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Opioid use disorder

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https://www.readbyqxmd.com/read/28723312/alcohol-marijuana-and-opioid-use-disorders-5-year-patterns-and-characteristics-of-emergency-department-encounters
#1
Amber L Bahorik, Derek D Satre, Andrea H Kline-Simon, Constance M Weisner, Kelly C Young-Wolff, Cynthia I Campbell
BACKGROUND: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorder in an integrated health system. METHODS: In a retrospective design, electronic health record (EHR) data identified patients with ≥ 1 of three common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574)...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#2
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723266/age-of-initiation-psychopathology-and-other-substance-use-are-associated-with-time-to-use-disorder-diagnosis-in-persons-using-opioids-nonmedically
#3
Ty S Schepis, Jahn K Hakes
BACKGROUND: Nonmedical use of prescription opioids (NMUPO) is an ongoing public health challenge, as NMUPO is associated with psychopathology, other drug use and fatal overdose. These concomitant risks are greatest in those with opioid use disorder (OUD), but the development of NMUPO-related use disorder is poorly understood. The primary aim of this study was to establish factors associated with the development of and time to OUD among persons engaged in NMUPO. METHODS: Data were from Wave 1 of the National Epidemiologic Study on Alcohol and Related Conditions, with 1,755 participants endorsing lifetime NMUPO...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28721822/opioid-antagonists-for-pharmacological-treatment-of-gambling-disorder-are-they-relevant
#4
Caroline Victorri-Vigneau, Andrew Spiers, Pascal Caillet, Mélanie Bruneau, Gaëlle Challet-Bouju, Marie Grall-Bronnec
Background To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective This study aims to evaluate the relevance of opioid antagonists for treating GD. Method A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed...
July 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28720623/prescription-opioid-use-among-adults-with-mental-health-disorders-in-the-united-states
#5
Matthew A Davis, Lewei A Lin, Haiyin Liu, Brian D Sites
BACKGROUND: The extent to which adults with mental health disorders in the United States receive opioids has not been adequately reported. METHODS: We performed a cross-sectional study of a nationally representative sample of the noninstitutionalized U.S. adult population from the Medical Expenditure Panel Survey. We examined the relationship between mental health (mood and anxiety) disorders and prescription opioid use (defined as receiving at least 2 prescriptions in a calendar year)...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28719885/racial-and-ethnic-differences-in-opioid-agonist-treatment-for-opioid-use-disorder-in-a-u-s-national-sample
#6
Noa Krawczyk, Kenneth A Feder, Michael I Fingerhood, Brendan Saloner
BACKGROUND: Opioid Agonist Treatment (OAT) is the standard of care for the treatment of opioid use disorders. However, most people in treatment do not receive OAT. This study evaluated whether there are racial and/or ethnic differences in OAT receipt among adults entering specialty treatment for opioid use disorders in publicly-funded treatment programs across the U.S. METHODS: Using data from the national Treatment: Episode Data Base, odds of OAT receipt were compared among black, Hispanic and white clients...
July 11, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28719096/the-effect-of-state-laws-designed-to-prevent-nonmedical-prescription-opioid-use-on-overdose-deaths-and-treatment
#7
Ioana Popovici, Johanna Catherine Maclean, Bushra Hijazi, Sharmini Radakrishnan
Nonmedical use of prescription opioids has reached epidemic levels in the United States and globally. In response, federal, state, and local governments are taking actions to address substantial increases in prescription opioid addiction and its associated harms. This study examines the effect of two state laws specifically designed to curtail access to prescription opioids to nonmedical users: pain management clinic and doctor shopping laws. We use administrative data on overdose deaths and admissions to specialty substance use disorder treatment coupled with a differences-in-differences design...
