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Opioid use disorder

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https://www.readbyqxmd.com/read/28914697/are-we-ready-to-treat-hepatitis-c-virus-in-individuals-with-opioid-use-disorder-assessment-of-readiness-in-european-countries-on-the-basis-of-an-expert-generated-model
#1
Nat Wright, Jens Reimer, Lorenzo Somaini, Carlos Roncero, Icro Maremmani, Nicolas Simon, Peter Krajci, Richard Littlewood, Oscar D'Agnone, Hannu Alho, Benjamin Rolland
Individuals with a history of injecting drugs have a high prevalence of chronic hepatitis C (HCV) infection. Many have a history of opioid use disorder (OUD). Despite novel treatments with improved efficacy and tolerability, treatment is limited in the group. A faculty of experts shared insights from clinical practice to develop an HCV care-readiness model. Evidence and expert knowledge was collected. Ten experts developed a model of three factors (with measures): 'healthcare engagement', 'guidance' and 'place'...
September 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28914663/physicians-decision-making-when-implementing-buprenorphine-with-new-patients-conjoint-analyses-of-data-from-a-cohort-of-current-prescribers
#2
Hannah K Knudsen, Michelle R Lofwall, Sharon L Walsh, Jennifer R Havens, Jamie L Studts
OBJECTIVES: Few studies have considered how providers make decisions to prescribe buprenorphine to new patients with opioid use disorder. This study examined the relative importance of patients' clinical, financial, and social characteristics on physicians' decision-making related to willingness to prescribe buprenorphine to new patients and the number of weeks of medication that they are willing to initially prescribe after induction. METHODS: A national sample of 1174 current prescribers was surveyed...
September 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28910257/between-a-rock-and-a-hard-place-prescription-opioid-restrictions-in-the-time-of-fentanyl-and-other-street-drug-adulterants
#3
Tessa Cheng, Kora DeBeck
Non-medical prescription opioid use (NMPOU) has increased alarmingly across Canada and resulted in strict prescribing restrictions on opioids. Despite a clear need to reduce opioid prescriptions in response to this crisis, few other policies have been implemented and this singular focus is incongruent with the known characteristics of substance use disorders, negative effects of supply reduction policies, and realities of pain management. Given the recent rise of fentanyl and other dangerous adulterants in street drugs, this commentary argues that a comprehensive response to NMPOU that includes improvements to addiction management and harm-reduction services is urgently needed...
September 14, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28905733/why-it-s-inappropriate-not-to-treat-incarcerated-patients-with-opioid-agonist-therapy
#4
Sarah E Wakeman
Due to the criminalization of drug use and addiction, opioid use disorder is overrepresented in incarcerated populations. Decades of evidence supports opioid agonist therapy as a highly effective treatment that improves clinical outcomes and reduces illicit opioid use, overdose death, and cost. Opioid agonist therapy has been both studied within correctional facilities and initiated prerelease. It has been found to be beneficial, yet few incarcerated persons receive this evidence-based treatment. In addition to not offering treatment initiation for those who need it, most correctional facilities forcibly withdraw stable patients from opioid agonist therapy upon their entry into the criminal justice system...
September 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28898165/internalized-stigma-among-patients-with-substance-use-disorders-at-a-tertiary-care-center-in-india
#5
Siddharth Sarkar, Yatan Pal Singh Balhara, Saurabh Kumar, Vinay Saini, Akriti Kamran, Vaibhav Patil, Swarndeep Singh, Shreeya Gyawali
Internalized stigma among individuals with substance use disorders is a major barrier for accessing mental health services. This study aimed to assess internalized stigma among individuals with substance use disorders and to assess the relationship of internalized stigma with the quality of life. This cross-sectional study recruited 201 patients with a clinical diagnosis of at least opioid or alcohol use disorder according to Diagnostic and Statistical Manual 5 at a public-funded tertiary care center in India...
September 12, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/28894357/advances-in-the-delivery-of-buprenorphine-for-opioid-dependence
#6
REVIEW
Richard N Rosenthal, Viral V Goradia
Opioid use disorders (OUDs) have long been a global problem, but the prevalence rates have increased over 20 years to epidemic proportions in the US, with concomitant increases in morbidity and all-cause mortality, but especially opioid overdose. These increases are in part attributable to a several-fold expansion in the prescription of opioid pain medications over the same time period. Opioid detoxification and psychosocial treatments alone have each not yielded sufficient efficacy for OUD, but μ-opioid receptor agonist, partial agonist, and antagonist medications have demonstrated the greatest overall benefit in OUD treatment...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28893820/providing-office-based-treatment-of-opioid-use-disorder
#7
Courtenay Gilmore Wilson, E Blake Fagan
No abstract text is available yet for this article.
