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https://www.readbyqxmd.com/read/28527855/initiation-of-extended-release-naltrexone-xr-ntx-for-opioid-use-disorder-prior-to-release-from-prison
#1
Peter D Friedmann, Donna Wilson, Randall Hoskinson, Michael Poshkus, Jennifer G Clarke
BACKGROUND: Opioid use disorder is common in prison populations, and prison release is a high-risk time for relapse and overdose. Initiation of extended release injectable naltrexone (XR-NTX)) prior to prison release might decrease relapse among opioid-dependent persons. OBJECTIVE: This pilot study examined the feasibility and acceptability of XR-NTX injection prior to prison release among adult inmates with opioid use disorder, followed by six months of community XR-NTX treatment...
April 19, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28526967/update-on-barriers-to-pharmacotherapy-for-opioid-use-disorders
#2
REVIEW
Anjalee Sharma, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Robert P Schwartz
PURPOSE OF REVIEW: The recent heroin and prescription opioid misuse epidemic has led to a sharp increase in the number of opioid overdose deaths in the USA. Notwithstanding the availability of three FDA-approved medications (methadone, buprenorphine, and naltrexone) to treat opioid use disorder, these medications are underutilized. This paper provides an update from the recent peer-reviewed literature on barriers to the use of these medications. FINDINGS: These barriers are interrelated and can be categorized as financial, regulatory, geographic, attitudinal, and logistic...
June 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28521781/telling-our-stories-heroin-assisted-treatment-and-snap-activism-in-the-downtown-eastside-of-vancouver
#3
Susan Boyd, Dave Murray, Donald MacPherson
BACKGROUND: This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28521199/safety-profile-of-injectable-hydromorphone-and-diacetylmorphine-for-long-term-severe-opioid-use-disorder
#4
Eugenia Oviedo-Joekes, Suzanne Brissette, Scott MacDonald, Daphne Guh, Kirsten Marchand, Salima Jutha, Scott Harrison, Amin Janmohamed, Derek Z Zhang, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
AIMS: To review the safety profile of injectable hydromorphone and diacetylmorphine and explore if adverse events (AEs) or serious adverse events (SAEs) were associated with dose and patterns of attendance. METHODS: This was a non-inferiority randomized double-blind controlled trial (Vancouver, Canada) testing hydromorphone (n=100) and diacetylmorphine (n=102) for the treatment of severe opioid use disorder. Medications were delivered under the supervision of trained Registered Nurses up to three times daily...
May 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28506855/rates-and-risk-factors-for-opioid-dependence-and-overdose-after-urologic-surgery
#5
Arpeet S Shah, Robert H Blackwell, Paul C Kuo, Gopal N Gupta
INTRODUCTION: Effective pain management is a critical component of the perioperative process, with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose (ODO) among patients undergoing urologic surgery and to identify risk factors of ODO. METHODS: A retrospective review of urologic surgery from 2007-2011. Data sources included the Healthcare Cost and Utilization Project Inpatient, Ambulatory Surgery, and Emergency Department datasets...
May 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28506719/two-fatalities-associated-with-synthetic-opioids-ah-7921-and-mt-45
#6
Helena Fels, Julia Krueger, Hans Sachs, Frank Musshoff, Matthias Graw, Gabriele Roider, Andreas Stoever
In this study, two fatalities associated with the synthetic opioids AH-7921 and MT-45 are reported. Within the last few years, both compounds have emerged on the recreational drug market and are sold as "research chemicals" on the internet. In the first case, a 22-year-old woman was found dead in the bedroom of her apartment by two of her friends. A plastic bag labeled "AH-7921" was found in the apartment and the two friends stated that the deceased had consumed AH-7921 prior to her death. The woman was a known drug addict...
