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https://www.readbyqxmd.com/read/27923102/pain-treatment-continues-to-be-inaccessible-for-many-patients-around-the-globe-second-phase-of-opioid-price-watch-a-cross-sectional-study-to-monitor-the-prices-of-opioids
#1
Tania Pastrana, Roberto Wenk, Lukas Radbruch, Ebtesam Ahmed, Liliana De Lima
BACKGROUND: Strong opioids are a cornerstone of pain treatment, of which morphine is considered an essential analgesic by the World Health Organization. Access to opioids is limited, due to restrictive laws, limited education, and high prices. This is the second phase of a global project to monitor and report the dispensing price of opioids with the specific aim to expand and increase the information and allow further analysis of the challenges in their availability and affordability...
December 6, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27922764/comparison-of-abuse-suspected-suicidal-intent-and-fatalities-related-to-the-7-day-buprenorphine-transdermal-patch-versus-other-opioid-analgesics-in-the-national-poison-data-system
#2
Paul M Coplan, Nelson E Sessler, Venkatesh Harikrishnan, Richa Singh, Charles Perkel
OBJECTIVE: Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain. DESIGN: Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014...
December 6, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27871509/a-cross-sectional-study-of-preoperative-medication-adherence-and-early-postoperative-recovery
#3
Anthony P Notaras, Elisabeth Demetriou, Jessica Galvin, Erez Ben-Menachem
STUDY OBJECTIVE: To quantify the impact of preoperative medication adherence on recovery length of stays and complication rates. DESIGN: Cross-sectional analytical study. SETTING: Postanesthetic care unit (PACU) of a single-center tertiary hospital. PATIENTS: Surgical patients admitted for surgery at our institution over a 4-month period. INTERVENTION: A data collection tool was used to collect demographic data, length of stay in recovery, prespecified conditions likely to impact on PACU recovery (chronic pain, insulin-dependent diabetes, epilepsy, hypertension, on a methadone program, and Parkinson disease), medication compliance, and complications in PACU...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27780901/fentanyl-and-methadone-used-as-adjuncts-to-bupivacaine-for-lumbosacral-epidural-analgesia-in-sheep
#4
R DeRossi, R C Pagliosa, A Q de Carvalho, G G Macedo, L C Hermeto
Six healthy, female, mixed-breed 18-24-month-old sheep weighing 30-48 kg were submitted to lumbosacral epidural bupivacaine in combination with either methadone or fentanyl. Epidural catheters were placed in six sheep that were given three treatments: (Bup) bupivacaine (0.5 mg/kg) alone; (BupMet) bupivacaine (0.25 mg/kg) plus methadone (0.3 mg/kg); and (BupFent) bupivacaine (0.25 mg/kg) plus fentanyl (0.002 mg/kg). Haemodynamic variables, respiratory rate, rectal temperature, analgesia by applying a standard painful stimulus, motor block and sedative scores were compared among the three treatments...
October 25, 2016: Veterinary Record
https://www.readbyqxmd.com/read/27754734/successful-treatment-of-opioid-refractory-cancer-pain-with-short-course-low-dose-ketamine
#5
Julie M Waldfogel, Suzanne Nesbit, Steven P Cohen, Sydney M Dy
Opioids remain the mainstay of treatment for severe cancer pain, but up to 20% of patients have persistent or refractory pain despite rapid and aggressive opioid titration, or develop refractory pain after long-term opioid use. In these scenarios, alternative agents and mechanisms for analgesia should be considered. This case report describes a 28-year-old man with metastatic pancreatic neuroendocrine cancer with severe, intractable pain despite high-dose opioids including methadone and a hydromorphone patient-controlled analgesia (PCA)...
October 18, 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27729254/opioid-dependence-and-pregnancy-minimizing-stress-on-the-fetal-brain
#6
REVIEW
John J McCarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid-dependent pregnant women delivering babies at risk for neonatal abstinence syndrome prompted a US Government Accountability Office report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are 3 general sources of dependence: untreated opioid use disorder, pain management, and medication-assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27726521/use-of-methadone-as-an-adjuvant-medication-to-low-dose-opioids-for-neuropathic-pain-in-the-frail-elderly-a-case-series
#7
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
December 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27693901/efficacy-and-safety-of-two-methadone-titration-methods-for-the-treatment-of-cancer-related-pain-the-equimeth2-trial-methadone-for-cancer-related-pain
#8
Philippe Poulain, Marie-Pierre Berleur, Shimsi Lefki, Danièle Lefebvre, Gisèle Chvetzoff, Eric Serra, Fibra Tremellat, Alain Derniaux, Marilène Filbet
CONTEXT: In the European Association for Palliative Care recommendations for cancer pain management, there was no consensus regarding the indications, titration or monitoring of methadone. OBJECTIVES: This national, randomized, multicentre trial aimed to compare two methadone titration methods (stop-and-go vs progressive) in patients with cancer-related pain who were inadequately relieved by or intolerant to level 3 opioids. METHODS: The primary endpoint was the rate of success/failure at Day 4, defined as pain relief (reduction of at least two points on the visual scale and a pain score <5 for 2 consecutive days) and no overdose (Rudkin scale ≥3 and respiratory rate <8/min)...
