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Prescription drug abuse misuse

Nathaniel M Rickles, Amy L Huang, Michelle B Gunther, Winney J Chan
BACKGROUND: Prescription opioid abuse has rapidly increased in recent years and is now considered a national epidemic by the United States government. Community pharmacies are at the forefront of opioid abuse, given their role in dispensing opioid prescriptions. Despite this role, however, there are few known guidelines to help community pharmacists navigate the process of detecting and managing prescription opioid abuse. OBJECTIVES: To develop and evaluate a candidate guideline, based on clinical experience and existing literature, to help community pharmacists monitor and manage potential opioid prescription abuse...
February 21, 2018: Research in Social & Administrative Pharmacy: RSAP
V Pauly, E Frauger, M Lepelley, M Mallaret, Q Boucherie, J Micallef
AIM: The aim was to characterize patterns of Methylphenidate (MPH) use in France in both children and adults over a three year period. METHODS: Using the French General Health Insurance database limited to two areas covering approximately 4 million individuals, we made up a cohort of incident MPH users between July 2010 and June 2013. Splitting them into distinct age groups ( [18-24]; [25;49]; >=50 years olds for adults and less than 6 years old, [6-11] and [12;17] for children), we described these populations at MPH initiation and during follow-up according to duration of treatment, quantities dispensed, and co-prescription with Central Nervous System (CNS) drugs...
March 7, 2018: British Journal of Clinical Pharmacology
Athena K Petrides, Stacy E F Melanson, Michalis Kantartjis, Rachel D Le, Christiana A Demetriou, James G Flood
BACKGROUND: Oral fluid (OF) has become an increasingly popular matrix to assess compliance in pain management and addiction settings as it reduces the likelihood of adulteration. However, drug concentrations and windows of detection are not as well studied in OF as in urine (UR). We compared the clinical utility and analytical performance of OF and UR as matrices for detecting common benzodiazepines and opioids. METHODS: OF and UR concentrations of 5 benzodiazepines and 7 opioids were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 263 paired OF and UR specimens...
February 27, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Janusz Springer, Wiesław Jerzy Cubała
Tianeptine is an atypical antidepressant approved in 25 countries for the treatment of depressive syndromes. Tianeptine abuse among psychiatric patients in the community and at inpatient wards has been increasingly reported in recent years. The purpose of this article is to alert clinicians to tianeptine abuse potential and identify any patterns in the literature. We searched the Academic Search Complete, Google Scholar, MEDLINE, Science Citation Index, Scopus, and the Social Sciences Citation Index for articles published between 1960-2017 in any language containing the keywords: "tianeptine abuse," "tianeptine misuse," "tianeptine dependence...
March 1, 2018: Journal of Psychoactive Drugs
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Julie Sramcik, Alan D Kaye
PURPOSE OF REVIEW: The opioid crisis most likely is the most profound public health crisis our nation has faced. In 2015 alone, 52,000 people died of drug overdoses, with over 30,000 of those people dying from opioid drugs. A recent community forum led by the Cleveland Clinic contrasted this yearly death rate with the loss of 58,000 American lives in 4 years of the Vietnam War. The present review describes the origins of this opioid epidemic and provides context for our present circumstances...
February 23, 2018: Current Pain and Headache Reports
Brian J Piper, Michael J Suarez, John P Piserchio, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Clare E Desrosiers, Stephanie D Nichols
BACKGROUND: The opioid epidemic is rapidly evolving and new tools are needed to combat drug abuse. The Maine Diversion Alert Program (DAP) is an informational resource that facilitates communication about drug arrests between the criminal justice and healthcare fields. The objectives of this report were to: (1) describe the illegal and prescription pharmaceuticals reported to the DAP; (2) determine if the drugs implicated in arrests changed from the first to latter half of 2016; (3) identify the demographic and other characteristics of arrestees; and (4) outline the strengths and limitations of the DAP for other areas considering implementing similar programs...
February 6, 2018: Forensic Science International
John D Cramer, Brad Wisler, And Christopher J Gouveia
Objective The United States is facing an epidemic of opioid addiction. Deaths from opioid overdose have quadrupled in the past 15 years and now surpass annual deaths during the height of the human immunodeficiency virus epidemic. There is a link between opioid prescriptions after surgery, opioid misuse, opioid diversion, and use of other drugs of abuse. As surgeons, otolaryngologists contribute to this crisis. Our objective is to outline the risk of abuse from opioids in the management of acute postoperative pain in otolaryngology-head and neck surgery (OHNS) and strategies to avoid misuse...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Ryan T Lacy, Hannah K Schorsch, Bridget P Austin
Diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) has risen drastically over the past 20 years in the United States and abroad. Amphetamine-based prescription stimulants are the most prescribed treatment for ADHD and the diversion of these drugs has also increased. Reports indicate 61% of individuals with an ADHD medication prescription have sold or shared their medication. Exposure to prescription stimulants, especially for those without an ADHD diagnosis, may increase susceptibility to drugs of abuse...
February 2018: Experimental and Clinical Psychopharmacology
Jeffrey Guina, Brian Merrill
This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision-sometimes mutually agreed-upon and sometimes unilateral-to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e...
January 30, 2018: Journal of Clinical Medicine
Andrew R Gallucci, Christine Hackman, Amanda Wilkerson
BACKGROUND: There is a well-established inverse relationship in undergraduate samples between a person's religious coping and substance abuse. Positive religious coping (PRC) has been associated with decreases in the use of alcohol, tobacco, and marijuana. Investigations examining prescription drug misuse and PRC found that higher levels of PRC were related to a reduction in the misuse of some prescription drugs. However, the literature has yet to identify an inverse relationship between PRC and the misuse of prescription stimulants (MPS) among undergraduates...
