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https://www.readbyqxmd.com/read/29791013/frontline-science-buprenorphine-decreases-ccl2-mediated-migration-of-cd14-cd16-monocytes
#1
Matias Jaureguiberry-Bravo, Lillie Lopez, Joan W Berman
HIV infection of the CNS causes neuroinflammation and damage that contributes to the development of HIV-associated neurocognitive disorders (HAND) in greater than 50% of HIV-infected individuals, despite antiretroviral therapy (ART). Opioid abuse is a major risk factor for HIV infection. It has been shown that opioids can contribute to increased HIV CNS pathogenesis, in part, by modulating the function of immune cells. HIV enters the CNS within two weeks after peripheral infection by transmigration of infected monocytes across the blood brain barrier (BBB)...
May 23, 2018: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/29790360/-current-and-future-pharmacotherapy-of-severe-psychiatric-disorders
#2
Eva Češková
Despite of tremendous development in CNS research, current treatment is suboptimal especially in severe mental disorders. In medicine, there are two main methods of improving the healthcare provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring, but also implementation of general trends into the clinical practice. New pharmacological options include drugs aimed at other than monoaminergic systems and old drugs used before the psychopharmacological era...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29786898/adults-with-comorbid-posttraumatic-stress-disorder-alcohol-use-disorder-and-opioid-use-disorder-the-effectiveness-of-modified-prolonged-exposure
#3
Kelly R Peck, Julie A Schumacher, Paul R Stasiewicz, Scott F Coffey
Opioid use disorders (OUDs) are a growing problem in the United States. When OUDs co-occur with problematic drinking and posttraumatic stress disorder (PTSD), negative drug-related mental and physical health outcomes may be exacerbated. Thus, it is important to establish whether PTSD treatments with established efficacy for dually diagnosed individuals also demonstrate efficacy in individuals who engage in problematic drinking and concurrent opioid misuse. Adults who met DSM-IV-TR criteria for PTSD and alcohol dependence were recruited from a substance use treatment facility and were randomly assigned to receive either modified prolonged exposure (mPE) therapy for PTSD or a non-trauma-focused comparison treatment...
May 22, 2018: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29786144/self-initiated-use-of-topical-cannabidiol-oil-for-epidermolysis-bullosa
#4
Malcolm P Chelliah, Zachary Zinn, Phoung Khuu, Joyce M C Teng
Epidermolysis bullosa is a rare blistering skin disorder that is challenging to manage because skin fragility and repeated wound healing cause itching, pain, limited mobility, and recurrent infections. Cannabidiol, an active cannabinoid found in cannabis, is postulated to have antiinflammatory and analgesic effects. We report 3 cases of self-initiated topical cannabidiol use in patients with epidermolysis bullosa in an observational study. One patient was weaned completely off oral opioid analgesics. All 3 reported faster wound healing, less blistering, and amelioration of pain with cannabidiol use...
May 22, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29785888/the-impact-of-oprm1-s-genetic-polymorphisms-on-methadone-maintenance-treatment-in-opioid-addicts-a-systematic-review
#5
Bilel Oueslati, Olfa Moula, Rim Ghachem
AIM: Methadone is a long-acting opioid receptor agonist. It is prescribed to patients with opioid-related use disorders. The OPRM1 gene encodes for methadone's main receptor. It appears that polymorphisms in OPRM1 may affect the efficacy of methadone maintenance treatment (MMT). OBJECTIVE: Our purpose was to identify all relevant published papers dealing with the impact ofOPRM1's SNPs  on MMT's efficacy and to summarize results in order to evaluate the relevance of conducting pretherapeutic genotyping in opioid addicts prior to the onset of MMT...