September 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27677086/-comparison-of-ultrasound-guided-femoral-and-sciatic-nerve-block-versus-epidural-anaesthesia-for-orthopaedic-surgery-in-dogs
#9
Mareike Arnholz, Stephan Hungerbühler, Clarissa Weil, Alexandra F Schütter, Karl Rohn, Julia Tünsmeyer, Sabine B R Kästner
OBJECTIVE: Comparison of ultrasound-guided femoral and sciatic nerve block versus epidural anaesthesia with bupivacaine and morphine for orthopaedic surgery of the pelvic limb in dogs with respect to analgesic effectiveness, clinical utility and side effects. MATERIAL AND METHODS: The study included 22 dogs (American Society of Anesthesiologists, ASA grades I and II) undergoing orthopaedic surgery distal to the mid-femoral bone. The study was designed as a randomized, prospective, blinded clinical trial...
September 27, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/27673162/poster-410-incidence-of-patients-testing-positive-for-methadone-in-a-pain-clinic-with-a-negative-prescription-drug-monitoring-program-pdmp-report
#10
Francis P Lagattuta, Jason Williford, Physician Assistant
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27624605/dependence-to-legally-prescribed-opioid-analgesics-in-a-university-hospital-in-medellin-colombia-an-observational-study
#11
Maria G Garcia-Orjuela, Lineth Alarcon-Franco, Juan C Sanchez-Fernandez, Yuli Agudelo, Andres F Zuluaga
BACKGROUND: In some countries the misuse and diversion of prescribed opioid analgesic is increasing considerably, but there is no official data regarding the situation in Colombia. The aim of this study was to identify all dependent to opioid analgesics legally prescribed patients that were treated in a University Hospital in Medellin, Colombia during 4 years and to characterize this population. METHODS: Observational study in a University Hospital in Medellin, Colombia, searching for patients with ICD-10 codes related with opioid related disorders, adverse events or pain and treated between January 2011 and December 2014...
2016: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27623143/trends-in-the-distribution-of-opioids-in-puerto-rico-1999-2013
#12
Sausan El Burai Félix, Karin A Mack, Christopher M Jones
OBJECTIVE: Limited information has been published about opioid prescribing practices in Puerto Rico. The objective of this study was to create baseline trends of opioids distributed over a period of fourteen years in Puerto Rico. METHODS: We examined data from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) for the period 1999-2013. ARCOS data reflects the amount of controlled substances legally dispensed. Analyses include the distribution of opioids (in morphine milligram equivalent kg per 10,000 persons) by year and entity (pharmacy, hospital, practitioner)...
September 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27574837/psychiatric-disorders-among-patients-seeking-treatment-for-co-occurring-chronic-pain-and-opioid-use-disorder
#13
Declan T Barry, Christopher J Cutter, Mark Beitel, Robert D Kerns, Christopher Liong, Richard S Schottenfeld
OBJECTIVE: Psychiatric comorbidities complicate treatment of patients with chronic pain and opioid use disorder, but the prevalence of specific comorbid psychiatric disorders in this population has not been systematically investigated. METHODS: 170 consecutive participants entering a treatment research program for co-occurring chronic pain and opioid use disorder between March 2009 and July 2013 were evaluated with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I/P) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV)...
August 30, 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27573717/prospective-study-of-neuropathic-pain-after-definitive-surgery-for-extremity-osteosarcoma-in-a-pediatric-population
#14
Doralina L Anghelescu, Brenda D Steen, Huiyun Wu, Jianrong Wu, Najat C Daw, Bhaskar N Rao, Michael D Neel, Fariba Navid
BACKGROUND: Neuropathic pain (NP) after definitive surgery for extremity osteosarcoma (OS) has not been previously characterized. This study prospectively investigates the incidence, duration, and treatment of NP in limb sparing surgery and amputation groups. PROCEDURE: In patients treated for OS on a chemotherapy and definitive surgery (limb sparing vs. amputation) protocol (OS08), we prospectively collected the following data: (i) demographical data (age, sex, race); (ii) NP time of onset and duration; and (iii) dose (starting, maximum) and duration of gabapentin, amitriptyline, and methadone treatment...
