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Opioid Detoxification

Gerod Hall, Sarah Walters, Hannah Gould, Sungwoo Lim
BACKGROUND: Homeless persons with substance use disorders (SUD) have high disease risk, poor access to healthcare, and are frequent users of Medicaid and other social services. Low-demand supportive housing with no prerequisites for treatment or sobriety has been shown to improve housing stability and decrease public service use for chronically homeless persons with serious mental illness (SMI) and chronic medical conditions. The impact of low-demand housing on individuals with SUD but without co-occurring SMI has been little studied...
March 12, 2018: Substance Abuse
Alyssa M Peckham, Kirk E Evoy, Jordan R Covvey, Leslie Ochs, Kathleen A Fairman, David A Sclar
OBJECTIVE: Research suggests medical consequences of gabapentin overuse depends on whether gabapentin is abused alone or with opioids to potentiate an opioid "high." The objective of this study was to assess predictors of gabapentin overuse with or without concomitant opioids. METHODS: Data were obtained from the Truven Health MarketScan® Commercial Claims and Encounters database for years 2013 to 2015. Eligibility criteria were gabapentin utilization, with or without opioids, for 120 days or longer throughout a 12-month observation period...
February 27, 2018: Pharmacotherapy
Sara Jafari, Sana Khajehpour, Emran Mohammad Razzaghi, Kazem Heidari, Mehdi Soleimani, Padideh Ghaeli
Objective: Craving for substance abuse is a usual and complicated problem in patients, with opioid addiction who are in opioid detoxifying process. Craving has been added as one of the diagnostic criteria of substance use disorders in DSM-5. The present trial aimed at comparing the effects of celecoxib versus ibuprofen in reducing pain and decreasing the desire to use opiates in patients undergoing opiate detoxification (n = 32). Method: A total of 32 patients (both inpatients and outpatients), who were undergoing opiate detoxification procedure and met the inclusion criteria entered this 4- week study...
October 2017: Iranian Journal of Psychiatry
J H Ivers, F Larkan, J Barry
The aim of the study was to gain an in-depth understanding of opioid-dependent patients' lived experiences post-detoxification. METHOD: The study employed a naturalistic, observational longitudinal design, involving baseline screening and tracking of patients post-detoxification, with follow-up interviews at three, six, and nine months to observe specific processes of interest. This in-depth investigation of patients at four points was new within an Irish context and novel throughout the literature...
February 15, 2018: Journal of Psychoactive Drugs
Sheheryar Muhammad, John R Tomko, Laura M Wilson
Purpose: The purpose of this study was to determine the incidence of ibuprofen administration in patients who are undergoing alcohol and opioid detoxification, and have concomitant alcohol-related thrombocytopenia. Methods: This was a single-center, cross-sectional, prospective, observational study. A daily manual review of electronic health records was conducted for patients admitted to the detoxification unit of the hospital. Patients who (1) were of age 18 years or more, (2) were ordered both alcohol and opioid detoxification protocols, and (3) had a platelet count of less than 150 000/µL were included in the study...
February 2018: Hospital Pharmacy
Alexia Anagnostopoulos, Alison G Abraham, Becky L Genberg, Gregory D Kirk, Shruti H Mehta
BACKGROUND: Prescription drug misuse and its consequences (e.g., overdose) are a major public health concern. While national focus has been on opioids, misuse of sedatives/tranquilizers also occurs. Here we describe the use, correlates, and sources of prescription drugs in a community-based cohort of people who inject drugs (PWID). METHODS: We included participants of the AIDS Linked to the IntraVenous Experience (ALIVE) study in follow-up in 2014. We defined prescription drug use as use of opioids or sedatives/tranquilizers considering both medical "prescribed by a doctor" and non-medical sources "obtained from the street/friend/relative...
February 2, 2018: Addictive Behaviors
RaeAnn E Anderson, Bryce Hruska, Alec P Boros, Christopher J Richardson, Douglas L Delahanty
BACKGROUND AND OBJECTIVES: Poly-substance use and psychiatric comorbidity are common among individuals receiving substance detoxification services. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are the most common co-occurring psychiatric disorders with substance use disorder (SUD). Current treatment favors a one-size-fits-all approach to treating addiction focusing on one substance or one comorbidity. Research examining patterns of substance use and comorbidities can inform efforts to effectively identify and differentially treat individuals with co-occurring conditions...
March 2018: Journal of Substance Abuse Treatment
Allison G Robertson, Michele M Easter, Hsiu-Ju Lin, Linda K Frisman, Jeffrey W Swanson, Marvin S Swartz
Adults suffering from a serious mental illness (SMI) and a substance use disorder are at especially high risk for poor clinical outcomes and also arrest and incarceration. Pharmacotherapies for treating opioid dependence could be a particularly important mode of treatment for opioid-dependent adults with SMI to lower their risk for overdose, high-cost hospitalizations, repeated emergency department visits, and incarceration, given relapse rates are very high following detoxification in the absence of one of the three FDA-approved pharmacotherapies...
