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Opioid use disorder

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https://www.readbyqxmd.com/read/28340233/increase-in-drug-overdose-deaths-involving-fentanyl-rhode-island-january-2012-march-2014
#1
Melissa C Mercado, Steven A Sumner, M Bridget Spelke, Michele K Bohm, David E Sugerman, Christina Stanley
Objective.:  This study identified sociodemographic, substance use, and multiple opioid prescriber and dispenser risk factors among drug overdose decedents in Rhode Island, in response to an increase in overdose deaths (ODs) involving fentanyl. Methods.:  This cross-sectional investigation comprised all ODs reviewed by Rhode Island's Office of the State Medical Examiners (OSME) during January 2012 to March 2014. Data for 536 decedents were abstracted from OSME's charts, death certificates, toxicology reports, and Prescription Monitoring Program (PMP) databases...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340046/validation-of-a-screening-risk-index-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-in-a-us-commercial-health-plan-claims-database
#2
Barbara K Zedler, William B Saunders, Andrew R Joyce, Catherine C Vick, E Lenn Murrelle
Objective.:  To validate a risk index that estimates the likelihood of overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids. Subjects and Methods.:  A case-control analysis of 18,365,497 patients with an opioid prescription from 2009 to 2013 in the IMS PharMetrics Plus commercially insured health plan claims database (CIP). An OIRD event occurred in 7,234 cases. Four controls were selected per case. Validity of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD), developed previously using Veterans Health Administration (VHA) patient data, was assessed...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339890/pennsylvania-state-core-competencies-for-education-on-opioids-and-addiction
#3
Michael A Ashburn, Rachel L Levine
Objective.:  The objective of this project was to develop core competencies for education on opioids and addiction to be used in all Pennsylvania medical schools. Methods.:  The Pennsylvania Physician General created a task force that was responsible for the creation of the core competencies. A literature review was completed, and a survey of graduating medical students was conducted. The task force then developed, reviewed, and approved the core competencies...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#4
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28333533/a-randomized-clinical-trial-of-behavioral-couples-therapy-versus-individually-based-treatment-for-drug-abusing-women
#5
Timothy J O'Farrell, Jeremiah A Schumm, Marie M Murphy, Patrice M Muchowski
OBJECTIVE: Behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance and relationship outcomes among substance use disorder patients. This study compared BCT with IBT for drug-abusing women. METHOD: Sixty-one women, mostly White, late 30s, with primary substance use disorder other than alcohol (74% opioid), and male partners were randomized to 26 sessions over 13 weeks of BCT plus 12-step-oriented IBT (i.e., BCT + IBT) or IBT...
April 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28328314/from-education-to-practice-addressing-opioid-misuse-through-healthcare-provider-training-a-special-issue-of-saj
#6
Adam J Gordon, John Daniel Harding
Opioid misuse may be ignored by providers who are unwilling or not confident in engaging the complex nature of substance use disorders among their patient populations. Addiction is a complex disease and although providers often are comfortable in identifying, assessing, and treating the complex diseases of their patients, basic knowledge and skills of identification, assessment, and treatment expertise involving opioids for pain, addressing opioid misuse, and treatment of opioid use disorder are lacking. Initiatives to improve knowledge of opioid use, misuse, and opioid use disorder among health care providers are emerging...
March 22, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28328148/long-term-follow-up-study-of-community-based-patients-receiving-xr-ntx-for-opioid-use-disorders
#7
Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R Levin, Edward V Nunes, John J Mariani, Adam Bisaga
BACKGROUND AND OBJECTIVES: Extended-release naltrexone (XR-NTX) is FDA-approved to prevent relapse in patients with Opioid Use Disorder. However little is known about long-term use among community-based outpatients. METHODS: Retrospective chart review and long-term follow-up survey among individuals (N = 168) who entered an outpatient XR-NTX trial between 2011 and 2015, during which participants were offered three monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of four domains: (1) substance use; (2) treatment continuation; (3) barriers; and (4) attitudes...
