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Pain pill addictions

Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Brittany Chapman, Kristin L Schreiber, Robert R Edwards, Adam W Carrico, Edward W Boyer
BACKGROUND: Opioid analgesics are commonly prescribed on an as-needed (PRN) basis for acute painful conditions. Uncertainty of how patients actually take PRN opioids, coupled with a desire to completely cover pain, leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids. This opioid surplus becomes a source for diversion and nonmedical opioid use. Understanding patterns of actual opioid ingestion after acute painful conditions can help clinicians counsel patients on safe opioid use, and allow timely recognition and intervention when escalating opioid self-dosing occurs, to prevent tolerance and addiction...
December 2017: Anesthesia and Analgesia
Adam C Pomerleau, Jeanmarie Perrone, Jason A Hoppe, Matthew Salzman, Paul S Weiss, Lewis S Nelson
INTRODUCTION: Our study sought to examine the opioid analgesic (OA) prescribing decisions of emergency department (ED) providers who have themselves used OA therapeutically and those who have not. A second objective was to determine if OA prescribing decisions would differ based on the patient's relationship to the provider. METHODS: We distributed an electronic survey to a random sample of ED providers at participating centers in a nationwide research consortium...
November 2016: Western Journal of Emergency Medicine
Reuben J Strayer, Sergey M Motov, Lewis S Nelson
The United States is currently experiencing a public health crisis of opioid addiction, which has its genesis in an industry marketing effort that successfully encouraged clinicians to prescribe opioids liberally, and asserted the safety of prescribing opioids for chronic non-cancer pain, despite a preponderance of evidence demonstrating the risks of dependence and misuse. The resulting rise in opioid use has pushed drug overdose deaths in front of motor vehicle collisions to become the leading cause of accidental death in the country...
February 2017: American Journal of Emergency Medicine
Nalini Vadivelu, Leandro Lumermann, Richard Zhu, Gopal Kodumudi, Amir O Elhassan, Alan David Kaye
Drug addiction is present in a significant proportion of the population in the USA and worldwide. Drug addiction can occur with the abuse of many types of substances including cocaine, marijuana, stimulants, alcohol, opioids, and tranquilizers. There is a high likelihood that clinicians will encounter patients with substance abuse disorders on a regular basis with the prevalence of the use of illicit substances and the high rate of abuse of prescription drugs. The use of abuse deterrent formulations of prescription opioid agents, pill counts, and urine drug abuse screenings are all useful strategies...
May 2016: Current Pain and Headache Reports
Y E Tian, Li-Rong Teng, Zhen-Zuo Wang, Min Zhao, Qing-Fan Meng, Jia-Hui Lu, Jian-Ming Tian, Wei-Wei Zhang, Xiaoyi Zheng, D I Wang, LE-Sheng Teng
Jia-Yuan-Qing pill (JYQP) composed of Porcellio laevis Latreille, Corydalis Rhizoma and Radix Cynanchi Paniculati at a ratio of 9:7:7 has been found to be an effective analgesic agent. The present study aimed to evaluate the safety, addictive potential and anti-cancer pain activity of JYQP in a rat model. During the 6-month chronic toxicity test, no significant changes in general behavior, defecation, postural abnormalities, dietary or water intake or blood biochemical parameters were observed in male and female rats...
June 2015: Experimental and Therapeutic Medicine
Catherine S Hwang, Lydia W Turner, Stefan P Kruszewski, Andrew Kolodny, G Caleb Alexander
OBJECTIVES: Physicians are a key stakeholder in the epidemic of prescription opioid abuse. Therefore, we assessed their knowledge of opioid abuse and diversion, as well as their support for clinical and regulatory interventions to reduce opioid-related morbidity and mortality. MATERIALS AND METHODS: We conducted a nationally representative postal mail survey of 1000 practicing internists, family physicians, and general practitioners in the United States between February and May 2014...
April 2016: Clinical Journal of Pain
Abolfazl Goreishi, Zahra Shajari
BACKGROUND: In order to assess the status of drug abuse and likely addiction among university students, a descriptive study was designed. METHODS: 1200 subjects among the students of three universities in Zanjan were selected by stratified random sampling and their demographic information and history of substance abuse including hookah, cigarette, codeine, ibuprofen, alcohol, diazepam, tramadol, cannabis, opium, grass, heroin, crack, X pill, morphine, marijuana, Librium, and LSD were assessed by a standard questionnaire and were analyzed in 2010...
January 2013: Addiction & Health
Jooyoung Lee
How do gunshot victims manage pain without health care? This paper examines this question through ethnographic data of a single gunshot victim who self-medicated with Percocet. The observations for this paper were collected in Philadelphia between January of 2010 and October of 2011, and were part of a larger ethnographic study that included 40 gunshot victims recruited from an outpatient trauma clinic. Although this victim was able to manage his pain, he ultimately became addicted to Percocet and became entangled in the personal stress and conflicts of his pill hustlers...
December 2013: Social Science & Medicine
Raminta Daniulaityte, Russel Falck, Robert G Carlson
BACKGROUND: There has been a rise in the illicit use of pharmaceutical opioids ("pain pills") in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views. METHODS: The qualitative sub-sample (n=47) was selected from a larger sample of 396 young adults (18-23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use...
