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Opioid withdrawal

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https://www.readbyqxmd.com/read/29053731/determination-of-%C3%AE-%C3%AE-and-%C3%AE%C2%BA-opioid-receptors-in-forebrain-cortex-of-rats-exposed-to-morphine-for-10-days-comparison-with-animals-after-20-days-of-morphine-withdrawal
#1
Hana Ujcikova, Martina Hlouskova, Kristina Cechova, Katerina Stolarova, Lenka Roubalova, Petr Svoboda
BACKGROUND: Chronic exposure of mammalian organism to morphine results in adaption to persistent high opioid tone through homeostatic adjustments. Our previous results indicated that in the frontal brain cortex (FBC) of rats exposed to morphine for 10 days, such a compensatory adjustment was detected as large up-regulation of adenylylcyclases I (8-fold) and II (2.5-fold). The other isoforms of AC (III-IX) were unchanged. Importantly, the increase of ACI and ACII was reversible as it disappeared after 20 days of morphine withdrawal...
2017: PloS One
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#2
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29047208/expression-of-aromatase-in-the-rostral-ventromedial-medulla-and-its-role-in-the-regulation-of-visceral-pain
#3
Po Gao, Xiao-Wei Ding, Li Dong, Ping Luo, Guo-Hua Zhang, Wei-Fang Rong
AIMS: Estrogens are known to exert a wide spectrum of actions on brain functions including modulation of pain. Besides the circulating estrogens produced mainly by the ovaries, many brain regions are also capable of de novo synthesizing estrogens, which may exert important modulatory effects on neuronal functions. This study was aimed to test the hypothesis that aromatase, the enzyme that catalyzes the conversion of testosterone to estradiols, may be distributed in the rostral ventromedial medulla (RVM), where it may impact on visceral pain...
October 18, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29046888/imaging-sex-differences-in-regional-brain-metabolism-during-acute-opioid-withdrawal
#4
Giovanni C Santoro, Joseph Carrion, Stephen L Dewey
The rate of opioid overdose continues to rise, necessitating improved treatment options. Current therapeutic approaches rely on administration of either a blocking agent, such as naloxone, or chronic treatment with replacement drugs, including methadone and/or buprenorphine. Recent findings suggest that males and females respond to these treatments uniquely. In an effort to better understand this sex-specific variation in treatment efficacy, we investigated the effects of acute opioid withdrawal in male and female rats using 18FDG and microPET...
April 2017: Journal of Alcoholism and Drug Dependence
https://www.readbyqxmd.com/read/29046747/ventricular-fibrillation-due-to-overdose-of-loperamide-the-poor-man-s-methadone
#5
Amr Salama, Yana Levin, Pramod Jha, Richard Alweis
Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29045256/a-quality-improvement-initiative-to-increase-scoring-consistency-and-accuracy-of-the-finnegan-tool-challenges-in-obtaining-reliable-assessments-of-drug-withdrawal-in-neonatal-abstinence-syndrome
#6
Wendy Timpson, Cheryl Killoran, Louise Maranda, Alan Picarillo, Elisabeth Bloch-Salisbury
BACKGROUND: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses. METHODS: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale...
October 17, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29045243/use-of-ketamine-in-a-multimodal-analgesia-setting-for-rapid-opioid-tapering-in-a-profoundly-opioid-tolerant-patient-a-case-report
#7
Elise M Strickler, Eric S Schwenk, Mitchell J Cohen, Eugene R Viscusi
Opioids are frequently used for the treatment of chronic pain, and patients taking high doses are at increased risk of complications and adverse opioid-related events. Ketamine is appealing as an opioid adjunct because of its lack of respiratory depression and potential prevention of hyperalgesia and central sensitization. We present a case in which a ketamine infusion was utilized over a 7-day period to provide rapid taper of a daily dose of 400 mg of morphine equivalents to less than one-third of that dose on discharge with unchanged pain levels and no symptoms of opioid withdrawal...
October 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29038236/efficacy-of-prophylactic-treatment-for-oxycodone-induced-nausea-and-vomiting-among-patients-with-cancer-pain-point-a-randomized-placebo-controlled-double-blind-trial
#8
Hiroaki Tsukuura, Masayuki Miyazaki, Tatsuya Morita, Mihoko Sugishita, Hiroshi Kato, Yuka Murasaki, Bishal Gyawali, Yoko Kubo, Masahiko Ando, Masashi Kondo, Kiyofumi Yamada, Yoshinori Hasegawa, Yuichi Ando
BACKGROUND: Although opioid-induced nausea and vomiting (OINV) often result in analgesic undertreatment in patients with cancer, no randomized controlled trials have evaluated the efficacy of prophylactic antiemetics for preventing OINV. We conducted this randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of prophylactic treatment with prochlorperazine for preventing OINV. MATERIALS AND METHODS: Cancer patients who started to receive oral oxycodone were randomly assigned in a 1:1 ratio to receive either prochlorperazine 5 mg or placebo prophylactically, given three times daily for 5 days...