March 22, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28327378/gender-related-psychopathology-in-opioid-use-disorder-results-from-a-representative-sample-of-italian-addiction-services
#8
Beniamino Leone, Marco Di Nicola, Lorenzo Moccia, Mauro Pettorruso, Luisa De Risio, Giuseppe Nucara, Lorenzo Zamboni, Antonino Callea, Luigi Janiri, Mauro Cibin, Fabio Lugoboni
AIMS: Gender and psychiatric comorbidity seem to influence patients' inter-individual response to Opioid Substitution Treatments (OST) in Opioid Use Disorder (OUD) management. The aim of the study was to assess psychopathological dimensions in an Italian sample of OUD individuals entering a methadone/buprenorphine maintenance program; secondary, we evaluated the possible gender-specific differences within the psychopathological profiles. METHODS: In a cross-sectional study, we recruited 1052 (792 male; 260 female) OUD subjects receiving OST...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28325149/low-dose-naltrexone-in-the-treatment-of-fibromyalgia
#9
Samy K Metyas, Karen Yeter, John Solyman, Daniel Arkfeld
Fibromyalgia is a chronic pain disorder characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance and cognitive impairment. A significant number of fibromyalgia patients do not respond adequately to the current drugs (pregabalin, milnacipran, duloxetine) approved for fibromyalgia treatment by the Food and Drug Administration (FDA). Thus, there is still a need for adjunctive therapies. Naltrexone is an opioid receptor antagonist used to treat alcohol and opioid dependence. It is hypothesized that low dose naltrexone causes transient blockade of opioid receptors centrally resulting in a rebound of endorphin function which may attenuate pain in fibromyalgia...
March 21, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28322170/utilizing-delta-opioid-receptors-and-peptides-for-cytoprotection-implications-in-stroke-and-other-neurological-disorders
#10
Marci G Crowley, M Grant Liska, Trenton Lippert, Sydney Coreya, Cesar V Borlongan
The opioid system has been elucidated as a potential target for therapy in a variety of neurological disorders including stroke. Delta opioid receptors have been revealed to pose an especially compelling biological function for new neuroprotective therapies. Two distinct therapeutic mechanisms have been characterized for delta opioid receptors s, namely, these receptors aid in maintaining ionic homeostasis and initiate endogenous neuroprotective pathways. Specific agonists of delta opioid receptors, such as (D-Ala2, D-Leu5) enkephalin (DADLE), have displayed the ability to promote neuronal survival and mitigate apoptotic pathways...
March 20, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28319509/a-high-preoperative-pain-and-symptom-profile-predicts-worse-pain-outcomes-for-children-after-spine-fusion-surgery
#11
Terri Voepel-Lewis, Michelle S Caird, Alan R Tait, Shobha Malviya, Frances A Farley, Ying Li, Matthew D Abbott, Tara van Veen, Afton L Hassett, Daniel J Clauw
BACKGROUND: Preoperative pain predicts persistent pain after spine fusion, yet little is understood about the nature of that pain, related symptoms, and how these symptoms relate to postoperative pain outcomes. This prospective study examined children's baseline pain and symptom profiles and the association between a high symptom profile and postoperative outcomes. METHODS: Seventy children (aged 10-17 years) scheduled for correction of idiopathic scoliosis completed pain and symptom surveys during their preoperative visit (ie, pain intensity [0-10 numeric rating scores], a pediatric version of the 2011 fibromyalgia survey criteria [including pain locations and symptom severity scale], neuropathic pain symptoms [painDETECT], and Patient-Reported Outcome Measurement System measures of fatigue, depression, function, pain interference, and pain catastrophizing)...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28315549/substance-abuse-and-addiction-implications-for-pain-management-in-patients-with-cancer%C3%A2
#12
Yu-Ping Chang
BACKGROUND: Substance use disorders (SUDs) are chronic diseases that may complicate the nursing care of patients with cancer, affecting their ability to adhere to treatment protocols, responses to cancer pain, and use of opioids for analgesia. OBJECTIVES: This article explores how the presence of an SUD may affect oncology nursing care and pain management. METHODS: The PubMed and CINAHL® databases were searched for articles from 1980-2016 using the keywords cancer, cancer pain, addiction, substance abuse, and alcoholism...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28301697/managing-opioid-withdrawal-for-hospital-patients-in-custody
#13
Connie R Shi, Manjinder S Kandola, Matthew Tobey, Elizabeth Singer
Dr. Brown, a hospitalist, admits Mark, a patient transferred from a local jail for management of cellulitis. The patient, who was taken into custody two days prior to hospital admission, has a history of intravenous heroin use. Mark explains that he had been prescribed buprenorphine-naloxone maintenance therapy for opioid use disorder for several years prior to being arrested and had not used other opioids during that time. As a policy, the jail where Mark is detained does not prescribe opioid agonists, and his maintenance therapy was stopped upon his arrival there...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28301370/debate-are-benzodiazepines-appropriate-treatments-for-patients-with-substance-use-disorders-yes
#14
Tae Woo Park
Benzodiazepines are a controversial treatment for anxiety in patients with substance use disorders. Concerns include risk of addiction, overdose, and diversion. But benzodiazepines are among the most effective and well-tolerated treatments for anxiety, and are safe for the majority of patients who take them. Though not appropriate for all cases, particularly in those with an active opioid use disorder, benzodiazepines should be considered as a treatment for patients with substance use disorders after careful weighing of benefits and harms...
