits...
January 7, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28034982/enhancing-risk-assessment-in-patients-receiving-chronic-opioid-analgesic-therapy-using-natural-language-processing
#8
Irina V Haller, Colleen M Renier, Mitch Juusola, Paul Hitz, William Steffen, Michael J Asmus, Terri Craig, Jack Mardekian, Elizabeth T Masters, Thomas E Elliott
OBJECTIVES:  Clinical guidelines for the use of opioids in chronic noncancer pain recommend assessing risk for aberrant drug-related behaviors prior to initiating opioid therapy. Despite recent dramatic increases in prescription opioid misuse and abuse, use of screening tools by clinicians continues to be underutilized. This research evaluated natural language processing (NLP) together with other data extraction techniques for risk assessment of patients considered for opioid therapy as a means of predicting opioid abuse...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28024664/long-term-use-of-opioids-in-210-officially-registered-patients-with-chronic-noncancer-pain-in-taiwan-a-cross-sectional-study
#9
Tso-Chou Lin, Luo-Ping Ger, Joseph V Pergolizzi, Robert B Raffa, Ju-O Wang, Shung-Tai Ho
BACKGROUND/PURPOSE: Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. METHODS: An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine...
December 23, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28007501/synergistic-attenuation-of-chronic-pain-using-mu-opioid-and-cannabinoid-receptor-2-agonists
#10
Shaness A Grenald, Madison A Young, Yue Wang, Michael H Ossipov, Mohab M Ibrahim, Tally M Largent-Milnes, Todd W Vanderah
The misuse of prescription opiates is on the rise with combination therapies (e.g. acetaminophen or NSAIDs) resulting in severe liver and kidney damage. In recent years, cannabinoid receptors have been identified as potential modulators of pain and rewarding behaviors associated with cocaine, nicotine and ethanol in preclinical models. Yet, few studies have identified whether mu opioid agonists and CB2 agonists act synergistically to inhibit chronic pain while reducing unwanted side effects including reward liability...
December 20, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/28005315/methadone-callbacks-within-a-veterans-affairs-opioid-treatment-program-detecting-methadone-misuse
#11
Ann J Cotton, Leandra J Shipley, Lisa H Glynn, Josie Tracy, Andrew J Saxon
BACKGROUND AND OBJECTIVES: A "callback" requires patients to bring in take-home methadone doses for inspection. An opioid treatment program (OTP) quality-improvement project examined random versus "for-cause" callbacks. METHOD: Eighty-two random callbacks and 60 for-cause callbacks were conducted among patients enrolled in an OTP (N = 183). RESULTS: Among patients with more take home doses, 6% of random callbacks versus 44% of for-cause callbacks were failed...
January 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28005123/addressing-the-opioid-epidemic-with-multimodal-pain-management
#12
Michael A Kelly
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28001962/benzodiazepine-dependence-among-young-adult-participants-in-the-club-scene-who-use-drugs
#13
Steven P Kurtz, Mance E Buttram, Hilary L Surratt
Young adults ages 18-29 report the highest rates of benzodiazepine (BZD) misuse in the United States. The majority of club drug users are also in this age group, and BZD misuse is prevalent among participants in club scenes. This article examines BZD dependence and its correlates among young adult participants in the electronic dance music (EDM) culture in Miami, Florida, who use drugs. Structured interviews were with men and women (N = 356) ages 18 to 29 who reported regular attendance at EDM venues and recent use of both club drugs and BZDs...
December 21, 2016: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28000295/drug-availability-adjustments-in-population-based-studies-of-prescription-opioid-abuse
#14
Alex Secora, James Phillip Trinidad, Rongmei Zhang, Rajdeep Gill, Gerald Dal Pan
PURPOSE: Population-based prescription opioid abuse studies in which one drug is compared to another, or drugs are compared across time, often account for the availability of those drugs in the community. The objective of this investigation is to assess consistency in the relative abuse ratios (RARs) across different approaches for adjusting for drug availability. METHODS: For the years 2004 through 2010, RARs for each of four prescription opioids (hydrocodone, oxycodone, hydromorphone, and morphine) were calculated using negative binomial regression...