March 2018: Journal of Substance Abuse Treatment
Elizabeth B Stuyt, Claudia A Voyles, Sara Bursac
Background: The National Acupuncture Detoxification Association (NADA) protocol, a simple standardized auricular treatment has the potential to provide vast public health relief on issues currently challenging our world. This includes but is not limited to addiction, such as the opioid epidemic, but also encompasses mental health, trauma, PTSD, chronic stress, and the symptoms associated with these conditions. Simple accessible tools that improve outcomes can make profound differences. We assert that the NADA protocol can have greatest impact when broadly applied by behavioral health professionals, Auricular Detoxification Specialists (ADSes)...
February 7, 2018: Medicines (Basel, Switzerland)
Brantley P Jarvis, August F Holtyn, Shrinidhi Subramaniam, D Andrew Tompkins, Emmanuel A Oga, George E Bigelow, Kenneth Silverman
AIMS: To review systematically the published literature on extended-release naltrexone (XR-NTX, Vivitrol®), marketed as a once-per-month injection product to treat opioid use disorder. We addressed the following questions: (1) How successful is induction on XR-NTX?; (2) What are adherence rates to XR-NTX?; and (3) Does XR-NTX decrease opioid use? Factors associated with these outcomes as well as overdose rates were examined. METHODS: We searched PubMed and used Google Scholar for forward citation searches of peer-reviewed articles from January 2006 to June 2017...
February 3, 2018: Addiction
(no author information available yet)
The Comprehensive Addiction and Recovery Act (CARA) of 2016, which became law on July 22, 2016, amended the Controlled Substances Act (CSA) to expand the categories of practitioners who may, under certain conditions on a temporary basis, dispense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treatment or detoxification treatment. Separately, the Department of Health and Human Services, by final rule effective August 8, 2016, increased to 275 the maximum number of patients that a practitioner may treat for opioid use disorder without being separately registered under the CSA for that purpose...
January 23, 2018: Federal Register
Xiu-Fang Chen, Lei Wang, Yong-Zheng Wu, Shi-Yu Song, Hai-Yan Min, Yan Yang, Xuan He, Qiao Liang, Long Yi, Yong Wang, Qian Gao
BACKGROUND: Type 2 diabetes is characterized by dyslipidemia and the accumulation of lipids in non-adipose tissue, including skeletal muscle. Puerarin, which is a natural isoflavonoid isolated from the root of the plant Pueraria lobata, has been shown to have antidiabetic activity. However, the lipid-reducing effect of puerarin, in particular in skeletal muscle, has not yet been addressed. METHODS: We examined the effect of puerarin on mitochondrial function and the oxidation of fatty acids in the skeletal muscle of high-fat diet/streptozotocin-induced diabetic rats...
January 12, 2018: Nutrition & Diabetes
Barbara Andraka-Christou, Matthew J Capone
AIM: Our aim was to compare physician-reported barriers to sublingual buprenorphine (BUP) and extended-release naltrexone (XR-NLT) prescribing in U.S. office-based practices, and to identify potential policies for minimizing these barriers. Only one previous qualitative study has examined physician-reported barriers to prescribing XR-NLT and no qualitative study has compared physician-reported barriers between the two medications. METHODS: Researchers conducted individual semi-structured and in-depth interviews with 20 licensed physicians in four U...
January 8, 2018: International Journal on Drug Policy
Rachel Vickers Smith, Elaine M Boland, April M Young, Michelle R Lofwall, Alexa Quiroz, Michele Staton, Jennifer R Havens
Gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary. Gabapentin has been linked with impaired driving and opioid use, highlighting the need to more fully understand its risk profile. Thirty-three individuals reporting recent nonmedical use of gabapentin were recruited from two ongoing longitudinal studies of drug users in Appalachian Kentucky to participate in focus groups. Four sessions were held (two in the community and two in jail settings), during which participants responded to questions regarding their personal experiences with gabapentin misuse...
February 2018: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
Shannon R Kenney, Bradley J Anderson, Genie L Bailey, Michael D Stein
INTRODUCTION: Naloxone is a safe and effective antidote for reversing opioid overdose. Layperson administration of naloxone is increasingly common, yet little is known about demographic and clinical factors associated with opioid users' likelihood of having administered naloxone to another opioid user who had overdosed. We examined predictors of reported naloxone administration in the past year. METHODS: Four hundred and sixty-eight patients were interviewed upon admission to brief, inpatient opioid detoxification between May and December of 2015...
January 2018: Journal of Substance Abuse Treatment
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...
December 1, 2017: JAMA Psychiatry
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
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
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
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
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