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Opioid overdose

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https://www.readbyqxmd.com/read/28214183/-misuse-and-dependence-on-prescription-opioids-prevention-identification-and-treatment
#1
B Rolland, D Bouhassira, N Authier, M Auriacombe, V Martinez, P Polomeni, G Brousse, R Schwan, P Lack, J Bachellier, S Rostaing, P Bendimerad, P Vergne-Salle, M Dematteis, S Perrot
Since the 1990s, the use of prescription opioids has largely spread, which has brought a real progress in the treatment of pain. The long-term use of prescription opioid is sometimes required, and may lead to pharmacological tolerance and withdrawal symptoms, i.e. pharmacological dependence on prescription opioids. Occasionally, this may also lead to misuse of prescription opioids (MPO). MPO preferentially occurs in vulnerable individuals, i.e., those with a young age, history of other addictive or psychiatric disorders, especially anxious and depressive disorders...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#2
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28202384/implementing-take-home-naloxone-in-an-urban-community-pharmacy
#3
Joshua L Akers, Ryan N Hansen, Ryan D Oftebro
OBJECTIVE: Morbidity and mortality associated with opioid use have increased across the nation, growing into what can only be described as an epidemic. SETTING: In Washington State between 2002 and 2004, the statewide death rate attributed to any opioid was 6.6 per 100,000 people, but between 2011 and 2013 it increased to 8.6 per 100,000 people. Pharmacies provide a unique access point for harm reduction services to patients due to their ease of accessibility in the community...
February 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28191702/hospitalizations-costs-and-outcomes-associated-with-heroin-and-prescription-opioid-overdoses-in-the-united-states-2001-2012
#4
Douglas J Hsu, Ellen P McCarthy, Jennifer P Stevens, Kenneth J Mukamal
BACKGROUND AND AIMS: The full burden of the opioid epidemic on U.S. hospitals has not been described. We aimed to estimate how heroin (HOD) and prescription opioid (POD) overdose-associated admissions, costs, outcomes, and patient characteristics have changed from 2001 - 2012. DESIGN: Retrospective cohort study of hospital admissions from the National Inpatient Sample. SETTING: United States of America. PARTICIPANTS: Hospital admissions in patients 18 years of age or older admitted with a diagnosis of HOD or POD...
February 13, 2017: Addiction
https://www.readbyqxmd.com/read/28190432/acute-neurotoxicology-of-drugs-of-abuse
#5
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188310/staring-down-the-opioid-epidemic
#6
EDITORIAL
Jeffrey R Unger
Nearly 80 people die every day in America from an opioid overdose. At the same time, sales of prescription painkillers have increased 4-fold since 1999.
January 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28182982/rapid-widespread-distribution-of-intranasal-naloxone-for-overdose-prevention
#7
Desiree Madah-Amiri, Thomas Clausen, Philipp Lobmaier
BACKGROUND: Take home naloxone programs have been successful internationally in training bystanders to reverse an opioid overdose with naloxone, an opioid antagonist. A multi-site naloxone distribution program began in Norway in 2014 as part of a national overdose prevention strategy. The aim of this study was to a) describe the program, and b) present findings from the government-supported intervention. METHODS: From July 2014 to December 2015, staff from multiple low-threshold facilities trained clients on how to use intranasal naloxone...
January 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28182980/bowling-alone-dying-together-the-role-of-social-capital-in-mitigating-the-drug-overdose-epidemic-in-the-united-states
#8
Michael J Zoorob, Jason L Salemi
BACKGROUND: Drug overdose deaths have risen precipitously over the last fifteen years. Substantial geographic variation, beyond a simple rural-urban dichotomy, exists in the concentration of overdose deaths, suggesting the existence of as-yet unidentified environmental variables that predict resilience (or vulnerability) to drug overdoses. Motivated by reports highlighting the role of community fragility in the opioid epidemic, we explore whether social capital attenuates overdose death rates...
January 25, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28177817/recent-increases-in-cocaine-related-overdose-deaths-and-the-role-of-opioids
#9
Christopher McCall Jones, Grant T Baldwin, Wilson M Compton
OBJECTIVES: To assess trends in cocaine overdose deaths and examine the role opioids play in these deaths. METHODS: We used data on drug overdose deaths in the United States from 2000 to 2015 collected in the National Vital Statistics System to calculate annual rates and numbers of cocaine-related overdose deaths overall and deaths both involving and not involving opioids. We assessed statistically significant changes in trends with joinpoint regression. RESULTS: Rates of cocaine-related overdose deaths increased significantly from 1...
March 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28166464/implementation-of-a-pharmacy-consult-to-reduce-co-prescribing-of-opioids-and-benzodiazepines-in-a-veteran-population
#10
Deborah Pardo, Lacey Miller, Dana Chiulli
BACKGROUND: The dangers of co-administration of opioid pain relievers (OPRs) and benzodiazepines (BZDs) are well documented. The combination of OPRs and BZDs make up the majority of medications involved in prescription drug-related overdose and are often used concomitantly. This pattern is consistent among the Veteran population where mental health illness and substance abuse are prominent. The Veterans Health Administration implemented the Opioid Safety Initiative (OSI) aimed at improving patient safety surrounding OPRs...
