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https://www.readbyqxmd.com/read/28647680/a-retrospective-review-of-unintentional-opioid-overdose-risk-and-mitigating-factors-among-acutely-injured-trauma-patients
#1
Jannette Baird, Mark Faul, Traci C Green, Jonathan Howland, Charles A Adams, Ann George, Michael J Mello
BACKGROUND: Opioid medication to treat acutely injured patients is usual care in trauma settings. A higher prevalence of alcohol and other substance misuse in this population compared to the general population increases the vulnerability of such patients to both misuse of their prescribed opioids, and also unintentional opioid overdose. The primary purpose of this study was to assess the prevalence of substance use and unintentional opioid overdose risk among acutely injured trauma patients, and to examine the frequency and predictors of high opioid dose at discharge...
June 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#2
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28645392/naloxone-access-and-use-for-suspected-opioid%C3%A2-overdoses
#3
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28645060/young-people-who-use-drugs-engaged-in-harm-reduction-programs-in-new-york-city-overdose-and-other-risks
#4
Michele Calvo, Jessica MacFarlane, Heather Zaccaro, Matthew Curtis, María Cabán, Jamie Favaro, Marian R Passannante, Taeko Frost
BACKGROUND: Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. METHODS: The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey...
June 15, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#5
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28627395/the-opioid-epidemic-is-an-historic-opportunity-to-improve-both-prevention-and-treatment
#6
Robert L DuPont
The current narrative describing the national opioid epidemic as the result of overprescribing opioid pain medicines fails to capture the full dimensions of problem and leads to inadequate and even confounding solutions. Overlooked is the fact that polysubstance use is nearly ubiquitous among overdose deaths, demonstrating that the opioid overdose death problem is bigger than opioids. The foundation of the nation's opioid overdose crisis - and the totality of the nation's drug epidemic - is widespread recreational pharmacology, the use of drugs for fun or "self-medication...
June 13, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28623805/heroin-and-pharmaceutical-opioid-overdose-events-emergency-medical-response-characteristics
#7
Caleb J Banta-Green, Phillip O Coffin, Jennie A Schoeppe, Joseph O Merrill, Lauren K Whiteside, Abigail K Ebersol
BACKGROUND: Emergency Medical Services (EMS) data may provide insight into opioid overdose incidence, clinical characteristics, and medical response. This analysis describes patient characteristics, clinical features, and EMS response to opioid overdoses, comparing heroin and pharmaceutical opioid (PO) overdoses, using a structured opioid overdose case criteria definition. METHODS: A case series study was conducted. EMS medical staff screened cases for possible overdoses and study staff categorized the likelihood of opioid overdose...
June 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28622067/opioid-involved-overdose-among-male-afghanistan-iraq-era-u-s-military-veterans-a-multidimensional-perspective
#8
Alex S Bennett, Luther Elliott, Andrew Golub, Brett Wolfson-Stofko, Honoria Guarino
BACKGROUND: Mirroring nationwide trends in a broad range of U.S. populations, an alarming number of Afghanistan/Iraq-era U.S. Military veterans have experienced opioid-related overdoses. A growing body of research has examined the proximal behaviors that can precipitate an overdose; considerably less is known about more distal physiological, psychosocial and structural influences on these risk behaviors. OBJECTIVES: This study adopts a multidimensional approach to better understand opioid-related overdose among U...
June 16, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28621658/zoning-out-methadone-and-rising-opioid-related-deaths-in-ontario-reforms-and-municipal-government-actions
#9
Carol Strike, Miroslav Miskovic
In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above...
June 16, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28614178/patterns-of-opioid-use-and-risk-of-opioid-overdose-death-among-medicaid-patients
#10
Renu K Garg, Deborah Fulton-Kehoe, Gary M Franklin
BACKGROUND: The Centers for Disease Control and Prevention recognizes Medicaid as a high-risk population for fatal opioid overdose. Further research is needed to identify factors that put Medicaid patients at increased risk. OBJECTIVE: To determine whether patterns of opioid use are associated with risk of opioid-related mortality among opioid users. DESIGN: This is a retrospective cohort study. PATIENTS: In total, 150,821 noncancer pain patients aged 18-64 years with ≥1 opioid prescription, April 2006 to December 2010, Washington Medicaid...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28609749/fatal-and-non-fatal-opioid-overdose-in-opioid-dependent-patients-treated-with-methadone-buprenorphine-or-implant-naltrexone
#11
Erin Kelty, Gary Hulse
BACKGROUND: Illicit opioid use is associated with high rates of fatal and non-fatal opioid overdose. This study aims to compare rates of fatal and serious but non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone, and to identify risk factors for fatal opioid overdose. METHODS: Opioid dependent patients treated with methadone (n=3515), buprenorphine (n=3250) or implant naltrexone (n=1461) in Western Australia for the first time between 2001 and 2010, were matched against state mortality and hospital data...
June 10, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28608586/metabolism-of-novel-opioid-agonists-u-47700-and-u-49900-using-human-liver-microsomes-with-confirmation-in-authentic-urine-specimens-from-drug-users
#12
Alex J Krotulski, Amanda L A Mohr, Donna M Papsun, Barry K Logan
Recently, the number of adverse events, including death, involving novel opioids has continued to increase, providing additional and sustained challenges for forensic and medical communities. Identification of emerging novel opioids can be challenging, compounded by detection windows and unknown metabolic profiles. In this study, human liver microsomes were used for the generation of in vitro metabolic profiles of U-47700 and U-49900. Generated metabolites were analyzed via a SCIEX TripleTOF® 5600+ quadrupole time-of-flight mass spectrometer and resulting data files were processing using MetabolitePilot™...