April 15, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28506507/syndrome-surveillance-of-fentanyl-laced-heroin-outbreaks-utilization-of-ems-medical-examiner-and-poison-center-databases
#7
P Quincy Moore, Joseph Weber, Steven Cina, Steven Aks
OBJECTIVE: Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. METHODS: We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28504483/comparison-of-a-new-intranasal-naloxone-formulation-to-intramuscular-naloxone-results-from-hypothesis-generating-small-clinical-studies
#8
Brandon T Gufford, Garrett R Ainslie, John R White, Matthew E Layton, Jeannie M Padowski, Gary M Pollack, Mary F Paine
Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of intravenous, intramuscular, and a new intranasal naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to intramuscular naloxone, geometric mean [90% CI] absolute bioavailability of intranasal naloxone was modestly lower (55 [43-70] versus 41 [27-62] %), whereas average (± SE) mean absorption time was substantially shorter (74 ± 8.8 versus 6.7 ± 4.9 min). The opioid-attenuating effects of intranasal naloxone were compared to intramuscular naloxone (2 mg) after administration of oral alfentanil (4 mg) to a separate group of six healthy volunteers pre-treated with 240 ml of water or grapefruit juice...
May 15, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28493329/risk-to-heroin-users-of-polydrug-use-of-pregabalin-or-gabapentin
#9
Abigail Lyndon, Suzanne Audrey, Claudia Wells, Erica S Burnell, Suzanne Ingle, Rob Hill, Matthew Hickman, Graeme Henderson
AIM: To examine the risk to heroin users of also using gabapentin or pregabalin (gabapentoids). DESIGN: Multi-disciplinary study: we (a) examined trends in drug-related deaths and gabapentoid prescription data in England and Wales to test for evidence that any increase in deaths mentioning gabapentin or pregabalin is associated with trends in gabapentoid prescribing and is concomitant with opioid use; (b) interviewed people with a history of heroin use about their polydrug use involving gabapentin and pregabalin; and (c) studied the respiratory depressant effects of pregabalin in the absence and presence of morphine in mice to determine whether concomitant exposure increased the degree of respiratory depression observed...
May 10, 2017: Addiction
https://www.readbyqxmd.com/read/28492461/overcoming-barriers-to-initiating-medication-assisted-treatment-for-heroin-use-disorder-in-a-general-medical-hospital-a-case-report-and-narrative-literature-review
#10
Sameer Hassamal, Matthew Goldenberg, Waguih Ishak, Margaret Haglund, Karen Miotto, Itai Danovitch
Deaths due to heroin overdoses are increasing and are the leading cause of death among intravenous heroin users. Although medication-assisted treatment (MAT) improves morbidity and mortality in patients with opioid use disorders, it is underutilized. Most efforts to expand access to MAT have focused on outpatient settings. Although the inpatient medical setting presents a critical opportunity to initiate treatment, general hospitals are often unfamiliar with MAT, creating a number of barriers to its use. In this report, we describe the case of a woman with heroin use disorder who was initiated on buprenorphine maintenance treatment while hospitalized for cardiac disease related to her intravenous heroin use...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28488993/physician-guide-to-appropriate-opioid-prescribing-for-noncancer-pain
#11
Timothy Munzing
Prescription opioid use for relief of noncancer pain has risen dramatically in the last 15 years, contributing to a quadrupling of opioid overdoses and prescription opioid-related deaths. This crisis is resulting in heightened attention by health care professionals and organizations, law enforcement, and the government. In this article, I highlight key topics in the management of patients using opioids (or potentially needing opioids) in outpatient clinical practice; federal and state law enforcement actions regarding physicians' illegal prescribing of opioids; multimodal approaches to pain control; nonmedication management of pain; response strategies when suspecting a patient of diverting or misusing opioids; and warning signs for abuse or diversion...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28486076/medical-providers-knowledge-and-concerns-about-opioid-overdose-education-and-take-home-naloxone-rescue-kits-within-veterans-affairs-health-care-medical-treatment-settings
#12
Rachel P Winograd, Corey S Davis, Maria Niculete, Elizabeth Oliva, Richard P Martielli
BACKGROUND: Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. METHODS: Prescribing providers (N = 45) completed surveys on baseline knowledge and concerns about the VA Overdose Education and Naloxone Distribution (OEND) initiative prior to attending an OEND educational training...
