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Opioids and chronic pain

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https://www.readbyqxmd.com/read/28214219/perpetuating-stigma-or-reducing-risk-perspectives-from-naloxone-consumers-and-pharmacists-on-pharmacy-based-naloxone-in-2-states
#1
Traci C Green, Patricia Case, Haley Fiske, Janette Baird, Shachan Cabral, Dina Burstein, Victoriana Schwartz, Nathan Potter, Alexander Y Walley, Jeffrey Bratberg
OBJECTIVES: Little is known about attitudes of pharmacists and consumers to pharmacy naloxone. We examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists from 2 early pharmacy naloxone adopter states: Massachusetts and Rhode Island. DESIGN: Eight focus groups (4 per state) were held in October to December 2015. SETTING AND PARTICIPANTS: Participants were recruited from pharmacies, health clinics, and community organizations; pharmacists were recruited from professional organizations and pharmacy colleges...
February 14, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28213817/breakthrough-cancer-pain-and-rational-drug-use
#2
Juan Manuel Núñez Olarte
Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain...
February 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28212183/cxcl12-cxcr4-signaling-contributes-to-the-pathogenesis-of-opioid-tolerance-a-translational-study
#3
Chih-Peng Lin, Kai-Hsiang Kang, Huang-Ju Tu, Ming-Yueh Wu, Tzu-Hung Lin, Houng-Chi Liou, Wei-Zen Sun, Wen-Mei Fu
BACKGROUND: Long-term opioid therapy for chronic pain may lead to analgesic tolerance, especially when administered intrathecally, thus preventing adequate pain relief. Discovering drug targets to treat opioid tolerance using a mechanism-based approach targeting opioid-induced neuroinflammation provides new therapeutic opportunities. In this study, we provide translational evidence that CXCL12/CXCR4 signaling contributes to the pathogenesis of opioid tolerance. METHODS: The CXCL12 levels in the cerebrospinal fluid of opioid-tolerant patients were compared with those of opioid-naive subjects...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28204957/insights-into-the-role-of-opioid-receptors-in-the-gi-tract-experimental-evidence-and-therapeutic-relevance
#4
James J Galligan, Catia Sternini
Opioid drugs are prescribed extensively for pain treatment but when used chronically they induce constipation that can progress to opioid-induced bowel dysfunction. Opioid drugs interact with three classes of opioid receptors: mu opioid receptors (MORs), delta opioid receptors (DOR), and kappa opioid receptors (KORs), but opioid drugs mostly target the MORs. Upon stimulation, opioid receptors couple to inhibitory Gi/Go proteins that activate or inhibit downstream effector proteins. MOR and DOR couple to inhibition of adenylate cyclase and voltage-gated Ca(2+) channels and to activation of K(+) channels resulting in reduced neuronal activity and neurotransmitter release...
February 16, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28204792/problematic-use-of-prescription-opioids-and-medicinal-cannabis-among-patients-suffering-from-chronic-pain
#5
Daniel Feingold, Itay Goor-Aryeh, Silviu Bril, Yael Delayahu, Shaul Lev-Ran
No abstract text is available yet for this article.
February 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28199203/neurogenetics-of-acute-and-chronic-opiate-opioid-abstinence-treating-symptoms-and-the-cause
#6
Kenneth Blum, Mark S Gold, William Jacobs, William Vaughn McCall, Marcelo Febo, David Baron, Kristina Dushaj, Zsolt Demetrovics, Rajendra D Badgaiyan
This review begins with a comprehensive history of opioid dependence and treatment in the United States. The focus is an evidence-based treatment model for opioid/opiate dependent individuals. The role of reward genetic polymorphisms and the epigenetic modifications that lead to vulnerability to use and misuse of opiates/opioid to treat pain are reviewed. The neurochemical mechanisms of acute opiate withdrawal and opiate/opioid reward mechanisms are explored with a goal of identifying specific treatment targets...
March 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28195856/pharmacoepidemiologic-analyses-of-opioid-use-among-oef-oif-ond-veterans
#7
Teresa J Hudson, Jacob T Painter, Brad Martin, Mark A Austen, James S Williams, John Fortney, Mark D Sullivan, Mark E Edlund
There is a great deal of concern about opioid use in Veterans, particularly those that served in Afghanistan (OEF) and Iraq (OIF and OND). The current study provides a detailed pharmacoepidemiologic analysis of opioid use among OEF/OIF/OND Veterans from FY09 to FY12. Data from three data repositories from the Veterans Health Administration (VHA) were used to describe demographic, clinical, and medication characteristics associated with opioid use among OEF/OIF/OND Veterans and among those with TBI. Logistic regression models were used to identify risks associated with chronic opioid use in FY12...