June 13, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28607654/qualitative-thallium-urinary-assays-are-almost-as-valuable-as-quantitative-tests-implication-for-outpatient-settings-in-low-and-middle-income-countries
#13
Amir Ghaderi, Hamid Reza Banafshe, Soroor Khodabandehlo, Fateme Mehrzad, Omid Mehrpour, Reza Afshari
BACKGROUND: Thallium (Tl), lead and steroid exposures were reported as a result of street drug consumption such as heroin and cocaine. OBJECTIVE: This study aimed to compare the values of qualitative and quantitative assays for detecting Tl as an adulterant in opioid-like compound drug users. METHODS: This case-control study was conducted throughout a specified time bracket ranging from May 2015 to November 2015 in Imam Reza Hospital, Mashhad, Iran...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28605020/report-of-increasing-overdose-deaths-that-include-acetyl-fentanyl-in-multiple-counties-of-the-southwestern-region-of-the-commonwealth-of-pennsylvania-in-2015-2016
#14
Jessica B Dwyer, Jennifer Janssen, Todd M Luckasevic, Karl E Williams
Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405...
June 12, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28604436/brief-report-nonfatal-overdose-events-among-persons-who-inject-drugs-findings-from-seven-national-hiv-behavioral-surveillance-cities-2009-2012
#15
William T Robinson, Catherine Kazbour, Tanner Nassau, Kiva Fisher, Shane Sheu, Alexis V Rivera, Alia Al-Tayyib, Sara Nelson Glick, Sarah Braunstein, Narquis Barak, Jennifer Shinefeld, Jonathon Poe, Henry Fisher Raymond, Kathleen Brady
The rate of drug and opioid overdose deaths in the United States has more than tripled over the past 15 years. The ability to conduct public health surveillance on nonfatal overdoses is limited. The current study used National HIV Behavioral Surveillance (NHBS) data to estimate recent and lifetime history of nonfatal overdose events in persons who inject drugs in 7 cities. Recent and lifetime experience of overdose events ranged from 3% to 20% and from 29% to 63%, respectively. Adapting systems such as NHBS may be useful in responding to and monitoring emergent public health problems such as the overdose epidemic...
July 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28602044/the-dynamic-interaction-between-pain-and-opioid-misuse
#16
REVIEW
Adrianne R Wilson-Poe, Jose A Moron
In 2014, drug overdose surpassed automobile accidents as the number one cause of accidental death for the first time in US history. The overdose epidemic is largely driven by opioids, and genuine prescription opioid analgesics play the biggest role in this phenomenon. Despite advancements in abuse deterrent formulations, prescription drug monitoring programs, and clinical assessments for the detection of abuse potential, drug overdoses continue to escalate. The CDC has recently issued new guidelines for opioid prescription, yet even these recommendations have their shortcomings...
June 11, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28601204/battlefield-analgesia-in-tactical-combat-casualty-care
#17
REVIEW
Ian S Wedmore, Frank K Butler
At the start of the Afghanistan conflict, battlefield analgesia for US military casualties was achieved primarily through the use of intramuscular (IM) morphine. This is a suboptimal choice, since IM morphine is slow-acting, leading to delays in effective pain relief and the risk of overdose and death when dosing is repeated in order to hasten the onset of analgesia. Advances in battlefield analgesia, pioneered initially by Tactical Combat Casualty Care (TCCC), and the Army's 75th Ranger Regiment, have now been incorporated into the Triple-Option Analgesia approach...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28597483/international-patent-applications-for-non-injectable-naloxone-for-opioid-overdose-reversal-exploratory-search-and-retrieve-analysis-of-the-patentscope-database
#18
REVIEW
Rebecca McDonald, Øyvind Danielsson Glende, Ola Dale, John Strang
ISSUES: Non-injectable naloxone formulations are being developed for opioid overdose reversal, but only limited data have been published in the peer-reviewed domain. Through examination of a hitherto-unsearched database, we expand public knowledge of non-injectable formulations, tracing their development and novelty, with the aim to describe and compare their pharmacokinetic properties. APPROACH: (i) The PatentScope database of the World Intellectual Property Organization was searched for relevant English-language patent applications; (ii) Pharmacokinetic data were extracted, collated and analysed; (iii) PubMed was searched using Boolean search query '(nasal OR intranasal OR nose OR buccal OR sublingual) AND naloxone AND pharmacokinetics'...
June 8, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28595027/clinical-outcomes-of-start-low-go-slow-methadone-initiation-for-cancer-related-pain-what-s-the-hurry
#19
Pippa Hawley, Lawrance Chow, Gillian Fyles, Aria Shokoohi, Mary-Jane O'Leary, Matthew Mittelstadt
BACKGROUND: Methadone has been shown to be effective for cancer pain. Most published switching methods are complete in less than three days, requiring very close supervision, usually in an inpatient setting. This need for hospitalization is a barrier to access. We present a large retrospective study of slow outpatient methadone starts and describe our starting method. METHODS: Charts were reviewed of patients referred to the Pain and Symptom Management/Palliative Care clinics at the six BC Cancer Agency's regional centers that underwent initiation of methadone for analgesia over a 14-year period...
June 8, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28594892/a-behavioral-typology-of-opioid-overdose-risk-behaviors-among-recent-veterans-in-new-york-city
#20
Alex S Bennett, Andrew Golub, Luther Elliott
OBJECTIVE: To identify meaningful classes of opioid-using military veterans in terms of self-reported opioid overdose risk behaviors. METHOD: The study recruited a sample of 218 military veterans in the NYC area who were discharged from active duty service after September 11, 2001 and reported past-month opioid use. Survey data including measures of mental health, social stressors, substance use, and opioid-related overdose risk behaviors were analyzed using Latent Class Analysis (LCA)...
2017: PloS One
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