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Opioid withdrawal

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https://www.readbyqxmd.com/read/29239457/opioids-and-immunosupression-in-oncological-postoperative-patients
#1
José Luis Bonilla-García, Manuel Cortiñas-Sáenz, Esperanza Del Pozo-Gavilán
INTRODUCTION: Recent animal studies demonstrated immunosuppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anesthesia Care Unit (PACU)-acquired infection after a schedule of sedoanalgesia of at least 6 days. METHOD: All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29236562/from-narcotic-to-normalizer-the-misperception-of-methadone-treatment-and-the-persistence-of-prejudice-and-bias
#2
Joycelyn Sue Woods, Herman Joseph
This article concentrates on methadone maintenance as a normalizer for the impairments of opioid addiction, and the misunderstandings of it as a substitute for heroin that continues an opiate addiction. Methadone treatment was developed by Drs. Dole, Nyswander, and Kreek. Their cutting-edge theory transformed the way that opioid addiction is perceived and their work changed methadone from a narcotic to withdraw addicts to a medication that is a maintenance normalizer for a chronic condition. Their extensive research involved the physiological and sociological normalizing effects of methadone and medical safety of the medication (Dole & Nyswander, 1967)...
December 13, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29231613/-effects-of-electroacupuncture-on-expression-of-%C3%AE-opioid-receptor-in-nucleus-ceruleus-in-rats-with-bone-cancer-pain-morphine-tolerance
#3
Taofang Fu, Lingling Wang, Junying Du, Feng Chen, Junfan Fang, Yi Liang, Jianqiao Fang
OBJECTIVE: To observe the effects of electroacupuncture (EA) on pain behavior in rats with bone cancer pain and morphine tolerance, and to explore partial action mechanism. METHODS: Forty-two SD healthy female rats were randomly divided into a sham operation group (7 rats), a bone cancer pain group (8 rats), a morphine tolerance group (9 rats), an EA group (9 rats) and a sham EA group (9 rats). The rats in the sham operation group were treated with injection of phosphate buffer saline at medullary cavity of left-side tibia, and the rats in the remaining groups were injected with MRMT-1 breast cancer cells...
May 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29231146/comparison-of-two-naloxone-regimens-in-addicted-methadone-overdosed-patients-a-clinical-trial-study
#4
Navid Khosravi, Nasim Zamani, Hossein Hassanian-Moghaddam, Ali Ostadi, Mitra Rahimi, Ali Kabir
BACKGROUND: Methadone toxicity is one of the major causes of death in opioid dependent individuals. OBJECTIVE: We aimed to compare two different protocols for naloxone in terms of reversal of overdose and frequency of complications in opioid-dependent methadone-intoxicated patients. METHODS: One-hundred opioid-dependent patients with signs/symptoms of methadone overdose were included. The patients were consecutively assigned into Tintinalli (group 1) or Goldfrank regimen protocol (group 2) of naloxone administration...
December 11, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29226017/buprenorphine-for-medication-assisted-treatment-of-opioid-use-disorder-in-pregnancy-relationship-to-neonatal-opioid-withdrawal-syndrome
#5
Niraj R Chavan, Kristin B Ashford, Amanda T Wiggins, Michelle R Lofwall, Agatha S Critchfield
Objective  To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design  We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups-pregnancies with versus without NOWS...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29223953/potential-role-for-acupuncture-in-the-treatment-of-food-addiction-and-obesity
#6
Jason Aaron Chen, Justin Albert Chen, Sanghoon Lee, Gerard Mullin
Addressing the global obesity epidemic requires innovative approaches that are also acceptable to affected individuals. There is growing evidence suggesting that food addiction, one contributor to obesity, bears many similarities to drug and alcohol addiction, presenting a potential role for addiction-focused acupuncture as a novel treatment modality. In this perspective article, we begin by briefly reviewing the evidence linking food and drug/alcohol addiction. We then describe the development of an acupuncture-based protocol for treating opioid addiction in Hong Kong in the 1970s and discuss the evidence base for acupuncture's efficacy in treating a range of substance use disorders...
December 9, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29219048/sodium-oxybate-therapy-for-the-treatment-of-alcohol-withdrawal-syndrome-and-the-maintenance-of-alcohol-abstinence
#7
Carmen Mannucci, Simona Pichini, Elvira Ventura Spagnolo, Fabrizio Calapai, Sebastiano Gangemi, Michele Navarra, Gioacchino Calapai
BACKGROUND: Gamma-hydroxybutyrate (GHB or sodium oxybate) is both an exogenous and endogenous molecule with neuromodulator properties. In the United States, GHB is an approved drug for the treatment of narcolepsy and narcolepsy with cataplexy in adults. In some European Union countries, sodium oxybate is applied for the treatment of opioid and alcohol withdrawal. OBJECTIVE: The aim of the present review was to describe the state of art of the pre-clinical research and the clinical evidence related to GHB used alone or in combination with other treatments in alcohol withdrawal syndrome and alcohol abstinence maintenance...
