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Opioid Detoxification

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https://www.readbyqxmd.com/read/29049469/the-effectiveness-of-injectable-extended-release-naltrexone-vs-daily-buprenorphine-naloxone-for-opioid-dependence-a-randomized-clinical-noninferiority-trial
#1
Lars Tanum, Kristin Klemmetsby Solli, Zill-E-Huma Latif, Jurate Šaltyte Benth, Arild Opheim, Kamni Sharma-Haase, Peter Krajci, Nikolaj Kunøe
Importance: To date, extended-release naltrexone hydrochloride has not previously been compared directly with opioid medication treatment (OMT), currently the most commonly prescribed treatment for opioid dependence. Objective: To determine whether treatment with extended-release naltrexone will be as effective as daily buprenorphine hydrochloride with naloxone hydrochloride in maintaining abstinence from heroin and other illicit substances in newly detoxified individuals...
October 18, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/29026504/loperamide-dependency-a-case-report
#2
Mehran Zarghami, Maryam Rezapour
BACKGROUND: Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia. CASE REPORT: Herein, we report a 35-year-old man with a 13-year history of abusing opioids who had undergone detoxification for four times during this period. He underwent detoxification for using 200 mg loperamide daily with anticholinergic agents, clonidine, non-steroidal analgesics, and diazepam...
January 2017: Addiction & Health
https://www.readbyqxmd.com/read/29021114/a-police-led-addiction-treatment-referral-program-in-gloucester-ma-implementation-and-participants-experiences
#3
Davida M Schiff, Mari-Lynn Drainoni, Zoe M Weinstein, Lisa Chan, Megan Bair-Merritt, David Rosenbloom
BACKGROUND: The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment. OBJECTIVE: To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program. METHODS: Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28965335/pregabalin-use-among-users-of-illicit-drugs-a-cross-sectional-survey-in-southern-germany
#4
Brendan J Snellgrove, Tilman Steinert, Susanne Jaeger
BACKGROUND: The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). OBJECTIVE: Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. METHODS: We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013...
October 2017: CNS Drugs
https://www.readbyqxmd.com/read/28940788/a-naturalistic-longitudinal-analysis-of-post-detoxification-outcomes-in-opioid-dependent-patients
#5
Jo-Hanna Ivers, Lina Zgaga, Brion Sweeney, Eamon Keenan, Catherine Darker, Bobby P Smyth, Joe Barry
INTRODUCTION AND AIMS: To provide an assessment of outcomes in a cohort of opioid-dependent patients post-detoxification. DESIGN AND METHODS: This study employed an observational longitudinal cohort design. Patients who completed detoxification in the three major Drug Dependency Units in Ireland during a 14-month period were included in the study (n = 143). Patients opting for one of the three pathways post-detoxification (inpatient aftercare, outpatient aftercare or no formal aftercare) were assessed in the final week of detoxification and followed up after 3, 6 and 9 months...
September 20, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28938502/-alarming-pregabalin-abuse-in-munich-prevalence-patterns-of-use-and-complications
#6
Nicolas Zellner, Florian Eyer, Tobias Zellner
Background Pregabalin is used e. g. for the treatment of neuropathic pain and anxiety disorder. Recently, its potential for abuse and addiction has become apparent. Methods From 2008 - 2015, we searched our database for the term "Pregabalin", including all patients treated in our department and all calls to the Poison Information Centre (PIC) Munich.From October 2013 to September 2014, all patients were included in a cohort study who either were admitted with a drug intoxication or who presented themselves for a course of detoxification (except ethanol)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28894357/advances-in-the-delivery-of-buprenorphine-for-opioid-dependence
#7
REVIEW
Richard N Rosenthal, Viral V Goradia
Opioid use disorders (OUDs) have long been a global problem, but the prevalence rates have increased over 20 years to epidemic proportions in the US, with concomitant increases in morbidity and all-cause mortality, but especially opioid overdose. These increases are in part attributable to a several-fold expansion in the prescription of opioid pain medications over the same time period. Opioid detoxification and psychosocial treatments alone have each not yielded sufficient efficacy for OUD, but μ-opioid receptor agonist, partial agonist, and antagonist medications have demonstrated the greatest overall benefit in OUD treatment...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28885299/correlates-of-stigma-severity-among-persons-seeking-opioid-detoxification
#8
Nikki Bozinoff, Bradley J Anderson, Genie L Bailey, Michael D Stein
INTRODUCTION: Among people with opioid use disorder (OUD), stigma is a known barrier to accessing treatment and has negative impacts on physical and mental health. The purpose of this study was to understand the factors associated with self-stigma and perceived stigma severity among people with OUD entering an inpatient detoxification program. METHODS: Between December 2015 and August 2016, consecutive persons seeking inpatient opioid detoxification were asked to complete a survey that included sociodemographic, drug use, treatment variables, an 8-item General Self-Stigma scale, and a 3-item Treatment Stigma scale...