February 6, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#11
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28163028/a-nationwide-pharmacy-chain-responds-to-the-opioid-epidemic
#12
Emily Shafer, Nyahne Bergeron, Renae Smith-Ray, Chester Robson, Rachel O'Koren
OBJECTIVES: To describe the 3-pronged approach taken by a large national retail pharmacy chain to address the opioid epidemic and associated overdoses. SETTING: Large national retail pharmacy chain with more than 8200 stores in 50 states. PRACTICE DESCRIPTION: Eight million customer interactions daily through in-store and digital settings. This is a company with a long history of responding to public health crises. PRACTICE INNOVATION: Initiated 3 programs to respond to the opioid crisis: 1) provide safe medication disposal kiosks; 2) expand national access to naloxone; and 3) provide education on the risk and avoidance of opioid overdose...
February 2, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28162348/-141-epidemiology-of-naloxone-use-for-opioid-overdose-in-a-tertiary-care-medical-center
#13
G Rudd-Barnard, S Pangarkar, N Moaleji, P Glassman
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28161300/development-and-delivery-of-a-pharmacist-training-program-to-increase-naloxone-access-in-kentucky
#14
Emma Palmer, Steve Hart, Patricia R Freeman
OBJECTIVE: To describe the development and delivery of a comprehensive training program for Kentucky pharmacists to enable dispensation of naloxone per protocol. PRACTICE DESCRIPTION: In May 2015, the Kentucky Board of Pharmacy (KBP) promulgated regulations outlining the requirements for pharmacists to initiate the dispensing of naloxone under a physician-approved protocol. The Advancing Pharmacy Practice in Kentucky Coalition, a partnership between Kentucky's Colleges of Pharmacy, KBP, and state and local pharmacists associations, developed and offered educational programming to fulfill this regulation...
February 1, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28160734/causes-of-death-and-expected-years-of-life-lost-among-treated-opioid-dependent-individuals-in-the-united-states-and-taiwan
#15
Kun-Chia Chang, Jung-Der Wang, Andrew Saxon, Abigail G Matthews, George Woody, Yih-Ing Hser
AIMS: This study compared the cause-specific standardized mortality ratios (SMRs) and expected years of life lost (EYLL) among opioid-dependent individuals in the United States and Taiwan. METHODS: Survival data came from two cohorts followed until 2014: The U.S. data were based on a randomized trial of 1267 opioid-dependent participants enrolled between 2006 and 2009; the Taiwan data were from a study of 983 individuals that began in 2006, when opioid agonist treatment (OAT) was implemented in Taiwan...
February 1, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#16
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison healthcare, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; 7 female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28159815/validation-of-the-prognostic-utility-of-the-electrocardiogram-for-acute-drug-overdose
#17
Alex F Manini, Ajith P Nair, Rajesh Vedanthan, David Vlahov, Robert S Hoffman
BACKGROUND: While it is certain that some emergency department patients with acute drug overdose suffer adverse cardiovascular events (ACVE), predicting ACVE is difficult. The prognostic utility of the ECG for heterogeneous drug overdose patients remains to be proven. This study was undertaken to validate previously derived features of the initial ECG associated with ACVE in this population. METHODS AND RESULTS: We performed a prospective validation cohort study to evaluate adult emergency department patients with acute drug overdose at 2 urban university hospitals over 5 years in whom an emergency department admission ECG was performed...
February 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28159503/an-interprofessional-education-workshop-to-develop-health-professional-student-opioid-misuse-knowledge-attitudes-and-skills
#18
Kristina Monteiro, Luba Dumenco, Sally Collins, Jeffrey Bratberg, Celia MacDonnell, Anita Jacobson, Richard Dollase, Paul George
OBJECTIVE: To implement and evaluate an interprofessional workshop focused on increasing student knowledge, skills, and attitudes toward opioid misuse. SETTING: The Warren Alpert Medical School of Brown University in Providence, Rhode Island, April 2016. PRACTICE DESCRIPTION: Health professional students from medicine, nursing, pharmacy, social work, and physical therapy participated in an interprofessional education workshop focused on opioid use disorder...
January 31, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28157415/high-concomitant-misuse-of-fentanyl-in-subjects-on-opioid-maintenance-treatment
#19
Daniela Krause, Diana Plörer, Gabriele Koller, Gabi Martin, Catja Winter, Roland Adam, Minavere Canolli, Jori Al-Iassin, Rainer Musselmann, Stephan Walcher, Frank Schäfer, Oliver Pogarell
BACKGROUND: Concomitant opioid misuse is an increasing problem in opioid maintenance treatment as it interferes with treatment success. OBJECTIVE: Therefore, the rates of concomitant fentanyl misuse in opioid maintained patients were investigated. METHODS: We conducted a cross-sectional study which consisted in collecting data via urine samples and questionnaires in Germany. Urine samples of patients on opioid maintenance treatment were gathered and fentanyl concentrations were measured from 2008 to 2012...
February 3, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28156665/efficacy-and-safety-of-methadone-in-the-treatment-of-pain-in-palliative-care-patients-with-cancer-the-equimeth2-national-randomized-open-phase-iii-study
#20
Marie Pierre Berleur, Shimsi Lefki, Daniele Lefebvre Kunt, Eric Serra, Gisele Chvetzoff, Alain Derniaux, Flora Tremellat, Marilène Filbet, Anna Simon, Bich Dang Vu, Cyril Guillaume
: 212 Background: Methadone is used more and more as a second-line treatment for refractory cancer pain in palliative care patients. METHODS: The study aimed to compare the effect of two methadone titration methods (Stop and Go vs progressive titration) in 146 palliative care cancer patients with pain inadequately relieved or intolerant to level 3 opioids. The primary endpoint was the rate of success/failure at Day 4 defined by pain relief (reduction of at least two points of the numerical scale (0 - 10) AND a pain score < 5 for 2 consecutive days) AND no overdose (Rudkin scale ≥ 3 AND respiratory rate < 8/min)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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