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Prescription Opioid

Ludmila N Bakhireva, Bradley D Holbrook, Shikhar Shrestha, Yuridia Leyva, Malia Ashley, Sandra Cano, Jean Lowe, Julia M Stephen, Lawrence Leeman
BACKGROUND: While use of prescription opioids and medication assisted therapy (MAT) for opioid use disorder in pregnancy, as well as the incidence of neonatal opioid withdrawal syndrome (NOWS) continue to rise, little is known about outcomes for children with NOWS beyond the newborn period. METHODS: We examined 1) prenatal MAT exposure vs. unexposed healthy controls [HC]; and 2) treatment for NOWS and NOWS severity on infant neurodevelopmental and behavioral outcomes at 5-8 months of age in 78 maternal-infant pairs from the ENRICH prospective cohort study...
December 13, 2018: Early Human Development
Joseph J Palamar, Benjamin H Han, Silvia S Martins
BACKGROUND: Benzodiazepine overdose rates have increased in the US, largely from concomitant use of other drugs such as opioids. Studies are needed to examine trends in prescription tranquilizer (e.g., benzodiazepine) use-with a particular focus on use of other drugs such as opioids-to continue to inform prevention efforts. METHODS: We conducted a secondary analysis of the 2005-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample...
December 8, 2018: Drug and Alcohol Dependence
Georgia G Luchen, Emily S Prohaska, Janelle F Ruisinger, Brittany L Melton
OBJECTIVES: (1) To evaluate the number of opioid/benzodiazepine (BZD) prescription changes resulting from pharmacist communication to prescriber(s); (2) to determine the number of patients on concurrent opioid/BZD therapy from single versus multiple prescribers; (3) to compare the number of opioid/BZD prescription changes resulting from communication when a single versus multiple prescribers was involved in a patient's care; and (4) to compare the number of opioid/BZD prescription changes resulting from communication via fax versus the Kansas Health Information Network (KHIN) direct messaging feature...
December 11, 2018: Journal of the American Pharmacists Association: JAPhA
Sarah E Wakeman, Yuchiao Chang, Susan Regan, Liyang Yu, James Flood, Joshua Metlay, Nancy Rigotti
OBJECTIVES: There has been a rapid increase in the presence of illicitly manufactured fentanyl in the heroin drug supply. Buprenorphine is an effective treatment for heroin and prescription opioid use disorder; however, little is known about treatment outcomes among people using fentanyl. We compared 6-month treatment retention and opioid abstinence among people initiating buprenorphine treatment who had toxicology positive for heroin compared to fentanyl at baseline. METHODS: Retrospective cohort study of 251 adult patients initiating office-based buprenorphine treatment who had available toxicology testing across an academic health system between August 2016 and July 2017...
December 13, 2018: Journal of Addiction Medicine
Javier Muriel, César Margarit, Jordi Barrachina, Pura Ballester, Andrea Flor, Domingo Morales, José F Horga, Eduardo Fernández, Ana M Peiró
The threats involved in the long-term opioid treatment of chronic non-cancer pain (CNCP) have increased notably. Strategies to identify at-risk patients are important because there is no clear evidence showing which screening or deprescription programmes are appropriate. Our aim was to evaluate the evidence provided by pharmacogenetics applied to predict an analgesic toxicity profile in prescription opioid use disorder (POUD) patients participating in an opioid deprescription programme. Pharmacogenetic markers were analysed in an observational, prospective deprescription programme for POUD patients (n = 88) treated for CNCP...
October 29, 2018: Basic & Clinical Pharmacology & Toxicology
Benedikt Fischer, Paul Kurdyak, Wayne Jones
PURPOSE: Opioid use and associated mortality and morbidity have substantially increased in Canada, which recent interventions have aimed to reduce. Tramadol is an atypical prescription-only (but unscheduled under Canada's narcotics law) opioid analgesic and not subject to controls for other (eg, strong) opioids. Given experiences in different jurisdictions, tramadol may have been increasingly dispensed as a "substitute" drug during a period with increasingly restrictive controls for other (scheduled) opioids...
