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Adolescent opioid

Young-A Heo, Lesley J Scott
A new sublingual buprenorphine/naloxone tablet (hereafter referred to as buprenorphine/naloxone; Zubsolv® ), combining a long-acting partial µ receptor agonist and an opioid antagonist, is approved for the treatment of opioid dependence in adults and adolescents aged > 15 years. This formulation has a higher bioavailability, better taste and faster sublingual dissolve time than a reference sublingual buprenorphine/naloxone tablet (Suboxone® ), advantages that provide greater patient preference (potentially improving adherence) and importantly may reduce the risk of buprenorphine parenteral abuse by providing similar buprenorphine exposure at an ≈ 30% lower dosage than reference buprenorphine/naloxone...
August 16, 2018: CNS Drugs
Claudia Espinosa, Ravi Jhaveri, A Sidney Barritt
PURPOSE: Hepatitis C, a chronic disease with deadly consequences, is no longer predominantly a disease of older people. METHODS: A limited search was conducted of the relevant literature on 2 topics: (1) the impact of hepatitis C on infants exposed by vertical transmission; and (2) the impact of hepatitis C infection on infected children and adolescents. The findings were supplemented by the first-hand experience of the authors. FINDINGS: Young people, including women of childbearing age, infants, children, and adolescents, are being especially affected by hepatitis C infection secondary to the intravenous drug use and opioid epidemic...
August 11, 2018: Clinical Therapeutics
Briony Larance, Natasa Gisev, Elena Cama, Elliot C Nelson, Shane Darke, Sarah Larney, Louisa Degenhardt
BACKGROUND AND AIMS: Little is known about transition pathways among heroin users prior to treatment. This study examined the demographic and clinical predictors of transition speed from heroin use, to dependence, to first treatment episode. METHODS: 1149 heroin-dependent participants recruited from opioid agonist treatment clinics in Sydney, Australia, underwent a structured interview. Age of onset (AOO) was collected for heroin use, dependence and treatment-seeking, childhood maltreatment, psychiatric history and other substance dependence...
May 25, 2018: Drug and Alcohol Dependence
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
Joseph M Firriolo, Laura C Nuzzi, Lauren C Schmidtberg, Brian I Labow
BACKGROUND: In light of the escalating opioid crisis, surgeons are increasingly focused on minimizing opioid use. Ketorolac has well-documented opioid-sparing effects in the postoperative period; however, its use is limited due to concerns of postoperative bleeding and hematoma formation. This study explores the relationship between hematoma formation and administration of perioperative ketorolac in adolescent females and young adult women undergoing reduction mammaplasty. It also aims to determine the effect of perioperative ketorolac administration on the requirement for opioid analgesia...
August 7, 2018: Plastic and Reconstructive Surgery
David P Martin, Walter P Samora, Allan C Beebe, Jan Klamar, Laura Gill, Tarun Bhalla, Giorgio Veneziano, Arlyne Thung, Dmitry Tumin, N'Diris Barry, Julie Rice, Joseph D Tobias
PURPOSE: To provide optimal conditions for neurophysiological monitoring and rapid awakening, remifentanil is commonly used during pediatric spinal surgery. However, remifentanil may induce hyperalgesia and increase postoperative opioid requirements. We evaluated the potential of methadone or magnesium to prevent remifentanil-induced hyperalgesia. METHODS: Using a prospective, randomized, blinded design, adolescents presenting for posterior spinal fusion to treat idiopathic scoliosis were assigned to receive desflurane with remifentanil alone (REMI), remifentanil + methadone (MET) (0...
August 4, 2018: Journal of Anesthesia
Robert Zura, Sue C Kaste, Michael J Heffernan, William K Accousti, Dominic Gargiulo, Zhe Wang, R Grant Steen
Adult fracture nonunion risk is related to injury severity and surgical technique, yet nonunion is not fully explained by these risk factors alone; biological risk factors are also important. We test a hypothesis that risk factors associated with pediatric fracture nonunion are similar to adult nonunion risk factors.Inception cohort study in a large payer database of pediatric fracture patients (0-17 years) in the United States in calendar year 2011. Continuous enrollment in the database was required for 12 months, to allow time to capture a nonunion diagnosis...
August 2018: Medicine (Baltimore)
Katelyn G Bennett, Calista M Harbaugh, Hsou Mei Hu, Christian J Vercler, Steven R Buchman, Chad M Brummett, Jennifer F Waljee
BACKGROUND: Surgical care represents an important source of opioid prescribing and chronic use, but rates of prolonged opioid use following pediatric procedures remain unclear. The authors describe the rates and risk factors for new persistent opioid use in patients after common cleft operations. METHODS: The authors examined claims from the Truven Marketscan databases from January 1, 2010 to December 31, 2014. The authors included opioid-naive patients ages 8 to 25, who underwent 1 of 10 cleft-related procedures...