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28893675/design-recruitment-outcomes-and-sample-characteristics-of-the-strategies-for-prescribing-analgesics-comparative-effectiveness-space-trial
#8
Erin E Krebs, Agnes C Jensen, Sean Nugent, Beth DeRonne, Indulis Rutks, David Leverty, Amy Gravely, Siamak Noorbaloochi, Matthew J Bair, Kurt Kroenke
This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded...
September 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28892721/glial-and-neuroinflammatory-targets-for-treating-substance-use-disorders
#9
REVIEW
Ryan K Bachtell, Jermaine D Jones, Keith G Heinzerling, Patrick M Beardsley, Sandra D Comer
BACKGROUND: The plenary session at the 2016 Behavior, Biology and Chemistry: Translational Research in Addiction Conference focused on glia as potential players in the development, persistence and treatment of substance use disorders. Glia partake in various functions that are important for healthy brain activity. Drugs of abuse alter glial cell activity producing several perturbations in brain function that are thought to contribute to behavioral changes associated with substance use disorders...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28890908/validation-study-of-a-predictive-algorithm-to-evaluate-opioid-use-disorder-in-a-primary-care-setting
#10
Maneesh Sharma, Chee Lee, Svetlana Kantorovich, Maria Tedtaotao, Gregory A Smith, Ashley Brenton
BACKGROUND: Opioid abuse in chronic pain patients is a major public health issue. Primary care providers are frequently the first to prescribe opioids to patients suffering from pain, yet do not always have the time or resources to adequately evaluate the risk of opioid use disorder (OUD). PURPOSE: This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm ("profile") incorporating phenotypic and, more uniquely, genotypic risk factors...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28890282/opioid-dosing-trends-over-eight-years-among-us-veterans-with-musculoskeletal-disorders-after-returning-from-service-in-support-of%C3%A2-recent-conflicts
#11
Ling Han, Heather Allore, Joseph Goulet, Harini Bathulapali, Melissa Skanderson, Cynthia Brandt, Sally Haskell, Erin Krebs
PURPOSE: To examine long-term opioid dosing trends among Veterans with chronic pain. METHODS: We identified 79,015 Veterans with musculoskeletal disorders who were dispensed greater than or equal to 1 opioid prescriptions between 2002 and 2009 after returning from recent conflicts. Opioid-dosing trends were examined using a generalized estimating equation while accounting for patient characteristics, temporal and geographic confounding. RESULTS: In total, 472,819 opioid prescriptions were dispensed (mean ± standard deviation: 6...
August 24, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28885301/perceptions-of-neighborhood-mediate-the-relationship-between-ptsd-symptoms-and-coping-in-a-neighborhood-matched-substance-using-sample
#12
Sara K Hertzel, Jennifer Schroeder, Landhing M Moran, Anika A Alvanzo, William J Kowalczyk, David H Epstein, Kenzie L Preston, Karran A Phillips
OBJECTIVES: People with substance use problems living in neighborhoods with high levels of disorder are disproportionately likely to experience trauma and develop PTSD symptoms. We sought to evaluate the relationships between objective neighborhood disorder, perceptions of neighborhood, and the use of maladaptive coping behaviors among both non-substance-using and substance-using participants with and without PTSD symptoms. METHODS: Participants (255 non-drug users [NDUs], 168 marijuana and/or alcohol users [MAUs], and 273 opioid and/or stimulant users) completed the Addiction Severity Index, PTSD Checklist-Civilian Version, The COPE Inventory, and the Perceived Neighborhood Scale...
September 6, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28885299/correlates-of-stigma-severity-among-persons-seeking-opioid-detoxification
#13
Nikki Bozinoff, Bradley J Anderson, Genie L Bailey, Michael D Stein
INTRODUCTION: Among people with opioid use disorder (OUD), stigma is a known barrier to accessing treatment and has negative impacts on physical and mental health. The purpose of this study was to understand the factors associated with self-stigma and perceived stigma severity among people with OUD entering an inpatient detoxification program. METHODS: Between December 2015 and August 2016, consecutive persons seeking inpatient opioid detoxification were asked to complete a survey that included sociodemographic, drug use, treatment variables, an 8-item General Self-Stigma scale, and a 3-item Treatment Stigma scale...