May 22, 2018: Pharmacogenomics
https://www.readbyqxmd.com/read/29784237/quality-of-life-and-well-being-following-inpatient-and-partial-hospitalization-treatment-for-opioid-use-disorder
#6
Claire E Blevins, Ana M Abrantes, Megan E Kurth, Alan L Gordon, Michael D Stein
Treatment of opioid use disorder often begins with brief intensive inpatient or outpatient programs. Given the high relapse rates following intensive treatment, it is important to determine factors that lead to success post-discharge. Incorporating assessment during and early post-discharge may help determine such factors. The current study evaluated changes in quality of life among individuals during and after discharge from inpatient and partial hospitalization opiate treatment programs. Participants (n = 143) were recruited while in the programs and were re-assessed one month later (n = 113)...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29781876/postpartum-pain-management
#7
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29781244/oprm1-influence-on-and-effectiveness-of-an-individualized-treatment-plan-for-prescription-opioid-use-disorder-patients
#8
Javier Muriel, César Margarit, Beatriz Planelles, María J Serralta, Carmen Puga, María-Del-Mar Inda, Esperanza Cutillas, Domingo Morales, José F Horga, Ana M Peiró
Screening for opioid use disorder should be considered in chronic non-cancer pain (CNCP) patients with long-term use of opioids. The aim of our study was to assess the effectiveness of an individualized treatment plan (ITP) for prescription opioid dependence that included screening of pharmacogenetic markers. An observational prospective study was performed using prescription opioid-dependent CNCP outpatients (n = 88). Patients were divided into nonresponders, responders, or high responders according to their response to the ITP...
May 20, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29779547/policy-pathways-to-address-provider-workforce-barriers-to-buprenorphine-treatment
#9
Rebecca L Haffajee, Amy S B Bohnert, Pooja A Lagisetty
At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part of medication-assisted treatment has high potential to address this gap because of its approval for use in non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, less than 4% of licensed physicians are approved to prescribe buprenorphine for opioid use disorder, and approximately 47% of counties lack a buprenorphine-waivered physician...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779544/prescribing-practices-of-rural-physicians-waivered-to-prescribe-buprenorphine
#10
C Holly A Andrilla, Cynthia Coulthard, Davis G Patterson
INTRODUCTION: Opioid use disorder is a serious public health burden, especially throughout rural America. Although efforts have been made to increase the availability of buprenorphine (an office-based medication-assisted treatment), more than 60% of rural counties in the U.S. lack a physician with a Drug Enforcement Administration waiver to prescribe it. METHODS: This study surveyed all rural physicians with a Drug Enforcement Administration waiver in 2016 to prescribe buprenorphine for opioid use disorder in the U...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29778774/continuous-opioid-substitution-treatment-over-five-years-heroin-use-trajectories-and-outcomes
#11
Brian Eastwood, John Strang, John Marsden
BACKGROUND: This is the first national study in England of continuous long-term opioid substitution treatment (OST). METHODS: All adults were admitted to community OST for opioid use disorder (OUD) in 2008/09 with continuous enrolment to 2013/14 (n = 7719). Heroin use trajectories were identified by multilevel Latent Class Growth Analysis. In Year 6 and 7 of follow-up, the outcome measure (analysed by multilevel, multivariable logistic regression) was 'successful completion and no re-presentation' (SCNR) to community treatment within six months...
May 16, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29778009/exploring-opioid-use-disorder-its-impact-and-treatment-among-individuals-experiencing-homelessness-as-part-of-a-family
#12
Avik Chatterjee, Eun Jin Yu, Lindsay Tishberg
BACKGROUND: Opioid Use Disorder (OUD) causes significant morbidity and mortality among people experiencing homelessness. We aimed to explore the unique way in which OUD impacts individuals experiencing homelessness as part of a family. METHODS: We conducted semi-structured interviews with adults experiencing OUD staying in Boston-area family shelters along with dependent children. We used Borkan's Immersion-Crystallization method to uncover themes from interview transcripts...
May 12, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29776349/randomised-controlled-trial-rct-of-cannabinoid-replacement-therapy-nabiximols-for-the-management-of-treatment-resistant-cannabis-dependent-patients-a-study-protocol
#13
Anjali K Bhardwaj, David J Allsop, Jan Copeland, Iain S McGregor, Adrian Dunlop, Marian Shanahan, Raimondo Bruno, Nghi Phung, Mark Montebello, Craig Sadler, Jessica Gugusheff, Melissa Jackson, Jennifer Luksza, Nicholas Lintzeris
BACKGROUND: The cannabis extract nabiximols (Sativex®) effectively supresses withdrawal symptoms and cravings in treatment resistant cannabis dependent individuals, who have high relapse rates following conventional withdrawal treatments. This study examines the efficacy, safety and cost-effectiveness of longer-term nabiximols treatment for outpatient cannabis dependent patients who have not responded to previous conventional treatment approaches. METHODS/DESIGN: A phase III multi-site outpatient, randomised, double-blinded, placebo controlled parallel design, comparing a 12-week course of nabiximols to placebo, with follow up at 24 weeks after enrolment...