July 27, 2018: Journal of Craniofacial Surgery
Ainsley M Sutherland, Judith Nicholls, James Bao, Hance Clarke
There is significant overlap in the pharmacological management of pain and psychological disorders. Appropriate treatment of patients' comorbid psychological disorders, including sleep disturbances often leads to an improvement in reported pain intensity. The three first line agents for neuropathic pain include tricyclic antidepressants and serotonin norepinephrine reuptake inhibitors which are medications originally developed as antidepressants. The other first line medication for chronic neuropathic pain are anticonvulsant medications initially brought to the market-place for the treatment of epilepsy and are also now being used for the treatment of anxiety disorders and substance withdrawal symptoms...
July 25, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
April N Naegeli, Lori Heath, Chunmei Zhou, Neehar Gupta, Carlton Dampier
We evaluated psychometric properties (validity, reliability, and responsiveness) of a modified Faces Pain Scale-Revised (FPS-R) in 257 patients with sickle cell anemia (SCA) 7 to below 18 years old in a randomized, multinational clinical study. The modified FPS-R asks patients to report, by daily diary, their worst intraday SCA-related pain. Intraclass correlation coefficient assessed test-retest reliability between month 1 and month 2. Pearson correlations between monthly mean SCA-related pain intensity, activity interference score, analgesic use, and opioid use assessed convergent validity...
July 23, 2018: Journal of Pediatric Hematology/oncology
Michele Maiers, Mustafa Agaoglu, Richard Brown, Christopher Cassirer, Kendrah DaSilva, Reidar P Lystad, Sarkaw Mohammad, Jessica J Wong
The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health. Three topics within public health have been identified that call for a renewed professional focus. These include healthy ageing; opioid misuse; and women's, children's, and adolescents' health. The World Federation of Chiropractic aims to enable chiropractors to proactively participate in health promotion and prevention activities in these areas, through information dissemination and coordinated partnerships...
2018: Chiropractic & Manual Therapies
Cecilia P Chung, S Todd Callahan, William O Cooper, William D Dupont, Katherine T Murray, Andrew D Franklin, Kathi Hall, Judith A Dudley, C Michael Stein, Wayne A Ray
BACKGROUND AND OBJECTIVES: Little is known about opioid prescribing for children without severe conditions. We studied the prevalence of and indications for outpatient opioid prescriptions and the incidence of opioid-related adverse events in this population. METHODS: This retrospective cohort study between 1999 and 2014 included Tennessee Medicaid children and adolescents aged 2 to 17 without major chronic diseases, prolonged hospitalization, institutional residence, or evidence of a substance use disorder...
August 2018: Pediatrics
Camelia C Minică, Karin J H Verweij, Peter J van der Most, Hamdi Mbarek, Manon Bernard, Kristel R van Eijk, Penelope A Lind, Meng Zhen Liu, Dominique F Maciejewski, Teemu Palviainen, Cristina Sánchez-Mora, Richard Sherva, Michelle Taylor, Raymond K Walters, Abdel Abdellaoui, Timothy B Bigdeli, Susan J T Branje, Sandra A Brown, Miguel Casas, Robin P Corley, George Davey Smith, Gareth E Davies, Erik A Ehli, Lindsay Farrer, Iryna O Fedko, Iris Garcia-Martínez, Scott D Gordon, Catharina A Hartman, Andrew C Heath, Ian B Hickie, Matthew Hickman, Christian J Hopfer, Jouke Jan Hottenga, René S Kahn, Jaakko Kaprio, Tellervo Korhonen, Henry R Kranzler, Ken Krauter, Pol A C van Lier, Pamela A F Madden, Sarah E Medland, Michael C Neale, Wim H J Meeus, Grant W Montgomery, Ilja M Nolte, Albertine J Oldehinkel, Zdenka Pausova, Josep A Ramos-Quiroga, Vanesa Richarte, Richard J Rose, Jean Shin, Michael C Stallings, Tamara L Wall, Jennifer J Ware, Margaret J Wright, Hongyu Zhao, Hans M Koot, Tomas Paus, John K Hewitt, Marta Ribasés, Anu Loukola, Marco P Boks, Harold Snieder, Marcus R Munafò, Joel Gelernter, Dorret I Boomsma, Nicholas G Martin, Nathan A Gillespie, Jacqueline M Vink, Eske M Derks
BACKGROUND AND AIMS: Cannabis is one of the most commonly used substances among adolescents and young adults. Earlier age at cannabis initiation is linked to adverse life outcomes including multi-substance use and dependence. This study estimated the heritability of age at first cannabis use and identify associations with genetic variants. METHODS: A twin-based heritability analysis using 8,055 twins from three cohorts was performed. We then carried-out a genome wide survival meta-analysis of age at first cannabis use in a discovery sample of 24,953 individuals from nine European, North American, and Australian cohorts, and a replication sample of 3,735 individuals...
