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Opioid use disorder

Soteri Polydorou, Stephen Ross, Peter Coleman, Laura Duncan, Nichole Roxas, Anil Thomas, Sonia Mendoza, Helena Hansen
OBJECTIVES: This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS: This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Santhanalakshmi Sundaramurthy, Balasubramaniam Annamalai, Devadoss J Samuvel, Toni S Shippenberg, Lankupalle D Jayanthi, Sammanda Ramamoorthy
Kappa opioid receptor (KOR) agonists produce dysphoria and psychotomimesis. While KOR agonists produce pro-depressant-like effects, KOR antagonists produce anti-depressant-like effects in rodent models. The cellular mechanisms and downstream effector(s) by which KOR ligands produce these effects are not clear. KOR agonists modulate serotonin (5-HT) transmission in the brain regions implicated in mood and motivation regulation. Presynaptic serotonin transporter (SERT) activity is critical in the modulation of synaptic 5-HT and, subsequently, in mood disorders...
October 12, 2016: Neuropharmacology
Zhengxin Cai, Song Ye Li, Richard Pracitto, Antonio Navarro, Anupama Shirali, Jim Ropchan, Yiyun Henry Huang
Kappa opioid receptor (KOR) antagonists are potential drug candidates for diseases such as treatment-refractory depression, anxiety, and addictive disorders. PET imaging radiotracers for KOR can be used in occupancy study to facilitate drug development, and to investigate the roles of KOR in health and diseases. We have previously developed two 11C-labeled antagonist radiotracers with high affinity and selectivity toward KOR. What is limiting their wide applications is the short half-life of 11C. Herein, we report the synthesis of a first 18F-labeled KOR antagonist radiotracer and the initial PET imaging study in a non-human primate...
October 14, 2016: ACS Chemical Neuroscience
Daniel Ayanga, Daryl Shorter, Thomas R Kosten
Opioid Use Disorder (OUD) is a significant public health concern, negatively impacting the medical, psychological, and social domains of an individual's life as well as creating substantial burdens for society. Effective treatment interventions are necessary for reduction of OUD and its consequences. Pharmacotherapy represents a central component of management. Areas Covered: This review focuses on pharmacologic strategies for OUD treatment, discussing both primary as well as adjunctive therapy modalities. We will discuss both medications used during detoxification to treat withdrawal, as well as those used as maintenance therapy...
October 13, 2016: Expert Opinion on Pharmacotherapy
Uros Rakita, Peter Giacobbe, Chris Cavacuiti
OBJECTIVES: To assess the acceptability and quality of web-based videoconferencing telemedicine consultation platform in the treatment of opioid use disorder at TrueNorth Medical Centre. METHODS: We conducted an interview based quality improvement initiative using an investigator-designed questionnaire. The questionnaire consisted of 17 Agree/Disagree questions, measured on a 7-point Likert scale and 2 questions where patients had the ability to elaborate qualitatively on their perceptions and experiences with their telemedicine service...
2016: SAGE Open Medicine
Mahboubeh Firouzkouhi Moghadam, Seyed-Sepehr Hashemian, Masoud Pishjoo, Sanaz Ghasemi, Ahmad Hajebi, Alireza Noroozi
BACKGROUND: About 10 million children worldwide live or work on the street. International reports estimate the prevalence of substance use among street children to be between 25% - 90%, which is who were referredntal disorders and high-risk behaviors. OBJECTIVES: The objective of this study was to report the outcomes of assisted withdrawal of opioid-dependent vulnerable children and adolescents who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb hospital, an academic hospital in Zahedan city...
August 2016: Iranian Journal of Pediatrics
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
(no author information available yet)
This final rule outlines annual reporting requirements for practitioners who are authorized to treat up to 275 patients with covered medications in an office-based setting. This final rule will require practitioners to provide information on their annual caseload of patients by month, the number of patients provided behavioral health services and referred to behavioral health services, and the features of the practitioner's diversion control plan. These reporting requirements will help the Department of Health and Human Services (HHS) ensure compliance with the requirements of the final rule, "Medication Assisted Treatment for Opioid Use Disorders," published in the Federal Register on July 8, 2016...
September 27, 2016: Federal Register
E Carlino, A Piedimonte, F Benedetti
Placebos have long been considered a nuisance in clinical research, for they have always been used as comparators for the validation of new treatments. By contrast, today they represent an active field of research, and, due to the involvement of many mechanisms, the study of the placebo effect can actually be viewed as a melting pot of concepts and ideas for neuroscience. There is not a single placebo effect, but many, with different mechanisms across different medical conditions and therapeutic interventions...
2017: Handbook of Clinical Neurology
Daniel P Riggins, Chinazo O Cunningham, Yuming Ning, Aaron D Fox
BACKGROUND: Opioid use disorder is a common cause of morbidity and mortality among people living with HIV/AIDS. Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. We hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. METHODS: We analyzed data from a multi-site cohort study of BMT integrated into HIV care...
August 11, 2016: Substance Abuse
Travis T Wager, Thomas A Chappie, David Horton, Ramalakshmi Y Chandrasekaran, Brian M Samas, Elizabeth Dunn-Sims, Cathleen Hsu, Nawshaba Nawreen, Michelle A Vanase-Frawley, Rebecca E O'Connor, Christopher Schmidt, Keith Dlugolenski, Nancy C Stratman, Mark J Majchrzak, Bethany L Kormos, David Nguyen, Aarti Sawant-Basak, Andy N Mead
Dopamine receptor antagonism is a compelling molecular target for the treatment of a range of psychiatric disorders, including substance use disorders. From our corporate compound file we identified a structurally unique D3 receptor (D3R) antagonist scaffold, 1. Through a hybrid approach, we merged key pharmacophore elements from 1 and D3 agonist 2 to yield the novel D3R/D2R antagonist PF-4363467 (3). Compound 3 was designed to possess CNS drug-like properties as defined by its CNS MPO desirability score (≥4/6)...
