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Opioid prescribing

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https://www.readbyqxmd.com/read/29778769/mandatory-review-of-a-prescription-drug-monitoring-program-and-impact-on-opioid-and-benzodiazepine-dispensing
#1
Erin L Winstanley, Yifan Zhang, Rebecca Mashni, Sydney Schnee, Jonathan Penm, Jill Boone, Cameron McNamee, Neil J MacKinnon
BACKGROUND: The purpose of this study is to determine whether Ohio House Bill 341, which mandated the use of Ohio's Prescription Drug Monitoring Program (PDMP), was an effective regulatory strategy to reduce opioid and benzodiazepine dispensing. METHOD: Secondary analysis of Ohio's PDMP data on prescription opioids and benzodiazepines dispensed from November 2014 to March 2017. An interrupted time series analysis was conducted to determine if there was a significant change in the quantity of opioids and benzodiazepines dispensed...
May 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29777388/a-retrospective-study-of-opioid-prescribing-patterns-at-hospital-discharge-in-surgical-patients-with-obstructive-sleep-apnea
#2
Samir M Kendale, Jing Wang, Jeanna D Blitz, Steven Calvino, Germaine Cuff, Nicholas Barone, Andrew D Rosenberg, Lisa Doan
PURPOSE: Obstructive sleep apnea (OSA) is a risk factor for complications with postoperative opioid use, and in those patients with known or suspected OSA, minimization of postoperative opioids is recommended. We hypothesize that despite these recommendations, surgical patients with known or suspected OSA are prescribed postoperative opioids at hospital discharge at similar doses to those without OSA. METHODS: This was a retrospective analysis of the electronic health records of surgical patients from 1 November 2016 to 30 April 2017 at a single academic institution...
May 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29776688/naloxone-laws-facilitate-the-establishment-of-overdose-education-and-naloxone-distribution-programs-in-the-united-states
#3
Barrot H Lambdin, Corey S Davis, Eliza Wheeler, Stephen Tueller, Alex H Kral
BACKGROUND: The opioid overdose crisis in the United States continues to worsen. Opioid overdose mortality is entirely preventable with timely administration of naloxone. Since 2001, many states have passed laws to create an enabling environment for the implementation of overdose education and naloxone distribution (OEND) programs. We assessed whether state-level naloxone laws and their provisions stimulated the implementation of OEND programs in the United States. METHODS: Covering the period from 2000 to 2014, we utilized five data sources including the Westlaw legal database, the Prescription Drug Abuse Policy System, the Harm Reduction Coalition's OEND database, National Center of Health Statistics and the United States Census...
May 12, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29776349/randomised-controlled-trial-rct-of-cannabinoid-replacement-therapy-nabiximols-for-the-management-of-treatment-resistant-cannabis-dependent-patients-a-study-protocol
#4
Anjali K Bhardwaj, David J Allsop, Jan Copeland, Iain S McGregor, Adrian Dunlop, Marian Shanahan, Raimondo Bruno, Nghi Phung, Mark Montebello, Craig Sadler, Jessica Gugusheff, Melissa Jackson, Jennifer Luksza, Nicholas Lintzeris
BACKGROUND: The cannabis extract nabiximols (Sativex®) effectively supresses withdrawal symptoms and cravings in treatment resistant cannabis dependent individuals, who have high relapse rates following conventional withdrawal treatments. This study examines the efficacy, safety and cost-effectiveness of longer-term nabiximols treatment for outpatient cannabis dependent patients who have not responded to previous conventional treatment approaches. METHODS/DESIGN: A phase III multi-site outpatient, randomised, double-blinded, placebo controlled parallel design, comparing a 12-week course of nabiximols to placebo, with follow up at 24 weeks after enrolment...
May 18, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29774774/undertreatment-of-pain-and-low-use-of-opioids-in-latin-america
#5
César Amescua García, Joao Batista Santos Garcia, María Del Rosario Berenguel Cook, Frantz Colimon, José Alberto Flores Cantisani, Carlos Guerrero, María Del Rocío Guillén Núnez, John Jairo Hernández Castro, Durval Campos Kraychete, Argelia Lara-Solares, Osvandré Lech, María Antonieta Rico Pazos, Manuel Sempértegui Gallegos, Lizandra Pattaro Marcondes
Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries...