October 16, 2017: Oncologist
https://www.readbyqxmd.com/read/29035918/dopaminergic-mechanisms-in-periaqueductal-gray-mediated-antinociception
#9
Glaucia Tobaldini, Rafael A Reis, Natalia F Sardi, Mayla K Lazzarim, Dabna H Tomim, Marcelo M S Lima, Luana Fischer
As important as perceiving pain is the ability to modulate this perception in some contextual salient situations. The periaqueductal gray (PAG) is perhaps the most important site of endogenous pain modulation; however, little is known about dopaminergic mechanisms underlying PAG-mediated antinociception. In this study, we used a pharmacological approach to evaluate this subject. We found that µ-opioid receptor-induced antinociception (DAMGO, 0.3 μg) from PAG was blocked by the coadministration of either D1-like or D2-like dopaminergic antagonists (SCH23390, 2, 4, and 6 μg or raclopride, 2 and 4 μg, respectively) both in the tail-flick and in the mechanical paw-withdrawal test...
October 13, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/29024875/social-networking-online-to-recover-from-opioid-use-disorder-a-study-of-community-interactions
#10
Alexandra R D'Agostino, Allison R Optican, Shaina J Sowles, Melissa J Krauss, Kiriam Escobar Lee, Patricia A Cavazos-Rehg
BACKGROUND: Social media has increasingly become a venue for health discourse and support, particularly for vulnerable individuals. This study examines user-generated content of an online Reddit community targeting individuals recovering from opiate addiction. METHODS: 100 Reddit posts and their comments were collected from the online community on August 19, 2016. Posts were qualitatively coded for opioid use disorder (OUD) criteria as outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as well as other common themes...
October 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29024786/neurobiological-correlates-of-pain-avoidance-like-behavior-in-morphine-dependent-and-non-dependent-rats
#11
Amanda R Pahng, Rod I Paulsen, M Adrienne McGinn, Kimberly N Edwards, Scott Edwards
Repeated use of opioids can lead to the development of analgesic tolerance and dependence. Additionally, chronic opioid exposure can cause a paradoxical emergence of heightened pain sensitivity to noxious stimuli, termed hyperalgesia, which may drive continued or escalated use of opioids to manage worsening pain symptoms. Opioid-induced hyperalgesia has traditionally been measured in rodents via reflex-based assays, including the von Frey method. To better model the cognitive/motivational dimension of pain in a state of opioid dependence and withdrawal, we employed a recently developed non-reflex-based method for measuring pain avoidance-like behavior in animals (mechanical conflict avoidance test)...
October 9, 2017: Neuroscience
https://www.readbyqxmd.com/read/29021111/exploring-mortality-among-drug-treatment-clients-the-relationship-between-treatment-type-and-mortality
#12
Belinda Lloyd, Renee Zahnow, Monica J Barratt, David Best, Dan I Lubman, Jason Ferris
AIMS: Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. METHODS: A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28974443/toxicological-aspects-of-the-interesterified-fat-from-processed-foods-influences-on-opioid-system-and-its-reward-effects-in-rats
#13
Laura H Milanesi, Karine Roversi, Caren T D Antoniazzi, Hecson J Segat, Maikel Kronbauer, Lívia F D'avila, Verônica T Dias, Marcel H M Sari, Raquel C S Barcelos, Luana H Maurer, Tatiana Emanuelli, Marilise E Burger, Fabíola Trevizol
Considering the high consumption of processed foods, interesterified fat (IF) has been used to replace trans fat, since it may harm nervous system functions. Opioids are intensely used to alleviate pain, and have a highly addictive potential. Therefore, their improper use is related to addiction, tolerance, and withdrawal syndrome. Wistar rats received soybean oil (SO) or IF during gestation, lactation and post-weaning until pups' adolescence. On post-natal day 39, animals received morphine (4 mg/kg i.p.) in the conditioned place preference (CPP) paradigm...
