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Opioid overdose

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https://www.readbyqxmd.com/read/29343479/postsurgical-prescriptions-for-opioid-naive-patients-and-association-with-overdose-and-misuse-retrospective-cohort-study
#1
Gabriel A Brat, Denis Agniel, Andrew Beam, Brian Yorkgitis, Mark Bicket, Mark Homer, Kathe P Fox, Daniel B Knecht, Cheryl N McMahill-Walraven, Nathan Palmer, Isaac Kohane
OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use...
January 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29342356/the-dark-side-of-total-synthesis-strategies-and-tactics-in-psychoactive-drug-production
#2
Schuyler A Chambers, Jenna M DeSousa, Eric D Huseman, Steven D Townsend
Humankind has used and abused psychoactive drugs for millennia. Formally, a psychoactive drug is any agent that alters cognition and mood. The term "psychotropic drug" is neutral and describes the entire class of substrates, licit and illicit, of interest to governmental drug policy. While these drugs are prescribed for issues ranging from pain management to anxiety, they are also used recreationally. In fact, the current opioid epidemic is the deadliest drug crisis in American history. While the topic is highly politicized with racial, gender, and socioeconomic elements, there's no denying the toll drug mis- and overuse is taking on this country...
January 17, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29336948/the-effect-of-a-potentially-tamper-resistant-oxycodone-formulation-on-opioid-use-and-harm-main-findings-of-the-national-opioid-medications-abuse-deterrence-nomad-study
#3
Briony Larance, Timothy Dobbins, Amy Peacock, Robert Ali, Raimondo Bruno, Nicholas Lintzeris, Michael Farrell, Louisa Degenhardt
BACKGROUND: Escalation of pharmaceutical opioid use and harm in North America is well-documented, with similar issues emerging in Australia. One response is the development of tamper-resistant formulations of opioids. A potentially tamper-resistant formulation of controlled-release oxycodone was introduced in Australia in April, 2014, rapidly replacing the non-tamper-resistant formulation. Our study is the most systematic and comprehensive examination of the impact of a new opioid formulation to date, assessing the effect of tamper-resistant formulation of controlled-release oxycodone on population-level opioid use and opioid-related harm (ie, overdose, help-seeking, and treatment-seeking); and opioid use, tampering, and preference for the tamper-resistant formulation of controlled-release oxycodone compared with other drugs or formulations among sentinel populations likely to tamper with pharmaceutical opioids...
January 10, 2018: Lancet Psychiatry
https://www.readbyqxmd.com/read/29335260/an-emergency-response-to-the-opioid-overdose-crisis-in-canada-a-regulated-opioid-distribution-program
#4
Mark Tyndall
No abstract text is available yet for this article.
January 15, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#5
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29322813/opioid-drug-poisonings-in-ohio-adolescents-and-young-adults-2002-2014
#6
Sarah Caupp, Janine Steffan, Junxin Shi, Krista K Wheeler, Henry A Spiller, Marcel J Casavant, Henry Xiang
CONTEXT: Opioids represent a drug class that adolescents and young adults intentionally misuse and abuse. When taken on their own or with other substances in this manner, opioids pose an increased risk of overdose and potential death. OBJECTIVE: To determine trends of opioid drug poisonings among adolescents and young adults in Ohio from 2002 to 2014 using Poison Control Center (PCC) data. METHODS: Data were obtained from Ohio PCCs from 2002 to 2014 for opioid drug poisonings amongst 10-29 year olds...
January 11, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29319475/drug-overdose-deaths-in-the-united-states-1999-2016
#7
Holly Hedegaard, Margaret Warner, Arialdi M Miniño
Data from the National Vital Statistics System, Mortality: -In 2016, there were more than 63,600 drug overdose deaths in the United States. -The age-adjusted rate of drug overdose deaths in 2016 (19.8 per 100,000) was 21% higher than the rate in 2015 (16.3). -Among persons aged 15 and over, adults aged 25-34, 35-44, and 45-54 had the highest rates of drug overdose deaths in 2016 at around 35 per 100,000. -West Virginia (52.0 per 100,000), Ohio (39.1), New Hampshire (39.0), the District of Columbia (38.8), and Pennsylvania (37...