May 18, 2018: Pain Management
https://www.readbyqxmd.com/read/29771793/the-association-of-chronic-pain-and-long-term-opioid-therapy-with-hiv-treatment-outcomes
#6
Jessica S Merlin, Dustin Long, William C Becker, Edward R Cachay, Katerina A Christopolous, Kasey Claborn, Heidi M Crane, E Jennifer Edelman, Richard Harding, Stefan G Kertesz, Jane M Liebschutz, W Christopher Mathews, Michael J Mugavero, Sonia Napravnik, Connall O'Cleirigh, Michael S Saag, Joanna L Starrels, Robert Gross
BACKGROUND: Chronic pain occurs in up to 85% of persons living with HIV (PLWH) and is commonly treated with long-term opioid therapy (LTOT). We investigated the impact of chronic pain and LTOT on HIV outcomes. METHODS: This was prospective cohort study conducted between 7/2015-7/2016 in five HIV primary care clinics. Chronic pain was defined as ≥moderate pain for ≥3 months on the Brief Chronic Pain Questionnaire and ≥4/10 on the Pain Enjoyment of life and General activity (PEG) questionnaire...
May 4, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29762767/concerns-and-help-seeking-among-patients-using-opioids-for-management-of-chronic-noncancer-pain
#7
Briony Larance, Gabrielle Campbell, Teleri Moore, Suzanne Nielsen, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Wayne Hall, Richard Mattick, Courtney O'Donnell, Louisa Degenhardt
Background: The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. Methods: Data were collected from 1,086 people prescribed opioids for CNCP via a large prospective cohort called the Pain and Opioids IN Treatment (POINT) study. Patients' characteristics and help-seeking were examined according to scores on the Prescribed Opioids Difficulties Scale (PODS)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29762757/how-are-real-time-opioid-prescribing-cognitions-by-emergency-providers-influenced-by-reviewing-the-state-prescription-drug-monitoring-program
#8
Aaron Landau, Michael Lynch, Clifton Callaway, Brian Suffoletto
Objective: To understand how real-time opioid prescribing cognitions by emergency medicine (EM) providers are influenced by review of the state prescription drug monitoring program (PDMP). Methods: We collected prospective data from a convenience sample of 103 patient encounters for pain from 23 unique EM providers. After seeing the patient, before and immediately after reviewing the PDMP, EM providers answered how much they thought "the patient need[ed] an opioid to help manage their pain?", how concerned they were "about drug abuse and/or diversion?", and whether they planned to prescribe an opioid (yes/no)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#9
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
May 14, 2018: Pain
https://www.readbyqxmd.com/read/29760569/concomitant-use-of-opioid-medications-with-triptans-or-serotonergic-antidepressants-in-us-office-based-physician-visits
#10
Kyle C Molina, Kathleen A Fairman, David A Sclar
Background: Opioids are not recommended for routine treatment of migraine because their benefits are outweighed by risks of medication overuse headache and abuse/dependence. A March 2016 US Food and Drug Administration (FDA) safety communication warned of the risk of serotonin syndrome from using opioids concomitantly with 5-hydroxytryptamine receptor agonists (triptans) or serotonergic antidepressants: selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29758355/alcohol-and-opioid-use-in-chronic-pain-a-cross-sectional-examination-of-differences-in-functioning-based-on-misuse-status
#11
Kevin E Vowles, Katie Witkiewitz, Melissa Pielech, Karlyn A Edwards, Mindy L McEntee, Robert W Bailey, Lena Bolling, Mark D Sullivan
Opioid misuse is regularly associated with disrupted functioning in those with chronic pain. Less work has examined whether alcohol misuse may also interfere with functioning. This study examined frequency of opioid and alcohol misuse in 131 individuals (61.1% female) prescribed opioids for the treatment of chronic pain. Participants completed an anonymous survey online, consisting of measures of pain, functioning, and opioid and alcohol misuse. Cut-scores were used to categorize individuals according to substance misuse status; individuals were categorized as follows: 35...
May 11, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29758294/american-academy-of-physical-medicine-and-rehabilitation-position-statement-on-opioid-prescribing
#12
Cathy Mendelsohn
No abstract text is available yet for this article.
May 11, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29756393/opioid-prescribing-practices-in-patients-undergoing-surgery-for-oral-cavity-cancer
#13
John Pang, Kathryn R Tringale, Viridiana J Tapia, Bharat A Panuganti, Jesse R Qualliotine, Aria Jafari, Sunny J Haft, Lawrence S Friedman, Timothy Furnish, Kevin T Brumund, Joseph A Califano, Charles S Coffey
OBJECTIVES: Opioids have been overprescribed after general and orthopedic surgeries, but prescribing patterns have not been reported for head and neck surgery. The objectives of this retrospective review are to describe postoperative opioid prescriptions after oral cancer surgery and determine which patients receive higher amounts. METHODS: A single institution retrospective review was performed for 81 adults with oral cavity tumors undergoing surgery. Opioid prescriptions upon discharge were reported in daily oral morphine equivalents (OME)...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29754987/a-statewide-effort-to-reduce-high-dose-opioid-prescribing-through-coordinated-care-organizations
#14
Daniel M Hartung, Lindsey Alley, Gillian Leichtling, P Todd Korthuis, Christi Hildebran
BACKGROUND: Oregon's Medicaid program is delivered through 16 Coordinated Care Organizations (CCOs) participating in a statewide performance improvement program to reduce high-dose opioid prescribing. CCOs were allowed flexibility to develop their own dose targets and any policies, trainings, guidelines, and/or materials to meet these targets. In this study, we characterize CCO strategies to reduce high-dose opioid prescribing across the 16 CCOs. METHODS: We reviewed relevant CCO documents and conducted semi-structured interviews with CCO administrators to acquire opioid-related policies, practices, timelines and contextual factors...
