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Adolescent opioid

Vicki Osborne, Catherine W Striley, Sara J Nixon, Almut G Winterstein, Linda B Cottler
BACKGROUND: Non-medical use (NMU) of prescription opioids is a public health concern and sex differences in prevalence of NMU have been observed previously. Little is known about how youth are obtaining and using these drugs. While any regular use could be problematic, NMU is particularly concerning. More information is needed on NMU patterns among youth and how these patterns might differ by sex. METHODS: The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) recruited youth 10-18 years of age from 10 US metropolitan areas from 2008 to 2011 with a final sample of 11,048 youth...
October 9, 2018: Addictive Behaviors
Garth D Meckler, David C Sheridan, Christina J Charlesworth, Nicoleta Lupulescu-Mann, Hyunjee Kim, Benjamin C Sun
OBJECTIVES: To characterize the frequency of opioid prescribing for pediatric headache in both ambulatory and emergency department (ED) settings, including prescribing rates by provider type. STUDY DESIGN: A retrospective cohort study of Washington State Medicaid beneficiaries, aged 7-17 years, with an ambulatory care or ED visit for headache between January 1, 2012, and September 30, 2015. The primary outcome was any opioid prescribed within 1 day of the visit...
September 28, 2018: Journal of Pediatrics
Maria A Parker, James C Anthony
Among young people who start using prescription pain relievers (PPRs) for feeling-states such as "to get high" or otherwise beyond boundaries intended by prescribers, the most recent epidemiological incidence estimates show 2%-9% with rapid-onset opioid dependence. In this work, we study recently active underage alcohol dependence as a susceptibility marker and estimate alcohol dependence-associated PPR rates of use, once use starts. In recent U.S. epidemiological samples, we identified 16,125 community-dwelling 12-to-20-year-olds with standardized assessments of both problem drinking and newly incident extra-medical PPR use...
September 27, 2018: Experimental and Clinical Psychopharmacology
Bryan Stefek, L Timothy Wolfe, Mark Cohen
We present the case of a 14-year-old boy with obesity, hypertension, and chronic loperamide abuse who presented to our facility with symptoms of opioid withdrawal and type 1 Brugada pattern on an electrocardiogram. He was treated for anxiety and withdrawal. There were no documented dysrhythmias. His Brugada pattern resolved by hospital day 5 and remained resolved 12 days postadmission. Genetic testing revealed a heterozygous missense mutation in the SCN5A gene (c. 5038G>A, p. Ala1680Thr), which has been reported in association with Brugada syndrome...
October 2018: Pediatrics
Linnea Granholm, Lova Segerström, Ingrid Nylander
Adolescent binge drinking is associated with an increased risk of substance use disorder, but how ethanol affects the central levels of endogenous opioid peptides is still not thoroughly investigated. The aim of this study was to examine the effect of repeated episodic ethanol exposure during adolescence on the tissue levels of three different endogenous opioid peptides in rats. Outbred Wistar rats received orogastric (i.e., gavage) ethanol for three consecutive days per week between 4 and 9 weeks of age. At 2 h and 3 weeks, respectively, after the last exposure, beta-endorphin, dynorphin B and Met-enkephalin-Arg6 Phe7 (MEAP) were analyzed with radioimmunoassay...
2018: Frontiers in Psychiatry
Leila Ahmad-Molaei, Hossein Hassanian-Moghaddam, Fariba Farnaghi, Carlos Tomaz, Abbas Haghparast
Methadone is used as a substitution drug for the treatment of opioid dependence and chronic pain. Despite its widespread use and availability, there is a serious concern with respect to the relative safety of methadone. The purpose of this study was to characterize how acute methadone overdose affects the cognitive and motor performance of naïve healthy rats. The methadone overdose was induced by administering an acute toxic dose of methadone (15 mg/kg; ip; the equivalent dose of 80% of LD50 ) to adolescent rats...
2018: Frontiers in Pharmacology
Amanda M Brandow, Karla Hansen, Melodee Nugent, Amy Pan, Julie A Panepinto, Cheryl L Stucky
Sickle cell disease (SCD) pain associates with cold temperature and touch. Patients and murine models with SCD have baseline thermal and mechanical pain. In SCD mice, the baseline hypersensitivity is exacerbated by experimental vaso-occlusive crises. We hypothesized that SCD patients will similarly experience increased hypersensitivity to thermal and mechanical stimuli during acute painful events compared to baseline health. We conducted a prospective study of 24 SCD patients ages 7-19 yrs. Patients underwent quantitative sensory testing to thermal (cold/heat) and mechanical stimuli on the thenar eminence of the non-dominant hand (glabrous skin) and the lateral dorsum of the foot (hairy skin) during baseline health and within 48 hrs of hospitalization for acute pain...
September 20, 2018: Pain
Anna L Goldman, Harrison G Pope, Shalender Bhasin
Context: The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AAS, and the need for an integrated health policy and regulatory response to stem these epidemics. Evidence Acquisition: We searched for studies published in English language prior to June 2018...
