keyword
https://read.qxmd.com/read/38514141/identifying-provider-patient-and-practice-factors-that-shape-long-term-opioid-prescribing-for-cancer-pain-a-qualitative-study-of-american-and-australian-providers
#21
JOURNAL ARTICLE
Soraya Fereydooni, Karl Lorenz, Azin Azarfar, Tim Luckett, Jane L Phillips, William Becker, Karleen Giannitrapani
INTRODUCTION: Prescribing long-term opioid therapy is a nuanced clinical decision requiring careful consideration of risks versus benefits. Our goal is to understand patient, provider and context factors that impact the decision to prescribe opioids in patients with cancer. METHODS: We conducted a secondary analysis of the raw semistructured interview data gathered from 42 prescribers who participated in one of two aligned concurrent qualitative studies in the USA and Australia...
March 21, 2024: BMJ Open
https://read.qxmd.com/read/38506917/efficacy-of-integrating-the-management-of-pain-and-addiction-via-collaborative-treatment-impact-in-individuals-with-chronic-pain-and-opioid-use-disorder-protocol-for-a-randomized-clinical-trial-of-a-digital-cognitive-behavioral-treatment
#22
JOURNAL ARTICLE
R Ross MacLean, Brett Ankawi, Mary A Driscoll, Melissa A Gordon, Tami L Frankforter, Charla Nich, Sara K Szollosy, Jennifer M Loya, Larissa Brito, Margaridha I P Ribeiro, Sara N Edmond, William C Becker, Steve Martino, Mehmet Sofuoglu, Alicia A Heapy
BACKGROUND: Chronic pain is common among individuals with opioid use disorder (OUD) who are maintained on medications for OUD (MOUD; eg, buprenorphine or methadone). Chronic pain is associated with worse retention and higher levels of substance use. Treatment of individuals with chronic pain receiving MOUD can be challenging due to their increased clinical complexity. Given the acute and growing nature of the opioid crisis, MOUD is increasingly offered in a wide range of settings, where high-quality, clinician-delivered, empirically validated behavioral treatment for chronic pain may not be available...
March 20, 2024: JMIR Research Protocols
https://read.qxmd.com/read/38501738/simplified-processing-and-rapid-quantification-of-buprenorphine-norbuprenorphine-and-their-conjugated-metabolites-in-human-plasma-using-uplc-ms-ms-assessment-of-buprenorphine-exposure-during-opioid-use-disorder-treatment
#23
JOURNAL ARTICLE
Wenchen Zhao, Osama Y Alshogran, Hongfei Zhang, Anand Joshi, Elizabeth E Krans, Steve Caritis, Imam H Shaik, Raman Venkataramanan
Opioid use disorder (OUD) is a chronic neurobehavioral ailment and is prevalent in pregnancy. OUD is commonly treated with methadone or buprenorphine (BUP). Pregnancy is known to alter the pharmacokinetics of drugs and may lead to changes in drug exposure and response. A simple, specific, and sensitive analytical method for measuring the parent drug and its metabolites is valuable for assessing the impact of pregnancy on drug exposure. A new liquid chromatography-tandem mass spectrometric method that utilized a simple protein precipitation procedure for sample preparation and four deuterated internal standards for quantification was developed and validated for BUP and its major metabolites (norbuprenorphine [NBUP], buprenorphine-glucuronide [BUP-G], and norbuprenorphine-glucuronide [NBUP-G]) in human plasma...
April 2024: Journal of Mass Spectrometry: JMS
https://read.qxmd.com/read/38500669/observational-analysis-of-the-influence-of-medical-marijuana-use-on-quality-of-life-in-patients
#24
JOURNAL ARTICLE
Mark D Kelley, Marwah Obaid, Edward M Miller, Marla Bowie, Zachary S Heeter
INTRODUCTION: A significant gap exists in the understanding and utilization of medical marijuana and its effects on a patient's quality of life. This is largely attributed to Cannabis' sp. Schedule 1 classification, which has impeded the scientific investigation of its effects on the endocannabinoid system (ECS) and quality of life. Additionally, conflicting results from previous studies highlight the need for more research to provide guidance to both patients and clinicians regarding the therapeutic potential of medical marijuana...
2024: Medical cannabis and cannabinoids
https://read.qxmd.com/read/38500333/effect-of-a-multidisciplinary-review-panel-on-daily-morphine-milligram-equivalents-for-patients-with-chronic-pain
#25
JOURNAL ARTICLE
Glenn R Kauppila, Sarah M Strahm, Erica L Vogel, Stephanie M Raap, Dana H Cash, Kaitlin J Yost
INTRODUCTION/OBJECTIVE: Physicians and other health care professionals are challenged regularly to balance managing pain for patients with chronic pain receiving chronic opioid therapy (COT) with following the national guidelines and standards regarding daily morphine milligram equivalents (MME). This quality improvement project aimed to determine the effect of referral to a multidisciplinary review panel on daily MME for patients receiving COT for chronic pain. METHODS: This quality improvement project included patients who had an established relationship with a primary care or community internal medicine clinician at a large health care organization and were referred to a newly created multidisciplinary review panel for their recommendations regarding treatment of pain...