July 13, 2018: Addiction
Eduardo R Butelman, Angelo G I Maremmani, Silvia Bacciardi, Carina Y Chen, Joel Correa da Rosa, Mary Jeanne Kreek
Background: The impact of increasing non-medical cannabis use on vulnerability to develop opioid use disorders has received considerable attention, with contrasting findings. A dimensional analysis of self-exposure to cannabis and other drugs, in individuals with and without opioid dependence (OD) diagnoses, may clarify this issue. Objective: To examine the age of onset of maximal self-exposure to cannabis, alcohol, cocaine, and heroin, in volunteers diagnosed with OD, using a rapidly administered instrument (the KMSK scales)...
2018: Frontiers in Psychiatry
Anava A Wren, Rachel Bensen, Lindsay Sceats, Melody Dehghan, Helen Yu, Jessie J Wong, Donna MacIsaac, Zachary M Sellers, Cindy Kin, K T Park
Background: Opioids are commonly prescribed for relief in inflammatory bowel disease (IBD). Emerging evidence suggests that adolescents and young adults are a vulnerable population at particular risk of becoming chronic opioid users and experiencing adverse effects. Objectives: This study evaluates trends in the prevalence and persistence of chronic opioid therapy in adolescents and young adults with IBD in the United States. Method: A longitudinal retrospective cohort analysis was conducted with the Truven MarketScan Database from 2007 to 2015...
July 7, 2018: Inflammatory Bowel Diseases
Rachel Mosher Henke, Ali Bonakdar Tehrani, Mir M Ali, Ryan Mutter, Maryann Mazer-Amirshahi, Peggy L O'Brien, Tami L Mark
OBJECTIVE: This study assessed trends in days' supply for opioid prescriptions filled by adolescents with commercial insurance and Medicaid. METHODS: IBM MarketScan commercial and Medicaid pharmacy claims data were used to measure days' supply among adolescents (2005-2016) and to determine whether there were differences between patients with commercial insurance or Medicaid coverage. RESULTS: The 2-3 days' supply decreased from 50.5% (2005) to 36...
July 9, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Jane M Garbutt, Katharine Kulka, Sherry Dodd, Randall Sterkel, Kathryn Plax
OBJECTIVE: The most common source for misused opioids is pain relievers prescribed for family and friends. Our objective was to assess knowledge, attitudes and behaviors of adolescents' caregivers regarding prescribed opioids in the home. METHODS: The self-administered survey was completed by caregivers in the waiting rooms of 12 pediatric practices in the mid-west. Eligibility required living in a home where youth ≥10 years old were frequently present. 700 of 793 (88...
July 5, 2018: Academic Pediatrics
Ty S Schepis, Christian J Teter, Sean Esteban McCabe
BACKGROUND: Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type (i.e., nonmedical misuse, medical misuse and mixed misuse) and substance use disorder (SUD) symptoms from PDM by educational status/attainment...
August 1, 2018: Drug and Alcohol Dependence
Clare Donohoe, Judy K Bosi, April Sykes, Zhaohua Lu, Belinda Mandrell
OBJECTIVES: To describe the clinical characteristics of children and adolescents undergoing hematopoietic cell transplantation (HCT) who develop oral mucositis. SAMPLE & SETTING: 45 patients who underwent HCT from July 2015 to May 2016 at St. Jude Children's Research Hospital in Memphis, Tennessee. METHODS & VARIABLES: Clinical factors were described as transplantation type, mucositis severity or grade, mucositis duration, days to engraftment, total parenteral nutrition (TPN) support, IV opioid pain management use during mucositis, positive blood or oral cultures, and length of hospitalization, then compared across mucositis grade...
July 2, 2018: Oncology Nursing Forum
Sara Post, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A Smith
OBJECTIVE: To investigate buprenorphine exposures among children and adolescents ≤19 years old in the United States. METHODS: Data were analyzed from calls to US poison control centers for 2007-2016 from the National Poison Data System. RESULTS: From 2007 to 2016, there were 11 275 children and adolescents ≤19 years old exposed to buprenorphine reported to US poison control centers. Most exposures were among children <6 years old (86...
July 2018: Pediatrics
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