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https://www.readbyqxmd.com/read/27911073/reducing-risky-alcohol-use-what-health-care-systems-can-do
#1
Amity E Quinn, Mary Brolin, Maureen T Stewart, Brooke Evans, Constance Horgan
Risky, non-dependent alcohol use is prevalent in the United States, affecting 25% of adults (Centers for Disease Control and Prevention, 2014b). Massachusetts has higher rates of alcohol use and binge drinking than most states (Substance Abuse and Mental Health Services Administration, 2015). Serious physical, social, and economic consequences result. Excessive alcohol use contributes to cancer, cardiovascular disease, sleep disorders, birth defects, motor vehicle injuries, and suicide, and it complicates management of chronic illnesses (Green, McKnight-Eily, Tan, Mejia, & Denny, 2016; Laramee et al...
April 27, 2016: Issue Brief
https://www.readbyqxmd.com/read/27903034/prescription-drug-abuse-a-timely-update
#2
Benny Monheit, Danusia Pietrzak, Sandra Hocking
BACKGROUND: Prescription drug abuse is a rising problem in Australia and pharmaceutical drugs have been the most frequent contributors to overdose deaths in Victoria in recent years. OBJECTIVE: The objectives of this article are to examine the main prescription drugs contributing to overdose deaths and to consider how doctors may help in reducing this problem. DISCUSSION: Data from the Coroners Court of Victoria list the main drugs that contributed to drug-related deaths in 2009-15...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27899527/biased-agonists-of-the-kappa-opioid-receptor-suppress-pain-and-itch-without-causing-sedation-or-dysphoria
#3
Tarsis F Brust, Jenny Morgenweck, Susy A Kim, Jamie H Rose, Jason L Locke, Cullen L Schmid, Lei Zhou, Edward L Stahl, Michael D Cameron, Sarah M Scarry, Jeffrey Aubé, Sara R Jones, Thomas J Martin, Laura M Bohn
Agonists targeting the kappa opioid receptor (KOR) have been promising therapeutic candidates because of their efficacy for treating intractable itch and relieving pain. Unlike typical opioid narcotics, KOR agonists do not produce euphoria or lead to respiratory suppression or overdose. However, they do produce dysphoria and sedation, side effects that have precluded their clinical development as therapeutics. KOR signaling can be fine-tuned to preferentially activate certain pathways over others, such that agonists can bias signaling so that the receptor signals through G proteins rather than other effectors such as βarrestin2...
November 29, 2016: Science Signaling
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#4
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#5
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27894311/access-to-substance-use-treatment-among-young-adults-who-use-prescription-opioids-non-medically
#6
Elliott J Liebling, Jesse L Yedinak, Traci C Green, Scott E Hadland, Melissa A Clark, Brandon D L Marshall
BACKGROUND: Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. METHODS: This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days...
November 29, 2016: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/27884758/magnesium-enhances-opioid-induced-analgesia-what-we-have-learnt-in-the-past-decades
#7
REVIEW
Magdalena Bujalska-Zadrożny, Jan Tatarkiewicz, Kamila Kulik, Małgorzata Filip, Marek Naruszewicz
Opioids are increasingly used in alleviating pain, including cancer-related pain and postoperative pain. Unfortunately, the development of tolerance, the resistance of neuropathic pain on opioid analgesia or other undesirable effects may limit their utility. In order to reduce opioid doses, and thereby to avoid the risk of side effects and sudden deaths due to overdosing, attempts have been made to introduce co-analgesics. Due to an increasing amount of data concerning a potential enhance of opioid analgesia by the physiological antagonist of N-methyl-d-aspartate receptors, magnesium ions (Mg(2+)), a concomitant use of such a combination seems to be interesting from a clinical point of view...
November 21, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27873121/challenges-to-treatment-of-chronic-pain-and-addiction-during-the-opioid-crisis
#8
REVIEW
Daniel Krashin, Natalia Murinova, Mark Sullivan
Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society...
December 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27859761/methadone-complications-amongst-opioid-dependent-patients-in-malaysia-a-case-series
#9
Philip George, Balasingam Vicknasingam, Sivakumar Thurairajasingam, Parameswaran Ramasamy, Haslina Mohd Yusof, Mohd Azhar Bin Mohd Yasin, Zia U Bahkt Sultan Shah
INTRODUCTION AND AIMS: Opioid dependence remains the main type of illicit substance used in Malaysia, which has an estimated 187 771 opiate users. There are currently 333 active methadone maintenance treatment centres nationwide. Although methadone has proven to be an effective maintenance therapy, it has clinical concerns which can have an impact on its effectiveness and safety. DESIGN, METHODS AND RESULTS: A case series of seven patients from Malaysian private and public hospital settings who had an adverse reaction with methadone is discussed...
November 8, 2016: Drug and Alcohol Review
https://www.readbyqxmd.com/read/27858590/turning-the-tide-or-riptide-the-changing-opioid-epidemic
#10
Stefan G Kertesz
The US opioid epidemic has changed profoundly in the last 3 years, in ways that require substantial recalibration of the US policy response. This report summarizes the changing nature of overdose deaths in Jefferson County (home to Birmingham, Alabama) using data updated through June 30, 2016. Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, while opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015...
November 18, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#11
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27844475/rhode-island-board-of-medical-licensure-and-discipline-illustration-of-the-disciplinary-process-as-it-pertains-to-cases-involving-opioid-prescribing
#12
James V McDonald
Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline.
