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Narcotic abuse

Mark R Jones, Alan D Kaye, Laxmaiah Manchikanti, Joshua A Hirsch
PURPOSE OF REVIEW: The prevalence of chronic pain and prescription opioid abuse has resulted in epidemic problems for patients and clinicians. The consequences are taking a heavy toll on patients, physicians, and society. Specific to radiology, a significant need exists for best practice assessment and treatment approaches for pain management, as patients with chronic pain often undergo radiological tests of unclear clinical relevance. RECENT FINDINGS: The USA is amid an opioid-prescribing epidemic and resultant overdose public health emergency...
February 23, 2018: Current Pain and Headache Reports
Sidney H Schnoll
The abuse of opioids in the US is not a new problem. In 1973 David Musto published his book, The American Disease: Origins of Narcotic Control, which described the problem as dating back to the time of the Civil War. Continued attempts to address it through legislation, law enforcement, prevention, treatment, and the development of less abuseable pain relievers have shown limited success.
February 21, 2018: Clinical Pharmacology and Therapeutics
Reza Ghanbari, Susan Sumner
Drug addiction has been associated with an increased risk for cancer, psychological complications, heart, liver, and lung disease, as well as infection. While genes have been identified that can mark individuals at risk for substance abuse, the initiation step of addiction is attributed to persistent metabolic disruptions occurring following the first instance of narcotic drug use. Advances in analytical technologies can enable the detection of thousands of signals in body fluids and excreta that can be used to define biochemical profiles of addiction...
January 31, 2018: Trends in Molecular Medicine
Joseph M Banno, Katherine Shield, Krunal Patel, Anupam A Sule
Mycobacterium abscessus is a fast growing, non-tubercular mycobacterium (NTM) found in water. NTM bacteremia is usually seen in immunocompromised patients who have intravascular catheters. Mycobacterium abscessus bacteremia is often caused by exposure to contaminated water supply in hemodialysis units. A 28-year-old female with poorly controlled diabetes mellitus, end stage renal disease (on hemodialysis via Ash catheter), and recurrent deep vein thrombosis presented to the hospital with proximal right leg deep vein thrombosis...
November 27, 2017: Curēus
Kirsten Wiese Simonsen, Kristian Linnet, Brian Schou Rasmussen
OBJECTIVES: The objective of this study was to examine the frequency of psychoactive drugs and alcohol in drivers under suspicion of driving under the influence of drugs and alcohol in 2015 and 2016 in the eastern part of Denmark. The trends in the number of traffic cases sent for drug analysis since 2000 and alcohol analysis since 2011 are also discussed. METHODS: Blood samples from drivers suspected of being under the influence of alcohol and/or medication and/or illicit drugs in 2015 and 2016 were investigated as requested by the police...
January 25, 2018: Traffic Injury Prevention
Jacopo Lucchetti, Claudio M Marzo, Alice Passoni, Federico Moro, Angelo di Clemente, Renzo Bagnati, Luigi Cervo, Marco Gobbi
3,4-Dichloro-N-benzamide (AH-7921) is a cyclohexyl-methylbenzamide derivative with analgesic activity, whose abuse was associated with several fatal intoxications, included in Schedule I of UN Single Convention on Narcotic Drugs. We validated an HPLC-MS/MS method to investigate its brain disposition and metabolism after single and repeated injections; in parallel, we evaluated its central behavioral effects. After an intraperitoneal injection of 10 mg/kg, the analgesic effect appeared after 5 min and persisted up to 4 h; brain absorption was rapid (tmax 30 min) and large (brain-to-plasma ratio 16), with active concentration >700 ng/g...
January 20, 2018: Neuropharmacology
Mahyar Etminan, M Reza Nouri, Mohit Sodhi, Bruce C Carleton
OBJECTIVE: Recently, there has been great interest in the use, abuse and over-prescribing of opioid analgesics for children. However, there is a paucity of evidence on patterns of prescribing of both narcotic and non-narcotic analgesics for children by dentists. METHODS: We used a population-wide prescription drug database (PharmaNet) in British Columbia, Canada, to examine prescribing and dispensing of analgesics surrounding dental procedures. We examined all drugs prescribed for children by dentists between 1997 and 2013, as we had access to data on drug doses and days of medication supply...
August 2017: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
(no author information available yet)
OBJECTIVE: Mechanical ventilation (MV) in preterm infants (PTI) causes discomfort. Whether it causes pain is controversial. Meta analysis reviews of published work on PTI during MV have shown no clinically significant impact of opioids on pain scales, and hence not recommended for routine use in neonatal intensive care units (NICUs). Similarly regular use of sedative midazolam is also not recommended. Therefore we hypothesized a downward trend in narcotics and sedatives used in MV of PTI in NICUs...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Shereen Abdelhakim Abdelaleem, Osama A Hassan, Rasha F Ahmed, Nagwa M Zenhom, Rehab A Rifaai, Nashwa F El-Tahawy
Tramadol is a synthetic, centrally acting analgesic. It is the most consumed narcotic drug that is prescribed in the world. Tramadol abuse has dramatically increased in Egypt. Long term use of tramadol can induce endocrinopathy. So, the aim of this study was to analyze the adrenal insufficiency induced by long term use of tramadol in experimental animals and also to assess its withdrawal effects through histopathological and biochemical genetic study. Forty male albino rats were used in this study. The rats were divided into 4 groups (control group, tramadol-treated group, and withdrawal groups)...
