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Opioid prescribing

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https://www.readbyqxmd.com/read/29349283/is-self-rated-health-in-adolescence-a-predictor-of-prescribed-medication-in-adulthood-findings-from-the-nord-tr%C3%A3-ndelag-health-study-and-the-norwegian-prescription-database
#1
Tina Lokke Vie, Karl Ove Hufthammer, Turid Lingaas Holmen, Eivind Meland, Hans Johan Breidablik
Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years' prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16...
April 2018: SSM—Population Health
https://www.readbyqxmd.com/read/29347984/the-effects-of-state-rules-on-opioid-prescribing-in-indiana
#2
Morhaf Al Achkar, Shaun Grannis, Debra Revere, Palmer MacKie, Meredith Howard, Sumedha Gupta
BACKGROUND: Prescription opioids have been linked to over half of the 28,000 opioid overdose deaths in 2014. High rates of prescription opioid non-medical use have continued despite nearly all states implementing large-scale prescription drug monitoring programs (PDMP), which points to the need to examine the impact of state PDMP's on curbing inappropriate opioid prescribing. In the short-term, PDMPs have been associated with short-term prescribing declines. Yet little is known about how such policies differentially impact patient subgroups or are interpreted by prescribing providers...
January 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#3
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29343479/postsurgical-prescriptions-for-opioid-naive-patients-and-association-with-overdose-and-misuse-retrospective-cohort-study
#4
Gabriel A Brat, Denis Agniel, Andrew Beam, Brian Yorkgitis, Mark Bicket, Mark Homer, Kathe P Fox, Daniel B Knecht, Cheryl N McMahill-Walraven, Nathan Palmer, Isaac Kohane
OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use...
January 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29342356/the-dark-side-of-total-synthesis-strategies-and-tactics-in-psychoactive-drug-production
#5
Schuyler A Chambers, Jenna M DeSousa, Eric D Huseman, Steven D Townsend
Humankind has used and abused psychoactive drugs for millennia. Formally, a psychoactive drug is any agent that alters cognition and mood. The term "psychotropic drug" is neutral and describes the entire class of substrates, licit and illicit, of interest to governmental drug policy. While these drugs are prescribed for issues ranging from pain management to anxiety, they are also used recreationally. In fact, the current opioid epidemic is the deadliest drug crisis in American history. While the topic is highly politicized with racial, gender, and socioeconomic elements, there's no denying the toll drug mis- and overuse is taking on this country...
January 17, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29340937/association-between-electronic-medical-record-implementation-of-default-opioid-prescription-quantities-and-prescribing-behavior-in-two-emergency-departments
#6
M Kit Delgado, Frances S Shofer, Mitesh S Patel, Scott Halpern, Christopher Edwards, Zachary F Meisel, Jeanmarie Perrone
No abstract text is available yet for this article.
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29338578/cannabis-use-is-associated-with-lower-odds-of-prescription-opioid-analgesic-use-among-hiv-infected-individuals-with-chronic-pain
#7
Nancy L Sohler, Joanna L Starrels, Laila Khalid, Marcus A Bachhuber, Julia H Arnsten, Shadi Nahvi, John Jost, Chinazo O Cunningham
BACKGROUND: Chronic pain is common in the United States and prescribed opioid analgesics use for noncancer pain has increased dramatically in the past two decades, possibly accounting for the current opioid addiction epidemic. Co-morbid drug use in those prescribed opioid analgesics is common, but there are few data on polysubstance use patterns. OBJECTIVE: We explored patterns of use of cigarette, alcohol, and illicit drugs in HIV-infected people with chronic pain who were prescribed opioid analgesics...
January 17, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29338150/the-role-of-cannabinoids-in-pain-control-the-good-the-bad-and-the-ugly
#8
Joseph V Pergolizzi, Jo Ann Lequang, Robert Taylor, Robert B Raffa, Daniel Colucci
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29334921/a-pilot-feasibility-randomised-controlled-trial-of-an-adjunct-brief-social-network-intervention-in-opiate-substitution-treatment-services
#9
Ed Day, Alex Copello, Jennifer L Seddon, Marilyn Christie, Deborah Bamber, Charlotte Powell, Carmel Bennett, Shabana Akhtar, Sanju George, Andrew Ball, Emma Frew, Ilias Goranitis, Nick Freemantle
BACKGROUND: Approximately 3% of people receiving opioid substitution therapy (OST) in the UK manage to achieve abstinence from prescribed and illicit drugs within three years of commencing treatment. Involvement of families and wider social networks in supporting psychological treatment may be an effective strategy in facilitating recovery, and this pilot study aimed to evaluate the impact of a social network-focused intervention for patients receiving OST. METHODS: A two-site, open feasibility trial randomised patients receiving OST for at least 12 months but still reporting illicit opiate use in the past 28 days to one of three treatments: 1) treatment as usual (TAU), 2) Brief Social Behaviour and Network Therapy (B-SBNT) + TAU, or 3) Personal Goal Setting (PGS) + TAU...
January 15, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29333954/prevalence-diagnosis-and-treatment-rates-of-mood-disorders-among-opioid-users-under-criminal-justice-supervision
#10
Mary Mbaba, Shan-Estelle Brown, Alese Wooditch, Marissa Kiss, Amy Murphy, Suneeta Kumari, Faye Taxman, Frederick Altice, William B Lawson, Sandra A Springer
BACKGROUND: Individuals involved in the criminal justice system have disproportionately high rates of psychiatric disorders when compared to the general U.S. POPULATION: If left untreated, the likelihood of subsequent arrest increases and risk for adverse health consequences is great, particularly among opioid users. OBJECTIVES: To explore the prevalence, characteristics, and treatment of mood disorders among justice involved opioid-dependent populations...