September 6, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28841495/adverse-childhood-experience-effects-on-opioid-use-initiation-injection-drug-use-and-overdose-among-persons-with-opioid-use-disorder
#9
Michael D Stein, Micah T Conti, Shannon Kenney, Bradley J Anderson, Jessica N Flori, Megan M Risi, Genie L Bailey
INTRODUCTION: Adverse childhood experiences are associated with the development of substance use disorders. With opioid use disorder, a growing concern in the United States, we were interested in examining the relationship between adverse experiences and three landmarks of opioid use: age of opioid initiation, injection drug use, and lifetime overdose. METHODS: Between May and December 2015, we interviewed consecutive persons seeking inpatient opioid detoxification...
October 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28836712/religious-coping-in-patients-with-severe-substance-use-disorders-receiving-acute-inpatient-detoxification
#10
Morgan M Medlock, David H Rosmarin, Hilary S Connery, Margaret L Griffin, Roger D Weiss, Sterling L Karakula, R Kathryn McHugh
BACKGROUND AND OBJECTIVES: Religious coping, one of the most widely studied components of spirituality among psychiatric populations, has rarely been addressed in patients with severe substance use disorders (SUD). The aim of our study was to elucidate whether religious coping is related to symptom expression and mutual-help participation. METHODS: Self-reported religious coping was assessed in individuals sequentially admitted to a private psychiatric hospital for inpatient detoxification...
October 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28800186/ameliorative-response-to-detoxification-psychotherapy-and-medical-management-in-patients-maintained-on-opioids-for-pain
#11
Molly Belkin, Howard Stephen Reinheimer, Jordan Levy, Brian Johnson
BACKGROUND AND OBJECTIVES: The prevalence of opioid-induced hyperalgesia (OIH) among patients maintained on opioids for chronic non-malignant pain has not been estimated. As a contribution toward establishing its prevalence, we report a case series of opioid maintained patients whose pain tolerance was measured by the cold pressor test at baseline. METHODS: A case series of 117 patients who had undergone detoxification was reviewed retrospectively. Most patients (n = 108) and selected non-addicted support persons who accompanied them (controls; n = 37) had cold pressor time (CPT) assessments at baseline...
October 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28780607/strategies-to-identify-and-reduce-opioid-misuse-among-patients-with-gastrointestinal-disorders-a-systematic-scoping-review
#12
REVIEW
Salva N Balbale, Itishree Trivedi, Linda C O'Dwyer, Megan C McHugh, Charlesnika T Evans, Neil Jordan, Laurie A Keefer
BACKGROUND: Scoping reviews are preliminary assessments intended to characterize the extent and nature of emerging research evidence, identify literature gaps, and offer directions for future research. We conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. METHODS: We performed structured keyword searches to identify manuscripts published through June 2016 in the PubMed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases to extract original research articles that described healthcare practices, tools, or interventions to identify and reduce opioid misuse among GI patients...
October 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28741741/addiction-related-interactions-of-pregabalin-with-morphine-in-mice-and-humans-reinforcing-and-inhibiting-effects
#13
Elena Vashchinkina, Ossi Piippo, Olga Vekovischeva, Evgeny Krupitsky, Ruslan Ilyuk, Nikholay Neznanov, Kirill Kazankov, Igor Zaplatkin, Esa R Korpi
The gabapentinoid pregabalin is a rapid-acting anxiolytic and analgesic, possibly suitable in supervised opioid detoxification. However, clinicians have been cautious in using it because of its unknown addictive risk and rising number of mortalities after pregabalin self-medication in opioid abusers. Here, we studied interactions of pregabalin and morphine on reward functions of the dopamine system in mice and the efficacy of pregabalin on withdrawal in opioid addicts. After the treatment of mice with pregabalin and morphine, we used electrophysiology to study neuroplasticity in midbrain slices, self-administration and conditioned place preference tests to investigate the rewarding potential of pregabalin and naloxone-precipitated morphine withdrawal to evaluate opioid withdrawal symptoms...