September 2012: International Journal on Drug Policy
Richard B Francoeur
This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring...
2011: Risk Management and Healthcare Policy
Bill H McCarberg
OBJECTIVE: To determine the current status of performing urine drug tests (UDTs) for monitoring chronic pain therapy, with an emphasis on their use in opioid treatment and the need for improved physician education about UDTs. RESULTS: Although opioids are commonly used in the treatment of chronic pain, their use is associated with an increased risk for drug abuse, addiction, diversion, and overdose in chronic pain patients. Thus, adherence with opioid therapy is central to optimal chronic pain management...
November 2011: Postgraduate Medicine
Joanne C Lin, Reem K Jan, HeeSeung Lee, Maree-Ann Jensen, Rob R Kydd, Bruce R Russell
RATIONALE: ‘Party Pills’ containing benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) have been used in a recreational context since the 1990s and, prior to April 2008, were legally available in New Zealand. Taken together, they have been reported to produce a ‘high’ similar to that produced by 3,4-methylenedioxymethamphetamine (MDMA). OBJECTIVES: There has been little research on the subjective effects of piperazines in humans. The purpose of this study is to further investigate the subjective and physiological responses following an oral dose of BZP combined with TFMPP in males...
April 2011: Psychopharmacology
Peggy Compton, Priscilla Kehoe, Karabi Sinha, Matt A Torrington, Walter Ling
Individuals on methadone maintenance for the treatment of addiction (MM) are demonstrated to be hyperalgesic to cold-pressor pain in comparison to matched controls and ex-opioid addicts, a finding described as clinical evidence of opioid-induced hyperalgesia (OIH). Interestingly, opioids induce hyperalgesia via many of the same neuro-inflammatory and central sensitization processes that occur with the development of neuropathic pain. Evaluated in this study was the efficacy of a key pharmacotherapy for neuropathic pain, gabapentin (GPN), to reverse OIH in MM patients...
June 1, 2010: Drug and Alcohol Dependence
Steven D Passik
Both chronic pain and prescription opioid abuse are prevalent and exact a high toll on patients, physicians, and society. Health care professionals must balance aggressive treatment of chronic pain with the need to minimize the risks of opioid abuse, misuse, and diversion. A thorough, ongoing assessment can help fashion a multimodal therapeutic plan, stratify patients by risk, and identify those who may exhibit aberrant behaviors after receiving opioid therapy. Appropriate safeguards (eg, urine drug screens, pill counts) may be used when necessary...
July 2009: Mayo Clinic Proceedings
Sudie E Back, Rebecca A Payne, Angela E Waldrop, Arthur Smith, Scott Reeves, Kathleen T Brady
OBJECTIVES: Patients who are prescribed opioids often display 1 or more aberrant prescription use behaviors (eg, requesting early refills, borrowing medication from family), which raise concern among healthcare professionals. Little is known about the sex differences in specific types of aberrant behaviors or sex-specific predictors of such behaviors. The current study is aimed to begin addressing this gap in the literature. METHODS: A battery of anonymous, self-report assessments was administered to 121 (49 men, 72 women) chronic pain patients enrolled in an outpatient pain management clinic...
July 2009: Clinical Journal of Pain
Marilyn H Byrne, Laura Lander, Martha Ferris
No abstract text is available yet for this article.
February 2009: Health & Social Work
Mary-Ann Fitzcharles, Deborah DaCosta, Mark A Ware, Yoram Shir
UNLABELLED: We have examined the characteristics of the pain experience as well as barriers to optimal pain management in 60 patients with rheumatoid arthritis (RA) consecutively attending a specialist rheumatology practice. Pain was reported to be moderate to severe in 32 (53%) and mild to absent in 28 (47%). Sixty-five percent of all patients, including almost half of those with moderate to severe pain, reported satisfaction with current pain control. The average number of barriers to pain management for individual patients was 2...
March 2009: Journal of Pain: Official Journal of the American Pain Society
Howard S Smith
Although there is no "ideal analgesic," scientists and clinicians alike continue to search for compounds with qualities which may approach the "ideal analgesic." Characteristics of an "ideal" analgesic may include: the agent is a full agonist providing optimal/maximal analgesia for a wide range/variety of pain states (e.g., broad spectrum analgesic activity), it does not exhibit tolerance, it produces no unwanted effects and minimal adverse effects, it has no addictive potential, it does not facilitate pain/hyperalgesia, it has a long duration, it has high oral bioavailability, it is not vulnerable to important drug interactions, it is not significantly bound to plasma proteins, it has no active metabolites, it has linear kinetics, and it is eliminated partly by hydrolysis to an inactive metabolite (without involvement of oxidative and conjugative enzymes)...
March 2008: Pain Physician
James E Lessenger, Steven D Feinberg
The nonmedical use of prescription or over-the-counter (OTC) medications implies that the user is using them for reasons other than those indicated in the prescribing literature or on the box label. The abuse of these medications is a national issue. Intentional drug abuse of prescribed and OTC medicines has climbed steadily. Data from the 2005 National Survey on Drug Use and Health demonstrated that 6.4 million (2.6%) people aged 12 or older had used prescription drugs for nonmedical reasons during the past month...
January 2008: Journal of the American Board of Family Medicine: JABFM
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