May 1, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29752906/tramadol-understanding-the-risk-of-serotonin-syndrome-and-seizures
#15
REVIEW
Sameer Hassamal, Karen Miotto, William Dale, Itai Danovitch
Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol's serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is modest in the general population but if left untreated, the morbidity and mortality can be high, and therefore prompt recognition and management is essential...
May 9, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29752818/fluoxetine-uses-in-nociceptive-pain-management-a-promising-adjuvant-to-opioid-analgesics
#16
Mostafa M Hamdy, Mohamed M Elbadr, Ahmed Barakat
Fluoxetine, a commonly prescribed antidepressant, use in nociceptive pain management represent one of the unsettled issues of fluoxetine therapeutics. By reviewing the literature about fluoxetine's possible roles in this setting; those could be solitary antinociceptive effect, enhancement of acute morphine analgesia, blocking morphine tolerance development, and blocking dependence development and associated abstinence syndrome. In this study, we examined those four alleged roles of fluoxetine. Moreover, since effective alleviation of morphine tolerance, dependence, and abstinence syndrome represents one of the most challenging medical needs, we biochemically analyzed fluoxetine effect on these phenomena...
May 12, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29752012/impact-of-multidisciplinary-chart-reviews-on-opioid-dose-reduction-and-monitoring-practices
#17
Julianna Rivich, Jocelyn McCauliff, Allison Schroeder
INTRODUCTION: The Veterans Affairs (VA) Eastern Colorado Health Care System implemented an Opioid Safety Initiative (OSI); this included multidisciplinary chart reviews of patients with chronic, non-malignant pain on high-dose opioid therapy to provide safety recommendations to prescribers through the electronic medical record. Our study objective was to evaluate the impact of these documented recommendations. Outcomes included change in total daily opioid dose, concurrent prescribing of opioids and benzodiazepines, adherence to local VA/Veterans Integrated Service Network (VISN) policy, and monitoring practices...
April 27, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29746919/opioid-medication-use-in-the-surgical-patient-an-assessment-of-prescribing-patterns-and-utilization
#18
Wen Hui Tan, Jennifer Yu, Sara Feaman, Jared M McAllister, Lindsey G Kahan, Mary A Quasebarth, Jeffrey A Blatnik, J Christopher Eagon, Michael M Awad, L Michael Brunt
BACKGROUND: With the epidemic of prescription opioid abuse in the United States, rates of opioid-related unintentional deaths have risen dramatically. However, little data exists comparing postoperative opioid prescriptions with patient use. We sought to better elucidate this relationship in surgical patients. STUDY DESIGN: A prospective cohort study was conducted of narcotic-naïve patients undergoing open and laparoscopic abdominal procedures on a minimally invasive surgery service...
May 7, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29744859/prescription-opioid-use-in-pregnancy
#19
REVIEW
Julie Blandthorn, Laura Leung, Yuan Loke, D Martyn Lloyd-Jones, Robin Thurman, Ellen Bowman, Yvonne Bonomo
Prescription medications, including opioid analgesics, are increasingly prescribed in Australia and internationally. More women are presenting in pregnancy with prescription opioid use which can potentially cause harm to the mother and fetus. This article outlines the different types of prescription opioids, defines how prescription opioid use disorder presents clinically and suggests a rational clinical approach to assess and manage patients in the context of pregnancy and their infants.
May 10, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29741427/time-course-of-subacute-pain-after-transoral-robotic-surgery-tors-for-oropharyngeal-squamous-cell-carcinoma-versus-traditional-bilateral-tonsillectomy-in-adults-a-case-control-study
#20
Susanne Irene Scott, Anne Kathrine Østergaard Madsen, Niclas Rubek, Hani Ibrahim Channir, Henrik Kehlet, Christian von Buchwald
OBJECTIVE: To examine pain after Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) versus traditional bilateral tonsillectomy in adults. METHODS: Pain evolvement was assessed in a prospective case-control design of 16 consecutive patients treated with TORS for early stage OPSCC versus 12 patients, who underwent bilateral tonsillectomy on suspicion of malignant disease. The TORS group received an optimized analgesia regime of preoperative oral celecoxib and gabapentin, intra- and postoperative high-dose intravenous dexamethasone, and regular postoperative oral contalgin, gabapentin, celecoxib, paracetamol and rescue morphine...
May 9, 2018: Acta Oto-laryngologica
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