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Opioid overdose

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https://www.readbyqxmd.com/read/28810127/medicaid-prior-authorization-and-opioid-medication-abuse-and-overdose
#1
Gerald Cochran, Adam J Gordon, Walid F Gellad, Chung-Chou H Chang, Wei-Hsuan Lo-Ciganic, Carroline Lobo, Evan Cole, Winfred Frazier, Ping Zheng, David Kelley, Julie M Donohue
OBJECTIVES: The US opioid medication epidemic has resulted in serious health consequences for patients. Formulary management tools adopted by payers, specifically prior authorization (PA) policies, may lower the rates of opioid medication abuse and overdose. We compared rates of opioid abuse and overdose among enrollees in plans that varied in their use of PA from "High PA" (ie, required PA for 17 to 74 opioids), with "Low PA" (ie, required PA for 1 opioid), and "No PA" policies for opioid medications...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#2
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28801372/multi-variant-genetic-panel-for-genetic-risk-of-opioid-addiction
#3
Keri Donaldson, Laurence Demers, Kirk Taylor, Joe Lopez, Sherman Chang
Over 116 million people worldwide have chronic pain and prescription dependence. In the US, opioids account for the majority of overdose deaths, and in 2014, almost 2 million Americans abused or were dependent on prescription opioids. Genetic factors may play a key role in opioid prescription addiction. Herein, we describe genetic variations between opioid addicted and non-addicted populations and derive a predictive model determining risk of opioid addiction. This case cohort study compares the frequency of 16 single nucleotide polymorphisms involved in the brain reward pathways in patients with and without opioid addiction...
August 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28800256/the-critical-care-crisis-of-opioid-overdoses-in-the-united-states
#4
Jennifer P Stevens, Michael J Wall, Lena Novack, John Marshall, Douglas J Hsu, Michael D Howell
RATIONALE: Opioid abuse is increasing, but its impact on critical care resources in the United States is unknown. OBJECTIVE: We hypothesized that there would be a rising need for critical care among opioid-associated overdoses in the United States. METHODS: We analyzed all adult admissions using a retrospective cohort study from 162 hospitals in 44 states discharged between January 1, 2009 - September 31, 2015 to describe the incidence of intensive care unit (ICU) admissions for opioid overdose over this time...
August 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28799847/the-willingness-of-people-who-inject-drugs-in-boston-to-use-a-supervised-injection-facility
#5
Casey León, Lena Cardoso, Sarah Mackin, Barry Bock, Jessie M Gaeta
BACKGROUND: In Massachusetts, the number of opioid-related deaths has increased 350% since 2000. In the setting of increasing overdose deaths, one potential intervention is Supervised Injection Facilities (SIFs). This study explores willingness of people who inject drugs in Boston to use a SIF and examines factors associated with willingness. METHODS: A cross-sectional survey of a convenience sample of 237 people who inject drugs and utilize Boston's needle exchange program (NEP)...
August 11, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28797652/geographic-variation-in-opioid-and-heroin-involved-drug-poisoning-mortality-rates
#6
Christopher J Ruhm
INTRODUCTION: An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates. This analysis supplies improved estimates of state opioid and heroin involved drug fatality rates in 2014, and changes from 2008 to 2014. METHODS: Reported mortality rates were calculated directly from death certificates and compared to corrected rates that imputed drug involvement when no drug was specified...
August 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28796591/utilization-of-buprenorphine-and-methadone-among-opioid-users-who-inject-drugs
#7
Judith I Tsui, Richard Burt, Hanne Thiede, Sara N Glick
BACKGROUND: There has been a rise in opioid abuse and related injection drug use in the United States and treatment for opioid use disorders may be underutilized. The study aim was to describe utilization of opioid agonist therapy (OAT), and assess factors associated with utilization of OAT, among persons who inject drugs (PWID) in the Seattle metropolitan area. METHODS: We used data from the 2015 National HIV Behavioral Surveillance (NHBS) system among PWID in the Seattle area...