December 7, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/29208190/preventing-blood-borne-virus-infection-in-people-who-inject-drugs-in-the-uk-systematic-review-stakeholder-interviews-psychosocial-intervention-development-and-feasibility-randomised-controlled-trial
#8
Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, Noreen Mdege, John Strang, Avril Taylor, Judith Watson
BACKGROUND: Opioid substitution therapy and needle exchanges have reduced blood-borne viruses (BBVs) among people who inject drugs (PWID). Some PWID continue to share injecting equipment. OBJECTIVES: To develop an evidence-based psychosocial intervention to reduce BBV risk behaviours and increase transmission knowledge among PWID, and conduct a feasibility trial among PWID comparing the intervention with a control. DESIGN: A pragmatic, two-armed randomised controlled, open feasibility trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29207895/nonpharmacological-management-of-neonatal-abstinence-syndrome-a-review-of-the-literature
#9
Gareth Ryan, Anishnaabe Bimaadiziwin, Joe Dooley, Lianne Gerber Finn, Len Kelly
BACKGROUND: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives. Although commonly employed effectively in neonatal care, there is a lack of published information regarding nonpharmacological management of the NAS infant. OBJECTIVE: The purpose of this review was to summarize the current literature on nonpharmacological management of NAS...
December 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29200566/opioid-withdrawal-presenting-as-delirium-and-role-of-buprenorphine-a-case-series
#10
Sourav Das, Divyashree Sah, Shiladitya Nandi, Payel Das
Opioid withdrawal is very rarely characterized by delirium unlike alcohol or benzodiazepine withdrawal. PubMed search through October 2016 reveals only two case series on delirium as feature of withdrawal in opioid dependence syndrome. We report two cases of opioid withdrawal (heroin) presenting with delirium when low-dose buprenorphine (2 mg/day) was added. Both the cases had no other substance abuse history and nil contributory past and family history. Both of them were improved after increasing the buprenorphine dosage to 6-8 mg/day...
September 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/29196208/eradicate-a-prospective-evaluation-combining-radium-223-dichloride-and-abiraterone-acetate-plus-prednisone-in-patients-with-castration-resistant-prostate-cancer
#11
Neal D Shore, Ronald F Tutrone, Neil F Mariados, Luke T Nordquist, Bryan A Mehlhaff, Karyn J Steere, Stacey S Harrelson
BACKGROUND: Multiple castration-resistant prostate cancer (CRPC) therapies are approved by the United States Food and Drug Administration. Radium-223 dichloride (Ra-223) with abiraterone acetate plus prednisone have different mechanisms of action and distinct off-target side-effect profiles. We prospectively investigated their combined safety, tolerability, and patient-reported outcome measures. PATIENTS AND METHODS: eRADicAte, an investigator-initiated, phase II trial, studied 31 patients with metastatic CRPC, from 5 United States uro-oncology research sites...
November 7, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29183835/antinociceptive-effects-of-mixtures-of-mu-opioid-receptor-agonists-and-cannabinoid-receptor-agonists-in-rats-impact-of-drug-and-fixed-dose-ratio
#12
David R Maguire, Charles P France
Pain is a significant clinical problem, and there is a need for effective pharmacotherapies with fewer adverse effects than currently available drugs (e.g., mu opioid receptor agonists). Cannabinoid receptor agonists enhance the antinociceptive effects of mu opioid receptor agonists, but it remains unclear which drugs and in what proportion will yield the most effective and safest treatments. The antinociceptive effects of the mu opioid receptor agonists etorphine and morphine alone and in combination with the cannabinoid receptor agonists Δ9-THC and CP55940 were studied in male Sprague-Dawley rats (n=16) using a warm water tail withdrawal procedure...
