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Opioids AND Pain

Daniel M Becker
Mortality rates for middle-aged whites in the U.S. are rising due to drugs, alcohol, and depression. Unique to our country, these "deaths of despair" disproportionately occur among the under-educated, who are at particular risk for dying young. At one time, less-educated persons aspired to work in the same factory as their parents, at union wages, with benefits. Those jobs, and the sense of community and prosperity and security they allowed, are evaporating. Many former workers suffer from chronic pain, which underlies America's ongoing opioid overdose epidemic...
September 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Sarah F Rosen, Boram Ham, Michael Haichin, Ilana C Walters, Sarasa Tohyama, Susana G Sotocinal, Jeffrey S Mogil
The processing of pain in the central nervous system is now known to have an important immune component, including T cells of the adaptive immune system. T cells have been shown to release endogenous opioids, and although it is well known that opioids have effects on T cell populations, very little attention has been given to the converse: how T cells may affect opioid regulation. We find here that in addition to displaying significantly increased baseline pain sensitivity across various pain modalities, T cell deficient mice (CD-1 nude, Rag1 null mutant and Cd4 null mutant) exhibit pronounced deficiencies in morphine inhibition of thermal or inflammatory pain...
October 16, 2018: Pain
Marissa Pavlinich, Danielle Perret, William Evan Rivers, Justin Hata, Christopher Visco, Marlis Gonzalez-Fernandez, Tiffany Knowlton, John Whyte
No abstract text is available yet for this article.
November 2018: American Journal of Physical Medicine & Rehabilitation
Marianne Myhre, Henrik Børsting Jacobsen, Stein Andersson, Audun Stubhaug
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Pregabalin has shown opioid sparing and analgesic effects in the early postoperative period; however, perioperative effects on cognition have not been studied. A randomized, parallel group, placebo-controlled investigation in 80 donor nephrectomy patients was previously performed that evaluated the analgesic, opioid-sparing, and antihyperalgesic effects of pregabalin. This article describes a secondary exploratory analysis that tested the hypothesis that pregabalin would impair cognitive function compared to placebo...
October 17, 2018: Anesthesiology
Kelly R Peck, Jennifer L Harman, Doralina L Anghelescu
Pain and emotional distress are relevant risk factors as clinicians assess for aberrant opioid-associated behavior and provide adequate and responsible pain relief to patients who engage in behaviors that may be interpreted as drug seeking in nature. The present case illustrates how undertreated pain and treatment-related anxiety affected the opioid use of a young adult with cancer. Because these risk factors were identified during the initial consult, the treatment team was able to implement a multimodal and multidisciplinary treatment approach that provided the patient with better analgesia and coping skills for anxiety...
October 18, 2018: Journal of Adolescent and Young Adult Oncology
Deborah S Keller, Jianying Zhang, Manish Chand
BACKGROUND: Opioids are a mainstay for postsurgical pain management, but have associated complications and costs, and contribute to the opioid epidemic. While efforts to reduce opioid use exist, little study has been done on opioid utilization and its impact across surgical approaches. Our goal was to evaluate the impact of opioid utilization on quality measures and costs after open and laparoscopic colorectal surgery. METHODS: The Premier database was reviewed for inpatient colorectal procedures from January 01, 2014, to September 30, 2015...
October 17, 2018: Surgical Endoscopy
Genevieve F Dash, Anna C Wilson, Benjamin J Morasco, Sarah W Feldstein Ewing
Despite being a significant public health concern, the role of opioid prescriptions in potentiating risk of opioid misuse in the context of pediatric pain has been under-investigated. To address this gap, the present review identifies theory-based hypotheses about these associations, reviews the extant literature on opioid prescriptions that supports these hypotheses, and provides routes for future empirical studies. A multi-level model of mechanisms through which opioid prescriptions may impact pain and other negative outcomes in youth, including risk for opioid misuse and related problems, is proposed with particular attention paid to the role that psychologists can play in informing policies and developing preventative interventions in healthcare settings...