December 12, 2018: Pharmacoepidemiology and Drug Safety
Hildi Hagedorn, Marie Kenny, Adam J Gordon, Princess E Ackland, Siamak Noorbaloochi, Wei Yu, Alex H S Harris
BACKGROUND: In the US, emergency room visits and overdoses related to prescription opioids have soared and the rates of illicit opioid use, including heroin and fentanyl, are increasing. Opioid use disorder (OUD) is associated with higher morbidity and mortality, higher HIV and HCV infection rates, and criminal behavior. Opioid agonist therapy (OAT; methadone and buprenorphine) is proven to be effective in treating OUD and decreasing its negative consequences. While the efficacy of OAT has been established, too few providers prescribe OAT to patients with OUD due to patient, provider, or system factors...
December 13, 2018: Addiction Science & Clinical Practice
Matthew Daubresse, G Caleb Alexander, Deidra C Crews, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: Hemodialysis (HD) patients frequently experience pain. Previous studies of HD patients suggest increased opioid prescribing through 2010. It remains unclear if this trend continued after 2010 or declined with national trends. METHODS: Longitudinal cohort study of 484,745 HD patients in the United States Renal Data System/Medicare data. We used Poisson/negative binomial regression to estimate annual incidence rates of opioid prescribing between 2007 and 2014...
December 13, 2018: American Journal of Nephrology
Joseph K Eibl, Andrew S Wilton, Alexandra M Franklyn, Paul Kurdyak, David C Marsh
OBJECTIVES: Benzodiazepine (BZD) use is common in patients who are engaged in methadone as a treatment for opioid use disorder. BZD prescribing is generally discouraged for this patient population due to the increased risk of BZD dependence and BZD use disorder, medication-assisted treatment (MAT) discontinuation, and opioid-overdose death. However, some patients have concurrent mental health disorders, where BZD use may be clinically indicated. This study evaluates the impact of prescribed BZD on MAT outcomes...
December 12, 2018: Journal of Addiction Medicine
Harvey L Nicholson, Jolene Vincent
BACKGROUND: Prescription opioid misuse (POM) is a significant problem among U.S. adults, including Blacks, as indicated by past research. Despite potential gender differences in POM among Black adults, previous research has yet to examine this possibility. OBJECTIVES: This study identified the prevalence and unique correlates of POM among both Black men and Black women. Results were compared to those of Whites. METHODS: We used data from 2015-2016 National Survey on Drug Use and Health (N = 60,133)...
December 13, 2018: Substance Use & Misuse
Pierce D Nunley, Timothy R Deer, Ramsin M Benyamin, Peter S Staats, Jon E Block
Background: Lumbar spinal stenosis (LSS) causes significant pain and functional impairment, and medical management has increasingly included the prescription of opioid-based analgesics. Interspinous process decompression (IPD) provides a minimally-invasive treatment option for LSS. Methods: This study estimated the type, dosage, and duration of opioid medications through 5 years of follow-up after IPD with the Superion Indirect Decompression System (Vertiflex Inc...
2018: Journal of Pain Research
E Castagno, A F Urbino, R L Mancusi, F Benini
Pain is a major cause of admissions to pediatric emergency departments, but is often inappropriately managed (1). The findings of the Pain Practice in Italian Pediatric Emergency Departments on the appropriate use of paracetamol and ibuprofen have previously been reported (1,2). This multicentre, retrospective study evaluated the prescription of opioids given to patients up to the age of 14 with acute non-procedural pain by 18 Italian emergency departments between October 2014 and January 2015. This article is protected by copyright...
December 8, 2018: Acta Paediatrica
J Schneider, R Kreutz, J Bolbrinker
Due to high prescription rates as well as the frequent use as over the counter drugs, it is of interest to consider non-opioid analgesics when evaluating the quality and appropriateness of a given overall medication. This article sums up the basic pharmacology and main adverse effects of these analgesics. Non-opioids can be further classified according to their additional mechanisms of action besides analgesia. High-dose acetylsalicylic acid, traditional nonsteroidal anti-inflammatory drugs, and coxibs exhibit antipyretic and anti-inflammatory properties...
December 7, 2018: Der Schmerz
Erica Holland, Brian T Bateman, Naida Cole, Ashley Taggart, Laura A Robinson, Ronan Sugrue, Xinling Xu, Julian N Robinson
OBJECTIVE: To evaluate the effects of eliminating the routine use of oral opioids for postcesarean delivery analgesia on postcesarean opioid consumption. METHODS: At a tertiary care center, we implemented a quality improvement intervention among faculty practice patients undergoing cesarean delivery, which consisted of 1) eliminating routine ordering of oral opioids after cesarean delivery, 2) implementing guidelines for ordering a short course of opioids when deemed necessary, and 3) coupling opioid prescribing at discharge to patterns of opioid use in-hospital combined with shared decision-making...
