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https://www.readbyqxmd.com/read/28324483/the-contribution-of-drug-overdose-to-educational-gradients-in-life-expectancy-in-the-united-states-1992-2011
#1
Jessica Y Ho
Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992-2011...
March 21, 2017: Demography
https://www.readbyqxmd.com/read/28323538/relationships-between-a-dissociative-subtype-of-ptsd-and-clinical-characteristics-in-patients-with-substance-use-disorders
#2
Michaela Mergler, Martin Driessen, Ursula Havemann-Reinecke, Dirk Wedekind, Christel Lüdecke, Martin Ohlmeier, Claudia Chodzinski, Sybille Teunißen, Steffen Weirich, Detlef Schläfke, Walter Renner, Ingo Schäfer, Gertrud Koesters, Christian Dette, Olaf Reis, Elisabeth H Sylvester, Martin Hoppe, Markus Stuppe, Thomas Broese, Udo Schneider, Christina Pletke
The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index...
March 21, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28323507/heroin-and-methamphetamine-injection-an-emerging-drug-use-pattern
#3
Alia Al-Tayyib, Stephen Koester, Sig Langegger, Lisa Raville
OBJECTIVE: We sought to describe an emerging drug use pattern characterized by injection of both methamphetamine and heroin. We examined differences in drug injection patterns by demographics, injection behaviors, HIV and HCV status, and overdose. METHODS: Persons who inject drugs (PWID) were recruited as part of the National HIV Behavioral Surveillance (NHBS) system in Denver, Colorado. We used chi-square statistics to assess differences between those who reported only heroin injection, only methamphetamine injection, and combined heroin and methamphetamine injection...
March 21, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#4
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319291/high-risk-of-overdose-death-following-release-from-prison-variations-in-mortality-during-a-15-year-observation-period
#5
Anne Bukten, Marianne Riksheim Stavseth, Svetlana Skurtveit, Aage Tverdal, John Strang, Thomas Clausen
BACKGROUND AND AIMS: The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been sufficiently investigated. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: This 15-year cohort study includes all persons (n= 91,090) released from prison (01...
March 20, 2017: Addiction
https://www.readbyqxmd.com/read/28315808/benzodiazepine-z-drug-and-pregabalin-prescriptions-and-mortality-among-patients-in-opioid-maintenance-treatment-a-nation-wide-register-based-open-cohort-study
#6
Tove Abrahamsson, Jonas Berge, Agneta Öjehagen, Anders Håkansson
BACKGROUND: Use of sedatives may increase risk of death in opioid users. The aim of the study was to assess whether prescription of sedatives may be associated with mortality in patients in opioid maintenance treatment. METHODS: This retrospective register-based open cohort study included nation-wide register data including all individuals who were dispensed methadone or buprenorphine as opioid maintenance treatment for opioid dependence between July, 2005 and December, 2012 (N=4501)...
February 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28315595/the-social-logic-of-naloxone-peer-administration-harm-reduction-and-the-transformation-of-social-policy
#7
Rachel Faulkner-Gurstein
This paper examines overdose prevention programs based on peer administration of the opioid antagonist naloxone. The data for this study consist of 40 interviews and participant observation of 10 overdose prevention training sessions at harm reduction agencies in the Bronx, New York, conducted between 2010 and 2012. This paper contends that the social logic of peer administration is as central to the success of overdose prevention as is naloxone's pharmacological potency. Whereas prohibitionist drug policies seek to isolate drug users from the spaces and cultures of drug use, harm reduction strategies like peer-administered naloxone treat the social contexts of drug use as crucial resources for intervention...
March 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28306366/serum-osmolal-gap-in-clinical-practice-usefulness-and-limitations
#8
George Liamis, Theodosios D Filippatos, Angelos Liontos, Moses S Elisaf
BACKGROUND: Although serum osmolal gap can be a useful diagnostic tool, clinicians are not familiar with its use in clinical practice. OBJECTIVES: The review presents in a series of questions-answers and under a clinical point of view the current data regarding the use of osmolal gap. DISCUSSION: The definition and the best formula used for the calculation of osmolal gap, the main causes of increased osmolal gap with or without increased anion gap metabolic acidosis, as well as the role of concurrent lactic acidosis or ketoacidosis are presented under a clinical point of view...
March 17, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#9
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
https://www.readbyqxmd.com/read/28301370/debate-are-benzodiazepines-appropriate-treatments-for-patients-with-substance-use-disorders-yes
#10
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/28299971/addressing-excess-risk-of-overdose-among-recently-incarcerated-people-in-the-usa-harm-reduction-interventions-in-correctional-settings
#11
Lauren Brinkley-Rubinstein, David H Cloud, Chelsea Davis, Nickolas Zaller, Ayesha Delany-Brumsey, Leah Pope, Sarah Martino, Benjamin Bouvier, Josiah Rich
Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs...
March 13, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28299558/body-pushing-prescription-drugs-and-hospital-admission
#12
Roger W Byard, Michaela Kenneally
A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police...
