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Opioid overdose

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https://www.readbyqxmd.com/read/29778489/trends-in-non-medical-prescription-opioids-and-heroin-co-use-among-adults-2003-2014
#1
Sasha Mital, Michael Windle, Hannah L F Cooper, Natalie D Crawford
BACKGROUND: Patterns in non-medical prescription opioid (NMPO) and heroin use have recently shifted, with evidence that NMPO-only users transition to NMPO and heroin co-use. Co-use is associated with increased risk of morbidity and overdose, highlighting the need for further investigation. This study aims to quantify, describe, and explore trends in co-use. METHODS: Using data from the 2003-2014 National Surveys on Drug Use and Health, we compared co-use to NMPO- and heroin-only use across demographic, substance use and mental health characteristics with chi-squared tests...
May 16, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29778009/exploring-opioid-use-disorder-its-impact-and-treatment-among-individuals-experiencing-homelessness-as-part-of-a-family
#2
Avik Chatterjee, Eun Jin Yu, Lindsay Tishberg
BACKGROUND: Opioid Use Disorder (OUD) causes significant morbidity and mortality among people experiencing homelessness. We aimed to explore the unique way in which OUD impacts individuals experiencing homelessness as part of a family. METHODS: We conducted semi-structured interviews with adults experiencing OUD staying in Boston-area family shelters along with dependent children. We used Borkan's Immersion-Crystallization method to uncover themes from interview transcripts...
May 12, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29776702/naloxone-use-among-emergency-department-patients-with-opioid-overdose
#3
Catherine A Marco, William Trautman, Alexander Cook, Dennis Mann, Jordan Rasp, Oswald Perkins, Michael Ballester
BACKGROUND: Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses. OBJECTIVE: This study was undertaken to identify experiences regarding naloxone use among ED patients with opioid overdose. METHODS: This prospective survey study was conducted at an urban level I trauma center. A survey was administered to eligible ED patients after unintentional opioid overdose...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776688/naloxone-laws-facilitate-the-establishment-of-overdose-education-and-naloxone-distribution-programs-in-the-united-states
#4
Barrot H Lambdin, Corey S Davis, Eliza Wheeler, Stephen Tueller, Alex H Kral
BACKGROUND: The opioid overdose crisis in the United States continues to worsen. Opioid overdose mortality is entirely preventable with timely administration of naloxone. Since 2001, many states have passed laws to create an enabling environment for the implementation of overdose education and naloxone distribution (OEND) programs. We assessed whether state-level naloxone laws and their provisions stimulated the implementation of OEND programs in the United States. METHODS: Covering the period from 2000 to 2014, we utilized five data sources including the Westlaw legal database, the Prescription Drug Abuse Policy System, the Harm Reduction Coalition's OEND database, National Center of Health Statistics and the United States Census...
May 12, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29771745/national-institute-on-drug-abuse-international-program-improving-opioid-use-disorder-treatment-through-international-research-training
#5
Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29769132/toots-tastes-and-tester-shots-user-accounts-of-drug-sampling-methods-for-gauging-heroin-potency
#6
Sarah G Mars, Jeff Ondocsin, Daniel Ciccarone
BACKGROUND: Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. METHODS: Between 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption...
May 16, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29766592/scoring-the-best-deal-quantity-discounts-and-street-price-variation-of-diverted-oxycodone-and-oxymorphone
#7
Jacob A Lebin, David L Murphy, Stevan Geoffrey Severtson, Gabrielle E Bau, Nabarun Dasgupta, Richard C Dart
BACKGROUND: Diverted prescription opioids are significant contributors to drug overdose mortality. Street price has been suggested as an economic metric of the diverted prescription opioid black market. This study examined variables that may influence the street price of diverted oxycodone and oxymorphone. METHODS: A cross-sectional study was conducted utilizing data from the previously validated, crowdsourcing website StreetRx. Street price reports of selected oxycodone and oxymorphone products, between August 22, 2014 and June 30, 2016, were considered for analysis...
May 15, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29766045/post-stroke-intranasal-naloxone-delivery-reduces-microglial-activation-and-improves-behavioral-recovery-from-ischemic-injury
#8
Jenni E Anttila, Katrina Albert, Emily S Wires, Kert Mätlik, Lisa C Loram, Linda R Watkins, Kenner C Rice, Yun Wang, Brandon K Harvey, Mikko Airavaara
Ischemic stroke is the leading cause of disability, and effective therapeutic strategies are needed to promote complete recovery. Neuroinflammation plays a significant role in stroke pathophysiology, and there is limited understanding of how it affects recovery. The aim of this study was to characterize the spatiotemporal expression profile of microglial activation and whether dampening microglial/macrophage activation post-stroke facilitates the recovery. For dampening microglial/macrophage activation, we chose intranasal administration of naloxone, a drug that is already in clinical use for opioid overdose and is known to decrease microglia/macrophage activation...
March 2018: ENeuro
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#9
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
May 14, 2018: Pain
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#10
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758542/fentanyl-self-testing-outside-supervised-injection-settings-to-prevent-opioid-overdose-do-we-know-enough-to-promote-it
#11
Catherine R McGowan, Magdalena Harris, Lucy Platt, Vivian Hope, Tim Rhodes
Since 2013, North America has experienced a sharp increase in unintentional fatal overdoses: fentanyl, and its analogues, are believed to be primarily responsible. Currently, the most practical means for people who use drugs (PWUD) to avoid or mitigate risk of fentanyl-related overdose is to use drugs in the presence of someone who is in possession of, and experienced using, naloxone. Self-test strips which detect fentanyl, and some of its analogues, have been developed for off-label use allowing PWUD to test their drugs prior to consumption...
