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https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#1
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28496355/cannabis-as-a-substitute-for-prescription-drugs-a-cross-sectional-study
#2
James M Corroon, Laurie K Mischley, Michelle Sexton
BACKGROUND: The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. METHODS: A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28455085/randomized-controlled-trial-of-intravenous-acetaminophen-for-postcesarean-delivery-pain-control
#3
Brie Altenau, Catrina C Crisp, C Ganga Devaiah, Donna S Lambers
BACKGROUND: Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009.(1) Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. OBJECTIVE: The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28317510/predictors-and-outcomes-of-twelve-step-sponsorship-of-stimulant-users-secondary-analyses-of-a-multisite-randomized-clinical-trial
#4
Dennis C Wendt, Kevin A Hallgren, Dennis C Daley, Dennis M Donovan
OBJECTIVE: This secondary data analysis explored predictors and outcomes of having a 12-step sponsor among individuals receiving treatment for stimulant use disorders, inclusive of four types of 12-step groups (Narcotics Anonymous, Alcoholics Anonymous, Cocaine Anonymous, and Crystal Meth Anonymous). METHOD: For a multisite randomized clinical trial, participants (N = 471; 59% women) were recruited among adult patients in 10 U.S. community treatment programs. Participants were randomized into treatment as usual (TAU) or a 12-step facilitation (TSF) intervention: Stimulant Abuser Groups to Engage in 12-Step (STAGE-12)...
March 2017: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/28314070/long-lasting-effects-of-chronic-heavy-cannabis-abuse
#5
Joannis N Nestoros, Elena Vakonaki, Manolis N Tzatzarakis, Athanasios Alegakis, Markos D Skondras, Aristidis M Tsatsakis
BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the extent of short-term memory impairment and schizophrenia-like symptoms in heavy and systematic cannabis users and the association between the severity of abuse and the longevity of its persistent symptoms after refraining from such use. METHODS: A complete psychiatric examination and a psychometric evaluation were performed in 48 solely cannabis users. Additionally, head hair samples were analyzed and the detected cannabinoids levels were correlated with the psychometric findings...
June 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#6
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28292504/pharmacists-perceptions-regarding-the-impact-of-hydrocodone-rescheduling-on-prescription-volume-workflow-management-and-patient-outcomes
#7
Tyler J Varisco, Motolani E Ogunsanya, Jamie C Barner, Marc L Fleming
OBJECTIVES: To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling. DESIGN: A cross-sectional mail survey. SETTING: Texas community pharmacies from October to December 2015...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28290530/identifying-life-threatening-admissions-for-drug-dependence-or-abuse-iliadda-derivation-and-validation-of-a-model
#8
Tri-Long Nguyen, Thierry Boudemaghe, Géraldine Leguelinel-Blache, Céline Eiden, Jean-Marie Kinowski, Yannick Le Manach, Hélène Peyrière, Paul Landais
Given that drug abuse and dependence are common reasons for hospitalization, we aimed to derive and validate a model allowing early identification of life-threatening hospital admissions for drug dependence or abuse. Using the French National Hospital Discharge Data Base, we extracted 66,101 acute inpatient stays for substance abuse, dependence, mental disorders or poisoning associated with medicines or illicit drugs intake, recorded between January 1(st), 2009 and December 31(st), 2014. We split our study cohort at the center level to create a derivation cohort and a validation cohort...
March 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28240756/assessment-and-therapeutic-choice-in-septic-arthritis-of-the-hip-in-an-intravenous-drug-abuser-case-report-at-14-years-follow-up-and-review-of-literature
#9
REVIEW
P Persiani, F M Ranaldi, O Mazza, A Calistri, M Bove, M Crostelli, C Villani
INTRODUCTION: Osteoarticular infections are found frequently in drug addicted individuals, representing one of the main reasons for their hospitalization. Through inoculation, the pathogenic agents can enter the individual's system directly through the skin or parenterally, transmitted, that is, through syringes and other objects used during such practice. In these particular conditions, or when the medical history is vague, a warranted suspicion and the execution of targeted research can help in the diagnosis of high-risk patients such as addicts...
January 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28191368/a-rare-case-of-adult-onset-intussusception-complicated-by-narcotic-dependence
#10
Saira J Khan, Ashley M Desmarais, Bellal Joseph, Richard Amini
This report describes a rare case of adult intussusception in a patient with a history of a Roux-en-Y gastric bypass procedure; complicated by a history of narcotic abuse, methadone dependence, and methamphetamine abuse. Adult patients who have undergone a Roux-en-Y gastric bypass procedure may be at an increased risk of developing intussusception, and clinicians involved in their care should be aware of this potential complication.
January 8, 2017: Curēus
https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-nonheroin-opioid-overdoses-experience-at-an-academic-medical-center
#11
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Martin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and nonheroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. DESIGN: Retrospective cohort study. SETTING: Large academic medical center. PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28050185/comparing-acceptance-and-commitment-group-therapy-and-12-steps-narcotics-anonymous-in-addict-s-rehabilitation-process-a-randomized-controlled-trial
#12
Manoochehr Azkhosh, Ali Farhoudianm, Hemn Saadati, Fateme Shoaee, Leila Lashani
Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz...