March 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28301369/-should-patients-with-substance-use-disorders-be-prescribed-benzodiazepines-no
#15
Robert L DuPont
Patients with substance use disorders (SUDs) should not use benzodiazepines to treat anxiety, insomnia, or anything else, for the same reasons that they should not drink any alcohol or use other drugs, regardless of their primary drug used. Once the addiction "switch" is thrown on, it never again goes off. This question has additional relevance today because in 2016, the US Food and Drug Administration put black box warnings on all benzodiazepines and opioid analgesics about the serious risks associated with their concomitant use...
March 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28301219/management-of-comorbid-bipolar-disorder-and-substance-use-disorders
#16
Ihsan M Salloum, Edson Sherwood Brown
BACKGROUND: The comorbidity of substance use disorders (SUDs) in bipolar disorder is among the highest in psychiatric disorders. Evidence-based controlled psychosocial or pharmacological interventions trials, which may guide treatment decisions, have not been systematically reviewed. OBJECTIVE: To present a narrative review of the public health and clinical significance of this condition, including diagnostic and treatment implications, and to evaluate controlled trials conducted to date...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28301070/substance-use-disorders-and-the-risk-of-suicide-mortality-among-men-and-women-in-the-us-veterans-health-administration
#17
Kipling M Bohnert, Mark A Ilgen, Samantha Louzon, John F McCarthy, Ira R Katz
BACKGROUND AND AIMS: Limited information is available regarding links between specific substance use disorders (SUDs) and suicide mortality; however, the preliminary evidence that is available suggests that suicide risk associated with SUDs may differ for men and women. This study aimed to estimate associations between SUDs and suicide for men and women receiving Veterans Health Administration (VHA) care. DESIGN: A cohort study using national administrative health records...
March 16, 2017: Addiction
https://www.readbyqxmd.com/read/28298794/anesthetic-implications-in-a-child-with-crouzon-syndrome
#18
Ajeet Kumar, Nitika Goel, Chandni Sinha, Abhishek Singh
Crouzon syndrome (CS) is an autosomal dominant genetic disorder characterized by craniofacial dysostosis. Premature fusion of skull base leads to midfacial hypoplasia, shallow orbit, mandibular prognathism, overcrowding of upper teeth, high-arched palate, and upper airway obstruction. It is important for anesthesiologists managing such patients to recognize and avoid potential airway complications. Here, we present a case of a 10-year-old child with CS posted for ptosis correction surgery. Use of peripheral nerve blocks to cut down opioid requirement, inhalational induction, and maintenance are key aspects in successful management of such cases...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296674/impact-of-medicaid-expansion-on-medicaid-covered-utilization-of-buprenorphine-for-opioid-use-disorder-treatment
#19
Hefei Wen, Jason M Hockenberry, Tyrone F Borders, Benjamin G Druss
BACKGROUND: Buprenorphine has been proven effective in treating opioid use disorder. However, the high cost of buprenorphine and the limited prescribing capacity may restrict access to this effective medication-assisted treatment for opioid use disorder. OBJECTIVE: To examine whether Medicaid expansion and physician prescribing capacity may have impacted buprenorphine utilization covered by Medicaid. RESEARCH DESIGN: We used a quasi experimental difference-in-differences design to compare the pre-post changes in Medicaid-covered buprenorphine prescriptions and buprenorphine spending between the 26 states that implemented Medicaid expansions under the Affordable Care Act in 2014 and those that did not...
April 2017: Medical Care
https://www.readbyqxmd.com/read/28296579/perceived-impacts-of-the-affordable-care-act-perspectives-of-buprenorphine-prescribers
#20
Hannah K Knudsen, Jamie L Studts
The Affordable Care Act (ACA) has been heralded as a major policy change that is expected to transform the delivery of substance use disorder (SUD) treatment. Few studies have reported on the perceived impacts of ACA from the perspectives of SUD treatment providers, such as physicians who prescribe buprenorphine to patients with opioid use disorder. The present study describes buprenorphine prescribers' perceptions regarding impacts of the ACA on the delivery of buprenorphine and examines whether state-level approaches to implementing ACA are associated with its perceived impacts...
March 15, 2017: Journal of Psychoactive Drugs
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