August 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28794799/recommendations-for-action-a-community-meeting-in-preparation-for-a-mass-casualty-opioid-overdose-event-in-southeastern-ontario
#8
Kieran Michael Moore, Nicholas Papadomanolakis-Pakis, Adrienne Hansen-Taugher, Tianxiu H Guan, Brian Schwartz, Paula Stewart, Pamela Leece, Richard Bochenek
Given the steady rise of overdose morbidity and mortality in North America, and increasing frequency of sudden clusters of non-fatal and fatal overdoses in other jurisdictions, regional preparedness plans to respond effectively to clusters of overdoses may reduce the impact of such events on the population. On the 27th of February 2017 in Kingston, Ontario, KFL&A Public Health, in collaboration with public health partners, hosted a full-day workshop involving table-top exercises and discussions for service partners on how to prepare for, respond to, and manage a mass-casualty event secondary to opioid overdose in Southeastern Ontario...
2017: BMC Proceedings
https://www.readbyqxmd.com/read/28792293/the-opioid-epidemic-challenges-of-sustained-remission
#9
Nitin Chopra, Lauren H Marasa
Opioid use disorder is a growing epidemic, with an alarming number of associated deaths. In 2014, in the United States, 18,893 lethal overdoses were related to prescription opioids and 10,574 due to heroin. Despite the growing number of treatment options for substance use disorders, which are chronic, relapsing-remitting conditions, relapse rates remain as high as 91%. In the United States, 7.5 million children reside with at least one patient who abuses drugs or alcohol. Mothers are twice as likely to lose custody of their children...
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#10
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28772173/heroin-use-onset-among-nonmedical-prescription-opioid-users-in-the-club-scene
#11
Hilary L Surratt, Steven P Kurtz, Mance Buttram, Maria A Levi-Minzi, Maria E Pagano, Theodore J Cicero
BACKGROUND: Nonmedical prescription opioid use (NMPOU) is well documented among participants in the club scene, yet prior studies have not examined transition to heroin use. We prospectively examined heroin initiation among a sample of young adults with drug involvement associated with participation in the club scene, to understand factors that influence transition from NMPOU to heroin and to identify opportunities for intervention. METHODS: Data were drawn from a randomized trial that enrolled 750 Miami-based club and prescription drug users through respondent driven sampling, and tested the efficacy of assessment interventions in reducing risk...
July 26, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28772172/naloxone-use-among-overdose-prevention-trainees-in-new-york-city-a-longitudinal-cohort-study
#12
Anne Siegler, Zina Huxley-Reicher, Lara Maldjian, Robyn Jordan, Chloe Oliver, Andrea Jakubowski, Hillary V Kunins
BACKGROUND: Providing naloxone to laypersons who are likely to witness an opioid overdose is now a widespread public health response to the national opioid overdose epidemic. Estimating the proportion of individuals who use naloxone can define its potential impact to reduce overdose deaths at a population level. We determined the proportion of study participants who used naloxone within 12 months following training and factors associated with witnessing overdose and naloxone use. METHODS: We conducted a prospective, observational study of individuals completing overdose prevention training (OPT) between June and September 2013...
July 24, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28770975/paracetamol-acetaminophen-for-chronic-non-cancer-pain-in-children-and-adolescents
#13
REVIEW
Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson, David G Williams, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28768409/opiates-and-plasticity-in-the-ventral-tegmental-area
#14
Ludovic D Langlois, Fereshteh S Nugent
Opioids are among the most effective pain relievers; however, their abuse has been on the rise worldwide evident from an alarming increase in accidental opioid overdoses. This demands for an urgent increase in scientific endeavors for better understanding of main cellular mechanisms and circuits involved in opiate addiction. Preclinical studies strongly suggest that memories associated with positive and negative opioid experiences are critical in promoting compulsive opiate-seeking and opiate-taking behaviors, and relapse...
