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Prescription Opioid

Cornelius B Groenewald, Emily F Law, Emma Fisher, Sarah E Beals-Erickson, Tonya M Palermo
Prescription opioid misuse is a serious public health concern, yet antecedent factors are poorly described. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (n = 14,784), we examined the longitudinal relationship between history of adolescent chronic pain and odds of misusing prescription opioids in adulthood. The primary predictor variable was chronic pain status during adolescence. The primary outcome variables were prescription opioid misuse during early adulthood and adulthood...
August 8, 2018: Journal of Pain: Official Journal of the American Pain Society
A Coloma-Carmona, J L Carballo, J Rodríguez-Marín, C J van-der Hofstadt
BACKGROUND: Withdrawal symptoms have been widely shown to be a useful indicator of the severity of opioid dependence. One of the most used instruments to assess them is the Adjective Rating Scale for Withdrawal (ARSW). However, there is a lack of adaptations and validations for its use with prescription opioids, even less for chronic pain patients under treatment with these analgesics. Thus, the aims of this study were to analyze the psychometric properties and invariance across gender of the ARSW in a sample of chronic non-cancer pain patients...
August 10, 2018: European Journal of Pain: EJP
Tara Gomes, Wayne Khuu, Diana Craiovan, Diana Martins, Jordan Hunt, Kathy Lee, Mina Tadrous, Muhammad M Mamdani, J Michael Paterson, David N Juurlink
BACKGROUND: The Canadian opioid crisis is a complex, multifaceted problem involving prescribed, diverted and illicitly manufactured opioids. This study sought to characterize the contribution of prescribed opioids to opioid-related hospitalizations in Canada. METHODS: We conducted a cross-sectional study of all individuals who were admitted to hospital for opioid toxicity in British Columbia (BC), Manitoba and Ontario between April 2015 and March 2016. We used prescription claims to ascertain active prescription opioid use at time of hospital admission...
July 31, 2018: Drug and Alcohol Dependence
M Carmen Blanco-Gandía, Marta Rodríguez-Arias
Addiction pharmacotherapy aims to prevent drug abstinence symptoms, reduce drug craving and relapse, and normalize physiologic functions disrupted by chronic use of the drug. During the last 50 years, there has been an enormous revolution in pharmacotherapy for drug addiction. From abstinence as practically the only treatment option available, there are now multiple drugs on the market that have proved their efficacy in treating opiate and alcohol disorders. The present review will focus on the pharmacological treatments of the drugs whose consumption most affects individuals and society: alcohol and opiates...
August 7, 2018: European Journal of Pharmacology
Sarah S Osmundson, Britany L Raymond, Bradley T Kook, LeAnn Lam, Elizabeth B Thompson, Leslie A Schornack, Catherine E Voorhees, Michael G Richardson
OBJECTIVE: To evaluate whether individualized postdischarge oxycodone prescribing guided by inpatient opioid use reduces the number of unused opioid tablets after cesarean birth. METHODS: We conducted a randomized, controlled trial of women aged 18 years or older undergoing cesarean birth. Participants were randomized at discharge in a 1:1 ratio to a standard (30 tablets of 5 mg oxycodone) or an individualized oxycodone prescription (predicted based on each patient's inpatient opioid use)...
August 6, 2018: Obstetrics and Gynecology
Malavika Prabhu, Heloise Dubois, Kaitlyn James, Lisa R Leffert, Laura E Riley, Brian T Bateman, Marie Henderson
OBJECTIVE: To assess whether a multiphase, departmental quality improvement effort decreases opioid prescribing and increases multimodal analgesic use after cesarean delivery. METHODS: This is a prospective quality improvement study. In phase 1 of the protocol, discharge providers implemented counseling regarding expectations for pain, typical need for opioids, and importance of multimodal nonopioid analgesic use and used shared decision-making to determine the number of opioids prescribed...
August 4, 2018: Obstetrics and Gynecology
Jennifer J Carroll, Josiah D Rich, Traci C Green
OBJECTIVES: Buprenorphine/naloxone, an evidence-based treatment for opioid use disorder, is sometimes diverted for non-medical use. In Rhode Island, the prevalence of opioid use and, more recently, of fentanyl in the illicit drug supply is driving overdose fatalities, which increases the need for treatment and raises questions about the changing role of diverted medication in shaping overdose risk. METHODS: This study considered data from 2 Rhode Island based studies (conducted in 2009 and 2016, respectively) of people who use illicit or diverted prescription opioids and their patterns of buprenorphine/naloxone diversion...
