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Opioid Detoxification

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https://www.readbyqxmd.com/read/28894357/advances-in-the-delivery-of-buprenorphine-for-opioid-dependence
#1
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
#2
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
#3
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
#4
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...
August 24, 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
#5
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...
August 11, 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
#6
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...
August 5, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28554602/the-relationship-between-diversion-related-attitudes-and-sharing-and-selling-buprenorphine
#15
Shannon R Kenney, Bradley J Anderson, Genie L Bailey, Michael D Stein
OBJECTIVE: Buprenorphine medication-assisted treatment (B-MAT) is an efficacious and popular outpatient treatment for opioid use disorder. However, the likelihood of buprenorphine diversion is a public health concern. We examined the relationship between attitudes toward diversion as predictors of both sharing and selling buprenorphine. METHOD: Participants (n=476) were patients undergoing short-term inpatient opioid detoxification. Multinomial logistic regression was used to estimate the adjusted association of sharing and selling buprenorphine with demographics, substance use behaviors, and attitudes toward sharing and selling buprenorphine...
July 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28553701/opioid-antagonists-with-minimal-sedation-for-opioid-withdrawal
#16
REVIEW
Linda Gowing, Robert Ali, Jason M White
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the endpoint of long-term substitution treatment. OBJECTIVES: To assess the effects of opioid antagonists plus minimal sedation for opioid withdrawal. Comparators were placebo as well as more established approaches to detoxification, such as tapered doses of methadone, adrenergic agonists, buprenorphine and symptomatic medications. SEARCH METHODS: We updated our searches of the following databases to December 2016: CENTRAL, MEDLINE, Embase, PsycINFO and Web of Science...
May 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28548574/overdose-education-and-naloxone-distribution-for-veterans-with-opioid-use-disorder-results-from-a-pilot-initiative
#17
Grace Chang, Michelle Davids, Alan Kershaw
Patients with opioid use disorder are at a high risk of overdose. To minimize that risk, a program offering intranasal naloxone rescue kits was piloted at a Veterans Administration Hospital. The purpose of this study was to characterize veterans who accepted these potentially lifesaving kits. Retrospective medical chart review of 158 veterans with opioid use disorder receiving treatment on either the inpatient psychiatry detoxification units or outpatient methadone maintenance setting who were offered overdose education and naloxone rescue kits...
May 26, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28543191/methadone-buprenorphine-and-naltrexone-for-the-treatment-of-opioid-use-disorder-in-pregnant-women
#18
REVIEW
Tran H Tran, Brooke L Griffin, Rebecca H Stone, Kathleen M Vest, Timothy J Todd
Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed...
July 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28541119/treatment-of-opioid-use-disorder-with-ibogaine-detoxification-and-drug-use-outcomes
#19
Thomas Kingsley Brown, Kenneth Alper
BACKGROUND: Ibogaine is a monoterpene indole alkaloid used in medical and nonmedical settings for the treatment of opioid use disorder. Its mechanism of action is apparently novel. There are no published prospective studies of drug use outcomes with ibogaine. OBJECTIVES: To study outcomes following opioid detoxification with ibogaine. METHODS: In this observational study, 30 subjects with DSM-IV Opioid Dependence (25 males, 5 females) received a mean total dose of 1,540 ± 920 mg ibogaine HCl...
May 25, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28529359/the-journey-of-opioid-substitution-therapy-in-india-achievements-and-challenges
#20
Ravindra Rao
Opioids are one of the most problematic illegal substances globally. Opioid abuse is associated with complications in various spheres of the user's life, his/her family, and the society. Injecting drug use (IDU) is also linked to public health problems such as HIV infection and viral hepatitis. Medications form an important cornerstone in the treatment of opioid dependence. Treatment strategies such as "detoxification" alone or long-term treatment with opioid antagonist have limited acceptability and retention rates...
January 2017: Indian Journal of Psychiatry
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