September 6, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28882155/barriers-to-retention-in-methadone-maintenance-therapy-among-people-who-inject-drugs-in-bangkok-thailand-a-mixed-methods-study
#14
Kanna Hayashi, Lianping Ti, Prempreeda Pramoj Na Ayutthaya, Paisan Suwannawong, Karyn Kaplan, Will Small, Thomas Kerr
BACKGROUND: Methadone maintenance therapy (MMT) is a mainstay for treating opioid use disorder and preventing and managing HIV among people who inject drugs (PWID). While previous research suggested low dosing of methadone and high rates of discontinuation of MMT among PWID in Thailand, little is known about patients' lived experiences with MMT in this setting. Therefore, we conducted a mixed-methods study to examine barriers to retention in MMT among PWID in Bangkok, Thailand, with particular attention to methadone dosing...
September 7, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28880201/decrease-in-healthcare-utilization-and-costs-for-opioid-users-following-residential-integrated-treatment-for-co-occurring-disorders
#15
Siobhan Morse, Brian E Bride
BACKGROUND: Opioid use results in higher healthcare utilization and costs, particularly among those with co-occurring mental health disorders. Presumably, effective treatment would result in a reduction in healthcare utilization and costs. To date, research has not examined this question. As such, the purpose of this study was to estimate and compare pre- and post-treatment healthcare utilization and costs for individuals receiving residential integrated treatment for co-occurring mental health and opioid use disorders...
September 7, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28871491/robust-age-but-limited-sex-differences-in-mu-opioid-receptors-in-the-rat-brain-relevance-for-reward-and-drug-seeking-behaviors-in-juveniles
#16
Caroline J W Smith, Aarane M Ratnaseelan, Alexa H Veenema
In the brain, the µ-opioid receptor (MOR) is involved in reward-seeking behaviors and plays a pivotal role in the mediation of opioid use disorders. Furthermore, reward-seeking behaviors and susceptibility to opioid addiction are particularly evident during the juvenile period, with a higher incidence of opioid use in males and higher sensitivity to opioids in females. Despite these age and sex differences in MOR-mediated behaviors, little is known regarding potential age and sex differences in the expression of MORs in the brain...
September 4, 2017: Brain Structure & Function
https://www.readbyqxmd.com/read/28869859/maternal-buprenorphine-treatment-and-infant-outcome
#17
Lauren M Jansson, Martha L Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree Jones, Rebeca Rios, Van L King, Neeraj Gandotra, Lorraine Millio, Janet A DiPietro
BACKGROUND AND OBJECTIVES: Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. METHODS: The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28869858/internalized-stigma-as-an-independent-risk-factor-for-substance-use-problems-among-primary-care-patients-rationale-and-preliminary-support
#18
Magdalena Kulesza, Katherine E Watkins, Allison J Ober, Karen C Osilla, Brett Ewing
BACKGROUND: Little is known about internalized stigma among primary care patients, and whether the presence of internalized stigma is related to the severity of substance use problems independent of substance use-related variables. We sought to examine the relationship between internalized stigma and substance use problems among primary care patients with opioid or alcohol use disorders (OAUDs). METHODS: We present baseline data from 393 primary care patients who were enrolled in a study of collaborative care for OAUDs...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28868159/the-effects-of-residential-dual-diagnosis-treatment-on-alcohol-abuse
#19
Stephen J Schoenthaler, Kenneth Blum, Lyle Fried, Marlene Oscar-Berman, John Giordano, Edward J Modestino, Rajendra Badgaiyan
This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p < .005). A comparison between patients with and without weekly relapse produced significant differences in hospitalization (odds ratio 11...
July 2017: Journal of Systems and Integrative Neuroscience
https://www.readbyqxmd.com/read/28867560/prevalence-and-characteristics-of-opioid-related-deaths-involving-alcohol-in-ontario-canada
#20
Tara Gomes, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Wim van den Brink
BACKGROUND: While it is well known that patients receiving opioids should refrain from alcohol consumption, little is known about the involvement of alcohol in opioid-related deaths. METHODS: We conducted a population-based analysis of opioid-related deaths in Ontario with and without alcohol involvement between 1993 and 2013, and reported rates overall and stratified by manner of death. We compared the characteristics of individuals who died of an opioid overdose based on the presence or absence of alcohol involvement...
August 5, 2017: Drug and Alcohol Dependence
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