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https://www.readbyqxmd.com/read/28650247/burden-of-alcohol-abuse-or-dependence-among-long-term-opioid-users-with-chronic-noncancer-pain
#1
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna D Coutinho, Paul P Yeung, Richard White
BACKGROUND: Substance abuse disorders among chronic noncancer pain (CNCP) patients add to the clinical challenges and economic burden of caring for such patients. Despite potential risks, some CNCP patients with a history of alcohol abuse or dependence (AAD) and pain that is refractory to nonopioid treatment options may still need opioids for pain management. However, there is a lack of data on adverse outcomes in long-term opioid users with CNCP and a history of substance abuse or AAD disorders...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28649992/a-key-role-for-neurotensin-in-chronic-stress-induced-anxiety-like-behaviour-in-rats
#2
Catherine P Normandeau, Ana Paula Ventura Silva, Emily R Hawken, Staci Angelis, Calvin Sjaarda, Xudong Liu, José Miguel Pêgo, Éric C Dumont
Chronic stress is a major cause of anxiety disorders that can be reliably modeled pre-clinically, providing insight into alternative therapeutic targets for this mental health illness. Neuropeptides have been targeted in the past to no avail possibly due to our lack of understanding of their role in pathological models. In this study we use a rat model of chronic stress-induced anxiety-like behaviours and hypothesized that neuropeptidergic modulation of synaptic transmission would be altered in the Bed Nucleus of the Stria Terminalis (BNST), a brain region suspected to contribute to anxiety disorders...
June 26, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28648164/-pharmacological-treatment-of-chronic-non-cancer-pain
#3
Gitte Handberg
19% of the grown-up Danish population suffer from a chronic pain condition. Most patients are treated by general practi-tioners (GPs), and only a smaller group need specialist treatment. This article goes through the pharmacological possibilities available with a special focus on treatment by GPs. For chronic pain as fibromyalgia and low back pain non-steroidal anti-inflammatory drugs and paracetamol are not recommended on a regular basis. The main pharmacological treatment is tricyclic antidepressants and gabapentinoids...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28648160/-strategies-to-avoid-the-risk-of-addiction-when-treating-patients-with-chronic-pains
#4
Jette Højsted, Henrik Rindom
Addiction is a feared complication of long-term opioid treatment in patients with chronic pains. Strategies to decrease the risk of addiction include estimating of risk factors, establishing treatment goals realistic for pain and function, considering how to discontinue therapy if treatment goals are not achieved, avoiding administration forms with rapid absorption, using validated screening instruments and avoiding high opioid doses. If signs of addiction do occur, precautions to hinder overuse of opioid should be taken...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28647677/buprenorphine-augmentation-improved-symptoms-of-ocd-compared-to-placebo-results-from-a-randomized-double-blind-and-placebo-controlled-clinical-trial
#5
Mohammad Ahmadpanah, Amin Reihani, Ali Ghaleiha, Alireza Soltanian, Mohammad Haghighi, Leila Jahangard, Dena Sadeghi Bahmani, Edith Holsboer-Trachsler, Serge Brand
BACKGROUND: In the search for new psychopharmacologic options in the treatment of obsessive-compulsive disorders (OCD), some findings suggested that augmentation with buprenorphine, a partial-opioid agonist used to treat opioid addiction, moderate acute pain and moderate chronic pain, is worthy of consideration. Accordingly, to explore this possibility further, a double-blinded, placebo-controlled clinical trial was performed. METHOD: A total of 43 patients (mean age: 34...
June 13, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28647454/elevated-serum-met-5-enkephalin-levels-correlate-with-improved-clinical-and-behavioral-outcomes-in-experimental-autoimmune-encephalomyelitis
#6
Michael D Ludwig, Ian S Zagon, Patricia J McLaughlin
Methionine enkephalin ([Met(5)]-enkephalin, Opioid growth factor (OGF)) is a small neuropeptide with growth-related as well as immunomodulatory properties. OGF is distributed widely throughout the body, is both autocrine and paracrine produced, and has a very short half-life in serum. In addition to its neurotransmitter functions, OGF inhibits cell replication of a wide variety of cells involved in the autoimmune process. In this preclinical study, mice were immunized with myelin oligodendrocytic glycoprotein (MOG35-55) to establish a chronic progressive form of autoimmune encephalomyelitis (EAE), and serum enkephalin levels were assessed throughout the disease as well as in response to OGF therapy in order to determine whether OGF may be a biological marker for EAE and multiple sclerosis...