January 15, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#11
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329750/women-and-the-experience-of-pain-and-opioid-use-disorder-a-literature-based-commentary
#12
Andrew L Koons, Marna Rayl Greenberg, Robert D Cannon, Gillian A Beauchamp
It is generally understood that pain experience and opioid abuse have relied on male-dominated models. However, sex and gender play a role in both pain experience and opioid use disorder. Using the previously validated Texas Tech University Health Sciences Center Sex and Gender Specific Health PubMed Advanced Search Tool, the authors used pertinent literature to develop this literature-based commentary on sex and gender differences in pain experience and opioid use disorder. Women report their experience of pain more frequently, have increased rates of diagnoses related to pain, have increased pain sensitivity, and have a variable response to pain and analgesia...
January 9, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29327358/opioid-medication-use-in-patients-with-gastrointestinal-diagnoses-vs-unexplained-gastrointestinal-symptoms-in-the-us-veterans-health-administration
#13
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29326869/prenatal-methadone-exposure-is-associated-with-altered-neonatal-brain-development
#14
Victoria J Monnelly, Devasuda Anblagan, Alan Quigley, Manuel Blesa Cabez, E Sarah Cooper, Helen Mactier, Scott I Semple, Mark E Bastin, James P Boardman
Methadone is used for medication-assisted treatment of heroin addiction during pregnancy. The neurodevelopmental outcome of children with prenatal methadone exposure can be sub-optimal. We tested the hypothesis that brain development is altered among newborn infants whose mothers were prescribed methadone. 20 methadone-exposed neonates born after 37 weeks' postmenstrual age (PMA) and 20 non-exposed controls underwent diffusion MRI at mean PMA of 39+ 2 and 41+ 1 weeks, respectively. An age-optimized Tract-based Spatial Statistics (TBSS) pipeline was used to perform voxel-wise statistical comparison of fractional anisotropy (FA) data between exposed and non-exposed neonates...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#15
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29325160/implementing-electronic-health-record-default-settings-to-reduce-opioid-overprescribing-a-pilot-study
#16
Kara Zivin, Jessica O White, Sandra Chao, Anna L Christensen, Luke Horner, Dana M Petersen, Morgan R Hobbs, Grace Capreol, Kevin A Halbritter, Christopher M Jones
Objective: To pilot test the effectiveness, feasibility, and acceptability of instituting a 15-pill quantity default in the electronic health record for new Schedule II opioid prescriptions. Design: A mixed-methods pilot study in two health systems, including pre-post analysis of prescribed opioid quantity and focus groups or interviews with prescribers and health system administrators. Methods: We implemented a 15-pill electronic health record default for new Schedule II opioids and assessed opioid quantity before and after implementation using electronic health record data on 6,390 opioid prescriptions from 448 prescribers...
January 9, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29324253/a-qualitative-study-comparing-physician-reported-barriers-to-treating-addiction-using-buprenorphine-and-extended-release-naltrexone-in-u-s-office-based-practices
#17
Barbara Andraka-Christou, Matthew J Capone
AIM: Our aim was to compare physician-reported barriers to sublingual buprenorphine (BUP) and extended-release naltrexone (XR-NLT) prescribing in U.S. office-based practices, and to identify potential policies for minimizing these barriers. Only one previous qualitative study has examined physician-reported barriers to prescribing XR-NLT and no qualitative study has compared physician-reported barriers between the two medications. METHODS: Researchers conducted individual semi-structured and in-depth interviews with 20 licensed physicians in four U...
January 8, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29319627/opioid-prescription-morbidity-and-mortality-in-us-transplant-recipients
#18
Kevin C Abbott, Chyng-Wen Fwu, Paul W Eggers, Anne W Eggers, Prudence P Kline, Paul L Kimmel
BACKGROUND: CDC guidelines recommend caution in prescribing opioids for chronic pain. The characteristics of opioid prescription (OpRx) among kidney transplant (KTx) recipients has not been described in a national population. METHODS: We assessed OpRx prevalence among prevalent KTx recipients, and associated duration (chronic, defined as ≥90 days in a year) and dosing (in morphine milligram equivalents per day, MME, of <50, 50-89, and ≥90) with outcomes, death and graft loss, among incident KTx recipients using 2006-2010 US Renal Data System files, including Medicare Part D for medication ascertainment...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29318006/naloxone-dosage-for-opioid-reversal-current-evidence-and-clinical-implications
#19
REVIEW
Rachael Rzasa Lynn, J L Galinkin
Opioid-related mortality is a growing problem in the United States, and in 2015 there were over 33,000 opioid-related deaths. To combat this mortality trend, naloxone is increasingly being utilized in a pre-hospital setting by emergency personnel and prescribed to laypersons for out-of-hospital administration. With increased utilization of naloxone there has been a subsequent reduction in mortality following an opioid overdose. Reversal of opioid toxicity may precipitate an opioid-withdrawal syndrome. At the same time, there is a risk of inadequate response or re-narcotization after the administration of a single dose of naloxone in patients who have taken large doses or long-acting opioid formulations, as the duration of effect of naloxone is shorter than that of many opioid agonists...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29316592/the-addition-of-diclofenac-to-a-multimodal-pain-control-regimen-decreases-postoperative-pain-and-opioid-consumption
#20
Nicole E George, Cheryle Gurk-Turner, Jennifer I Etcheson, Chukwuweike U Gwam, Randal De Souza, Spencer S Smith, James Nace, Ronald E Delanois
INTRODUCTION: Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients...
December 22, 2017: Surgical Technology International
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