September 30, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28971229/role-of-the-guanine-nucleotide-binding-protein-g%C3%AE-o-in-the-development-of-morphine-tolerance-and-dependence
#14
Jennifer T Lamberts, Lisa D Rosenthal, Emily M Jutkiewicz, John R Traynor
RATIONALE: The use of morphine and other opioids for chronic pain is limited by the development of analgesic tolerance and physical dependence. Morphine produces its effects by activating the μ opioid receptor, which couples to Gαi/o-containing heterotrimeric G proteins. Evidence suggests that the antinociceptive effects of morphine are mediated by Gαo. However, the role of Gαo in the development of morphine tolerance and dependence is unknown. OBJECTIVE: The objective of the study is to evaluate the contribution of Gαo to the development of morphine tolerance and dependence in mice...
October 3, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28968171/randomized-phase-iii-and-extension-studies-of-naldemedine-in-patients-with-opioid-induced-constipation-and-cancer
#15
Nobuyuki Katakami, Toshiyuki Harada, Toru Murata, Katsunori Shinozaki, Masakazu Tsutsumi, Takaaki Yokota, Masatsugu Arai, Yukio Tada, Masaru Narabayashi, Narikazu Boku
Purpose Opioid-induced constipation (OIC) is a frequent and debilitating adverse effect (AE) of opioids-common analgesics for cancer pain. We investigated the efficacy and safety of a peripherally acting μ-opioid receptor antagonist, naldemedine (S-297995), for OIC, specifically in patients with cancer. Patients and Methods This phase III trial consisted of a 2-week, randomized, double-blind, placebo-controlled study (COMPOSE-4) and an open-label, 12-week extension study (COMPOSE-5). In COMPOSE-4, eligible adults with OIC and cancer were randomly assigned on a 1:1 basis to receive once-daily oral naldemedine 0...
October 2, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28967123/antidepressant-like-effects-of-bu10119-a-novel-buprenorphine-analogue-with-mixed-kappa-mu-opioid-receptor-antagonist-properties-in-mice
#16
Abdulrahman Almatroudi, Mehrnoosh Ostovar, Christopher P Bailey, Stephen M Husbands, Sarah J Bailey
BACKGROUND AND PURPOSE: Κ-opioid receptor antagonists have potential for treating neuropsychiatric disorders. We have investigated the in vivo pharmacology of a novel buprenorphine analogue, BU10119, for the first time. EXPERIMENTAL APPROACH: To determine the opioid pharmacology of BU10119 (0.3-3 mg/kg, i.p.) in vivo, the warm-water tail withdrawal assay was used in adult male CD1 mice. A range of behavioural paradigms was used to investigate the locomotor effects, rewarding properties and antidepressant or anxiolytic potential of BU10119...
October 1, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28965335/pregabalin-use-among-users-of-illicit-drugs-a-cross-sectional-survey-in-southern-germany
#17
Brendan J Snellgrove, Tilman Steinert, Susanne Jaeger
BACKGROUND: The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). OBJECTIVE: Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. METHODS: We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013...
September 30, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28956316/anesthetic-implications-of-recreational-drug-use
#18
Pierre Beaulieu
PURPOSE: As the use of recreational drugs increases, the likelihood of an anesthesiologist perioperatively encountering patients using or addicted to these drugs will also increase. PRINCIPAL FINDINGS: Addicted patients may present for anesthetic care in a variety of circumstances in everyday elective surgeries or in acute or life-saving situations, such as emergency Cesarean delivery or trauma surgery. Therefore, it is important for anesthesiologists to know about the most common illicit drugs being used, their clinical presentation and side effects, and the anesthetic options that are beneficial or detrimental to these patients...
September 27, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28952972/acute-opiate-overdose-an-update-on-management-strategies-in-emergency-department-and-critical-care-unit
#19
Rukma Parthvi, Abhinav Agrawal, Sameer Khanijo, Adey Tsegaye, Arunabh Talwar
BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide...
September 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28950240/prevalence-and-motivations-for-kratom-use-in-a-sample-of-substance-users-enrolled-in-a-residential-treatment-program
#20
Kirsten Elin Smith, Thomas Lawson
BACKGROUND: Kratom use in the West has increased recently, yet the prevalence and motives for use among individuals with a history of substance use disorder (SUD) have not been fully examined. Kratom has been documented as a means of treating chronic pain, mitigating drug dependence, and easing withdrawal symptoms, yet it is unclear if substance users are utilizing kratom as a self-medication. Abuse liability, side effects, and overall appeal of kratom remain uncertain. METHODS: In April 2017, an anonymous survey regarding kratom use and motivations was completed by clients enrolled in a 12-Step-oriented residential program...
September 20, 2017: Drug and Alcohol Dependence
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