November 25, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29180560/dysrhythmias-with-loperamide-used-for-opioid-withdrawal
#13
Nicki D Vithalani, Christopher Heron, Ravishankar E Rao, Anthony F Cardell, Mark B Stephens
The antidiarrheal loperamide has had a recent, drastic increase in off-label use as an alternative treatment for symptoms of opioid withdrawal. The concept of this is easily discovered on the Internet and social media, where there are multiple blogs and forums promoting loperamide use at doses of 70 to 200 mg per day. Unfortunately, the serious side effects are not well recognized. Multiple cases of cardiac dysrhythmias contributing to death have been highlighted in recent literature. In November 2016, the US Food & Drug Administration released a statement highlighting the potential heart effects and risk of death with high doses of loperamide...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29179227/-on-the-risk-of-dependence-on-gabapentinoids
#14
Udo Bonnet, Norbert Scherbaum
In the last ten years, the prescriptions of the gabapentinoids gabapentin and pregabalin increased largely also in Germany. Since several national and international pharmacovigilance-databases have warned for abuse liabilities and overdose fatalities in association with both gabapentinoids, which moreover, became to be sold on internet and black-markets, their addictive power has been subject to an ongoing clinical debate. As pre- and post-approval clinical trials did not reveal significant signs of dependence on gabapentin or pregabalin, we systematically searched in PubMed and Scopus for clinical studies and case reports being associated with abuse of and dependence on these drugs...
November 27, 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29159398/cost-effectiveness-of-publicly-funded-treatment-of-opioid-use-disorder-in-california
#15
Emanuel Krebs, Benjamin Enns, Elizabeth Evans, Darren Urada, M Douglas Anglin, Richard A Rawson, Yih-Ing Hser, Bohdan Nosyk
Background: Only 1 in 5 of the nearly 2.4 million Americans with an opioid use disorder received treatment in 2015. Fewer than half of Californians who received treatment in 2014 received opioid agonist treatment (OAT), and regulations for admission to OAT in California are more stringent than federal regulations. Objective: To determine the cost-effectiveness of OAT for all treatment recipients compared with the observed standard of care for patients presenting with opioid use disorder to California's publicly funded treatment facilities...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#16
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29146238/ccr5-mediates-hiv-1-tat-induced-neuroinflammation-and-influences-morphine-tolerance-dependence-and-reward
#17
Maciej Gonek, Virginia D McLane, David L Stevens, Kumiko Lippold, Hamid I Akbarali, Pamela E Knapp, William L Dewey, Kurt F Hauser, Jason J Paris
The HIV-1 regulatory protein, trans-activator of transcription (Tat), interacts with opioids to potentiate neuroinflammation and neurodegeneration within the CNS. These effects may involve the C-C chemokine receptor type 5 (CCR5); however, the behavioral contribution of CCR5 on Tat/opioid interactions is not known. Using a transgenic murine model that expresses HIV-1 Tat protein in a GFAP-regulated, doxycycline-inducible manner, we assessed morphine tolerance, dependence, and reward. To assess the influence of CCR5 on these effects, mice were pretreated with oral vehicle or the CCR5 antagonist, maraviroc, prior to morphine administration...
November 13, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29143399/buprenorphine-naloxone-treatment-responses-differ-between-young-adults-with-heroin-and-prescription-opioid-use-disorders
#18
Mauricio Romero-Gonzalez, Abtin Shahanaghi, Gregory J DiGirolamo, Gerardo Gonzalez
BACKGROUND AND OBJECTIVES: Opioid use disorder among young adults is rising sharply with an increase in morbidity and mortality. This study examined differences in treatment response to a fixed dose of buprenorphine-naloxone between heroin (HU) and prescriptions opioids (POU) users. METHODS: Eighty opioid dependent young adults (M = 22 years) were treated with buprenorphine-naloxone 16-4 mg/day for 8 weeks. Differences between HU (N = 17) and POU (N = 63) on changes in weekly opioid use, opioid craving, withdrawal, and depression symptoms were analyzed with mixed-effects regression models...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29142795/comorbid-post-traumatic-stress-disorder-and-opioid-dependence
#19
Rikinkumar S Patel, Ahmed Elmaadawi, Suhayl Nasr, John Haskin
Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29134978/testicular-and-epididymal-histology-of-rats-chronically-administered-high-doses-of-phosphodiesterase-5-inhibitors-and-tramadol
#20
Victor U Nna, Augustine L Udefa, Emmanuel O Ofutet, Eme O Osim
Testicular oxidative stress, endocrine disruption and abnormal spermatogenesis in rats exposed to high doses ofphosphodiesterase-5 inhibitors (PDE5i) and opioids, with poor reversibility following withdrawal of treatment had beenreported. In this study, we examined the histopathological effects of high doses of sildenafil, tadalafil, tramadol andsildenafil+tramadol on the testes and epididymis of rats. Seventy male rats (180 - 200 g b.w) were assigned to one of fivegroups (n = 14), namely; A: control (0.2 mL normal saline), B: sildenafil (1 mg/100g b...
June 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
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