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Opioid overdose

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https://www.readbyqxmd.com/read/28918769/emergency-physicians-attitudes-and-perceived-barriers-to-the-implementation-of-take-home-naloxone-programs-in-canadian-emergency-departments
#1
Lauren Lacroix, Lisa Thurgur, Aaron M Orkin, Jeffrey J Perry, Ian G Stiell
OBJECTIVES: Rates of opioid-related deaths have reached the level of national public health crisis in Canada. Community-based opioid overdose education and naloxone distribution (OEND) programs distribute naloxone to people at risk, and the emergency department (ED) may be an underutilized setting to deliver naloxone to these people. The goal of this study was to identify Canadian emergency physicians' attitudes and perceived barriers to the implementation of take-home naloxone programs...
September 18, 2017: CJEM
https://www.readbyqxmd.com/read/28911989/u-47700-a-clinical-review-of-the-literature
#2
Kerry Anne Rambaran, Steven W Fleming, Jie An, Samantha Burkhart, Jakub Furmaga, Kurt C Kleinschmidt, A Michael Spiekerman, Saeed K Alzghari
BACKGROUND: U-47700 is a synthetic opioid developed by The Upjohn Company in the 1970s, which has recently appeared in the news and medical literature due to its toxicity. Currently, there are no clinical trial data assessing the safety of U-47700. OBJECTIVE: To describe the signs and symptoms of ingestion, laboratory testing, and treatment modalities for U-47700 intoxication. DISCUSSION: We searched PubMed, Embase, Web of Science, and EBSCO for articles using the term "U-47700" and "47700...
September 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28905733/why-it-s-inappropriate-not-to-treat-incarcerated-patients-with-opioid-agonist-therapy
#3
Sarah E Wakeman
Due to the criminalization of drug use and addiction, opioid use disorder is overrepresented in incarcerated populations. Decades of evidence supports opioid agonist therapy as a highly effective treatment that improves clinical outcomes and reduces illicit opioid use, overdose death, and cost. Opioid agonist therapy has been both studied within correctional facilities and initiated prerelease. It has been found to be beneficial, yet few incarcerated persons receive this evidence-based treatment. In addition to not offering treatment initiation for those who need it, most correctional facilities forcibly withdraw stable patients from opioid agonist therapy upon their entry into the criminal justice system...
September 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28894357/advances-in-the-delivery-of-buprenorphine-for-opioid-dependence
#4
REVIEW
Richard N Rosenthal, Viral V Goradia
Opioid use disorders (OUDs) have long been a global problem, but the prevalence rates have increased over 20 years to epidemic proportions in the US, with concomitant increases in morbidity and all-cause mortality, but especially opioid overdose. These increases are in part attributable to a several-fold expansion in the prescription of opioid pain medications over the same time period. Opioid detoxification and psychosocial treatments alone have each not yielded sufficient efficacy for OUD, but μ-opioid receptor agonist, partial agonist, and antagonist medications have demonstrated the greatest overall benefit in OUD treatment...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28889218/opioid-use-following-gynecologic-and-pelvic-reconstructive-surgery
#5
Lekha S Hota, Hussein A Warda, Miriam J Haviland, Frances M Searle, Michele R Hacker
INTRODUCTION AND HYPOTHESIS: Opioid use, addiction, and overdose are a growing epidemic in the USA. Our objective was to determine whether the amount of opioid medication prescribed following gynecologic and pelvic reconstructive surgery is insufficient, adequate, or in excess. We hypothesized that we were overprescribing postoperative opioids. METHODS: Participants who were at least 18 years old and underwent gynecologic and/or pelvic reconstructive surgery from April through August 2016 were eligible to participate...
September 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28887789/deaths-from-opioid-overdosing-implications-of-coroners-inquest-reports-2008-2012-and-annual-rise-in-opioid-prescription-rates-a-population-based-cohort-study
#6
Elspeth E Shipton, Ashleigh J Shipton, Jonathan A Williman, Edward A Shipton
INTRODUCTION: In the late 1990s multiple physicians and advocacy organizations promoted increased use of opioids for the treatment of acute, chronic and cancer pain. There has been an exponential growth in opioid prescribing in the last 20 years in the United States of America, in Australia, and in other developed Western countries. There are negative consequences associated with the liberal use of opioids. The primary aim of this population-based cohort study is to investigate the opioid-related death rate in New Zealand between 1 January 2008 and 31 December 2012...
