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Opioid Detoxification

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https://www.readbyqxmd.com/read/27776678/cognitive-behavioral-therapy-improves-treatment-outcomes-for-prescription-opioid-users-in-primary-care-buprenorphine-treatment
#1
Brent A Moore, David A Fiellin, Christopher J Cutter, Frank D Buono, Declan T Barry, Lynn E Fiellin, Patrick G O'Connor, Richard S Schottenfeld
To determine whether treatment outcomes differed for prescription opioid and heroin use disorder patients, we conducted a secondary analysis of a 24-week (N=140) randomized trial of physician management (PM) or PM plus cognitive behavioral therapy (CBT) in primary care buprenorphine/naloxone treatment. Self-reported opioid use and urine toxicology analyses were obtained weekly. We examined baseline demographic differences between primary prescription opioid use patients (n=49) and primary heroin use patients (n=91) and evaluated whether treatment response differed by assigned condition...
December 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27740713/tincture-of-opium-for-treating-opioid-dependence-a-systematic-review-of-safety-and-efficacy
#2
Mohammadali Nikoo, Nooshin Nikoo, Sanam Javid, Afshar Amiri, Marc Vogel, Fiona Choi, Amir Ali Sepehry, Amir Hooshang Bagheri Valoojerdi, Kerry Jang, Christian Schütz, Shahin Akhondzadeh, Michael Krausz
BACKGROUND AND AIMS: Recently, there has been a growing interest in using Opium Tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication. METHODS: We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation & Theses Database, Iran Medex, clinicaltrials.gov, and who.int/trialsearch) with no language or publication date limitations. Two reviewers selected Randomized Controlled Trials (RCT), cohort /case-control/ cross-sectional studies and case-series on safety or efficacy of OT for treating opioid dependence and then extracted reported measures of mentioned outcomes from selected studies...
October 14, 2016: Addiction
https://www.readbyqxmd.com/read/27739172/progressive-white-matter-impairment-as-a-predictor-of-outcome-in-a-cohort-of-opioid-dependent-patient-s-post-detoxification
#3
Jo-Hanna Ivers, Jacqueline Fitzgerald, Christopher Whelan, Brion Sweeney, Eamon Keenan, Andrew Fagan, Jason McMarrow, Jim Meany, Joe Barry, Thomas Frodl
White matter impairment is associated with opioid dependence. However, the specific neuropathology related to opioid dependence is still not fully understood. The main aims of this study were to: (1) assess the association between white matter impairment and duration of dependence; (2) examine whether this impairment correlates with treatment outcome measures in opioid-dependent patients post-detoxification. Fifty-eight opioid-dependent patients participated, 20 females and 38 males, across three groups: less than 10 years use (n = 18), 10-15 years use (n = 26) and 16-25+ years use (n = 14)...
October 13, 2016: Addiction Biology
https://www.readbyqxmd.com/read/27734745/update-on-pharmacotherapy-for-treatment-of-opioid-use-disorder
#4
Daniel Ayanga, Daryl Shorter, Thomas R Kosten
Opioid Use Disorder (OUD) is a significant public health concern, negatively impacting the medical, psychological, and social domains of an individual's life as well as creating substantial burdens for society. Effective treatment interventions are necessary for reduction of OUD and its consequences. Pharmacotherapy represents a central component of management. Areas covered: This review focuses on pharmacologic strategies for OUD treatment, discussing both primary as well as adjunctive therapy modalities. We will discuss both medications used during detoxification to treat withdrawal, as well as those used as maintenance therapy...
December 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27722007/predictors-of-relapse-after-inpatient-opioid-detoxification-during-1-year-follow-up
#5
Harsh Chalana, Tanu Kundal, Varun Gupta, Amandeep Singh Malhari
Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion...
2016: Journal of Addiction
https://www.readbyqxmd.com/read/27692193/non-prescribed-buprenorphine-in-new-york-city-motivations-for-use-practices-of-diversion-and-experiences-of-stigma
#6
Bennett Allen, Alex Harocopos
Non-medical use of opioid analgesics (OAs) has increased in the United States over the past decade. Concurrently, access to opioid agonist therapies (OATs) such as buprenorphine has expanded. However, there has been little in-depth qualitative exploration into circumstances surrounding buprenorphine diversion and non-prescribed use. This study reports on qualitative data from in-depth interviews conducted with persons in New York City reporting non-medical OA use in the past 12 months. Participants (n=42) were aged between 18 and 49 years...
November 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27692182/community-based-methadone-maintenance-in-a-large-detention-center-is-associated-with-decreases-in-inmate-recidivism
#7
Verner S Westerberg, Barbara S McCrady, Mandy Owens, Paul Guerin
Because it is not common in the U.S. for jails to allow inmates to continue opioid medications that have been started in the community, we aimed to assess whether inmates maintained on methadone showed different rates of recidivism, lengths of incarceration, and types of offenses than other incarcerated groups. We also analyzed rates of return to home clinics after release. In order to answer these questions this study used extant data from 960 adult inmates in a large metropolitan detention center who were in 1 of 4 groups: general population with no known substance use disorders, alcohol detoxification, methadone maintenance (MMT), and opioid detoxification...