July 25, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
September 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28692407/overdose-history-is-associated-with-postdetoxification-treatment-preference-for-persons-with-opioid-use-disorder
#15
Michael D Stein, Jessica N Flori, Megan M Risi, Micah T Conti, Bradley J Anderson, Genie L Bailey
BACKGROUND: Without aftercare treatment, persons discharged from short-term inpatient detoxification for opioid use disorder are at high risk of relapse. In previous work, those who were recently homeless or had pending legal problems were more likely to prefer residential treatment for aftercare. Here, based on clinical experience, the authors hypothesize that a particular clinical factor, surviving an opioid overdose, will be associated with aftercare preference. METHODS: Between May and December 2015, the authors surveyed consecutive persons seeking inpatient opioid detoxification...
July 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28631527/buprenorphine-naloxone-versus-methadone-and-lofexidine-in-community-stabilisation-and-detoxification-a-randomised-controlled-trial-of-low-dose-short-term-opiate-dependent-individuals
#16
Fergus D Law, Alison M Diaper, Jan K Melichar, Simon Coulton, David J Nutt, Judy S Myles
Buprenorphine/naloxone, methadone and lofexidine are medications with utility in the treatment of opiate withdrawal. We report the first randomised controlled trial to compare the effects of these two medications on withdrawal symptoms and outcome during opiate induction/stabilisation and detoxification. A double-blind randomised controlled trial was conducted in an outpatient satellite clinic of a specialist drug service. Eighty opiate dependent individuals meeting DSM-IV criteria for opiate dependence, using ⩽ ½ g heroin smoked/chased or ¼ g heroin injected or ⩽ 30mg methadone, with ⩽ 3 years of opioid dependency, underwent a short-term opiate treatment programme involving induction/stabilisation on methadone 30mg or buprenorphine/naloxone 4mg/1mg, followed by detoxification (where the methadone group was assisted by lofexidine)...
June 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28631421/impact-of-synthetic-cannabinoids-on-the-duration-of-opioid-related-withdrawal-and-craving-among-patients-of-addiction-clinics-in-kazakhstan-a-prospective-case-control-study
#17
Mariya Prilutskaya, Francesco Saverio Bersani, Ornella Corazza, Sergey Molchanov
OBJECTIVE: The aim of the study was to prospectively assess whether regular use of synthetic cannabinoids (SCs) affects the duration of opioid-related withdrawal and craving symptoms in patients undergoing drug detoxification treatments. METHODS: Patients (n = 193) with opioid use disorder, among which 47 patients are regularly using SCs, underwent integrated drug detoxification therapies. The Clinical Opiate Withdrawal Scale and a specific visual analogue scale were used to assess opioid withdrawal and craving symptoms over time...
May 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28607934/opioid-addiction-social-problems-associated-and-implications-of-both-current-and-possible-future-treatments-including-polymeric-therapeutics-for-giving-up-the-habit-of-opioid-consumption
#18
REVIEW
M Cristina Benéitez, M Esther Gil-Alegre
BACKGROUND: Detoxification programmes seek to implement the most secure and compassionate ways of withdrawing from opiates so that the inevitable withdrawal symptoms and other complications are minimized. Once detoxification has been achieved, the next stage is to enable the patient to overcome his or her drug addiction by ensuring consumption is permanently and completely abandoned, only after which can the subject be regarded as fully recovered. METHODS: A systematic search on the common databases of relevant papers published until 2016 inclusive...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28561914/opioid-use-disorder-in-pregnancy
#19
REVIEW
Van Roper, Kim J Cox
Opioid use disorder (OUD) in pregnancy has increased significantly in the past 10 years. Women with OUD may often be undertreated or untreated because of limited accessibility to treatment, particularly in rural areas. Because detoxification is not recommended during pregnancy due to the potential for adverse outcomes in the fetus and a high risk of relapse for the woman, more primary care providers need to be well versed in opioid-assisted therapy. In addition, recent changes in Food and Drug Administration regulations now allow nurse practitioners and physician assistants with specialized training to provide buprenorphine treatment for pregnant women with OUD in primary care settings...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28559639/opium-withdrawal-delirium-two-case-reports
#20
Ravi C Sharma, Ramesh Kumar, Dinesh Dutt Sharma, Pankaj Kanwar
Two patients with opium dependence developed delirium during abstinence. The delirium resolved completely within 48-58 hours of appropriate treatment. Caution needs to be exercised during opioid detoxification in timely detecting and treating potentially life-threatening condition like delirium.
January 26, 2017: Psychopharmacology Bulletin
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