June 21, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28646359/music-as-an-adjunct-to-opioid-based-analgesia
#7
Peter R Chai, Stephanie Carreiro, Megan L Ranney, Ketki Karanam, Marko Ahtisaari, Robert Edwards, Kristin L Schreiber, Lubabah Ben-Ghaly, Timothy B Erickson, Edward W Boyer
Epidemic increases in opioid use in the USA and globally highlight the need for effective adjunctive therapies to opioid-based analgesia. Given the shortcomings of behavioral adjuncts to opioid-based pain treatment, an urgent need exists for pain-related behavioral interventions that resonate with broad patient populations, can be delivered confidentially in any environment, and can incorporate new content automatically. Understanding the potential for automated behavioral therapies like music therapy in modulating the experience of pain may unlock methods to transition patients to lower doses of pharmacologic therapy or provide alternatives to opioids during acute exacerbations of pain...
June 23, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28645915/cebranopadol-blocks-the-escalation-of-cocaine-intake-and-conditioned-reinstatement-of-cocaine-seeking-in-rats
#8
Giordano de Guglielmo, Alessandra Matzeu, Jenni Kononoff, Julia Mattioni, Remi Martin-Fardon, Olivier George
Cebranopadol is a novel agonist of nociceptin/orphanin FQ peptide (NOP) and opioid receptors with analgesic properties that is being evaluated in clinical Phase 2 and Phase 3 trials for the treatment of chronic and acute pain. Recent evidence indicates that the combination of opioid and NOP receptor agonism may be a new treatment strategy for cocaine addiction. We sought to extend these findings by examining the effects of cebranopadol on cocaine self-administration (0.5 mg/kg/infusion) and cocaine conditioned reinstatement in rats with extended access to cocaine...
June 23, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28645137/-to-take-or-not-to-take-the-association-between-perceived-addiction-risk-expected-analgesic-response-and-likelihood-of-trying-novel-pain-relievers-in-self-identified-chronic-pain-patients
#9
D Andrew Tompkins, Andrew S Huhn, Patrick S Johnson, Michael T Smith, Eric C Strain, Robert R Edwards, Matthew W Johnson
BACKGROUND AND AIMS: Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity, and previous opioid experience would be positively associated with likelihood of risky medication use. DESIGN: This cross-sectional online study determined state/trait associations with addiction-related medication decisions in CPP...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28645065/cross-validation-of-short-forms-of-the-screener-and-opioid-assessment-for-patients-with-pain-revised-soapp-r
#10
Matthew D Finkelman, Robert N Jamison, Ronald J Kulich, Stephen F Butler, William C Jackson, Niels Smits, Scott G Weiner
BACKGROUND: The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a 24-item assessment designed to assist in the prediction of aberrant drug-related behavior (ADB) among patients with chronic pain. Recent work has created shorter versions of the SOAPP-R, including a static 12-item short form and two computer-based methods (curtailment and stochastic curtailment) that monitor assessments in progress. The purpose of this study was to cross-validate these shorter versions in two new populations...
June 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28644196/cebranopadol-a-novel-first-in-class-analgesic-drug-candidate-first-experience-in-patients-with-chronic-low-back-pain-in-a-randomized-clinical-trial
#11
Annette Christoph, Marie-Henriette Eerdekens, Maurits Kok, Gisela Volkers, Rainer Freynhagen
Chronic low back pain (LBP) is a common condition, usually with involvement of nociceptive and neuropathic pain components, high economic burden and impact on quality of life. Cebranopadol is a potent, first-in-class drug candidate with a novel mechanistic approach, combining nociceptin/orphanin FQ peptide and opioid peptide receptor agonism. We conducted the first Phase II, randomized, doubleblind, placebo- and active-controlled trial, evaluating the analgesic efficacy, safety, and tolerability of cebranopadol in patients with moderate to severe chronic LBP with and without neuropathic pain component...
June 21, 2017: Pain
https://www.readbyqxmd.com/read/28638291/pain-and-psychology-a-reciprocal-relationship
#12
REVIEW
Nalini Vadivelu, Alice M Kai, Gopal Kodumudi, Karine Babayan, Manuel Fontes, Matthew M Burg
BACKGROUND: Depression typically affects 5% of the general population, but among patients with chronic pain, 30%-45% experience depression. Studies have shown that the relationship between depression and pain is bidirectional: depression is a positive predictor of the development of chronic pain, and chronic pain increases the risk of developing depression. METHODS: This literature review focuses on the relationship between psychology and pain, covering studies that have investigated the association between depression, pain sensitivity, opioid abuse, and gender differences in pain perception...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28636752/comparison-of-effect-sizes-between-enriched-and-non-enriched-trials-of-analgesics-for-chronic-musculoskeletal-pain-a-systematic-review
#13
Tie P Yamato, Chris G Maher, Bruno T Saragiotto, Christina Abdel Shaheed, Anne M Moseley, Chung-Wei Christine Lin, Bart Koes, Andrew J McLachlan
OBJECTIVE: To investigate the use of an enriched study design on the estimates of treatment effect in analgesic trials for chronic musculoskeletal pain METHODS: Database searches were conducted from 2004 to 2014. We included randomised placebo-controlled trials evaluating pain medications for chronic musculoskeletal pain. Methodological quality was assessed using the PEDro scale. The estimates of treatment effect on pain and adverse events were compared between enriched and non-enriched designs...