November 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27687743/ethical-and-clinical-safety-considerations-in-the-design-of-an-effectiveness-trial-a-comparison-of-buprenorphine-versus-naltrexone-treatment-for-opioid-dependence
#8
Edward V Nunes, Joshua D Lee, Dominic Sisti, Andrea Segal, Arthur Caplan, Marc Fishman, Genie Bailey, Gregory Brigham, Patricia Novo, Sarah Farkas, John Rotrosen
We examine ethical challenges encountered in the design of an effectiveness trial (CTN-0051; X:BOT), comparing sublingual buprenorphine-naloxone (BUP-NX), an established treatment for opioid dependence, to the newer extended-release injectable naltrexone (XR-NTX). Ethical issues surrounded: 1) known poor effectiveness of one possible, commonly used treatment as usual control condition-detoxification followed by counseling without medication; 2) the role of patients' preferences for treatments, given that treatments were clinically approved and available to the population; 3) differences between the optimal "usual treatment" clinical settings for different treatments making it challenging to design a fair comparison; 4) vested interest groups favoring different treatments exerting potential influence on the design process; 5) potentially vulnerable populations of substance users and prisoners; 6) potential therapeutic misconception in the implementation of safety procedures; and 7) high cost of a large trial limiting questions that could be addressed...
September 28, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27615418/medication-overuse-headache-risk-factors-pathophysiology-and-management
#9
REVIEW
Hans-Christoph Diener, Dagny Holle, Kasja Solbach, Charly Gaul
Medication-overuse headache (MOH) is defined by the International Classification of Headache Disorders as a headache in patients with a pre-existing primary headache disorder that occurs on ≥15 days per month for >3 months, and is caused by overuse of medication intended for acute or symptomatic headache treatment. The prevalence of MOH in the general population is around 1%, but the condition is much more common in people with headache, in particular chronic migraine. The phenotype of the headache in MOH depends on the initial primary headache and the type of overused acute medication...
October 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27613150/acceptability-of-extended-release-naltrexone-by-heroin-dependent-patients-and-addiction-treatment-providers-in-the-netherlands
#10
Eline R Zaaijer, Anna E Goudriaan, Maarten W J Koeter, Jan Booij, Wim van den Brink
BACKGROUND: Extended-release naltrexone (XRNT) was developed to overcome poor treatment compliance with oral naltrexone in alcohol and opioid-dependent patients. XRNT injections are registered in the United States and Russia, but not in The Netherlands. However, XRNT can be obtained for individual patients, but it is expensive and not reimbursed by the health insurance. OBJECTIVES: This study evaluates the support for abstinence oriented treatment among heroin-dependent patients and the acceptability of XRNT injections by heroin-dependent patients and treatment providers in The Netherlands...
December 5, 2016: Substance Use & Misuse
https://www.readbyqxmd.com/read/27568856/opioid-detoxification-during-pregnancy-the%C3%A2-door-continues-to-open
#11
EDITORIAL
Winston A Campbell
No abstract text is available yet for this article.
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27563497/caring-for-pregnant-women-with-opioid-use-disorder-in-the-usa-expanding-and-improving-treatment
#12
Kelley A Saia, Davida Schiff, Elisha M Wachman, Pooja Mehta, Annmarie Vilkins, Michelle Sia, Jordana Price, Tirah Samura, Justin DeAngelis, Clark V Jackson, Sawyer F Emmer, Daniel Shaw, Sarah Bagley
PURPOSE OF THE REVIEW: Opioid use disorder in the USA is rising at an alarming rate, particularly among women of childbearing age. Pregnant women with opioid use disorder face numerous barriers to care, including limited access to treatment, stigma, and fear of legal consequences. This review of opioid use disorder in pregnancy is designed to assist health care providers caring for pregnant and postpartum women with the goal of expanding evidence-based treatment practices for this vulnerable population...
2016: Current Obstetrics and Gynecology Reports
https://www.readbyqxmd.com/read/27521809/nida-clinical-trials-network-ctn-0051-extended-release-naltrexone-vs-buprenorphine-for-opioid-treatment-x-bot-study-design-and-rationale
#13
Joshua D Lee, Edward V Nunes, Patricia Novo Mpa, Genie L Bailey, Gregory S Brigham, Allan J Cohen, Marc Fishman, Walter Ling, Robert Lindblad, Dikla Shmueli-Blumberg, Don Stablein, Jeanine May, Dagmar Salazar, David Liu, John Rotrosen
INTRODUCTION: For opioid-dependent patients in the US and elsewhere, detoxification and counseling-only aftercare are treatment mainstays. Long-term abstinence is rarely achieved; many patients relapse and overdose after detoxification. Methadone, buprenorphine-naloxone (BUP-NX) and extended-release naltrexone (XR-NTX) can prevent opioid relapse but are underutilized. This study is intended to develop an evidence-base to help patients and providers make informed choices and to foster wider adoption of relapse-prevention pharmacotherapies...