April 2017: Substance Abuse
https://www.readbyqxmd.com/read/28481656/multiple-naloxone-administrations-among-emergency-medical-service-providers-is-increasing
#13
Mark Faul, Peter Lurie, Jeremiah M Kinsman, Michael W Dailey, Charmaine Crabaugh, Scott M Sasser
BACKGROUND: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. METHODS: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs)...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28479631/curbing-prescription-opioid-dependency
#14
(no author information available yet)
An epidemic of overdoses and deaths from opioids is fuelled by increased prescribing and sales in North America. Tatum Anderson reports.
May 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#15
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28479011/extended-release-naltrexone-for-opioid-use-disorder-started-during-or-following-incarceration
#16
Thomas Lincoln, Benjamin D Johnson, Patrick McCarthy, Ellen Alexander
A western Massachusetts county jail began initiating extended-release naltrexone (XR-NTX) prior to release from incarceration and linking participants to community treatment providers upon release. Program barriers prevented the start of XR-NTX prior to release for a subset. METHODS: This report consists of the initial 67 jail releasees with opioid dependence, 47 who received XR-NTX before release, and 20 after release. Utility of the program was assessed by determining medication addiction treatment (MAT) retention rates at 4, 8, and 24 weeks...
April 6, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476275/beliefs-about-the-consequences-of-using-benzodiazepines-among-persons-with-opioid-use-disorder
#17
Michael D Stein, Bradley J Anderson, Shannon R Kenney, Genie L Bailey
BACKGROUND: Patients admitted to addiction treatment programs report high rates of concurrent opioid and benzodiazepine (BZD) use. This combination places individuals at high risk for accidental overdose and other serious consequences. However, little is known about the beliefs opioid users have about the consequences of BZD use. METHODS: We surveyed consecutive persons initiating inpatient opioid detoxification (N=476; 95.0% enrollment) and identified 245 who reported BZD use in the past 30days and/or had a positive toxicology...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476268/past-year-prevalence-of-prescription-opioid-misuse-among-those-11-to-30years-of-age-in-the-united-states-a-systematic-review-and-meta-analysis
#18
Ashly E Jordan, Natalie A Blackburn, Don C Des Jarlais, Holly Hagan
BACKGROUND: There are high levels of prescription and consumption of prescription opioids in the US. Misuse of prescription opioids has been shown to be highly correlated with prescription opioid-related morbidity and mortality including fatal and non-fatal overdose. We characterized the past-year prevalence of prescription opioid misuse among those 11-30years of age in the US. METHODS: A systematic review and meta-analysis were carried out following a published protocol and PRISMA guidelines...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28475079/treatment-of-opioid-overdose-a-brief-review-of-naloxone-pharmacology-and-delivery
#19
Thomas M Hendley, Elliot V Hersh, Paul A Moore, Berry Stahl, Mana Saraghi
No abstract text is available yet for this article.
May 2017: General Dentistry
https://www.readbyqxmd.com/read/28462386/association-of-variants-of-arginine-vasopressin-and-arginine%C3%A2-vasopressin-receptor-1a-with-severe-acetaminophen%C3%A2-liver-injury
#20
Matthew Randesi, Orna Levran, Joel Correa da Rosa, Julia Hankins, Jody Rule, Mary Jeanne Kreek, William M Lee
BACKGROUND & AIMS: Acetaminophen-related acute liver injury and liver failure (ALF) result from ingestion of supratherapeutic quantities of this analgesic, frequently in association with other forms of substance abuse including alcohol, opioids, and cocaine. Thus, overdosing represents a unique high-risk behavior associated with other forms of drug use disorder. METHODS: We examined a series of 21 single nucleotide polymorphisms (SNPs) in 9 genes related to impulsivity and/or stress responsivity that may modify response to stress...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
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