June 21, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28635181/buprenorphine-requires-concomitant-activation-of-nop-and-mop-receptors-to-reduce-cocaine-consumption
#14
Marsida Kallupi, Qianwei Shen, Giordano de Guglielmo, Dennis Yasuda, V Blair Journigan, Nurulain T Zaveri, Roberto Ciccocioppo
Buprenorphine's clinical use is approved for the treatment of heroin addiction; however, evidence supporting its efficacy in cocaine abuse also exists. While for heroin it has been demonstrated that the effect of buprenorphine is mediated by its ability to activate μ-opioid peptide receptor (MOP) receptors, the mechanism through which it attenuates cocaine intake remains elusive. We explored this mechanism using operant models where rodents were trained to chronically self-administer cocaine for 2 hours daily...
June 21, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28635179/changing-trends-in-opioid-use-among-u-s-rheumatoid-arthritis-patients
#15
Jeffrey R Curtis, Fenglong Xie, Christian Smith, Kenneth G Saag, Lang Chen, Timothy Beukelman, Melissa Mannion, Huifeng Yun, Stefan Kertesz
Introduction Opioid prescribing recently has come under intense scrutiny. However, longitudinal patterns of opioid prescription receipt in a population-based cohort of patients who have chronic pain, such as those with rheumatoid arthritis (RA), have not been well characterized. Methods We identified a cohort of RA patients based on 2006-2014 Medicare data and evaluated longitudinal time trends in regular opioid use (>=3 filled prescriptions in each 12 month interval). A separate analysis in 2014 assessed rheumatologist-specific variability in regular opioid prescription for RA patients...
June 21, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#16
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#17
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28631746/prevalence-of-androgen-deficiency-in-chronic-spinal-cord-injury-patients-suffering-from-erectile-dysfunction
#18
M Behnaz, Z Majd, M Radfar, H Ajami, M Qorbani, A Kokab
STUDY DESIGN: Retrospective cross-sectional study. OBJECTIVES: To estimate the prevalence of biochemical androgen deficiency in Iranian spinal cord injured men suffering from erectile dysfunction (ED) and to determine factors related to this problem. SETTING: An andrology clinic of a teaching hospital in Tehran. METHODS: Men, 18 years of age and older, with chronic (>2 years) spinal cord injury (SCI) suffering from ED were recruited...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28627589/effect-of-the-spinal-apelin%C3%A2-apj-system-on-the-pathogenesis-of-chronic-constriction-injury%C3%A2-induced-neuropathic-pain-in-rats
#19
Qingming Xiong, Wanyou He, Hanbing Wang, Jun Zhou, Yajun Zhang, Jian He, Chengxiang Yang, Bin Zhang
Apelin is hypothesized to serve a dual function in pain processing. Spinal administration of apelin induces hyperalgesia, while opioid receptors are implicated in the antinociceptive effects of apelin in acute nociceptive models. However, whether the apelin‑apelin receptor (APJ) system is involved in neuropathic pain remains to be elucidated. The present study aimed to evaluate the impact and mechanism of the spinal apelin‑APJ system in neuropathic pain. Chronic constriction injury (CCI) of the sciatic nerve produced sustained spinal apelin and APJ upregulation, which was associated with mechanical allodynia and heat hyperalgesia development in the hind‑paw plantar surface...
June 9, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28627395/the-opioid-epidemic-is-an-historic-opportunity-to-improve-both-prevention-and-treatment
#20
Robert L DuPont
The current narrative describing the national opioid epidemic as the result of overprescribing opioid pain medicines fails to capture the full dimensions of problem and leads to inadequate and even confounding solutions. Overlooked is the fact that polysubstance use is nearly ubiquitous among overdose deaths, demonstrating that the opioid overdose death problem is bigger than opioids. The foundation of the nation's opioid overdose crisis - and the totality of the nation's drug epidemic - is widespread recreational pharmacology, the use of drugs for fun or "self-medication...
June 13, 2017: Brain Research Bulletin
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