December 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/29318006/naloxone-dosage-for-opioid-reversal-current-evidence-and-clinical-implications
#8
REVIEW
Rachael Rzasa Lynn, J L Galinkin
Opioid-related mortality is a growing problem in the United States, and in 2015 there were over 33,000 opioid-related deaths. To combat this mortality trend, naloxone is increasingly being utilized in a pre-hospital setting by emergency personnel and prescribed to laypersons for out-of-hospital administration. With increased utilization of naloxone there has been a subsequent reduction in mortality following an opioid overdose. Reversal of opioid toxicity may precipitate an opioid-withdrawal syndrome. At the same time, there is a risk of inadequate response or re-narcotization after the administration of a single dose of naloxone in patients who have taken large doses or long-acting opioid formulations, as the duration of effect of naloxone is shorter than that of many opioid agonists...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29315508/changing-prescribing-behavior-in-the-united-states-moving-upstream-in-opioid-prescription-education
#9
H Jean, C Wiese, Raven R Piercey, Claire D Clark
In the U.S., deaths from prescription opioids have quadrupled since 1999, prompting authorities to declare an "opioid abuse" crisis. Rising overdose deaths were attributed to trends in the over-prescription of opioids, specifically the strength and duration of the initial prescription. We describe educational interventions designed to control health care professionals' (HCP) opioid prescribing in the wake of this crisis. A review of relevant programs for practicing providers, medical residents, and medical students reveals a focus on educational interventions that we describe, borrowing from sociologist John McKinlay's metaphor for public health interventions, as "downstream...
January 9, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29314075/alcohol-and-opioid-use-co-use-and-chronic-pain-in-the-context-of-the-opioid-epidemic-a-critical-review
#10
Katie Witkiewitz, Kevin E Vowles
The dramatic increase in opioid misuse, opioid use disorder (OUD), and opioid-related overdose deaths in the United States has led to public outcry, policy statements, and funding initiatives. Meanwhile, alcohol misuse and alcohol use disorder is a highly prevalent public health problem associated with considerable individual and societal costs. This paper provides a critical review of alcohol and opioid misuse, including issues of prevalence, morbidity, and societal costs. We also review research on interactions between alcohol and opioid use, the influence of opioids and alcohol on alcohol use disorder (AUD) and OUD treatment outcomes, respectively, the role of pain in the co-use of alcohol and opioids, and treatment of comorbid OUD and AUD...
January 4, 2018: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29310928/sofosbuvir-and-velpatasvir-for-hepatitis-c-virus-infection-in-people-with-recent-injection-drug-use-simplify-an-open-label-single-arm-phase-4-multicentre-trial
#11
Jason Grebely, Olav Dalgard, Brian Conway, Evan B Cunningham, Philip Bruggmann, Behzad Hajarizadeh, Janaki Amin, Julie Bruneau, Margaret Hellard, Alain H Litwin, Philippa Marks, Sophie Quiene, Sharmila Siriragavan, Tanya L Applegate, Tracy Swan, Jude Byrne, Melanie Lacalamita, Adrian Dunlop, Gail V Matthews, Jeff Powis, David Shaw, Maria Christine Thurnheer, Martin Weltman, Ian Kronborg, Curtis Cooper, Jordan J Feld, Chris Fraser, John F Dillon, Phillip Read, Ed Gane, Gregory J Dore
BACKGROUND: Despite revised guidelines that no longer exclude people who inject drugs (PWID) from treatment for hepatitis C virus (HCV) infection, many clinicians are reluctant to treat recent PWID. This study aimed to evaluate the efficacy of sofosbuvir and velpatasvir therapy in people with chronic HCV infection and recent injection drug use. METHODS: In this open-label, single-arm phase 4 trial (SIMPLIFY), we recruited participants with recent injection drug use (past 6 months) and chronic HCV genotype 1-6 infection from seven countries (19 sites)...
January 5, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29308587/opioids-with-abuse-deterrent-properties-a-regulatory-and-technological-overview
#12
J David Haddox
Three concurrent public health problems coexist in the United States: endemic nonmedical use/misuse of opioid analgesics, epidemic overdose fatalities involving opioid analgesics, and endemic chronic pain in adults. These intertwined issues comprise an opioid crisis that has spurred the development of formulations of opioids with abuse-deterrent properties and label claims (OADP). To reduce abuse and misuse of prescription opioids, the federal Food and Drug Administration (FDA) has issued a formal Guidance to drug developers that delineates four categories of testing to generate data sufficient for a description of a product's abuse-deterrent properties, along with associated claims, in its Full Prescribing Information (FPI)...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29308586/reality-and-responsibility-revisited-stakeholder-accountability-in-the-effort-to-develop-safer-opioids
#13
Steven D Passik, Howard A Heit, Michael DeGeorge
This supplement is dedicated to an exploration of the science, potential utility, and the current state of abuse-deterrent formulations (ADF) of opioid analgesics. There are many stakeholders in the search for safer pain treatments in general, and safer opioid therapy in particular. Healthcare providers, patients, third-party payors, law enforcement and government regulators, the pharmaceutical industry, and the media all have a stake in seeing pain treated and addiction and overdose avoided. As it applies to ADFs, obviously not everyone has a stake in seeing that ADFs succeed commercially; but all stakeholders certainly have a responsibility to see that any potential advance, including ADFs, in protecting the public health is fairly and thoroughly evaluated...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29308584/do-abuse-deterrent-opioid-formulations-work
#14
Richard C Dart, Janetta L Iwanicki, Nabarun Dasgupta, Theodore J Cicero, Sidney H Schnoll
OBJECTIVE: We performed a systematic review to answer the question, "Does the introduction of an opioid analgesic with abuse deterrent properties result in reduced overall abuse of the drug in the community?" DESIGN: We included opioid analgesics with abuse deterrent properties (hydrocodone, morphine, oxycodone) with results restricted to the metasearch term "delayed onset," English language, use in humans, and publication years 2009-2016. All articles that contained data evaluating misuse, abuse, overdose, addiction, and death were included...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29308583/letter-to-the-editor-opioid-overdose-protection-an-inevitable-need-to-address-an-alarming-epidemic
#15
Beatrice Setnik
No abstract text is available yet for this article.
