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https://www.readbyqxmd.com/read/28334467/revisiting-the-paradigm-shift-in-opioid-use-developments-and-implications-10%C3%A2-years-later
#1
Benedikt Fischer, Jürgen Rehm
A decade ago, we queried the unfolding of a 'paradigm shift' in illicit opioid use in North America, specifically involving a shift away from heroin to prescription opioid (PO) use. Today, this situation is more acute than ever, with prescription opioid misuse, morbidity and mortality amounting to one of the most severe substance use-related public health crises ever, now even impacting life expectancy in key population segments. Despite medical system-based PO dispensing and practices being recognised as core drivers of the PO crisis, effective policy measures have been long absent or limited-including those to reduce medical PO use to levels supported by best evidence for pain care...
March 23, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28328578/sustained-improvements-in-pain-mood-function-and-opioid-use-post-interdisciplinary-pain-rehabilitation-in-patients-weaned-from-high-and-low-dose-chronic-opioid-therapy
#2
Kelly L Huffman, Taylor E Rush, Youran Fan, Giries W Sweis, Brinder Vij, Edward C Covington, Judith Scheman, Manu Mathews
Increased prescribing of opioids for chronic non cancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs (ICPRP) focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007-2012. Participants included 413 patients on high dose (HD) chronic opioid therapy (COT; >100mg), 528 on low dose (LD) COT and 516 not on opioids (NO)...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28325710/no-evidence-of-compensatory-drug-use-risk-behavior-among-heroin-users-after-receiving-take-home-naloxone
#3
Jermaine D Jones, Aimee Campbell, Verena E Metz, Sandra D Comer
INTRODUCTION: Some fear that distribution of naloxone to persons at risk of experiencing an opioid overdose may reduce the perceived negative consequences of drug use, leading to riskier patterns of use. This study assessed whether participation in naloxone/overdose training altered drug use frequency, quantity or severity among heroin users in and out of treatment. METHODS: Clinical interviews were performed assessing patterns of heroin and other drug use prior to, and at multiple timepoints after overdose education and naloxone training...
March 9, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#4
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28315808/benzodiazepine-z-drug-and-pregabalin-prescriptions-and-mortality-among-patients-in-opioid-maintenance-treatment-a-nation-wide-register-based-open-cohort-study
#5
Tove Abrahamsson, Jonas Berge, Agneta Öjehagen, Anders Håkansson
BACKGROUND: Use of sedatives may increase risk of death in opioid users. The aim of the study was to assess whether prescription of sedatives may be associated with mortality in patients in opioid maintenance treatment. METHODS: This retrospective register-based open cohort study included nation-wide register data including all individuals who were dispensed methadone or buprenorphine as opioid maintenance treatment for opioid dependence between July, 2005 and December, 2012 (N=4501)...
February 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28315595/the-social-logic-of-naloxone-peer-administration-harm-reduction-and-the-transformation-of-social-policy
#6
Rachel Faulkner-Gurstein
This paper examines overdose prevention programs based on peer administration of the opioid antagonist naloxone. The data for this study consist of 40 interviews and participant observation of 10 overdose prevention training sessions at harm reduction agencies in the Bronx, New York, conducted between 2010 and 2012. This paper contends that the social logic of peer administration is as central to the success of overdose prevention as is naloxone's pharmacological potency. Whereas prohibitionist drug policies seek to isolate drug users from the spaces and cultures of drug use, harm reduction strategies like peer-administered naloxone treat the social contexts of drug use as crucial resources for intervention...
March 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#7
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
https://www.readbyqxmd.com/read/28301370/debate-are-benzodiazepines-appropriate-treatments-for-patients-with-substance-use-disorders-yes
#8
Tae Woo Park
Benzodiazepines are a controversial treatment for anxiety in patients with substance use disorders. Concerns include risk of addiction, overdose, and diversion. But benzodiazepines are among the most effective and well-tolerated treatments for anxiety, and are safe for the majority of patients who take them. Though not appropriate for all cases, particularly in those with an active opioid use disorder, benzodiazepines should be considered as a treatment for patients with substance use disorders after careful weighing of benefits and harms...
March 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28299971/addressing-excess-risk-of-overdose-among-recently-incarcerated-people-in-the-usa-harm-reduction-interventions-in-correctional-settings
#9
Lauren Brinkley-Rubinstein, David H Cloud, Chelsea Davis, Nickolas Zaller, Ayesha Delany-Brumsey, Leah Pope, Sarah Martino, Benjamin Bouvier, Josiah Rich
Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs...
March 13, 2017: International Journal of Prisoner Health
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#10
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28296569/naloxone-for-outpatients-at-risk-of-opioid-overdose-328
#11
Marcin Chwistek, Matthew Wolf
No abstract text is available yet for this article.