September 2018: Clinical Psychological Science
Bárbara B Garrido-Suárez, Gabino Garrido, Marian Castro-Labrada, Zenia Pardo-Ruíz, Addis Bellma Menéndez, Evelyn Spencer, Jozi Godoy-Figueiredo, Sergio H Ferreira, René Delgado-Hernández
The present study reproduces chronic post-ischemia pain (CPIP), a model of complex regional pain syndrome type I (CRPS-I), in rats to examine the possible transient and long-term anti-allodynic effect of mangiferin (MG); as well as its potential beneficial interactions with some standard analgesic drugs and sympathetic-mediated vasoconstriction and vasodilator agents during the earlier stage of the pathology. A single dose of MG (50 and 100 mg/kg, p.o.) decreased mechanical allodynia 72 h post-ischemia-reperfusion (I/R)...
2018: Frontiers in Pharmacology
Brenda Nachiyunde, Louisa Lam
Cardiac surgery induces severe postoperative pain and impairment of pulmonary function, increases the length of stay (LOS) in hospital, and increases mortality and morbidity; therefore, evaluation of the evidence is needed to assess the comparative benefits of different techniques of pain management, to guide clinical practice, and to identify areas of further research. A systematic search of the Cochrane Central Register of Controlled Trials, DARE database, Joanna Briggs Institute, Google scholar, PUBMED, MEDLINE, EMBASE, Academic OneFile, SCOPUS, and Academic search premier was conducted retrieving 1875 articles...
October 2018: Annals of Cardiac Anaesthesia
Vinicius Tieppo Francio, Brandon Barndt, Chris Towery, Travis Allen, Saeid Davani
A 34-year-old man with a history of gunshot wound (GSW) to the right upper chest developed secondary aortic valve endocarditis (AVE) and was treated with an artificial valve placement (AVP). Three months after, he presented to an outpatient pain management clinic right arm pain and was diagnosed with complex regional pain syndrome type II (CRPS II). The patient underwent a diagnostic sympathetic ganglion block, before undergoing endoscopic thoracic sympathectomy surgery. Successful outcomes revealed decreased pain, opioid utilisation and improved tolerance to therapy and activities of daily living...
October 16, 2018: BMJ Case Reports
Olufunmilayo O Adeyemi, Ismail O Ishola, Elizabeth T Adesanya, Destiny O Alohan
Background Tetracera alnifolia Willd. (Dilleniaceae) is used in traditional African Medicine for the treatment of headache, abdominal pain, and rheumatism. Hence, this study sought to investigate the antinociceptive and anti-inflammatory effects of the hydroethanolic leaf extract of T. alnifolia (HeTA) in rodents. Methods Antinociceptive activity was evaluated using the acetic acid-induced writhing, formalin-/capsaicin-induced paw licking and hot plate tests in mice. The contribution of opioidergic, l-arginine-nitric oxide, and ATP-sensitive potassium channel pathways in HeTA-induced antinociception was also evaluated...
October 17, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Paulo Reis-Pina, Peter G Lawlor, António Barbosa
No abstract text is available yet for this article.
September 28, 2018: Acta Médica Portuguesa
W Häuser, T Schubert, N Scherbaum, T Tölle
BACKGROUND: One major concern of long-term opioid therapy (LTOT) for chronic noncancer pain (CNCP) is the risk of abuse of prescribed opioids. OBJECTIVE: To examine the prevalence and predictors of opioid use-related hospitalizations and potential abuse of prescribed opioids by persons with LTOT for CNCP in a sample representative of the German statutory health insurance companies. METHODS: Retrospective cross-sectional study in 2014. Anonymized German health claims database, including 4,028,618 insured individuals of 69 German statutory health insurances...
October 16, 2018: Der Schmerz
Renata Zajączkowska, Wojciech Leppert, Joanna Mika, Magdalena Kocot-Kępska, Jarosław Woroń, Anna Wrzosek, Jerzy Wordliczek
Opioids comprise an important group of drugs used in cancer pain pharmacotherapy. In recent years, more and more studies have emerged indicating the potentially immunosuppressive effects of opioid analgesics and their serious consequences, including the risk of cancer progression. The identification of these risks has prompted a search for other effective, and most importantly, safer methods of perioperative analgesic management. Regional analgesia techniques, which allow for a significant reduction in opioid dosing and thus diminish the risk of immunosuppression associated with these drugs, seem to offer substantial hope in this respect...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
Luigi Cardia, Gioacchino Calapai, Domenico Quattrone, Cristina Mondello, Vincenzo Arcoraci, Fabrizio Calapai, Carmen Mannucci, Epifanio Mondello
Hydrocodone is one of the most prescribed oral analgesic drugs and it is one of the most abused drugs in general population. It is a mu-opioid agonist predominantly metabolized to the O-demethylated product hydromorphone and to the N-demethylated product norhydrocodone. The purpose of the study is to summarize the preclinical and clinical characteristics of hydrocodone. Pharmacokinetic aspect (terminal half-life, maximum serum concentration, and time to maximum serum concentration) of hydrocodone and the influence of metabolic genetic polymorphism in analgesic response to hydrocodone are also illustrated and commented...