January 5, 2018: Substance Use & Misuse
Brian Suffoletto, Michael Lynch, Charissa B Pacella, Donald M Yealy, Clifton W Callaway
Prescription drug monitoring programs (PDMPs) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the effect of a state-mandated PDMP on opioid prescribing by emergency medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 emergency departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law-mandated PDMP use on August 25, 2016...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
Jennifer A Lowry, Michele Burns, Diane P Calello
Pharmaceutical ingestions comprise an important part of pediatric toxicology. Based on the 2015 Annual Report of the American Association of Poison Control Centers' National Poison Data System, coupled with recent epidemiology articles on the topic of pediatric toxicology, it is apparent that poison prevention education has not been completely successful in decreasing exposures to toxic drugs. From the unintentional ingestion in a toddler due to unsafe storage to the intentional adolescent ingestion for misuse and abuse, pharmaceutical medications continue to cause harm...
December 1, 2017: Pediatric Annals
Martha A Boulton, Kathleen A O'Connell
PURPOSE: Nurses who abuse substances are a threat to patients, colleagues, society, and themselves. Research indicates that substance use often begins during undergraduate years. The purpose of this research was to identify rates of past year substance use by student nurses. METHOD: A quantitative, cross-sectional, correlational design was used to examine past year substance use by student nurses and to determine whether substance use is related to age, gender, race, relationship status, ethnicity, country of birth, type of school program, and year in program...
October 2017: Journal of Addictions Nursing
Christina L Zuch de Zafra, Carrie G Markgraf, David R Compton, Thomas J Hudzik
The development of novel drug candidates involves the thorough evaluation of potential efficacy and safety. To facilitate the safety assessment in light of global increases in prescription drug misuse/abuse, health authorities have developed guidance documents which provide a framework for evaluating the abuse liability of candidate therapeutics. The guidances do not distinguish between small molecules and biologics/biotherapeutics; however, there are key differences between these classes of therapeutics which are important drivers of concern for abuse...
February 2018: Regulatory Toxicology and Pharmacology: RTP
Dorota Wyczechowska, Hui-Yi Lin, Andrea LaPlante, Duane Jeansonne, Adam Lassak, Christopher H Parsons, Patricia E Molina, Francesca Peruzzi
HIV-associated neurocognitive disorders (HAND) affects more than half of persons living with HIV-1/AIDS (PLWHA). Identification of biomarkers representing the cognitive status of PLWHA is a critical step for implementation of successful cognitive, behavioral and pharmacological strategies to prevent onset and progression of HAND. However, the presence of co-morbidity factors in PLWHA, the most common being substance abuse, can prevent the identification of such biomarkers. We have optimized a protocol to profile plasma miRNAs using quantitative RT-qPCR and found a miRNA signature with very good discriminatory ability to distinguish PLWHA with cognitive impairment from those without cognitive impairment...
2017: Frontiers in Molecular Neuroscience
Udo Bonnet, Norbert Scherbaum
In the last ten years, the prescriptions of the gabapentinoids gabapentin and pregabalin increased largely also in Germany. Since several national and international pharmacovigilance-databases have warned for abuse liabilities and overdose fatalities in association with both gabapentinoids, which moreover, became to be sold on internet and black-markets, their addictive power has been subject to an ongoing clinical debate. As pre- and post-approval clinical trials did not reveal significant signs of dependence on gabapentin or pregabalin, we systematically searched in PubMed and Scopus for clinical studies and case reports being associated with abuse of and dependence on these drugs...
November 27, 2017: Fortschritte der Neurologie-Psychiatrie
Bridgette J Peteet
Prescription drug misuse (PDM) is the leading cause of accidental death in the U.S. One in five Americans report at least one lifetime incident of PDM. PDM has been studied extensively, yet there is limited inclusion of racial/ethnic minorities due to purportedly lower rates of PDM. However, health disparate groups often face more detrimental consequences of substance abuse including behavioral, social, and medical/mental health (e.g., injury, HIV/AIDS, incarceration, educational attainment, and comorbidity)...
November 27, 2017: Journal of Ethnicity in Substance Abuse
Jennifer L Cully
Drug overdose and opioid-involved deaths continue to increase across the United States. An end-condition related to opioid abuse is neonatal abstinence syndrome (NAS). The implications for pregnant or post-partum women using an opioid, whether prescribed or illicit, can have significant effects on their infant. First described in the 1970s, NAS is defined as a postnatal drug withdrawal syndrome that primarily occurs in opioid-exposed infants. There are no nationally accepted, evidence-based treatment protocols for these infants...
September 15, 2017: Pediatric Dentistry
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
Shyamashree Sinha, Mark Jensen, Sarah Mullin, Peter L Elkin
Background Prescription opioid pain medication overuse, misuse and abuse have been a significant contributing factor in the opioid epidemic. The rising death rates from opioid overdose have caused healthcare practitioners and researchers to work on optimizing pain therapy and limiting the prescriptions for pain medications. The state of New York has implemented a prescription drug monitoring program(PDMP), amended public health law to limit the prescription of opioids for acute pain and utilized the resources of the state and county health departments to help in curbing this epidemic...
2017: Online Journal of Public Health Informatics
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