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27842792/drug-toxicities-of-common-analgesic-medications-in-the-emergency-department
#13
REVIEW
Mateusz Ciejka, Khoa Nguyen, Martin H Bluth, Elizabeth Dubey
About 75% of patients present to the emergency department with a complaint of pain. There are multiple prescribed and over-the-counter medications that are available for the treatment of pain. Acetaminophen, opioids, and aspirin are commonly used agents that are available as single agents or in combination with other medications. However, all of these agents are susceptible to toxic overdose, which requires prompt recognition through clinical and laboratory assessment modalities and initiation of therapy to reduce the risk of morbidity and mortality...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27824771/maternal-deaths-from-suicide-and-overdose-in-colorado-2004-2012
#14
Torri D Metz, Polina Rovner, M Camille Hoffman, Amanda A Allshouse, Krista M Beckwith, Ingrid A Binswanger
OBJECTIVE: To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) to identify opportunities for prevention. METHODS: We report a case series of pregnancy-associated deaths resulting from self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care, and delivery hospitalization records were abstracted...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27815762/acceptability-of-naloxone-co-prescription-among-primary-care-providers-treating-patients-on-long-term-opioid-therapy-for-pain
#15
Emily Behar, Christopher Rowe, Glenn-Milo Santos, Diana Coffa, Caitlin Turner, Nina C Santos, Phillip O Coffin
BACKGROUND: Naloxone co-prescription is recommended for patients on long-term opioids for pain, yet there are few data on the practice. OBJECTIVE: To explore naloxone co-prescribing acceptability among primary care providers for patients on long-term opioids. DESIGN: We surveyed providers at six safety-net primary care clinics in San Francisco that had initiated naloxone co-prescribing. Providers were encouraged to offer naloxone to patients on long-term opioids or otherwise at risk of witnessing or experiencing an overdose...
November 4, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27810654/treatment-utilization-among-persons-with-opioid-use-disorder-in-the-united-states
#16
Li-Tzy Wu, He Zhu, Marvin S Swartz
BACKGROUND: The United States is experiencing an opioid overdose epidemic. Treatment use data from diverse racial/ethnic groups with opioid use disorder (OUD) are needed to inform treatment expansion efforts. METHODS: We examined demographic characteristics and behavioral health of persons aged ≥12 years that met criteria for past-year OUD (n=6,125) in the 2005-2013 National Surveys on Drug Use and Health (N=503,101). We determined the prevalence and correlates of past-year use of alcohol/drug use treatment and opioid-specific treatment to inform efforts for improving OUD treatment...
October 19, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27802876/something-for-pain-responsible-opioid-use-in-emergency-medicine
#17
Reuben J Strayer, Sergey M Motov, Lewis S Nelson
The United States is currently experiencing a public health crisis of opioid addiction, which has its genesis in an industry marketing effort that successfully encouraged clinicians to prescribe opioids liberally, and asserted the safety of prescribing opioids for chronic non-cancer pain, despite a preponderance of evidence demonstrating the risks of dependence and misuse. The resulting rise in opioid use has pushed drug overdose deaths in front of motor vehicle collisions to become the leading cause of accidental death in the country...
October 24, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27798775/attitudes-toward-naloxone-prescribing-in-clinical-settings-a-qualitative-study-of-patients-prescribed-high-dose-opioids-for-chronic-non-cancer-pain
#18
Shane R Mueller, Stephen Koester, Jason M Glanz, Edward M Gardner, Ingrid A Binswanger
BACKGROUND: Over the last 2 decades, medical providers have increasingly prescribed pharmaceutical opioids for chronic non-cancer pain, while opioid overdose death rates have quadrupled. Naloxone, an opioid antagonist, can be prescribed to patients with chronic pain to reverse an opioid overdose, yet little is known about how patients perceive this emerging practice. OBJECTIVE: This study assessed the knowledge and attitudes toward naloxone prescribing among non-cancer patients prescribed opioids in primary care...
October 31, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27788602/can-a-serum-acetaminophen-concentration-obtained-less-than-4-hours-post-ingestion-determine-which-patients-do-not-require-treatment-with-acetylcysteine
#19
Mark C Yarema, Jason P Green, Marco L A Sivilotti, David W Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Daniel A Spyker, Barry H Rumack
CONTEXT: The interpretation of acetaminophen concentrations obtained prior to 4 hours after an acute, single overdose remains unclear. Patient care decisions in the Emergency Department could be accelerated if such concentrations could reliably exclude the need for treatment. OBJECTIVE: To determine the agreement between a serum acetaminophen concentration obtained less than 4 hours after an acute ingestion and the subsequent 4 + hour concentration, and the predictive accuracy of early concentrations for identifying patients with potentially toxic exposures...
October 28, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27788591/chloroform-ingestion-causing-severe-gastrointestinal-injury-hepatotoxicity-and-dermatitis-confirmed-with-plasma-chloroform-concentrations
#20
Dushan Jayaweera, Shawkat Islam, Naren Gunja, Chris Cowie, James Broska, Latesh Poojara, Michael S Roberts, Geoffrey K Isbister
CONTEXT: Poisoning due to chloroform ingestion is rare. The classic features of acute chloroform toxicity include central nervous system (CNS) and respiratory depression, and delayed hepatotoxicity. CASE DETAILS: A 30-year-old female ingested 20-30 mL of 99% chloroform solution, which caused rapid loss of consciousness, transient hypotension and severe respiratory depression requiring endotracheal intubation and ventilation. She was alert by 12 h and extubated 16 h post-overdose...
October 28, 2016: Clinical Toxicology
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