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29305727/using-population-based-hospitalization-data-to-monitor-increases-in-conditions-causing-morbidity-among-persons-who-inject-drugs
#16
Melissa G Collier, Mona Doshani, Alice Asher
Epidemics of opioid use and injection drug use (IDU) are associated with an increase in HIV and viral hepatitis infections and overdose deaths in the United States. Persons who inject drugs (PWID) are also at risk for serious infections caused by skin organisms introduced via IDU. We examined National Inpatient Sample hospital discharge data to determine trends in three serious infectious disease-associated conditions that primarily affect PWID in addition to HIV and viral hepatitis: infective endocarditis (IE), central nervous system (CNS) abscesses, and osteomyelitis...
January 5, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29303948/cognitive-behavioral-therapy-for-chronic-pain-one-therapeutic-approach-for-the-opioid-epidemic
#17
Muhammad Hassan Majeed, Donna M Sudak
Opioids are frequently prescribed for chronic pain. For the past 2 decades, long-term opioid analgesic therapy was considered the cornerstone of effective pain management for chronic nonmalignant conditions, despite a lack of documented effectiveness and safety, with the attendant risk of addiction, overdose, and death. Cognitive behavioral therapy (CBT) may be used effectively to treat chronic pain, either as a stand-alone treatment or with other nonopioid pharmacological treatments. CBT improves pain-related outcomes along with mobility, quality of life, and disability and mood outcomes...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29303393/high-risk-prescribing-to-medicaid-enrollees-receiving-opioid-analgesics-individual-and-county-level-factors
#18
Sara E Heins, Mark J Sorbero, Christopher M Jones, Andrew W Dick, Bradley D Stein
BACKGROUND: Prescription opioid overdoses have increased dramatically in recent years, with the highest rates among Medicaid enrollees. High-risk prescribing includes practices associated with overdoses and a range of additional opioid-related problems. OBJECTIVES: To identify individual- and county-level factors associated with high-risk prescribing among Medicaid enrollees receiving opioids. METHODS: In a four-states, cross-sectional claims data study, Medicaid enrollees 18-64 years old with a new opioid analgesic treatment episode 2007-2009 were identified...
January 5, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29301012/diagnosis-of-heroin-overdose-in-an-8-year-old-boy-reliable-contribution-of-toxicological-investigations
#19
M Soichot, S Julliand, J Filatriau, A Hurbain, E Bourgogne, A Mihoubi, H Gourlain, B Delhotal-Landes
Toxicological investigations are often required by clinicians in comatose patients with suspected poisoning. However, the usefulness of toxicological analyses to support a diagnosis of acute poisoning is debated among clinicians and the interpretation of laboratory tests is challenging given the wide diversity of analytical techniques available. We report the case of an 8-year-old boy who was admitted to an intensive care unit with severe respiratory depression and neurological impairment. In order to formulate appropriate hypothesizes about the diagnosis and circumstances of intoxication, clinicians consulted toxicologists for a comprehensive toxicological screening...
December 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29297739/measuring-a-crisis-questioning-the-use-of-naloxone-administrations-as-a-marker-for-opioid-overdoses-in-a-large-u-s-ems-system
#20
Joseph M Grover, Taibah Alabdrabalnabi, Mehul D Patel, Michael W Bachman, Timothy F Platts-Mills, Jose G Cabanas, Jefferson G Williams
OBJECTIVE: The United States is currently experiencing a public health crisis of opioid overdoses. To determine where resources may be most needed, many public health officials utilize naloxone administration by EMS as an easily-measured surrogate marker for opioid overdoses in a community. Our objective was to evaluate whether naloxone administration by EMS accurately represents EMS calls for opioid overdose. We hypothesize that naloxone administration underestimates opioid overdose...
January 3, 2018: Prehospital Emergency Care
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