March 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#13
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28296569/naloxone-for-outpatients-at-risk-of-opioid-overdose-328
#14
Marcin Chwistek, Matthew Wolf
No abstract text is available yet for this article.
March 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28295513/toxicity-dependent-feasibility-bounds-for-the-escalation-with-overdose-control-approach-in-phase-i-cancer-trials
#15
Graham M Wheeler, Michael J Sweeting, Adrian P Mander
Phase I trials of anti-cancer therapies aim to identify a maximum tolerated dose (MTD), defined as the dose that causes unacceptable toxicity in a target proportion of patients. Both rule-based and model-based methods have been proposed for MTD recommendation. The escalation with overdose control (EWOC) approach is a model-based design where the dose assigned to the next patient is one that, given all available data, has a posterior probability of exceeding the MTD equal to a pre-specified value known as the feasibility bound...
March 15, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28295449/hepatic-mtdna-tlr9-microrna-223-forms-a-negative-feedback-loop-to-limit-neutrophil-over-activation-and-acetaminophen-hepatotoxicity
#16
Yong He, Dechun Feng, Man Li, Yanhang Gao, Teresa Ramirez, Haixia Cao, Seung-Jin Kim, Yang Yang, Yan Cai, Cynthia Ju, Hua Wang, Jun Li, Bin Gao
Acetaminophen (APAP) overdose is a leading cause of acute liver failure worldwide, in which mitochondrial DNA (mtDNA) released by damaged hepatocytes activates neutrophils via the binding of TLR9, further aggravating liver injury. Here, we demonstrated that mtDNA/TLR9 also activates a negative feedback pathway via the induction of microRNA-223 (miR-223) to limit neutrophil over-activation and liver injury. After injection of APAP in mice, levels of miR-223, the most abundant miRNAs in neutrophils, were highly elevated in neutrophils...
March 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28294319/grpr-antagonist-protects-from-drug-induced-liver-injury-by-impairing-neutrophil-chemotaxis-and-motility
#17
Rafael S Czepielewski, Natália Jaeger, Pedro E Marques, Maísa M Antunes, Maurício M Rigo, Débora M Alvarenga, Rafaela V Pereira, Rodrigo D da Silva, Tiago G Lopes, Vinícius D da Silva, Bárbara N Porto, Gustavo B Menezes, Cristina Bonorino
Drug-induced liver injury (DILI) is a major cause of acute liver failure (ALF), where hepatocyte necrotic products trigger liver inflammation, release of CXCR2 ligands (IL-8) and other neutrophil chemotactic molecules. Liver infiltration by neutrophils is a major cause of the life threatening tissue damage that ensues. A GRPR (gastrin-releasing peptide receptor) antagonist impairs IL-8-induced neutrophil chemotaxis in vitro. We investigated its potential to reduce acetaminophen-induced ALF, neutrophil migration and mechanisms underlying this phenomenon...
March 10, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28293108/risk-of-recurrent-overdose-associated-with-prescribing-patterns-of-psychotropic-medications-after-nonfatal-overdose
#18
Yasuyuki Okumura, Daisuke Nishi
OBJECTIVE: We aimed to estimate risk of recurrent overdose associated with psychosocial assessment by psychiatrists during hospitalization for nonfatal overdose and prescribing patterns of psychotropic medications after discharge. METHODS: A retrospective cohort study was conducted using a nationwide claims database in Japan. We classified patients aged 19-64 years hospitalized for nonfatal overdose between October 2012 and September 2013 into two cohorts: 1) those who had consulted a psychiatrist prior to overdose (n=6,790) and 2) those who had not (n=4,950)...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28292795/primary-care-management-of-opioid-use-disorders-abstinence-methadone-or-buprenorphine-naloxone
#19
REVIEW
Anita Srivastava, Meldon Kahan, Maya Nader
OBJECTIVE: To advise physicians on which treatment options to recommend for specific patient populations: abstinence-based treatment, buprenorphine-naloxone maintenance, or methadone maintenance. SOURCES OF INFORMATION: PubMed was searched and literature was reviewed on the effectiveness, safety, and side effect profiles of abstinence-based treatment, buprenorphine-naloxone treatment, and methadone treatment. Both observational and interventional studies were included...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28292769/association-between-concurrent-use-of-prescription-opioids-and-benzodiazepines-and-overdose-retrospective-analysis
#20
Eric C Sun, Anjali Dixit, Keith Humphreys, Beth D Darnall, Laurence C Baker, Sean Mackey
Objectives To identify trends in concurrent use of a benzodiazepine and an opioid and to identify the impact of these trends on admissions to hospital and emergency room visits for opioid overdose.Design Retrospective analysis of claims data, 2001-13.Setting Administrative health claims database.Participants 315 428 privately insured people aged 18-64 who were continuously enrolled in a health plan with medical and pharmacy benefits during the study period and who also filled at least one prescription for an opioid...
March 14, 2017: BMJ: British Medical Journal
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