May 18, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29775955/posttraumatic-stress-disorder-and-chronic-pain-are-associated-with-opioid-use-disorder-results-from-a-2012-2013-american-nationally-representative-survey
#14
Elena Bilevicius, Jordana L Sommer, Gordon J G Asmundson, Renée El-Gabalawy
BACKGROUND: Chronic pain conditions and posttraumatic stress disorder (PTSD) commonly co-occur and are associated with opioid use disorder (OUD). The aims of this paper were to identify prevalence estimates of OUD among individuals with and without PTSD and assess independent and combined contributions of PTSD and chronic pain conditions on OUD in a nationally representative sample. METHODS: Data were extracted from 36,309 individuals from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions...
May 7, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29774442/integrated-models-of-care-for-individuals-with-opioid-use-disorder-how-do-we-prevent-hiv-and-hcv
#15
REVIEW
Katherine M Rich, Joshua Bia, Frederick L Altice, Judith Feinberg
PURPOSE OF REVIEW: To describe models of integrated and co-located care for opioid use disorder (OUD), hepatitis C (HCV), and HIV. RECENT FINDINGS: The design and scale-up of multidisciplinary care models that engage, retain, and treat individuals with HIV, HCV, and OUD are critical to preventing continued spread of HIV and HCV. We identified 17 models within primary care (N = 3), HIV specialty care (N = 5), opioid treatment programs (N = 6), transitional clinics (N = 2), and community-based harm reduction programs (N = 1), as well as two emerging models...
May 17, 2018: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/29771763/recognizing-diagnosing-and-preventing-child-maltreatment-an-update-for-pediatric-clinicians
#16
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
May 15, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29771745/national-institute-on-drug-abuse-international-program-improving-opioid-use-disorder-treatment-through-international-research-training
#17
Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29766293/nmda-receptor-subunits-change-in-the-prefrontal-cortex-of-pure-opioid-and-multi-drug-abusers-a-post-mortem-study
#18
Hamidreza Daneshparvar, Mitra-Sadat Sadat-Shirazi, Monir Fekri, Solmaz Khalifeh, Ali Ziaie, Nasrin Esfahanizadeh, Nasim Vousooghi, Mohammad-Reza Zarrindast
Addiction is a chronic relapsing disorder and is one of the most important issues in the world. Changing the level of neurotransmitters and the activities of their receptors, play a major role in the pathophysiology of substance abuse disorders. It is well-established that N-methyl-D-aspartate receptors (NMDARs) play a significant role in the molecular basis of addiction. NMDAR has two obligatory GluN1 and two regionally localized GluN2 subunits. This study investigated changes in the protein level of GluN1, GluN2A, and GluN2B in the prefrontal cortex of drug abusers...
May 16, 2018: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/29766017/outcomes-according-to-discharge-location-for-persons-who-inject-drugs-receiving-outpatient-parenteral-antimicrobial-therapy
#19
Helen T D'Couto, Gregory K Robbins, Kevin L Ard, Sarah E Wakeman, Justin Alves, Sandra B Nelson
Background: Opioid use disorder poses a significant public health risk. Persons who inject drugs (PWID) suffer from high mortality and morbidity secondary to serious infectious diseases, often requiring prolonged courses of outpatient parenteral antibiotics. The goal of this study was to determine the outcomes of PWID discharged to home or to a skilled nursing or rehabilitation facility (SNF/rehab) with parenteral antibiotic treatment under an outpatient parenteral antimicrobial therapy (OPAT) program...
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29764482/healthcare-costs-and-utilization-associated-with-high-risk-prescription-opioid-use-a-retrospective-cohort-study
#20
Hsien-Yen Chang, Hadi Kharrazi, Dave Bodycombe, Jonathan P Weiner, G Caleb Alexander
BACKGROUND: Previous studies on high-risk opioid use have only focused on patients diagnosed with an opioid disorder. This study evaluates the impact of various high-risk prescription opioid use groups on healthcare costs and utilization. METHODS: This is a retrospective cohort study using QuintilesIMS health plan claims with independent variables from 2012 and outcomes from 2013. We included a population-based sample of 191,405 non-elderly adults with known sex, one or more opioid prescriptions, and continuous enrollment in 2012 and 2013...
May 16, 2018: BMC Medicine
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