September 8, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28885516/treating-acute-pain-in-the-opiate-dependent-patient
#7
Coleen Dever
Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28885239/opioid-use-in-children-and-adolescents-after-anterior-cruciate-ligament-repair
#8
Nicole Taylor, Shannon Frick, Samantha Killilea, Teri Dugan-Frost, Jean Solodiuk
Opioid overdose is a leading cause of death from unintentional injury in the United States. When more opioids are prescribed than needed, leftover opioids may be misused if not properly disposed. The purpose of this study is to describe the opioid use of subjects (aged 13-21 years) after an anterior cruciate ligament (ACL) repair. After obtaining IRB approval, we obtained consent from 100 subjects (over an 8-month period) undergoing ACL reconstructions performed by five sports medicine surgeons. The mean age of enrolled subjects was 16 years, most were female (60%) and white (72%)...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28882143/characteristics-of-persons-who-inject-drugs-and-who-witness-opioid-overdoses-in-vietnam-a-cross-sectional-analysis-to-inform-future-overdose-prevention-programs
#9
N A Blackburn, K E Lancaster, T V Ha, C A Latkin, W C Miller, C Frangakis, V A Chu, T Sripaipan, V M Quan, N L Minh, P T Vu, V F Go
BACKGROUND: Persons who use opioids have a high risk of overdose and associated mortality. In Vietnam, little is known about the characteristics of this population and the persons who are witness to those overdoses. One approach to combatting fatal overdose has been the use of peer interventions in which a friend or injecting partner administers overdose reversal medication, but availability in Vietnam of these medications is limited to pilot programs with aims to expand in the future (Le Minh and V...
September 7, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28879174/mobile-technology-to-increase-hiv-hcv-testing-and-overdose-prevention-response-among-people-who-inject-drugs
#10
Ian David Aronson, Alexander Bennett, Lisa A Marsch, Theodore C Bania
The United States faces dramatically increasing rates of opioid overdose deaths, as well as persistent ongoing problems of undiagnosed HIV and HCV infection. These problems commonly occur together in substance using populations that have limited, if any, access to primary care and other routine health services. To collectively address all three issues, we developed the Mobile Intervention Kit (MIK), a tablet computer-based intervention designed to provide overdose prevention and response training and to facilitate HIV/HCV testing in community settings...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28874942/effect-of-a-no-superuser-opioid-prescription-policy-on-ed-visits-and-statewide-opioid-prescription
#11
Zachary P Kahler, Paul I Musey, Jason T Schaffer, Annelyssa N Johnson, Christian C Strachan, Charles M Shufflebarger
INTRODUCTION: The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED) based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol's effect on superusers' annual ED visits. Secondary outcomes included a quantitative evaluation of statewide opioid prescriptions for these patients, unique prescribers of controlled substances, and ancillary testing...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28873050/randomized-pilot-trial-measuring-knowledge-acquisition-of-opioid-education-in-emergency-department-patients-using-a-novel-media-platform
#12
Bharath Chakravarthy, Shashank Somasundaram, Jennifer Mogi, Roshan Burns, Wirachin Hoonpongsimanont, Warren Wiechmann, Shahram Lotfipour
BACKGROUND: The number of active opioid analgesic prescriptions has risen steadily causing increases in nonmedical opioid use, addiction and overdose. Insufficient focus on patient discharge instructions has contributed to lack of patient awareness regarding dangers of opioids. We examine whether an educational Khan Academy-styled animation discharge instruction on the dangers and safe usage of opioid analgesics elicits higher knowledge acquisition than current standard of care. Additionally, we measure the feasibility of implementing this video discharge instruction in the emergency department (ED)...
September 5, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28867560/prevalence-and-characteristics-of-opioid-related-deaths-involving-alcohol-in-ontario-canada
#13
Tara Gomes, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Wim van den Brink
BACKGROUND: While it is well known that patients receiving opioids should refrain from alcohol consumption, little is known about the involvement of alcohol in opioid-related deaths. METHODS: We conducted a population-based analysis of opioid-related deaths in Ontario with and without alcohol involvement between 1993 and 2013, and reported rates overall and stratified by manner of death. We compared the characteristics of individuals who died of an opioid overdose based on the presence or absence of alcohol involvement...