July 18, 2017: Health Economics
https://www.readbyqxmd.com/read/28716608/opioidergic-and-dopaminergic-modulation-of-cost-benefit-decision-making-in-long-evans-rats
#8
Ileana Morales, Paul J Currie, Timothy D Hackenberg, Raúl Pastor
Eating disorders are associated with impaired decision-making and dysfunctional reward-related neurochemistry. The present study examined the potential contributions of dopamine and opioid signaling to these processes using two different decision-making tasks. In one task, Long Evans Rats chose between working for a preferred food (high-carbohydrate banana-flavored sucrose pellets) by lever pressing on a progressive-ratio schedule of reinforcement vs. obtaining less preferred laboratory chow that was concurrently available...
July 14, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28701461/opioid-use-disorder-and-type-2-diabetes-mellitus-effect-of-participation-in-buprenorphine-naloxone-substitution-programs-on-glycemic-control
#9
Devon Tilbrook, Jeffrey Jacob, Pierre Parsons, Craig Edwards, Kassandra Loewen, Len Kelly
OBJECTIVE: To measure the effect of buprenorphine-naloxone as opioid substitution therapy on glycemic control in patients with type 2 diabetes mellitus and opioid use disorder. DESIGN: Retrospective cohort study and secondary data analysis. SETTING: Northwestern Ontario. PARTICIPANTS: Patients with diabetes receiving opioid substitution therapy, as well as patients with diabetes only, who live in 6 remote First Nations communities...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#10
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
July 12, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28700371/total-pancreatectomy-for-recurrent-acute-and-chronic-pancreatitis-a-critical-review-of-patient-selection-criteria
#11
Mahya Faghih, Francisco Garcia Gonzalez, Martin A Makary, Vikesh K Singh
PURPOSE OF REVIEW: Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. RECENT FINDINGS: The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition...
July 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28699829/association-between-nonmedical-marijuana-and-pain-reliever-uses-among-individuals-aged-50
#12
Namkee G Choi, Diana M DiNitto, C Nathan Marti, Bryan Y Choi
Marijuana and pain reliever use for medical and nonmedical purposes has been increasing among older adults. Using the 2012-2013 U.S. National Survey on Alcohol and Related Conditions (NESARC-III), this study examined: (1) the association between past-year nonmedical marijuana and pain reliever use among adults aged 50+ years (N = 14,715); and (2) sociodemographic, health, and pain-related correlates of nonmedical marijuana and/or pain reliever use. The findings show that 3.87% and 3.12%, respectively, used marijuana and pain relievers nonmedically and 14...
July 12, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28699380/addressing-the-barriers-related-with-opioid-therapy-for-management-of-chronic-pain-in-india
#13
Gur Prasad Dureja, Paramanand N Jain, Muralidhar Joshi, Ashok Saxena, Gautam Das, Jaishid Ahdal, Prashant Narang
India has a high prevalence of chronic disorders which may be associated with persistent pain. Despite the availability of multiple treatment options, chronic pain is largely untreated and contributes to disability and mortality. Medical consumption of opioids remains low due to various barriers that prevent access to opioids for patients and healthcare practitioners. Stringent regulatory provisions outlined in the Narcotic Drugs and Psychotropic Substances Act (1985) have been major deterrents to adequate opioid use...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28699096/hepatitis-c-cascade-of-care-among-pregnant-women-on-opioid-agonist-pharmacotherapy-attending-a-comprehensive-prenatal-program
#14
Kimberly Page, Lawrence Leeman, Steven Bishop, Sandra Cano, Ludmila N Bakhireva
Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype...
