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https://www.readbyqxmd.com/read/28340165/attitudes-toward-opioids-and-risk-of-misuse-abuse-in-patients-with-chronic-noncancer-pain-receiving-long-term-opioid-therapy
#1
Grisell Vargas-Schaffer, Jennifer Cogan
Objectives.:  To determine the attitudes of patients toward long-term opioid therapy (LtOT) and the potential risk of misuse/abuse in patients with chronic noncancer pain (CNCP). Design.:  Prospective, descriptive epidemiological study. Setting.:  Multidisciplinary tertiary care pain center within the Montreal University Health Center. Subjects.:  Patients who had had at least one visit at least one year prior to the invitation...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340145/human-abuse-potential-of-the-new-opioid-analgesic-molecule-nktr-181-compared-with-oxycodone
#2
Lynn Webster, Jack Henningfield, August R Buchhalter, Suresh Siddhanti, Lin Lu, Aleksandrs Odinecs, Carlo J Di Fonzo, Michael A Eldon
Objective.:  Evaluate the human abuse potential, pharmacokinetics, pharmacodynamics, and safety of NKTR-181, a novel mu-opioid agonist molecule, relative to oxycodone. Design.:  This randomized, single-center, double-blind, active- and placebo-controlled five-period crossover study enrolled healthy, adult, non-physically dependent recreational opioid users. Setting.:  Inpatient clinical research site. Subjects. : Forty-two randomized subjects (73...
March 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339890/pennsylvania-state-core-competencies-for-education-on-opioids-and-addiction
#3
Michael A Ashburn, Rachel L Levine
Objective.:  The objective of this project was to develop core competencies for education on opioids and addiction to be used in all Pennsylvania medical schools. Methods.:  The Pennsylvania Physician General created a task force that was responsible for the creation of the core competencies. A literature review was completed, and a survey of graduating medical students was conducted. The task force then developed, reviewed, and approved the core competencies...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339199/structure-based-discovery-of-new-antagonist-and-biased-agonist-chemotypes-for-the-kappa-opioid-receptor
#4
Zhong Zheng, Xi-Ping Huang, Thomas J Mangano, Rodger Zou, Xin Chen, Saheem Zaidi, Bryan L Roth, Raymond C Stevens, Vsevolod Katritch
The ongoing epidemics of opioid overdose raises an urgent need for effective anti-addiction therapies and addiction-free painkillers. The κ-opioid receptor (KOR) has emerged as a promising target for both indications, raising demand for new chemotypes of KOR antagonists, as well as G-protein-biased agonists. We employed the crystal structure of the KOR-JDTic complex and ligand-optimized structural templates to perform virtual screening of available compound libraries for new KOR ligands. The prospective virtual screening campaign yielded a high 32% hit rate, identifying novel fragment-like and lead-like chemotypes of KOR ligands...
March 24, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28337700/experimental-research-showing-the-reduction-of-naloxone-place-aversion-by-oral-zinc-administration-in-rats
#5
Diana Ciubotariu, Raoul Vasile Lupușoru, Elena Luca, Liliana Mititelu-Tarțău, Cătălina Elena Lupușoru
Previous studies showed the attenuation of both morphine-dependence and morphine-place preference by zinc. Conditioned place preference and aversion are experimental models frequently used to test the reward-stimulating, respectively the aversive effects induced by different stimuli or substances. Addictive substances usually induce place preference (exhibit reward-stimulating properties), while their antagonists determine place-avoidance (aversion). The present study aimed to assess the effect determined by zinc sulphate oral administration (2 and 4 mg/kg/day, 14 days, prior to habituation) on the place aversion induced by two naloxone doses (1...
March 23, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#6
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28333316/convergent-balancing-selection-on-the-mu-opioid-receptor-in-primates
#7
Carolyn G Sweeney, Juliette M Rando, Helen N Panas, Gregory M Miller, Donna M Platt, Eric J Vallender
The mu opioid receptor is involved in many natural processes including stress response, pleasure, and pain. Mutations in the gene also have been associated with opiate and alcohol addictions as well as with responsivity to medication targeting these disorders. Two common and mutually exclusive polymorphisms have been identified in humans, A118G (N40D), found commonly in non-African populations, and C17T (V6A), found almost exclusively in African populations. While A118G has been studied extensively for associations and in functional assays, C17T is much less well understood...