March 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28292795/primary-care-management-of-opioid-use-disorders-abstinence-methadone-or-buprenorphine-naloxone
#12
REVIEW
Anita Srivastava, Meldon Kahan, Maya Nader
OBJECTIVE: To advise physicians on which treatment options to recommend for specific patient populations: abstinence-based treatment, buprenorphine-naloxone maintenance, or methadone maintenance. SOURCES OF INFORMATION: PubMed was searched and literature was reviewed on the effectiveness, safety, and side effect profiles of abstinence-based treatment, buprenorphine-naloxone treatment, and methadone treatment. Both observational and interventional studies were included...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28292769/association-between-concurrent-use-of-prescription-opioids-and-benzodiazepines-and-overdose-retrospective-analysis
#13
Eric C Sun, Anjali Dixit, Keith Humphreys, Beth D Darnall, Laurence C Baker, Sean Mackey
Objectives To identify trends in concurrent use of a benzodiazepine and an opioid and to identify the impact of these trends on admissions to hospital and emergency room visits for opioid overdose.Design Retrospective analysis of claims data, 2001-13.Setting Administrative health claims database.Participants 315 428 privately insured people aged 18-64 who were continuously enrolled in a health plan with medical and pharmacy benefits during the study period and who also filled at least one prescription for an opioid...
March 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28292508/pharmacy-based-statewide-naloxone-distribution-a-novel-top-down-bottom-up-approach
#14
Kate J Morton, Brianna Harrand, Carly Cloud Floyd, Craig Schaefer, Julie Acosta, Bridget Claire Logan, Karen Clark
OBJECTIVE: To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. SETTING: New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28292506/the-development-and-feasibility-of-a-pharmacy-delivered-opioid-intervention-in-the-emergency-department
#15
Erin L Winstanley, Rebecca Mashni, Sydney Schnee, Nate Miller, Susan M Mashni
OBJECTIVES: To develop a brief intervention and to assess the feasibility of pharmacy-delivered education on opioid safety and overdose prevention in the emergency department. METHODS: A convenience sample of patients (n = 102) approached between May and June 2016 at a single community-based suburban emergency department located in the Midwest. RESULTS: The intervention included scripted counseling to be delivered in person and 2 educational brochures...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28292502/opioid-overdose-education-and-naloxone-distribution-development-of-the-veterans-health-administration-s-national-program
#16
Elizabeth M Oliva, Melissa L D Christopher, Daina Wells, Mark Bounthavong, Michael Harvey, Julianne Himstreet, Thomas Emmendorfer, Michael Valentino, Mariano Franchi, Francine Goodman, Jodie A Trafton
OBJECTIVES: To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. SETTING: VHA's OEND program sought national implementation of OEND across all medical facilities (n = 142). PRACTICE DESCRIPTION: This paper describes VHA's efforts to facilitate nationwide health care system-based OEND implementation, including the critical roles of VHA's national pharmacy services and academic detailing services...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28292501/indian-health-service-pharmacists-engaged-in-opioid-safety-initiatives-and-expanding-access-to-naloxone
#17
Hillary Duvivier, Samantha Gustafson, Morgan Greutman, Tenzin Jangchup, Ashlee Knapp Harden, Aimee Reinhard, Keith Warshany
OBJECTIVE: To develop effective pharmacy-based interventions to mitigate harm from opioid use disorders. Programs include responsible opioid prescribing, expanded access to medication-assisted treatment (MAT), naloxone, and community interventions. SETTING: Clinical pharmacists practicing at Indian Health Service (IHS) locations in the Southwest, Midwest, and Great Lakes regions. These pharmacists serve culturally diverse American Indian populations throughout the United States and interface with tribal and federal programs to impact the opioid epidemic in Indian Country...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28277802/oxycodone-extended-release-capsules-for-the-treatment-of-chronic-pain
#18
Sebastiano Mercadante
As a consequence of greater prescription opioid utilization, there has been the parallel increase in misuse, abuse, and overdose, which are serious risks. Associated new formulations may be safer. Areas covered: The introduction of abuse-deterrent opioid formulations and continuous programs to improve opioid prescribing practices may limit the opioid abuse and its consequences. Oxycodone extended release capsules are an extended-release (ER), microsphere-in-capsule abuse-deterrent-formulation designed to retain its extended-release properties following tampering or misuse (e...
March 10, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28267693/predictors-of-in-hospital-postoperative-opioid-overdose-after-major-elective-operations-a-nationally-representative-cohort-study
#19
Christy E Cauley, Geoffrey Anderson, Alex B Haynes, Mariano Menendez, Brian T Bateman, Karim Ladha
OBJECTIVE: The aim of this study was to describe national trends and outcomes of in-hospital postoperative opioid overdose (OD) and identify predictors of postoperative OD. SUMMARY OF BACKGROUND DATA: In 2000, the Joint Commission recommended making pain the 5th vital sign, increasing the focus on postoperative pain control. However, the benefits of pain management must be weighed against the potentially lethal risk of opioid OD. METHODS: This is a retrospective multi-institutional cohort study of patients undergoing 1 of 6 major elective inpatient operation from 2002 to 2011 using the Nationwide Inpatient Sample, an approximately 20% representative sample of all United States hospital admissions...
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28259087/medical-marijuana-policies-and-hospitalizations-related-to-marijuana-and-opioid-pain-reliever
#20
Yuyan Shi
OBJECTIVES: Twenty-eight states in the U.S have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR...
February 21, 2017: Drug and Alcohol Dependence
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