August 7, 2018: Journal of Addiction Medicine
Jason N Doctor, Andy Nguyen, Roneet Lev, Jonathan Lucas, Tara Knight, Henu Zhao, Michael Menchine
Most opioid prescription deaths occur among people with common conditions for which prescribing risks outweigh benefits. General psychological insights offer an explanation: People may judge risk to be low without available personal experiences, may be less careful than expected when not observed, and may falter without an injunction from authority. To test these hypotheses, we conducted a randomized trial of 861 clinicians prescribing to 170 persons who subsequently suffered fatal overdoses. Clinicians in the intervention group received notification of their patients' deaths and a safe prescribing injunction from their county's medical examiner, whereas physicians in the control group did not...
August 10, 2018: Science
Erik Carvalho, Janet P Bettger, Lynn Bowlby, Marissa Carvalho, Daniel Dore, Misty W Corcoran, Ashley A Harris, Jennifer Bond, Adam P Goode
INTRODUCTION: Annually, >50% of the US population reports musculoskeletal (MSK) pain to a provider, with direct healthcare costs exceeding $185 billion. The number of MSK complaints and the associated costs are projected to rise, increasing demand for and burden on providers. Establishing new care models to decrease inefficiencies may lower costs and optimise care delivery. The purpose of the Integration of Musculoskeletal Physical Therapy Care in the Patient-Centred Medical Home (IMPaC) study is to compare initial evaluation by a physical therapist (PT) integrated into primary care versus initial evaluation by a primary care provider (PCP) for patients with an MSK complaint...
August 8, 2018: BMJ Open
Wen Hui Tan, Sara Feaman, Laurel Milam, Valerie Garber, Jared McAllister, Jeffrey A Blatnik, L Michael Brunt
BACKGROUND: In 2014, hydrocodone was moved from Schedule III to II, thus it could no longer be "called in" to a pharmacy. We analyzed current postoperative opioid prescribing patterns and the impact of the schedule change on the type and amount prescribed. METHODS: Opioid prescriptions for common surgeries at 1 medical center from 2013 to 2016 were analyzed retrospectively. Milligram morphine equivalents prescribed before and after the schedule change were compared by t tests, and interrupted time series models and drug frequencies were compared by χ2 and Fisher exact tests...
August 6, 2018: Surgery
Phil Skolnick
Naloxone is a specific, high affinity opioid antagonist that has been used to treat suspected or confirmed overdose for more than 40 years. Naloxone use was initially confined to an emergency room setting, but the dramatic rise in opioid overdose events over the past two decades has, with increasing frequency, shifted naloxone use to first responders including police, emergency medical technicians, and the friends and family of overdose victims. The opioids responsible for overdose events have also evolved, from prescription opioids to heroin and most recently, very high potency synthetic opioids such as fentanyl...
August 6, 2018: European Journal of Pharmacology
Sarah C Haight, Jean Y Ko, Van T Tong, Michele K Bohm, William M Callaghan
Opioid use by pregnant women represents a significant public health concern given the association of opioid exposure and adverse maternal and neonatal outcomes, including preterm labor, stillbirth, neonatal abstinence syndrome, and maternal mortality (1,2). State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic (3). Hospital discharge data from the 1999-2014 Healthcare Cost and Utilization Project (HCUP) were analyzed to describe U...
August 10, 2018: MMWR. Morbidity and Mortality Weekly Report
Zachary W Walker, Abigail R Vinson, Dean Babcock, Tara Benjamin, David M Haas
The aim of this study was to explore the "opiate misuse footprint" made by obstetrics and gynecology physicians in prescribing opioid medications for postpartum pain control that led to opioid misuse and opioid use disorder. Data were collected using intake information and anonymous surveys administered to pregnant women at local methadone clinics in Indianapolis, Indiana, in 2016-2017. Results from this study revealed that 40% of the 33 participants stated that the first drug they became addicted to was prescription opioids; 71% stated that the first opiate they became addicted to was a prescription pain medication...