2018: Frontiers in Pharmacology
Eduardo T Moro, Miller F Lambert, Ana Luiza Pereira, Thaís Artioli, Giuliana Graicer, Juliana Bevilacqua, Joshua Bloomstone
STUDY OBJECTIVES: The aim of the present study was to assess the quality of recovery from anesthesia in patients undergoing laparoscopic cholecystectomy (LC) under total intravenous anesthesia, who received either methadone or morphine for post-surgical analgesia by means of questionnaire Quality of Recovery-40 (QoR-40). DESIGN: Prospective Randomized Clinical Trial. SETTING: The setting was at an operating room, postoperative recovery area and hospital ward...
October 13, 2018: Journal of Clinical Anesthesia
Rovnat Babazade, Wael Saasouh, Amanda J Naylor, Natalya Makarova, Chiedozie I Udeh, Alparslan Turan, Belinda L Udeh
STUDY OBJECTIVE: Intravenous patient-controlled opioid analgesia (IVPCA), epidural analgesia and transversus abdominis plane (TAP) infiltrations are frequently used postoperative pain management modalities. The aim of this study was to conduct a cost-effectiveness analysis comparing the use of epidural, IVPCA, and TAP infiltrations with liposomal bupivacaine for analgesia in the first 72 h postoperatively in patients undergoing major lower abdominal surgery. DESIGN: Retrospective cost effectiveness analysis...
October 13, 2018: Journal of Clinical Anesthesia
William L Hasler, Laura A Wilson, Linda A Nguyen, William J Snape, Thomas L Abell, Kenneth L Koch, Richard W McCallum, Pankaj J Pasricha, Irene Sarosiek, Gianrico Farrugia, Madhusudan Grover, Linda A Lee, Laura Miriel, James Tonascia, Frank A Hamilton, Henry P Parkman
BACKGROUND & AIMS: Many patients with gastroparesis are prescribed opioids for pain control, but indications for opioid prescription and relations of opioid use to gastroparesis manifestations are undefined. We characterized associations of use of potent vs weaker opioids and presentations of diabetic and idiopathic gastroparesis. METHODS: We collected data on symptoms, gastric emptying, quality of life, and healthcare resource use from 583 patients with gastroparesis (more than 10% 4 hr scintigraphic retention) from the NIDDK Gastroparesis Consortium, from January 2007 through November 2016...
October 13, 2018: Clinical Gastroenterology and Hepatology
Kirin Gada, Leigh D Plant
Chronic pain is a debilitating and increasingly common medical problem with few effective treatments. In addition to the direct and indirect economic burden of pain syndromes, the concomitant increase in prescriptions for narcotics has contributed to a sharp rise in deaths associated with drug misuse-the 'opioid crisis'. Together, these issues highlight the unmet clinical and social need for a new generation of safe, efficacious analgesics. The detection and transmission of pain stimuli is largely mediated by somatosensory afferent fibres of the dorsal root ganglia...
October 16, 2018: British Journal of Pharmacology
Theresa Tharakan, Sydney Jiang, Judd Fastenberg, Thomas J Ow, Bradley Schiff, Richard V Smith, Vikas Mehta
Objectives To examine opioid-prescribing patterns after endocrine surgery. To evaluate factors associated with postoperative pain and opioid use. Study Design Cross-sectional. Setting Academic university health system. Subjects and Methods The study sample included 209 patients who underwent total thyroidectomy, hemithyroidectomy, or parathyroidectomy by 4 surgeons between August 2015 and November 2017. Eighty-nine patients completed a phone survey about postoperative pain and opioid use. Prescription, demographic, and comorbidity data were collected retrospectively...
October 16, 2018: Otolaryngology—Head and Neck Surgery
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