December 21, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27995643/loperamide-trends-in-abuse-and-misuse-over-13-years-2002-2015
#15
Daniel R Lasoff, Cynthia H Koh, Bryan Corbett, Alicia B Minns, F Lee Cantrell
STUDY OBJECTIVE: With the increasing amount of information available on the Internet describing techniques for using loperamide either for self-treatment of opioid withdrawal syndromes or for recreational use ("legal highs"), the objective was to describe a statewide poison control system's experience with loperamide misuse and abuse, with specific interest in cases of cardiotoxicity, and to determine if there has been a recent increase in reported loperamide misuse or abuse cases. DESIGN: Retrospective review...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27984346/an-examination-of-claims-based-predictors-of-overdose-from-a-large-medicaid-program
#16
Gerald Cochran, Adam J Gordon, Wei-Hsuan Lo-Ciganic, Walid F Gellad, Winfred Frazier, Carroline Lobo, Chung-Chou H Chang, Ping Zheng, Julie M Donohue
BACKGROUND: Health systems may play an important role in identification of patients at-risk of opioid medication overdose. However, standard measures for identifying overdose risk in administrative data do not exist. OBJECTIVE: Examine the association between opioid medication overdose and 2 validated measures of nonmedical use of prescription opioids within claims data. RESEARCH DESIGN: A longitudinal retrospective cohort study that estimated associations between overdose and nonmedical use...
December 15, 2016: Medical Care
https://www.readbyqxmd.com/read/27980029/risk-stratification-for-opioid-misuse-in-children-adolescents-and-young-adults-a-quality-improvement-project
#17
Rachel Thienprayoon, Kelly Porter, Michelle Tate, Marshall Ashby, Mark Meyer
BACKGROUND: The Pediatric Palliative and Comfort Care Team (PACT) at Cincinnati Children's Hospital Medical Center (CCHMC) provides opioids to a large population of patients in the ambulatory setting. Before this project, PACT had no reliable system to risk stratify patients for opioid misuse. METHODS: The global aim was safe opioid prescribing by the palliative care team. The specific, measurable, achievable, realistic, and timely aim was as follows: "In patients who present for follow up with PACT, we will use the "opioid bundle" to increase risk stratification for opioid misuse from 0% to 90% over 5 months...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27960575/assessing-the-impact-of-abuse-deterrent-opioids-ados-identifying-epidemiologic-factors-related-to-new-entrants-with-low-population-exposure
#18
Carl L Roland, Beatrice Setnik, David A Brown
OBJECTIVE: Prescription opioid misuse and abuse is a serious public health concern that can lead to overdose, addiction, and death. The development of opioid formulations designed to deter misuse and abuse is considered an important step towards addressing the problem, but the extent to which abuse-deterrent opioids (ADOs) actually deter abuse in the community requires confirmation through epidemiologic studies. Epidemiologic evaluations of misuse and abuse present several unique challenges related to study design, sources of data, and methodology, particularly for new entrant ADOs with low population exposure...
January 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27933366/deficits-in-autonomic-indices-of-emotion-regulation-and-reward-processing-associated-with-prescription-opioid-use-and-misuse
#19
Eric L Garland, Craig J Bryan, Yoshio Nakamura, Brett Froeliger, Matthew O Howard
RATIONALE: Prescription opioid misuse and high-dose opioid use may result in allostatic dysregulation of hedonic brain circuitry, leading to reduced emotion regulation capacity. In particular, opioid misuse may blunt the ability to experience and upregulate positive affect from natural rewards. OBJECTIVES: The purpose of this study was to examine associations between opioid use/misuse and autonomic indices of emotion regulation capability in a sample of chronic pain patients receiving prescription opioid pharmacotherapy...
December 8, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27931253/alcohol-use-in-opioid-agonist-treatment
#20
REVIEW
Seonaid Nolan, Jan Klimas, Evan Wood
Alcohol misuse among individuals receiving agonist treatment for an opioid use disorder is common and is associated with significant morbidity and mortality. At present, though substantial research highlights effective strategies for the screening, diagnosis and management of an alcohol or opioid use disorder individually, less is known about how best to care for those with a dual diagnosis especially since common treatments for opioid addiction may be contraindicated in a setting of alcohol use. This review summarizes existing research and characterizes the prevalence, clinical implications and management of alcohol misuse among individuals with opioid addiction...
December 8, 2016: Addiction Science & Clinical Practice
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