August 8, 2018: Journal of Psychoactive Drugs
Cheryl L Craigs, Robert M West, Adam Hurlow, Michael I Bennett, Lucy E Ziegler
BACKGROUND: The UK National Health Service is striving to improve access to palliative care for patients with advanced cancer however limited information exists on the level of palliative care support currently provided in the UK. We aimed to establish the duration and intensity of palliative care received by patients with advanced cancer and identify which cancer patients are missing out. METHODS: Retrospective cancer registry, primary care and secondary care data were obtained and linked for 2474 patients who died of cancer between 2010 and 2012 within a large metropolitan UK city...
2018: PloS One
Derek S Mason, Liliana Tenney, Peter W Hellyer, Lee S Newman
No abstract text is available yet for this article.
September 2018: American Journal of Public Health
Kathleen F Carlson, Tess A Gilbert, Benjamin J Morasco, Dagan Wright, Joshua Van Otterloo, Aldona Herrndorf, Lawrence J Cook
OBJECTIVE: To examine the prevalence of concurrent Veterans Health Administration (VA) and non-VA prescriptions for opioids and sedative-hypnotic medications among post-9/11 veterans in Oregon. DATA SOURCES: VA health care and prescription data were probabilistically linked with Oregon Prescription Drug Monitoring Program (PDMP) data. STUDY DESIGN: This retrospective cohort study examined concurrent prescriptions among n = 19,959 post-9/11 veterans, by year (2014-2016) and by patient demographic and clinical characteristics...
August 7, 2018: Health Services Research
Ivona Krizman-Matasic, Ivan Senta, Petra Kostanjevecki, Marijan Ahel, Senka Terzic
A comprehensive study aimed at monitoring of temporal variability of illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine and cannabis) and therapeutic opiate methadone in a large-sized European city using wastewater-based epidemiology (WBE) was conducted in the city of Zagreb, Croatia, during an 8-year period (2009-2016). The study addressed the impact of different sampling schemes on the assessment of temporal drug consumption patterns, in particular multiannual consumption trends and documented the possible errors associated with the one-week sampling scheme...
August 1, 2018: Science of the Total Environment
Peter Wayne New
The controversial issue of prescribing opioids to people with spinal cord damage who have severe pain is discussed in this paper. The reasons for concern regarding the increase in opioid prescription over recent years are outlined, along with a summary of the major potential adverse outcomes associated with opioids, such as falls, respiratory suppression, adverse endocrine effects, cognitive impairment, and the potential for opioid abuse, addiction and death. Situations when opioids are more appropriate are considered to be in the immediate post-trauma or post-operative periods...
2018: Spinal Cord Series and Cases
Jessica Delorme, Chouki Chenaf, Celian Bertin, Marie Riquelme, Alain Eschalier, Denis Ardid, Nicolas Authier
Treating pain and opioid use disorder represents a clinical challenge. While most studies that have assessed opioid analgesic use in opioid substitution treatment (OST) patients primarily address opioid analgesic misuse (1, 2), only few studies focused on OST patients assessed the prescription of analgesic opioids for chronic pain. We sought to compare the prevalence of analgesic opioid prescription (AOP) in two groups of chronic non-cancer pain (CNCP) patients: OST patients vs. the general population. This was a population-based cross-sectional study based on the French national healthcare claims database SNIIRAM (Système National d'Informations Inter-Régimes de l'Assurance Maladie) covering over 66 million people (98...
2018: Frontiers in Psychiatry
Catherine Baxley, Jeremiah Weinstock, Patrick J Lustman, Annie A Garner
Given the high rates of relapse among patients with opioid use disorder (OUD), it is crucial to identify modifiable risk factors for negative treatment outcomes. Anxiety sensitivity (AS) is 1 such risk factor that may be associated with negative OUD treatment outcomes. The present study examined the potential impact of AS on the withdrawal process, subsequent treatment engagement, and relapse among individuals with OUD. Adults undergoing inpatient detoxification ( N = 90) completed self-report and researcher-administered questionnaires on Day 4 of a 5-day buprenorphine-assisted detoxification protocol, and 1 month later a follow-up evaluation assessed treatment engagement and relapse...
August 6, 2018: Experimental and Clinical Psychopharmacology
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