February 11, 2017: Pain
https://www.readbyqxmd.com/read/28194646/nanoemulsion-thermoreversible-pluronic-f127-based-hydrogel-containing-hyptis-pectinata-lamiaceae-leaf-essential-oil-produced-a-lasting-anti-hyperalgesic-effect-in-chronic-noninflammatory-widespread-pain-in-mice
#8
Lucindo J Quintans-Júnior, Renan G Brito, Jullyana S S Quintans, Priscila L Santos, Zaine T Camargo, Péricles A Barreto, Maria F Arrigoni-Blank, Waldecy Lucca-Júnior, Luciana Scotti, Marcus T Scotti, Sandra J Kolker, Kathleen A Sluka
We evaluated if a nanostructured thermoreversible Pluronic F127-based hydrogel incorporated with Hyptis pectinata leaf essential oil (NE-EOH) produces a long-lasting anti-hyperalgesic effect on chronic muscle pain in an animal model. We induced chronic muscle pain by injecting the gastrocnemius with saline injections. Paw and muscle withdrawal thresholds and motor performance were evaluated after treatment and compared with morphine, diazepam, or vehicle. Naloxone and methysergide administration tested the involvement of opioid and serotonin receptors, respectively...
February 13, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28192790/systemic-pharmacologic-therapies-for-low-back-pain-a-systematic-review-for-an-american-college-of-physicians-clinical-practice-guideline
#9
Roger Chou, Richard Deyo, Janna Friedly, Andrea Skelly, Melissa Weimer, Rochelle Fu, Tracy Dana, Paul Kraegel, Jessica Griffin, Sara Grusing
Background: A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose: To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources: Ovid MEDLINE (January 2008 through November 2016), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and reference lists...
February 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28192789/noninvasive-treatments-for-acute-subacute-and-chronic-low-back-pain-a-clinical-practice-guideline-from-the-american-college-of-physicians
#10
Amir Qaseem, Timothy J Wilt, Robert M McLean, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials and systematic reviews published through April 2015 on noninvasive pharmacologic and nonpharmacologic treatments for low back pain. Updated searches were performed through November 2016...
February 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28192376/reasons-for-discontinuation-of-long-term-opioid-therapy-in-patients-with-and-without-substance-use-disorders
#11
Travis I Lovejoy, Benjamin J Morasco, Michael I Demidenko, Thomas H A Meath, Joseph W Frank, Steven K Dobscha
Several factors may accelerate opioid discontinuation rates, including lack of information about the long-term effectiveness of opioids for chronic pain, heightened awareness about opioid-related adverse events, closer monitoring of patients for opioid-related aberrant behaviors, and greater restrictions around opioid prescribing. Rates of discontinuation may be most pronounced in patients deemed to be at "high risk." The purpose of this study was to compare reasons for discontinuation of long-term opioid therapy (LTOT) between patients with and without substance use disorder (SUD) diagnoses receiving care within a major U...
March 2017: Pain
https://www.readbyqxmd.com/read/28190392/pi3k-akt-pathway-a-potential-therapeutic-target-for-chronic-pain
#12
Shu-Ping Chen, Ya-Qun Zhou, Dai-Qiang Liu, Wen Zhang, Anne Manyande, Xue-Hai Guan, Yu-Ke Tian, Da-Wei Ye, Deeq Mohamed Omar
Chronic pain is among the most disabling and costly disorders, with prevalence ranging from 10% to 55%. However, current therapeutic strategies for chronic pain are unsatisfactory due to our poor understanding of its mechanisms. Thus, novel therapeutic targets need to be found in order to improve these patients' quality of life. PI3K and its downstream Akt are widely expressed in the spinal cord, particularly in the laminae I-IV of the dorsal horn, where nociceptive C and Aδ fibers of primary afferents principally terminate...
February 10, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28188737/genetic-variation-in-the-behavioral-effects-of-buprenorphine-in-female-mice-derived-from-a-murine-model-of-the-oprm1-a118g-polymorphism
#13
Caroline A Browne, Rebecca L Erickson, Julie A Blendy, Irwin Lucki
Pharmacogenetic studies have identified the non-synonymous single nucleotide polymorphism (A118G) in the human mu opioid receptor (MOR) gene (OPRM1) as a critical genetic variant capable of altering the efficacy of opioid therapeutics. To date few studies have explored the potential impact of the OPRM1 A118G polymorphism on the pharmacological effects of buprenorphine (BPN), a potent MOR partial agonist and kappa opioid receptor antagonist, which is approved by the FDA for the treatment of opioid addiction and chronic pain...
February 7, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28187396/methyl-orvinol-dual-activity-opioid-receptor-ligand-inhibits-gastrointestinal-transit-and-alleviates-abdominal-pain-in-the-mouse-models-mimicking-diarrhea-predominant-irritable-bowel-syndrome
#14
Marta Zielińska, Agata Jarmuż, Andrzej Wasilewski, Gerta Cami-Kobeci, Stephen Husbands, Jakub Fichna
BACKGROUND: Diarrhea-predominant irritable bowel syndrome (IBS-D) is a functional disorder of the gastrointestinal (GI) tract. The major IBS-D symptoms include diarrhea, abdominal pain and discomfort. High density of opioid receptors (ORs) in the GI tract and their participation in the maintenance of GI homeostasis make ORs ligands an attractive option for developing new anti-IBS-D treatments. The aim of this study was to characterize the effect of methyl-orvinol on the GI motility and secretion and in mouse models mimicking symptoms of IBS-D...