December 4, 2018: Obstetrics and Gynecology
Olav Magnus Fredheim, Svetlana Skurtveit, Marte Handal, Vidar Hjellvik
Chronic pain due to either surgery, radiotherapy or chemotherapy is prevalent in long-term cancer survivors. Chronic pain due to successful cancer treatment should be treated as chronic non-malignant pain, primarily with non-pharmacological strategies. Based on complete national data from the Cancer registry of Norway and the Norwegian prescription database the aim of this study was to compare the use of non-opioid analgesics, opioids and benzodiazepines ten years after cancer diagnosis in long-term cancer survivors and the age and gender adjusted general population...
December 7, 2018: Pain
Maria E Linnaus, William W Sheaffer, Mariam N Ali-Mucheru, Cristine S Velazco, Matthew Neville, Richard J Gray
BACKGROUND: Surgeons are the fifth largest prescribers of opioids in the US. Few studies exist to describe surgeon prescribing practices. METHODS: A survey was conducted of surgical providers at all ACGME-accredited surgical residency programs. Statistical comparisons between groups were made. RESULTS: A total of 114 providers from 21 states responded; 58% male, 57% residents. Only 8% reported being told they were over-prescribing opioids...
December 3, 2018: American Journal of Surgery
Howard S Kim, Sabrina H Kaplan, Danielle M McCarthy, Daniel Pinto, Kyle J Strickland, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Physical therapy (PT) is commonly cited as a non-opioid pain strategy, and previous studies indicate PT reduces opioid utilization in outpatients with back pain. No study has yet examined whether PT is associated with lower analgesic prescribing in the ED setting. METHODS: This was a retrospective cohort study of discharged ED visits with a primary ICD-10 diagnosis relating to back or neck pain from 10/1/15 to 2/21/17 at an urban academic ED. Visits receiving a PT evaluation were matched with same-date visits receiving usual care...
October 23, 2018: American Journal of Emergency Medicine
Lan Guo, Min Luo, Wanxin Wang, Di Xiao, Chuhao Xi, Tian Wang, Meijun Zhao, Wei-Hong Zhang, Ciyong Lu
OBJECTIVE: The rising rate of suicidal behavior among adolescents is a growing concern, and sex differences may induce differential exposure to prescription drug misuse or suicidal behavior. We estimated, among Chinese adolescents, (1) the prevalence of nonmedical use of prescription drugs, suicidal ideation and suicide attempts; (2) whether nonmedical use of prescription drugs was independently associated with suicidal ideation and suicide attempts; and (3) whether there were sex differences in the associations...
December 10, 2018: Australian and New Zealand Journal of Psychiatry
Song Cai, Shreya Sai Bellampalli, Jie Yu, Wennan Li, Yingshi Ji, E M Kithsiri Wijeratne, Angie Dorame, Shizhen Luo, Zhiming Shan, May Khanna, Aubin Moutal, John M Streicher, A A Leslie Gunatilaka, Rajesh Khanna
For an affliction that debilitates an estimated 50 million of U.S. adults, the current chronic pain management approaches are inadequate. The Centers for Disease Control and Prevention have called for a minimization in opioid prescription and use for chronic pain conditions, and thus, it is imperative to discover alternative non-opioid based strategies. For the realization of this call, a library of natural products was screened in search of pharmacological inhibitors of both voltage-gated calcium channels and voltage-gated sodium channels, excellent targets due to their well-established roles in nociceptive pathways...
December 7, 2018: ACS Chemical Neuroscience
Gabrielle Campbell, Wayne Hall, Suzanne Nielsen
Pre-clinical research supports that cannabinoids reduce opioid dose requirements, but few studies have tested this in humans. This review evaluates ecological and epidemiological studies that have been cited as evidence that medical cannabis use may reduce opioid use and opioid-related harms. Medline and Embase were searched for relevant articles. Data were extracted on study setting, analyses approach, covariates, and outcomes. Eleven ecological and 14 epidemiological studies were found. In ecological studies, states that allow medical cannabis laws have reported a slower rate of increase in opioid overdose deaths compared with states without such laws...
December 6, 2018: International Review of Psychiatry
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