September 17, 2018: Journal of Clinical Endocrinology and Metabolism
E J M Achterberg, M M H van Swieten, D J Houwing, V Trezza, L J M J Vanderschuren
Social play behaviour is a vigorous form of social interaction abundant during the juvenile and adolescent phases of life in many mammalian species, including rats and humans. Social play is thought to be important for social, emotional and cognitive development. Being a rewarding activity, the expression of social play depends on its pleasurable and motivational properties. Since opioids have been widely implicated in reward processes, in the present study we investigated the role of opioids in the pleasurable and motivational properties of social play behaviour in rats...
September 12, 2018: Neuropharmacology
Hiroyuki Seki, Satoshi Ideno, Taiga Ishihara, Kota Watanabe, Morio Matsumoto, Hiroshi Morisaki
Posterior spinal fusion for adolescent idiopathic scoliosis is one of the most invasive surgical procedures performed in children and adolescents. Because of the extensive surgical incision and massive tissue trauma, posterior spinal fusion causes severe postoperative pain. Intravenous patient-controlled analgesia with opioids has been the mainstay of postoperative pain management in these patients. However, the use of systemic opioids is sometimes limited by opioid-related side effects, resulting in poor analgesia...
2018: Scoliosis and Spinal Disorders
James Dahlhamer, Jacqueline Lucas, Carla Zelaya, Richard Nahin, Sean Mackey, Lynn DeBar, Robert Kerns, Michael Von Korff, Linda Porter, Charles Helmick
Chronic pain, one of the most common reasons adults seek medical care (1), has been linked to restrictions in mobility and daily activities (2,3), dependence on opioids (4), anxiety and depression (2), and poor perceived health or reduced quality of life (2,3). Population-based estimates of chronic pain among U.S. adults range from 11% to 40% (5), with considerable population subgroup variation. As a result, the 2016 National Pain Strategy called for more precise prevalence estimates of chronic pain and high-impact chronic pain (i...
September 14, 2018: MMWR. Morbidity and Mortality Weekly Report
Christine L Mattson, Julie O'Donnell, Mbabazi Kariisa, Puja Seth, Lawrence Scholl, R Matthew Gladden
In 2016, 63,632 drug overdose deaths occurred in the United States, 42,249 (66.4%) of which involved opioids (1). The development of prevention programs are hampered by a lack of timely data on specific substances contributing to and circumstances associated with fatal overdoses. This report describes opioid overdose deaths (referred to as opioid deaths) for decedents testing positive for prescription opioids (e.g., oxycodone and hydrocodone), illicit opioids (e.g., heroin, illicitly manufactured fentanyl, and fentanyl analogs), or both prescription and illicit opioids, and describes circumstances surrounding the overdoses, in 11 states participating in CDC's Enhanced State Opioid Overdose Surveillance (ESOOS) program...
August 31, 2018: MMWR. Morbidity and Mortality Weekly Report
J Deanna Wilson, Justin Berk, Hoover Adger, Leonard Feldman
PURPOSE: Pediatricians play a role in reducing opioid-related harms, including deaths, for patients and families. We examine knowledge, attitudes, and barriers to overdose prevention and naloxone prescribing in the clinical setting by pediatric trainees. METHODS: Pediatric trainees at an academic medical center were surveyed using an adapted 17-item instrument examining knowledge, beliefs, and attitudes of naloxone and overdose prevention. RESULTS: Eighty-two percent reported frequent exposure to patients using opioids and at risk of overdose...
August 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Line Caes, Emma Fisher, Jacqui Clinch, Christopher Eccleston
Purpose of review: We review the prevalence of pediatric chronic musculoskeletal pain, the clinical need, the evidence for pharmacological, psychological, physical and, complementary approaches to pain management, and the possible future development of interdisciplinary and distance care. Recent findings: We summarize the Cochrane Systematic Reviews on pharmacological interventions, which show a lack of evidence to support or refute the use of all classes of medication for the management of pain...
2018: Current Treatment Options in Rheumatology
Alexander J Adams, Wallis T Muhly, Harshad G Gurnaney, Joy C Kerr, Lawrence Wells
Introduction Peripheral nerve blockade (PNB) can be a useful component of a multimodal analgesia approach in managing pain after knee arthroscopy. However, the impact of PNB and short-term recovery in pediatric patients, particularly adolescents, who underwent knee arthroscopy for anterior cruciate ligament (ACL) reconstruction and/or meniscus surgery (repair or resection) has not been well characterized. This prospective study presents observational data on short-term patient outcomes and side effects for 72 hours following discharging home of pediatric patients who underwent arthroscopic ACL and/or meniscus procedures with PNB...
June 21, 2018: Curēus
Dena Kota, Mai Alajaji, Deniz Bagdas, Dana E Selley, Laura J Sim-Selley, M Imad Damaj
RATIONALE: There is extensive literature regarding nicotine-opioid functional interactions. The possibility that use of nicotine products during adolescence might increase the risk of substance abuse such as morphine later in adulthood is particularly relevant to the current opioid crisis. OBJECTIVES: To investigate the effects of nicotine exposure for seven days during adolescence in mice on morphine reward as well as morphine physical dependence later in adulthood...
October 2018: Pharmacology, Biochemistry, and Behavior
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...
September 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 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...
October 1, 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 (N = 14,784), we examined the longitudinal relationship between a history of adolescent chronic pain and the 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 9, 2018: Journal of Pain: Official Journal of the American Pain Society
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