July 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28697916/treatments-for-opioid-use-disorder-among-pregnant-and-reproductive-aged-women
#15
REVIEW
Dennis J Hand, Vanessa L Short, Diane J Abatemarco
The increased prevalence of opioid use disorder and access to medical insurance is subsequently increasing the likelihood that medical professionals will encounter individuals with opioid use disorder. Sharp increases in opioid use disorder among women mean that obstetricians, gynecologists, and other reproductive medicine providers may be especially likely to encounter such patients. Medical professionals' understanding of treatment for opioid use disorder and their roles in their patients' treatment may increase referrals to treatment, reduce stigma, and improve the quality of medical care...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28694273/barriers-rural-physicians-face-prescribing-buprenorphine-for-opioid-use-disorder
#16
C Holly A Andrilla, Cynthia Coulthard, Eric H Larson
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective, office-based, medication-assisted treatment, but 60.1% of rural counties in the United States lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States and found that those who were not actively prescribing buprenorphine reported significantly more barriers than those who were, regardless of whether they were treating the maximum number of patients their waiver allowed...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694272/mortality-associated-with-time-in-and-out-of-buprenorphine-treatment-in-french-office-based-general-practice-a-7-year-cohort-study
#17
Julie Dupouy, Aurore Palmaro, Mélina Fatséas, Marc Auriacombe, Joëlle Micallef, Stéphane Oustric, Maryse Lapeyre-Mestre
In France, most cases of opioid use disorder are treated with buprenorphine by general practitioners in private practice. Using reimbursement data of a representative sample of the French population, Echantillon Généraliste des Bénéficiaires, we investigated mortality during periods when patients were in and out of treatment in a cohort of 713 new users of buprenorphine having a mean (SD) follow-up of 4.5 (1.5) years. The mortality rate was 0.63 per 100 person-years (95% CI, 0.40-0.85) overall. In a multivariate Cox regression model, compared with being in treatment, being out of treatment was associated with a markedly increased risk of death (hazard ratio = 29...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28693573/a-qualitative-assessment-of-an-abstinence-oriented-therapeutic-community-for-prisoners-with-substance-use-disorders-in-kyrgyzstan
#18
Lyuba Azbel, Julia Rozanova, Ingo Michels, Frederick L Altice, Heino Stöver
BACKGROUND: Kyrgyzstan, where HIV is concentrated in prisons and driven by injection drug use, provides a prison-based methadone maintenance therapy program as well as abstinence-oriented therapeutic community based on the 12-step model called the "Clean Zone." We aimed to qualitatively assess how prisoners navigate between these treatment options to understand the persistence of the Clean Zone despite a lack of evidence to support its effectiveness in treating opioid use disorders. METHODS: We conducted an analysis of policy documents and over 60 h of participant observation in February 2016, which included focus groups with a convenience sample of 20 therapeutic community staff members, 110 prisoners across three male and one female prisons, and qualitative interviews with two former Clean Zone participants...
July 10, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28692407/overdose-history-is-associated-with-post-detoxification-treatment-preference-for-persons-with-opioid-use-disorder
#19
Michael D Stein, Jessica N Flori, Megan M Risi, Micah T Conti, Bradley J Anderson, Genie L Bailey
BACKGROUND: Without aftercare treatment, persons discharged from short-term inpatient detoxification for opioid use disorder are at high risk of relapse. In previous work, those who were recently homeless or had pending legal problems were more likely to prefer residential treatment for aftercare. Here, based on clinical experience, we hypothesize that a particular clinical factor, surviving an opioid overdose, will be associated with aftercare preference. METHODS: Between May and December 2015, we surveyed consecutive persons seeking inpatient opioid detoxification...
July 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28691865/postpartum-emergency-department-visits-and-inpatient-readmissions-in-a-medicaid-population-of-mothers
#20
Deborah B Ehrenthal, Katie Gelinas, David A Paul, Abiy Agiro, Cynthia Denemark, Anthony J Brazen, Michael Pollack, Matthew K Hoffman
BACKGROUND: Little comprehensive literature exists to broadly examine risk factors for emergency department (ED) utilization or inpatient admission after obstetrical delivery. MATERIALS AND METHODS: We conducted a retrospective cohort study of Medicaid-insured women from 2009 to 2012 who delivered at a regional perinatal center in the Mid-Atlantic. Women were included if Medicaid was the primary payer of record for the delivery and there was continuous 9-month predelivery Medicaid eligibility...
July 10, 2017: Journal of Women's Health
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