August 30, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27572136/pharmacokinetics-and-analgesic-effects-of-methadone-in-children-and-adults-with-sickle-cell-disease
#15
Jennifer Horst, Melissa Frei-Jones, Elena Deych, William Shannon, Evan D Kharasch
BACKGROUND: Vaso-occlusive episodes (VOEs) are a significant source of morbidity among children and adults with sickle cell disease (SCD). There is little information on methadone use for SCD pain. This investigation evaluated methadone pharmacokinetics in children and adults with SCD, with a secondary aim to assess pain relief and opioid consumption. PROCEDURE: Participants included children (<18 years) and adults with a VOE requiring hospitalization. Patients were randomly assigned to receive standard care (opioid patient-controlled analgesia; control group) or one dose of intravenous methadone (0...
August 30, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27566722/pain-management-strategies-for-patients-on-methadone-maintenance-therapy-a-systematic-review-of-the-literature
#16
Mel Clark Taveros, Elizabeth J Chuang
CONTEXT: Prescription opioid and heroin abuse has increased substantially in recent years. Enrolment on opioid agonist therapy programmes is consequently increasing as well. As a result of these trends, more patients who present with acute pain secondary to a malignancy are also on chronic methadone maintenance therapy (MMT) for substance abuse. This combination of diagnoses presents a pain management challenge for palliative care providers. OBJECTIVES: This paper aims to gather and review the available medical literature pertaining to the use of opioid analgesia in methadone-maintained patients...
August 26, 2016: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/27554389/a-narrative-review-the-effects-of-opioids-on-sleep-disordered-breathing-in-chronic-pain-patients-and-methadone-maintained-patients
#17
Sameer Hassamal, Karen Miotto, Tisha Wang, Andrew J Saxon
BACKGROUND AND OBJECTIVES: Opioids increase the risk for sleep disordered breathing (SDB), but there are few studies examining the prevalence and risk factors for SDB, specifically central sleep apnea (CSA), and obstructive sleep apnea (OSA) in chronic pain patients on opioids as well as methadone maintained patients (MMPs). METHODS: A literature review was conducted in which SDB was confirmed by polysomnography (PSG) in chronic pain patients on opioids as well as patients with a diagnosis of an opioid use disorder or opioid dependence on methadone maintenance treatment (MMT)...
September 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/27550994/predictive-value-of-positive-drug-screening-results-in-an-urban-outpatient-population
#18
Roger L Bertholf, Rohit Sharma, Gary M Reisfield
Urine drug testing (UDT) has become an essential component in the management of patients prescribed opioid analgesics for the treatment of chronic non-malignant pain. Several laboratory methods are available to monitor adherence with the pharmacological regimen and abstinence from illicit or unauthorized medications. Immunochemical screening methods are rapid and economical, but they have limitations, including lack of specificity, and confirmatory methods are often necessary to verify presumptive positive results...
August 22, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27516365/association-between-commonly-prescribed-opioids-and-androgen-deficiency-in-men-a-retrospective-cohort-analysis
#19
Andrea L Rubinstein, Diane M Carpenter
OBJECTIVE: Androgen deficiency is common among men who use opioids daily for chronic pain. In previous studies, we found that long-acting opioids are associated with greater odds of androgen suppression than equipotent doses of short-acting opioids. Here we examined whether specific commonly prescribed opioids were associated with greater odds of androgen deficiency compared to hydrocodone. DESIGN: Retrospective cohort study. SETTING AND PATIENTS: Within a large, integrated health care delivery system, this study was comprised of men ages 18-80 on a stable regimen of a single opioid for chronic non-cancer pain...
August 11, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27494037/methadone-is-superior-to-fentanyl-in-treating-neuropathic-pain-in-patients-with-head-and-neck-cancer
#20
J Haumann, J W Geurts, S M J van Kuijk, B Kremer, E A Joosten, M H J van den Beuken-van Everdingen
BACKGROUND: Cancer pain is still inadequately treated in up to 60% of cancer patients. Based on the additional effect on the N-Methyl-d-Aspartate receptor, we expected that methadone (Met) could provide better pain relief than fentanyl (Fen) in cancer pain with a neuropathic pain component. METHODS: A randomised controlled trial was performed with 52 strong opioids naive patients with head-and-neck cancer with substantial pain (pain Numerical Rating Scale [NRS] > 4) and a neuropathic pain component (Douleur Neuropathique [DN4] > 4)...
September 2016: European Journal of Cancer
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