October 2016: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/27899527/biased-agonists-of-the-kappa-opioid-receptor-suppress-pain-and-itch-without-causing-sedation-or-dysphoria
#13
Tarsis F Brust, Jenny Morgenweck, Susy A Kim, Jamie H Rose, Jason L Locke, Cullen L Schmid, Lei Zhou, Edward L Stahl, Michael D Cameron, Sarah M Scarry, Jeffrey Aubé, Sara R Jones, Thomas J Martin, Laura M Bohn
Agonists targeting the kappa opioid receptor (KOR) have been promising therapeutic candidates because of their efficacy for treating intractable itch and relieving pain. Unlike typical opioid narcotics, KOR agonists do not produce euphoria or lead to respiratory suppression or overdose. However, they do produce dysphoria and sedation, side effects that have precluded their clinical development as therapeutics. KOR signaling can be fine-tuned to preferentially activate certain pathways over others, such that agonists can bias signaling so that the receptor signals through G proteins rather than other effectors such as βarrestin2...
November 29, 2016: Science Signaling
https://www.readbyqxmd.com/read/27881618/simultaneous-screening-and-quantification-of-basic-neutral-and-acidic-drugs-in-blood-using-uplc-qtof-ms
#14
Sergei Bidny, Kim Gago, Phuong Chung, Desdemona Albertyn, Daniel Pasin
An analytical method using ultra performance liquid chromatography (UPLC) quadrupole time-of-flight mass spectrometry (QTOF-MS) was developed and validated for the targeted toxicological screening and quantification of commonly used pharmaceuticals and drugs of abuse in postmortem blood using 100 µL sample. It screens for more than 185 drugs and metabolites and quantifies more than 90 drugs. The selected compounds include classes of pharmaceuticals and drugs of abuse such as: antidepressants, antipsychotics, analgesics (including narcotic analgesics), anti-inflammatory drugs, benzodiazepines, beta-blockers, amphetamines, new psychoactive substances (NPS), cocaine and metabolites...
April 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27842782/narcotic-analgesics-and-common-drugs-of-abuse-clinical-correlations-and-laboratory-assessment
#15
REVIEW
Martin H Bluth, Matthew R Pincus
Pain management is an evolving discipline. New formulations mature with promises of improved pain control, better dosing, and fewer side effects. These agents also have an equal risk for abuse. Street chemists are adept at manipulating drugs to more potent versions and creating new compositions of matter. The clinical assessment of the patient is paramount to developing an index of suspicion of overdose, toxicity, or illicit drug use; the clinical laboratory can be a resource to support investigations and guide therapy...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27747546/restraint-use-and-risky-driving-behaviors-across-drug-types-and-drug-and-alcohol-combinations-for-drivers-involved-in-a-fatal-motor-vehicle-collision-on-u-s-roadways
#16
Chang Liu, Yanlan Huang, Joyce C Pressley
BACKGROUND: While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. METHODS: The Fatality Analysis Reporting System (FARS) for 2008-2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932)...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27687421/the-novel-use-of-different-bupivacaine-preparations-with-combined-regional-techniques-for-postoperative-pain-management-in-non-opioid-based-laparoscopic-inguinal-herniorrhaphy
#17
Andrew C Eppstein, Bryan Sakamoto
Opioids are important for surgical pain control but may not be appropriate for patients with narcotic abuse histories or opioid intolerance. We describe a laparoscopic bilateral inguinal herniorrhaphy performed without perioperative or postoperative narcotics. Postoperative analgesia involves a novel technique using 2 different bupivacaine formulations that act synergistically to avoid lag time and provide extended pain relief during the acute surgical recovery phase.
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27670346/synthetic-and-natural-nutritional-supplements-health-allies-or-risk-to-public-health
#18
Nassia Kioukia-Fougia, Nikolaos Georgiadis, Konstantinos Tsarouhas, Fotini Vasilaki, Persefoni Fragkiadaki, Evangelia Meimeti, Christina Tsitsimpikou
BACKGROUND: The modern way of life involves high stress levels, poor eating habits, lack of exercise, obesity and other detrimental health factors. Nutritional supplements (NS) are complexes of nutrients with variant activity that may infer reversal to nutrient depletion. They tend to be popular amongst social categories associated with the healthy life style, such as the elite and amateur athletes, military people and the general population. OBJECTIVE: An overview of the state of play with regards to nutritional supplements -natural and synthetic-, is important both from toxicological and commercial point of view...
September 23, 2016: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/27549364/prescription-reporting-with-immediate-medication-utilization-mapping-primum-development-of-an-alert-to-improve-narcotic-prescribing
#19
Rachel B Seymour, Daniel Leas, Meghan K Wally, Joseph R Hsu
BACKGROUND: Prescription narcotic overdoses and abuse have reached alarming numbers. To address this epidemic, integrated clinical decision support within the electronic medical record (EMR) to impact prescribing behavior was developed and tested. METHODS: A multidisciplinary Expert Panel identified risk factors for misuse, abuse, or diversion of opioids or benzodiazepines through literature reviews and consensus building for inclusion in a rule within the EMR. We ran the rule "silently" to test the rule and collect baseline data...
August 22, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27507659/birth-order-and-hospitalization-for-alcohol-and-narcotics-use-in-sweden
#20
Kieron Barclay, Mikko Myrskylä, Per Tynelius, Daniel Berglind, Finn Rasmussen
BACKGROUND: Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. METHODS: We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings...
October 1, 2016: Drug and Alcohol Dependence
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