2024: Journal of Primary Care & Community Health
https://read.qxmd.com/read/38499566/co-targeting-the-kappa-opioid-receptor-and-dopamine-transporter-reduces-motivation-to-self-administer-cocaine-and-partially-reverses-dopamine-system-dysregulation
#26
JOURNAL ARTICLE
Paige M Estave, Steven E Albertson, Anushree N Karkhanis, Sara R Jones
Cocaine disrupts dopamine (DA) and kappa opioid receptor (KOR) system activity, with long-term exposure reducing inhibiton of DA uptake by cocaine and increasing KOR system function. Single treatment therapies have not been successful for cocaine use disorder; therefore, this study focuses on a combination therapy targeting the dopamine transporter (DAT) and KOR. Sprague Dawley rats self-administered 5 days of cocaine (1.5 mg/kg/inf, max 40 inf/day, FR1), followed by 14 days on a progressive ratio (PR) schedule (0...
March 18, 2024: Scientific Reports
https://read.qxmd.com/read/38499298/patient-perspectives-on-primary-care-providers-role-in-long-term-opioid-therapy
#27
JOURNAL ARTICLE
Lisa Eveline Maria Davies, Elsemiek A W Jansen-Groot Koerkamp, Ellen S Koster, Kelly-Jo Dalusong, Brigitte Koch, Arnt Schellekens, Mette Heringa, Marcel Bouvy
INTRODUCTION: Over the past decade, long-term use of prescription opioids for chronic non-cancer pain (CNCP) has risen globally despite the associated risks. The majority of opioid users receive their first prescription in primary care. AIM: To investigate the perspective of long-term opioid users in primary care regarding the role of healthcare providers (HCP) in their prolonged opioid use. DESIGN AND SETTING: Semi-structured interviews in Dutch primary care Methods: We recruited long-term opioid users for CNCP from seven community pharmacies in the Netherlands...
March 18, 2024: British Journal of General Practice
https://read.qxmd.com/read/38498620/patients-perspectives-on-discontinuing-buprenorphine-for-the-treatment-of-opioid-use-disorder
#28
JOURNAL ARTICLE
Jessica J Wyse, Alison Eckhardt, Dylan Waller, Adam J Gordon, Sarah Shull, Travis I Lovejoy, Katherine Mackey, Benjamin J Morasco
OBJECTIVES: Buprenorphine and other medications for opioid use disorder (OUD) are recommended as standard of care in the treatment of OUD and are associated with positive health and addiction-related outcomes. Despite benefits, discontinuation is common, with half of patients discontinuing in the first year of treatment. Addressing OUD is a major clinical priority, yet little is known about the causes of medication discontinuation from the patient perspective. METHODS: From March 2021 to April 2022, we conducted qualitative interviews with patients who had discontinued buprenorphine for the treatment of OUD within the past 12 months...
March 18, 2024: Journal of Addiction Medicine
https://read.qxmd.com/read/38497237/short-and-long-term-safety-of-discontinuing-chronic-opioid-therapy-among-older-adults-with-alzheimer-s-disease-and-related-dementia
#29
JOURNAL ARTICLE
Yu-Jung Jenny Wei, Almut G Winterstein, Siegfried Schmidt, Roger B Fillingim, Stephan Schmidt, Michael J Daniels, Steven T DeKosky
BACKGROUND: Limited evidence exists on the short- and long-term safety of discontinuing versus continuing chronic opioid therapy (COT) among patients with Alzheimer's disease and related dementias (ADRD). METHODS: This cohort study was conducted among 162,677 older residents with ADRD and receipt of COT using a 100% Medicare nursing home sample. Discontinuation of COT was defined as no opioid refills for ≥90 days. Primary outcomes were rates of pain-related hospitalisation, pain-related emergency department visit, injury, opioid use disorder (OUD) and opioid overdose (OD) measured by diagnosis codes at quarterly intervals during 1- and 2-year follow-ups...
March 1, 2024: Age and Ageing
https://read.qxmd.com/read/38491467/a-confirmed-case-of-xylazine-induced-skin-ulcers-in-a-person-who-injects-drugs-in-miami-florida-usa
#30
JOURNAL ARTICLE
Peyton V Warp, Maia Hauschild, David P Serota, Katrina Ciraldo, Irasema Cruz, Tyler S Bartholomew, Hansel E Tookes
BACKGROUND: Xylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida...