September 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27512336/the-need-for-psychosocial-interventions-to-facilitate-the-transition-to-extended-release-naltrexone-xr-ntx-treatment-for-opioid-dependence-a-concise-review-of-the-literature
#14
REVIEW
Susan E Ramsey, Dan Rounsaville, Randall Hoskinson, Tae Woo Park, Evan G Ames, Victor D Neirinckx, Peter Friedmann
Given the increase of opioid dependence and opioid-related morbidity and mortality, improving treatment options for individuals with opioid dependence warrants increased attention. This article provides a concise review of work in this area. Remission from opioid dependence can be very difficult to sustain, particularly in the absence of opioid replacement or opioid antagonist therapy. For those who wish to transition from opioid use or opioid replacement therapy to opioid antagonist therapy, a significant challenge can be the period of withdrawal symptoms that must be endured prior to the initiation of opioid antagonist therapy...
2016: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/27500873/-a-randomized-single-blind-study-of-the-efficacy-of-pregabalin-in-the-treatment-of-opioid-withdrawal-syndrome
#15
E M Krupitsky, R D Ilyuk, A D Mikhailov, K A Kazankov, K V Rybakova, E P Skurat, O G Grishina, I A Zaplatkin, M V Vetrova, N G Neznanov
AIM: To study the efficacy and safety of pregabalin (lyrica) in the complex treatment of opioid withdrawal syndrome (OWS). MATERIAL AND METHODS: HASH(0x4c31280) STUDY DESIGN: single-blind randomized symptom-triggered protocol with an active control. Thirty-four patients were randomly assigned to two groups. The first group (n=19) received up to 600 mg a day of pregabalin for six days along with symptomatic therapy (basic and symptom-triggered)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27493878/opioid-use-in-the-twenty-first-century-similarities-and-differences-across-national-borders
#16
Georgi Vasilev, Svetla Milcheva, Jasmin Vassileva
The global prevalence in the use of opiates and opioids has remained stable, though there were some unprecedented recent increases in opioid use and associated mortality and morbidity in the United States. Internationally, there is a strong tendency for consolidation of drug treatment strategies in favor of more systematic, structured and balanced approaches to regional and national drug policies. However, there are considerable differences in the scope, focus, and implementation of national drug policies and the political context is shaping drug prevention, treatment and rehabilitation efforts to an extent not typically observed in other public health domains...
September 2016: Current Treatment Options in Psychiatry
https://www.readbyqxmd.com/read/27462930/should-the-united-states-government-repeal-restrictions-on-buprenorphine-naloxone-treatment
#17
Kenneth Blum, Mark Gold, H Westley Clark, Kristina Dushaj, Rajendra D Badgaiyan
Attention must be focused on needed changes to the current United States law that restricts physicians who prescribe buprenorphine for the detoxification or treatment of Opioid Use Disorder, to accepting no more than 100 patients. The current system does not provide comprehensive treatment as defined by the American Society of Addiction Medicine (ASAM) criteria. In addition, it suffers from both fragmentation and stigma and will require a significant change to comply with ASAM's call for integrated delivery of comprehensive addiction treatment...
October 14, 2016: Substance Use & Misuse
https://www.readbyqxmd.com/read/27431049/buprenorphine-initiation-and-linkage-to-outpatient-buprenorphine-do-not-reduce-frequency-of-injection-opiate-use-following-hospitalization
#18
Phoebe A Cushman, Jane M Liebschutz, Bradley J Anderson, Merredith R Moreau, Michael D Stein
BACKGROUND: Buprenorphine has established effectiveness for outpatient treatment of opioid use disorder. Our previously published STOP (Suboxone Transition to Opiate Program) trial showed that buprenorphine induction, stabilization, and linkage to outpatient treatment in opioid-dependent inpatients (injection and non-injection drug users) decreased illicit opioid use over 6months. The present study was a planned subgroup analysis of injection opiate users from STOP. OBJECTIVE: To determine if inpatient buprenorphine initiation and linkage to outpatient buprenorphine reduce injection opiate users' frequency of injection opiate use (IOU)...
September 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27431047/reasons-for-benzodiazepine-use-among-persons-seeking-opioid-detoxification
#19
Michael D Stein, Mitika Kanabar, Bradley J Anderson, Anna Lembke, Genie L Bailey
BACKGROUND: Over the past decade, patients admitted to addiction treatment programs have reported increasing rates of concurrent opioid and benzodiazepine (BZD) use. This drug combination places individuals at high risk for accidental overdose. Little is known about reasons for BZD use among individuals seeking treatment for opioid use disorders. METHODS: We surveyed consecutive persons initiating inpatient opioid detoxification and identified 176 out of 438 who reported BZD use in the past 30 days and/or had a positive toxicology...
September 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27391853/methadone-for-the-treatment-of-prescription-opioids-dependence-a-retrospective-chart-review
#20
Pablo Barrio, Mohamed Ezzeldin, Pol Bruguera, Ana Pérez, Sara Mansilla, Marina Fàbrega, Anna Lligoña, Sílvia Mondón, Mercè Balcells
Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample...
June 14, 2016: Adicciones
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