August 16, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28767563/incidence-and-risk-factors-of-long-term-opioid-use-in-elderly-trauma-patients
#15
Raoul Daoust, Jean Paquet, Lynne Moore, Sophie Gosselin, Céline Gélinas, Dominique M Rouleau, Mélanie Bérubé, Judy Morris
OBJECTIVE: Evaluate the incidence and risk factors of opioid use 1 year after injury in elderly trauma patients. BACKGROUND: The current epidemic of prescription opioid misuse and overdose observed in North America generally concerns young patients. Little is known on long-term opioid use among the elderly trauma population. METHODS: In a retrospective observational multicenter cohort study conducted on registry data, all patients 65 years and older admitted (hospital stay >2 days) for injury in 57 adult trauma centers in the province of Quebec (Canada) between 2004 and 2014 were included...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28767538/two-fatal-intoxications-due-to-tramadol-alone-autopsy-case-reports-and-review-of-the-literature
#16
Sara Gioia, Massimo Lancia, Mauro Bacci, Fabio Suadoni
Since tramadol was marketed, it has been widely prescribed as a pain killer because of its relatively safe profile among opioids.Nevertheless, intoxication can occur: overdose can lead to fatal outcomes mostly in association with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased central nervous system (CNS) depression.Fatal outcomes only attributable to tramadol are a rare entity. In this case report, 2 fatal cases are described due to tramadol stand-alone intoxication with peculiar characteristics...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28762157/risk-markers-for-fatal-and-non-fatal-prescription-drug-overdose-a-meta-analysis
#17
REVIEW
Joanne E Brady, Rebecca Giglio, Katherine M Keyes, Charles DiMaggio, Guohua Li
BACKGROUND: Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28759547/nonmedical-prescription-opioid-use-for-the-self-treatment-of-pain-in-young-adults-a-national-shame
#18
Steven D Passik
: Evans et al. (2017) have pointed out how frequently and pervasively nonmedical prescription opioid use is associated with severe pain in young adults, especially young white males. This is a subset of such nonmedical users at tremendous risk of overdose (indeed 1/3 of the study respondents had an overdose event), especially given their concomitant use of benzodiazepines. Avoiding further contributing to the catastrophic rise in overdoses requires access to comprehensive pain care for these young adults. If they were to require opioid therapy, it would have to be in the context of a highly complex and expert variety of such care...
July 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28755832/-serious-adverse-drug-reactions-with-tramadol-reported-to-the-french-pharmacovigilance-database-between-2011%C3%A2-and-2015
#19
Florence Moulis, Vanessa Rousseau, Delphine Abadie, Kamel Masmoudi, Joëlle Micallef, Caroline Vigier, Sabrina Pierre, Anne Dautriche, François Montastruc, Jean-Louis Montastruc
BACKGROUND: Tramadol is an opioid and a serotonin reuptake inhibitor drug. It is approved for moderate to severe pain in adults. The aim of this study was to assess tramadol safety through a national pharmacovigilance study in France since dextropropoxyphen withdrawal in 2011. METHODS: We described all serious adverse drug reactions (SADRs) reported with tramadol in adults in the French National PharmacoVigilance Database from August 1st, 2011 to December 31st, 2015...
June 29, 2017: Thérapie
https://www.readbyqxmd.com/read/28750193/awareness-possession-and-use-of-take-home-naloxone-among-illicit-drug-users-vancouver-british-columbia-2014-2015
#20
Seonaid Nolan, Jane Buxton, Sabina Dobrer, Huiru Dong, Kanna Hayashi, M J Milloy, Thomas Kerr, Julio Montaner, Evan Wood
OBJECTIVES: Although take-home naloxone (THN) programs are integral in strategies to prevent overdose deaths among opioid users, the uptake of THN among people who use drugs (PWUD) (including non-opioid users) is unknown. The objectives of this study were to determine awareness, possession, and use of THN among PWUD in Vancouver, Canada, and identify barriers to adopting this strategy. METHODS: From December 1, 2014, to May 29, 2015, participants in 2 prospective cohort studies of PWUD in Vancouver completed a standardized questionnaire, which asked about awareness, possession, and use of THN; sociodemographic characteristics; and drug use patterns...
January 1, 2017: Public Health Reports
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