March 15, 2024: Harm Reduction Journal
https://read.qxmd.com/read/38486448/addressing-the-intersections-of-chronic-pain-and-oud-integrative-management-of-chronic-pain-and-oud-for-whole-recovery-impowr-research-network
#31
JOURNAL ARTICLE
Zu-In Su
The appearance of both chronic pain (CP) and opioid use disorder (OUD)/opioid misuse is common, can bidirectionally affect treatment outcomes, and can be challenging to treat. The successful treatment of these conditions can be further complicated by co-occurring hazardous alcohol use, general anxiety disorder, and/or major depressive disorder, and calls for the need to attend to the whole health of the patient. Health systems providing care for these individuals are often fragmented, and suffer from limited resources, expertise, and communication...
March 14, 2024: Subst Use Addctn J
https://read.qxmd.com/read/38484404/nine-year-substance-use-treatment-outcomes-with-buprenorphine-for-opioid-use-disorder-in-a-federally-qualified-health-center
#32
JOURNAL ARTICLE
Marwan Haddad, Emil Coman, Lauren Bifulco
BACKGROUND: Prescribing medication for opioid use disorder (MOUD) in primary care helps meet treatment demand, but few studies examine long-term treatment retention among medically-underserved primary care patients. METHODS: This 9-year retrospective study assessed overall retention at 6 months, and yearly up to 9 years, among 1451 patients with at least 6 months of buprenorphine prescription data from a federally-qualified health center (FQHC). We also examined whether patients who had gaps in treatment (>14 days without medication) later returned to care...
March 2, 2024: Drug and Alcohol Dependence
https://read.qxmd.com/read/38483366/five-year-longitudinal-follow-up-of-restorative-neurostimulation-shows-durability-of-effectiveness-in-patients-with-refractory-chronic-low-back-pain-associated-with-multifidus-muscle-dysfunction
#33
JOURNAL ARTICLE
Christopher Gilligan, Willem Volschenk, Marc Russo, Matthew Green, Christopher Gilmore, Vivek Mehta, Kristiaan Deckers, Kris De Smedt, Usman Latif, Dawood Sayed, Peter Georgius, Jonathan Gentile, Bruce Mitchell, Meredith Langhorst, Frank Huygen, Ganesan Baranidharan, Vikas Patel, Eugene Mironer, Edgar Ross, Alexios Carayannopoulos, Salim Hayek, Ashish Gulve, Jean-Pierre Van Buyten, Antoine Tohmeh, Jeffrey Fischgrund, Shivanand Lad, Farshad Ahadian, Timothy Deer, William Klemme, Richard Rauck, James Rathmell, Greg Maislin, Jan Pieter Heemels, Sam Eldabe
BACKGROUND: Adults with refractory, mechanical chronic low back pain associated with impaired neuromuscular control of the lumbar multifidus muscle have few treatment options that provide long-term clinical benefit. This study hypothesized that restorative neurostimulation, a rehabilitative treatment that activates the lumbar multifidus muscles to overcome underlying dysfunction, is safe and provides relevant and durable clinical benefit to patients with this specific etiology. MATERIALS AND METHODS: In this prospective five-year longitudinal follow-up of the ReActiv8-B pivotal trial, participants (N = 204) had activity-limiting, moderate-to-severe, refractory, mechanical chronic low back pain, a positive prone instability test result indicating impaired multifidus muscle control, and no indications for spine surgery...
March 11, 2024: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/38482391/take-home-naloxone-access-and-use-among-older-adults-living-with-pain-a-scoping-review
#34
REVIEW
Ryan R D Chan, Erin M Yakiwchuk, Katelyn Halpape
BACKGROUND: Opioids are a common treatment for older adults living with pain. Given high rates of polypharmacy and chronic comorbidities, older adults are at risk of opioid overdose. Evidence is now available that take-home naloxone (THN) supports reduction of opioid-related harms. It is unknown what THN initiatives are available for older adults, especially those living with chronic pain. OBJECTIVE: To summarize the literature regarding THN, with a focus on older adults using opioids for pain, including facilitators of and barriers to THN access, knowledge gaps, and pharmacist-led initiatives...
2024: Canadian Journal of Hospital Pharmacy
https://read.qxmd.com/read/38482044/sustained-morphine-exposure-alters-spinal-nmda-receptor-and-astrocyte-expression-and-exacerbates-chronic-pain-behavior-in-female-rats
#35
JOURNAL ARTICLE
Sara V Gonçalves, Stephen G Woodhams, Li Li, Gareth J Hathway, Victoria Chapman
INTRODUCTION: Sustained opioid use has long-term negative impacts on future pain experience, particularly in women. This study aimed to investigate the underlying spinal neurobiology of this clinical observation in an experimental model of joint pain. OBJECTIVES: In this study, we tested the hypothesis that sustained opioid treatment exacerbates chronic pain responses and alters spinal cord dorsal horn astrogliosis and the expression of GluN2B-containing N-methyl-d-aspartate receptors in female rats...