August 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28865800/the-role-of-continuing-medical-education-in-increasing-enrollment-in-prescription-drug-monitoring-programs
#14
John T Finnell, Robert K Twillman, Stephanie A Breslan, Jan Schultz, Lyerka Miller
PURPOSE: Opioid diversion, misuse, and abuse are rapidly growing problems in the United States; >60% of all drug overdose deaths involve an opioid. At least 49 states now have fully operational prescription drug monitoring programs (PDMPs) to support legitimate medical use of controlled substances; however, there is considerable underutilization of such programs. METHODS: To increase awareness of PDMPs and their use, a continuing medical education program including 2 webcasts and a series of newsletters was offered to health care providers...
August 30, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28863060/socialized-risk-and-privatized-profit-what-addictions-nurses-need-to-know-about-the-potential-repeal-of-the-affordable-care-act
#15
Katherine S Fornili
The aim of this column is to provide an overview of the positive impacts of the Patient Protection and Affordable Care Act of 2010 (ACA) on improved health care access, quality, and outcomes for individuals with substance use disorders (SUDs), including opioid use disorders and opioid overdose deaths. Addictions nurses should be alerted to the serious, often lethal consequences that individuals with SUDs will experience if the ACA is repealed. Proposed legislation to reverse major provisions of the ACA include the American Health Care Act of 2017 (H...
July 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28863059/recovery-beyond-buprenorphine-nurse-led-group-therapy
#16
Susanne A Fogger, Kathleen Lehmann
It has taken the tragedy of swelling opioid overdoses to raise addictions to national attention. This past year, a new law called the Comprehensive Addictions Recovery Act has helped to open doors for nurse practitioners and physician assistants to prescribe buprenorphine. Although this medication can assist those dependent on opioids in finding needed stability, medication-assisted treatment is only the beginning. Addiction and psychiatric nurses must play a larger role in providing various therapies that coincide with medication-assisted treatment to support ongoing recovery...
July 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28861516/cannabis-as-a-substitute-for-opioid-based-pain-medication-patient-self-report
#17
Amanda Reiman, Mark Welty, Perry Solomon
Introduction: Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. Materials and Methods: The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients...
2017: Cannabis and Cannabinoid Research
https://www.readbyqxmd.com/read/28860892/patterns-of-health-care-utilization-and-cost-before-and-after-opioid-overdose-findings-from-10-year-longitudinal-health-plan-claims-data
#18
Daniel D Maeng, John J Han, Michael H Fitzpatrick, Joseph A Boscarino
OBJECTIVE: To describe the longitudinal pattern of health care utilization and cost of care before and after opioid overdose (OD) over a 10-year period using health plan claims data. METHODS: Patients who had experienced opioid ODs between April 2005 and March 2015 were identified from Geisinger Health System's electronic health records. Among these patients, a subgroup of patients who were Geisinger Health Plan (GHP) members at any point between January 2006 and December 2015 were also identified...
2017: Substance Abuse and Rehabilitation
https://www.readbyqxmd.com/read/28859052/trends-in-deaths-involving-heroin-and-synthetic-opioids-excluding-methadone-and-law-enforcement-drug-product-reports-by-census-region-united-states-2006-2015
#19
Julie K O'Donnell, R Matthew Gladden, Puja Seth
Opioid overdose deaths quadrupled from 8,050 in 1999 to 33,091 in 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010-2015, heroin overdose deaths quadrupled from 3,036 to 12,989 (1). Sharp increases in the supply of heroin and illicitly manufactured fentanyl (IMF) are likely contributing to increased deaths (2-6). CDC examined trends in unintentional and undetermined deaths involving heroin or synthetic opioids excluding methadone (i.e., synthetic opioids)* by the four U...
September 1, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28859050/overdose-deaths-related-to-fentanyl-and-its-analogs-ohio-january-february-2017
#20
Raminta Daniulaityte, Matthew P Juhascik, Kraig E Strayer, Ioana E Sizemore, Kent E Harshbarger, Heather M Antonides, Robert R Carlson
Ohio is experiencing unprecedented loss of life caused by unintentional drug overdoses (1), with illicitly manufactured fentanyl (IMF) emerging as a significant threat to public health (2,3). IMF is structurally similar to pharmaceutical fentanyl, but is produced in clandestine laboratories and includes fentanyl analogs that display wide variability in potency (2); variations in chemical composition of these drugs make detection more difficult. During 2010-2015, unintentional drug overdose deaths in Ohio increased 98%, from 1,544 to 3,050...
September 1, 2017: MMWR. Morbidity and Mortality Weekly Report
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