December 5, 2016: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28185645/mu-opioid-receptors-in-gamma-aminobutyric-acidergic-forebrain-neurons-moderate-motivation-for-heroin-and-palatable-food
#15
Pauline Charbogne, Olivier Gardon, Elena Martín-García, Helen L Keyworth, Aya Matsui, Anna E Mechling, Thomas Bienert, Taufiq Nasseef, Anne Robé, Luc Moquin, Emmanuel Darcq, Sami Ben Hamida, Patricia Robledo, Audrey Matifas, Katia Befort, Claire Gavériaux-Ruff, Laura-Adela Harsan, Dominik von Elverfeldt, Jurgen Hennig, Alain Gratton, Ian Kitchen, Alexis Bailey, Veronica A Alvarez, Rafael Maldonado, Brigitte L Kieffer
BACKGROUND: Mu opioid receptors (MORs) are central to pain control, drug reward, and addictive behaviors, but underlying circuit mechanisms have been poorly explored by genetic approaches. Here we investigate the contribution of MORs expressed in gamma-aminobutyric acidergic forebrain neurons to major biological effects of opiates, and also challenge the canonical disinhibition model of opiate reward. METHODS: We used Dlx5/6-mediated recombination to create conditional Oprm1 mice in gamma-aminobutyric acidergic forebrain neurons...
December 26, 2016: Biological Psychiatry
https://www.readbyqxmd.com/read/28183077/restructuring-hedonic-dysregulation-in-chronic-pain-and-prescription-opioid-misuse-effects-of-mindfulness-oriented-recovery-enhancement-on-responsiveness-to-drug-cues-and-natural-rewards
#16
Eric L Garland, Matthew O Howard, Jon-Kar Zubieta, Brett Froeliger
No abstract text is available yet for this article.
2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/28182836/an-exploratory-study-evaluating-the-impact-of-opioid-and-non-opioid-pain-medications-on-serum-plasma-free-testosterone-and-free-estradiol-concentrations
#17
Julie A Ray, Mark M Kushnir, A Wayne Meikle, Jill E Sindt, Frederick G Strathmann
Chronic use of opioid medications has been reported to cause altered sexual function. It is not known if non-opioid pain medications have similar effects. Assessment of this effect through the measurement of concentrations of free hormones is limited. Positivity of opioid medications (hydrocodone, oxycodone, morphine, methadone, tramadol and fentanyl) and non-opioid pain medications (gabapentin or pregabalin) in human serum and plasma samples from adult men and women were evaluated for association with concentrations of free testosterone (fTe) and free estradiol (fE2) measured using equilibrium dialysis-liquid chromatography-tandem mass spectrometry methods...
February 9, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28182128/co-prescription-of-opioids-with-benzodiazepine-and-other-co-medications-among-opioid-users-differential-in-opioid-doses
#18
Che Suraya Zin, Fadhilah Ismail
PURPOSE: This study investigated the patterns of opioid co-prescription with benzodiazepine and other concomitant medications among opioid users. Opioid dose in each type of co-prescription was also examined. PATIENTS AND METHODS: This cross-sectional study was conducted among opioid users receiving concomitant medications at an outpatient tertiary hospital setting in Malaysia. Opioid prescriptions (morphine, fentanyl, oxycodone, dihydrocodeine and tramadol) that were co-prescribed with other medications (opioid + benzodiazepines, opioid + antidepressants, opioid + anticonvulsants, opioid + antipsychotics and opioid + hypnotics) dispensed from January 2013 to December 2014 were identified...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28182123/long-term-safety-and-analgesic-efficacy-of-buprenorphine-buccal-film-in-patients-with-moderate-to-severe-chronic-pain-requiring-around-the-clock-opioids
#19
Martin Hale, Veronica Urdaneta, M Todd Kirby, Qinfang Xiang, Richard Rauck
BACKGROUND: This open-label, single-arm study was conducted to evaluate the long-term safety and efficacy of a novel buprenorphine formulation, buprenorphine buccal film, in the treatment of moderate-to-severe chronic pain requiring around-the-clock opioids. METHODS: The primary purpose of this study was to evaluate the long-term safety and tolerability of buprenorphine buccal film. Five hundred and six patients who completed previous studies with buprenorphine buccal film (n=445; rollover patients) or were recruited de novo for this study (n=61) were enrolled in this study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28181146/when-people-with-opioid-induced-constipation-speak-a-patient-survey
#20
Robert S Epstein, J Russell Teagarden, Ali Cimen, Mark Sostek, Tehseen Salimi
INTRODUCTION: Opioid-induced constipation (OIC) is a common consequence of opioid use for chronic pain. OIC creates problems for patients independent of their pain syndromes, in addition to threatening pain treatment effectiveness. Healthcare practitioners need to be alert to how patients talk about OIC so that it is not missed. Using a survey mechanism, we sought patient expressions of the personal impact OIC imposes on how they are able to live their lives and on meanings that symptom relief would produce...
February 8, 2017: Advances in Therapy
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