April 2024: Pain Reports
https://read.qxmd.com/read/38481688/characterization-of-a-nonselective-opioid-receptor-functional-antagonist-implications-for-development-as-a-novel-opioid-dependence-medication
#36
JOURNAL ARTICLE
Siavash Shahbazi Nia, Yuma T Ortiz, Julio D Zuarth Gonzalez, Leila Shamir, Kofi Frimpong-Manson, Mohammad Anwar Hossain, Sadisna Shahi, Rayna Bandy, Anoushka Bhat, Dhavalkumar Patel, Hanin Diab, Jonathan Thompson, Lance R McMahon, Jenny L Wilkerson, Nadezhda A German
Opioids represent the most extensive category of abused substances in the United States, and the number of fatalities caused by these drugs exceeds those associated with all other drug overdoses combined. The administration of naltrexone, a potent pan-opioid receptor antagonist, to an individual dependent on opioids can trigger opioid withdrawal and induce severe side effects. There is a pressing demand for opioid antagonists free of opioid withdrawal effects. In our laboratory, we have identified a compound with affinity to mu, delta, and kappa opioid receptors in the range of 150-250 nM...
March 8, 2024: ACS Pharmacology & Translational Science
https://read.qxmd.com/read/38466269/opioid-prescribing-and-outcomes-in-patients-with-sickle-cell-disease-post-2016-cdc-guideline
#37
JOURNAL ARTICLE
Hyeun Ah Kang, Bofei Wang, Jamie C Barner, Kenneth I Ataga, Robert C Mignacca, Alicia Chang, Yahan Zhang
IMPORTANCE: Although the intention of the 2016 US Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain was not to limit pain treatment for patients with sickle cell disease (SCD), clinicians and patients have recognized the possibility that the guideline may have altered outcomes for this population. However, the outcomes of the 2016 guideline for this patient population are unknown. OBJECTIVE: To examine changes in opioid prescribing patterns and health outcomes among patients with SCD before and after the release of the 2016 CDC guideline...
March 11, 2024: JAMA Internal Medicine
https://read.qxmd.com/read/38464953/accounting-for-the-interplay-of-interpersonal-and-structural-trauma-in-the-treatment-of-chronic-non-cancer-pain-opioid-use-disorder-and-mental-health-in-urban-safety-net-primary-care-clinics
#38
JOURNAL ARTICLE
Stacy Castellanos, Alexis Cooke, Sedona Koenders, Neena Joshi, Christine Miaskowski, Margot Kushel, Kelly Ray Knight
While the epidemiological literature recognizes associations between chronic non-cancer pain (CNCP), opioid use disorder (OUD), and interpersonal trauma stemming from physical, emotional, sexual abuse or neglect, the complex etiologies and interplay between interpersonal and structural traumas in CNCP populations are underexamined. Research has documented the relationship between experiencing multiple adverse childhood experiences (ACEs) and the likelihood of developing an OUD as an adult. However, the ACEs framework is criticized for failing to name the social and structural contexts that shape ACE vulnerabilities in families...
November 15, 2023: SSM Ment Health
https://read.qxmd.com/read/38458849/implementation-of-a-clinic-based-yoga-program-for-chronic-pain
#39
JOURNAL ARTICLE
Sara Hall, Lauren R O'Keefe, Madisen K Janssen, Amanda A Herrmann, Leah R Hanson
PURPOSE: Although many integrative therapies exist, studies increasingly demonstrate yoga can help change the negative neuroplastic effects experienced by people living with chronic pain. Despite encouraging findings, a gap exists in accessible yoga programs designed to meet the individual needs of those experiencing limitations from chronic pain. This study evaluated a yoga program designed for people living with chronic pain delivered in a health care setting. Although yoga began as a spiritual practice thousands of years ago, it is now widely practiced for its physical and mental well-being aspects achieved through movement and breathing techniques...
March 7, 2024: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://read.qxmd.com/read/38455774/emergency-department-management-of-low-back-pain-a-comparative-review-of-guidelines-and-practices
#40
REVIEW
Alec M Werthman, Brayden D Jolley, Andrew Rivera, Melissa A Rusli
This narrative review examines the current best practices and guidelines for integrating pharmacologic interventions, imaging, and physiotherapy in the management of low back pain. The review also explores how patient factors such as age, sex, comorbidities, and prevalent pathologies/diagnoses influence the choice and effectiveness of these treatment approaches.
February 2024: Curēus
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