October 7, 2016: ACS Chemical Neuroscience
Stephen T Higgins, Sarah H Heil, Stacey C Sigmon, Jennifer W Tidey, Diann E Gaalema, Maxine L Stitzer, Hanna Durand, Janice Y Bunn, Jeff S Priest, Christopher A Arger, Mollie E Miller, Cecilia L Bergeria, Danielle R Davis, Joanna M Streck, Ivori Zvorsky, Ryan Redner, Ryan Vandrey, Lauren R Pacek
RATIONALE: The purpose of this study was to begin researching the effects of very low nicotine content cigarettes in smokers especially vulnerable to dependence to assess their potential as a less dependence-producing alternative to current commercial cigarettes. METHODS: Participants were 26 adult, daily cigarette smokers from one of three populations: economically disadvantaged women of reproductive age (n = 9), opioid-dependent individuals (n = 11), and individuals with affective disorders (n = 6)...
October 6, 2016: Psychopharmacology
Joseph W Sassani, Patricia J Mc Laughlin, Ian S Zagon
The Opioid Growth Regulatory System consists of opioid growth factor (OGF), [Met(5)]-enkephalin, and its unique receptor (OGFr). OGF inhibits cell division when bound to OGFr. Conversely, blockade of the interaction of OGF and OGFr, using the potent, long-acting opioid receptor antagonist, naltrexone (NTX), results in increased DNA synthesis and cell division. The authors have demonstrated both in vitro and in vivo that the addition of exogenous OGF or an increase in available OGFr decreases corneal epithelial cell division and wound healing...
2016: Journal of Diabetes Research
Zeyad T Sahli, Jae Jo, Shaker A Mousa, Frank I Tarazi
Restless legs syndrome (RLS) is a common neurological movement disorder, characterized by restless and unpleasant sensations in the deep inside of legs. The symptoms of RLS are less noticeable during daytime, but more prevalent at night. Therefore, the disorder can induce low quality of life, insomnia, and impairment of daytime activity. RLS in end-stage renal disease (ESRD) patients is especially problematic due to premature discontinuation of dialysis and increased mortality. The prevalence of RLS among dialysis patients is much higher compared to the prevalence of the same disorder in patients with normal renal functions...
October 5, 2016: CNS Spectrums
Disa Dahlman, Jonas Berge, Anna C Nilsson, Alex H Kral, Per Bjorkman, Anders C Hakansson
BACKGROUND: While methicillin-resistant Staphylococcus aureus (MRSA) is increasing in prevalence globally, Sweden is still a low-prevalence country enabling studies on the natural MRSA spread in subpopulations unaffected by a surrounding highly infected population. Substance dependence and injection drug use have been risk factors for MRSA carriage and infection in other countries. In this retrospective, longitudinal register study, we investigated MRSA epidemiology 1997-2013 in opioid and amphetamine-dependent individuals, in comparison with alcohol-dependent subjects...
October 4, 2016: Infectious Diseases
William A Carlezon, Andrew D Krystal
Kappa-opioid receptor (KOR) antagonists are currently being considered for the treatment of a variety of neuropsychiatric conditions, including depressive, anxiety, and substance abuse disorders. A general ability to mitigate the effects of stress, which can trigger or exacerbate these conditions, may explain their putative efficacy across such a broad array of conditions. The discovery of their potentially therapeutic effects evolved from preclinical research designed to characterize the molecular mechanisms by which experience causes neuroadaptations in the nucleus accumbens (NAc), a key element of brain reward circuitry...
October 2016: Depression and Anxiety
S Y Modi, D Dharaiya, A M Katramados, P Mitsias
BACKGROUND: Patients with status migrainosus often need to be admitted due to the severity of their headaches. Their hospitalization is often prolonged due to poor headache control. Large sample studies looking into the factors associated with prolonged length of stay (pLOS) in status migrainosus are lacking. METHODS: We utilized the Nationwide Inpatient Sample database to identify 4325 patients with primary discharge diagnosis of status migrainosus. Length of inpatient stay (LOS) of more than 6 days (90th percentile of LOS) was defined as pLOS...
October 2016: Neurohospitalist
Joseph A Boscarino, H Lester Kirchner, James M Pitcavage, Vijay R Nadipelli, Naoko A Ronquest, Michael H Fitzpatrick, John J Han
OBJECTIVE: Opioid overdoses (ODs) have been increasing, and harm reduction efforts are a priority. The success of these efforts will be dependent on the identification of at-risk patients and improved access to the antidote naloxone. Therefore, to identify access to naloxone and factors associated with negative health outcomes, we conducted a retrospective study of patients with OD to identify those at highest risk of adverse outcomes and to assess the use of naloxone. METHODS: We conducted a study of electronic health records for patients admitted to the largest multihospital system in the region - the Geisinger Health System (GHS) for ODs - from April 2005 through March 2015...
2016: Substance Abuse and Rehabilitation
Michelle Tuten, Julia M Shadur, Maxine Stitzer, Hendrée E Jones
OBJECTIVES: Reinforcement-based treatment (RBT) plus recovery housing (RBT(RH)) improves outcomes for individuals with opioid use disorders. No studies have examined the efficacy of RBT in the absence of abstinent-contingent housing. METHODS: We compared highly similar participants from a study of outpatient RBT (RBT, n=55) and the RBT(RH) (n=80) arm of a randomized trial wherein participants received abstinent-contingent payment for recovery housing sponsored by the research program...
September 10, 2016: Journal of Substance Abuse Treatment
Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
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