May 11, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29752701/pain-agreements-and-healthcare-utilization-in-a-veterans-affairs-primary-care-population-a-retrospective-chart-review
#12
Cynthia Kay, Erica Wozniak, Alice Ching, Joanne Bernstein
INTRODUCTION: The prevalence of chronic pain is enormous. In America, the management of chronic pain and opioids remains a critical focus. Guidelines recommend pain agreements as part of the management of chronic pain and opioids; however, evidence of improvement in patient outcomes is lacking. An aspect of patient outcome includes utilization of healthcare resources, such as emergency department visits and hospitalizations. It remains uncertain whether the use of pain agreements lessens healthcare utilization...
May 11, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29747875/young-adults-opioid-use-trajectories-from-nonmedical-prescription-opioid-use-to-heroin-drug-injection-drug-treatment-and-overdose
#13
Honoria Guarino, Pedro Mateu-Gelabert, Jennifer Teubl, Elizabeth Goodbody
INTRODUCTION: Recent research has begun to explore the transition from nonmedical use of prescription opioids (POs) to heroin and injection drug use, adding to earlier literature identifying factors that influence the transition from intranasal to injection use of heroin. However, little research has explored how these transitions are embedded within young people's broader opioid use trajectories - individual pathways that may also include experiences of nonfatal overdose and drug treatment...
May 1, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29744980/an-overview-of-take-home-naloxone-programs-in-australia
#14
Robyn Dwyer, Anna Olsen, Carrie Fowlie, Chris Gough, Ingrid van Beek, Marianne Jauncey, Nicholas Lintzeris, Grace Oh, Jane Dicka, Craig L Fry, Jeremy Hayllar, Simon Lenton
INTRODUCTION AND AIMS: Take-home naloxone (THN) programs commenced in Australia in 2012 in the Australian Capital Territory and programs now operate in five Australian jurisdictions. The purpose of this paper is to record the progress of THN programs in Australia, to provide a resource for others wanting to start THN projects, and provide a tool for policy makers and others considering expansion of THN programs in this country and elsewhere. DESIGN AND METHODS: Key stakeholders with principal responsibility for identified THN programs operating in Australia provided descriptions of program development, implementation and characteristics...
May 2018: Drug and Alcohol Review
https://www.readbyqxmd.com/read/29735629/harm-reduction-strategies-for-the-opiod-crisis
#15
Tessie Castillo
In order to reduce disease transmission and overdose death resulting from the opioid crisis, North Carolina has recently adopted several harm reduction programs, including community based naloxone distribution and syringe exchange. Additionally, discussions are taking place about safe injection facilities as a way to further reduce the harm of opioids.
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29735625/how-did-we-get-here-heroin-and-fentanyl-trafficking-trends-a-law-enforcement-perspective
#16
Leslie Cooley Dismukes
Illicit heroin and fentanyl are infecting North Carolina's communities, and causing an increasing number of overdose deaths. These trends in drug trafficking and opioid misuse represent a dramatic shift, necessitating a new and coordinated law enforcement response. The North Carolina Attorney General's Office is committed to working toward increased enforcement, prevention, and treatment to address this epidemic.
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29735615/facilitators-and-barriers-to-naloxone-kit-use-among-opioid-dependent-patients-enrolled-in-medication-assisted-therapy-clinics-in-north-carolina
#17
Prasana Khatiwoda, Rae Jean Proeschold-Bell, Christina S Meade, Lawrence P Park, Scott Proescholdbell
BACKGROUND Naloxone-an opioid antagonist that reverses the effects of opioids-is increasingly being distributed in non-medical settings. We sought to identify the facilitators of, and barriers to, opioid users using naloxone kits in North Carolina. METHODS In 2015, we administered a 15-item survey to a convenience sample of 100 treatment seekers at 4 methadone/buprenorphine Medication Assisted Therapy (MAT) clinics in North Carolina. RESULTS Seventy-four percent of participants reported having ever gotten a naloxone kit; this percentage was higher for females (81%) than males (63%) ( P = ...
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29735614/emergency-providers-opioid-prescribing-behaviors-among-medicare-part-d-beneficiaries-in-north-carolina-2013-2014-medication-utilization-and-costs
#18
Brittany Williams, Geoffrey Mospan, Rebecca Seabock, Chris Gillette, Michelle DeGeeter
BACKGROUND This study sought to quantify utilization and costs associated with opioid prescribing by emergency providers for Medicare Part D beneficiaries in North Carolina and the United States from 2013 to 2014. METHODS This was a retrospective examination of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013-2014. The main variables of interest were total number of prescription claims and total Medicare Part D medication costs for opioid analgesic medications. Generalized estimating equations were used to analyze the data...
May 2018: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29735382/evidence-based-nonpharmacologic-strategies-for-comprehensive-pain-care-the-consortium-pain-task-force-white-paper
#19
Heather Tick, Arya Nielsen, Kenneth R Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L Lemmon, Peter Wayne, Veronica Zador
Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC...
March 1, 2018: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29730987/stigma-associated-with-medication-treatment-for-young-adults-with-opioid-use-disorder-a-case-series
#20
Scott E Hadland, Tae Woo Park, Sarah M Bagley
BACKGROUND: Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment...
May 7, 2018: Addiction Science & Clinical Practice
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