2017: Journal of Toxicology
Seyed Mohammad Sadegh Ghoreishi, Fatemeh Shahbazi, Seyed Davood Mirtorabi, Mohammad Reza Ghadirzadeh, Seyed Saeed Hashemi Nazari
BACKGROUND: The estimate of mortality associated with illicit opiate use provides useful information to those directing and monitoring local, national and international policies and programs. This study investigated the epidemiology of mortality due to the illegal consumption of narcotics and psychotropic substances in the Iran to provide evidence-based public health data for useful programs and actions aimed at preventing drug-related mortality. STUDY DESIGN: A cross-sectional study...
October 14, 2017: Journal of Research in Health Sciences
Neal J Richmond
No abstract text is available yet for this article.
February 2017: JEMS: a Journal of Emergency Medical Services
Michael J Nooromid, Neel A Mansukhani, Benjamin W Deschner, Simon Moradian, Nabil Issa, Karen J Ho, Jonah J Stulberg
INTRODUCTION: Exposure to pain management curriculum in medical school is currently variable. This paper reports on formal prescribing education, self-perceived prescribing readiness, and prescribing practices among incoming surgical residents before and after a pain management training session. METHODS: Pre-residency survey of thirty surgical interns at a single urban medical center, followed by a repeat survey after an educational session on prescription writing and opioid abuse...
February 2018: American Journal of Surgery
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
Sophia D Becker, Daniel G Becker
PURPOSE OF REVIEW: We examine the current literature on pain management after sinus and nasal surgery. The goal after surgery is to provide effective pain management without having too many 'leftovers', as leftover medications are an important source of opioids that are fueling the current prescription narcotic epidemic in the United States. There are more than 250 000 sinus operations and 260 000 septoplasties performed annually, and surgeons commonly prescribe a narcotic pain medication for postoperative pain management...
February 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Justin Oltman, Oleg Militsakh, Mark D'Agostino, Brittany Kauffman, Robert Lindau, Andrew Coughlin, William Lydiatt, Daniel Lydiatt, Russell Smith, Aru Panwar
Importance: Perioperative analgesia strategies that rely solely on narcotics may contribute to adverse effects and concerns about opioid abuse or dependence. Multimodal analgesia protocols incorporating nonnarcotic agents may reduce the need for postoperative narcotic use. Objective: To evaluate the feasibility and safety of a multimodal analgesia protocol for outpatient head and neck surgical procedures and to identify the association of the multimodal analgesia protocol with postoperative pain perception scores and patient satisfaction...
October 19, 2017: JAMA Otolaryngology—Head & Neck Surgery
Alan L Gordon, Amy F Snyder
New Rhode Island regulations require physicians and other licensed practitioners to make significant adjustments to comply with new requirements for prescribing narcotics for chronic pain. Responding to the opioid epidemic, the new rules are intended to improve patient safety by changing physicians' prescribing patterns. However, the new rules may overlook the importance of treatment-access problems and the importance of buprenorphine products for treating pain and opioid dependence. Empirical data have demonstrated the safety and efficacy of buprenorphine in treating opioid-dependent patients with chronic pain, including those with and without substance abuse histories, but access to buprenorphine treatment remains limited throughout the state...
October 2, 2017: Rhode Island Medical Journal
Winfried Häuser, Tino Schubert, Norbert Scherbaum, Thomas Tölle
Recent evidence-based guidelines for long-term opioid therapy (LTOT) for chronic noncancer pain (CNCP) have defined daily morphine equivalent doses (MEQ/d) that require particular caution. The recommendation for a threshold MEQ/d is based on North American studies that have demonstrated negative health outcomes associated with high-dose LTOT for CNCP. We have conducted a retrospective cross-sectional study using an anonymized German health claims database, including 4,028,618 persons insured by 69 German statutory health insurances, representative of age and sex for the German population in 2014...
October 31, 2017: Pain
Alexandra Maas, Christoph Maier, Stefanie Iwersen-Bergmann, Burkhard Madea, Cornelius Hess
Besides its clinical application, the anaesthetic agent propofol is being increasingly misused, mostly by healthcare professionals, and its abuse potential gained worldwide attention after the tragic death of Michael Jackson in 2009. Due to the short duration of its narcotic effects, propofol abuse is especially easy to hide compared with the use of other recreational drugs. However, propofol possesses a very narrow therapeutic window between the desired effect and potentially fatal toxicity, making abuse of the drug extremely dangerous even in experienced physicians...
September 1, 2017: Journal of Pharmaceutical and Biomedical Analysis
Adam D Baruch, Daniel McBurney Morgan, Vanessa K Dalton, Carolyn Swenson
BACKGROUND: Despite the opioid epidemic in the U.S., little data exist to guide postoperative opioid prescribing in Obstetrics & Gynecology (Ob/Gyn). OBJECTIVE: To describe Ob/Gyn resident opioid prescription patterns in the U.S. and assess influential factors. METHODS: An anonymous survey was emailed to Ob/Gyn residents in the U.S. between January-February 2015. Respondents reported the typical number of discharge narcotic tablets prescribed following six common procedures...
September 1, 2017: Substance Use & Misuse
Tulika Bhattacharyya, Suhita Chopra Chatterjee, Dipannita Chand, Debolina Chatterjee, Jaydeep Sengupta
AIM: This study makes an assessment of end-of-life care of the elderly in private homes in Kolkata, West Bengal, India. PARTICIPANTS AND METHODS: Primary data were collected from private homes which supported elder care through observation and semi-structured interviews with primary family caregivers of the elderly. RESULTS: The study finds that the major factors preventing private homes from providing adequate care to the elderly were architecturally inadequate housing conditions, paucity of financial support, and scarcity of skilled caregivers...
July 2017: Indian Journal of Palliative Care
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