March 15, 2017: Molecular Biology and Evolution
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#8
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328578/sustained-improvements-in-pain-mood-function-and-opioid-use-post-interdisciplinary-pain-rehabilitation-in-patients-weaned-from-high-and-low-dose-chronic-opioid-therapy
#9
Kelly L Huffman, Taylor E Rush, Youran Fan, Giries W Sweis, Brinder Vij, Edward C Covington, Judith Scheman, Manu Mathews
Increased prescribing of opioids for chronic non cancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs (ICPRP) focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007-2012. Participants included 413 patients on high dose (HD) chronic opioid therapy (COT; >100mg), 528 on low dose (LD) COT and 516 not on opioids (NO)...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28328314/from-education-to-practice-addressing-opioid-misuse-through-healthcare-provider-training-a-special-issue-of-saj
#10
Adam J Gordon, John Daniel Harding
Opioid misuse may be ignored by providers who are unwilling or not confident in engaging the complex nature of substance use disorders among their patient populations. Addiction is a complex disease and although providers often are comfortable in identifying, assessing, and treating the complex diseases of their patients, basic knowledge and skills of identification, assessment, and treatment expertise involving opioids for pain, addressing opioid misuse, and treatment of opioid use disorder are lacking. Initiatives to improve knowledge of opioid use, misuse, and opioid use disorder among health care providers are emerging...
March 22, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28328148/long-term-follow-up-study-of-community-based-patients-receiving-xr-ntx-for-opioid-use-disorders
#11
Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R Levin, Edward V Nunes, John J Mariani, Adam Bisaga
BACKGROUND AND OBJECTIVES: Extended-release naltrexone (XR-NTX) is FDA-approved to prevent relapse in patients with Opioid Use Disorder. However little is known about long-term use among community-based outpatients. METHODS: Retrospective chart review and long-term follow-up survey among individuals (N = 168) who entered an outpatient XR-NTX trial between 2011 and 2015, during which participants were offered three monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of four domains: (1) substance use; (2) treatment continuation; (3) barriers; and (4) attitudes...
March 22, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28327378/gender-related-psychopathology-in-opioid-use-disorder-results-from-a-representative-sample-of-italian-addiction-services
#12
Beniamino Leone, Marco Di Nicola, Lorenzo Moccia, Mauro Pettorruso, Luisa De Risio, Giuseppe Nucara, Lorenzo Zamboni, Antonino Callea, Luigi Janiri, Mauro Cibin, Fabio Lugoboni
AIMS: Gender and psychiatric comorbidity seem to influence patients' inter-individual response to Opioid Substitution Treatments (OST) in Opioid Use Disorder (OUD) management. The aim of the study was to assess psychopathological dimensions in an Italian sample of OUD individuals entering a methadone/buprenorphine maintenance program; secondary, we evaluated the possible gender-specific differences within the psychopathological profiles. METHODS: In a cross-sectional study, we recruited 1052 (792 male; 260 female) OUD subjects receiving OST...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28325710/no-evidence-of-compensatory-drug-use-risk-behavior-among-heroin-users-after-receiving-take-home-naloxone
#13
Jermaine D Jones, Aimee Campbell, Verena E Metz, Sandra D Comer
INTRODUCTION: Some fear that distribution of naloxone to persons at risk of experiencing an opioid overdose may reduce the perceived negative consequences of drug use, leading to riskier patterns of use. This study assessed whether participation in naloxone/overdose training altered drug use frequency, quantity or severity among heroin users in and out of treatment. METHODS: Clinical interviews were performed assessing patterns of heroin and other drug use prior to, and at multiple timepoints after overdose education and naloxone training...
March 9, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28324627/hospitalized-opioid-dependent-patients-exploring-predictors-of-buprenorphine-treatment-entry-and-retention-after-discharge
#14
Christina S Lee, Jane M Liebschutz, Bradley J Anderson, Michael D Stein
OBJECTIVES: Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization. METHODS: This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT)...
March 21, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28322978/delta-opioid-receptor-antagonism-leads-to-excessive-ethanol-consumption-in-mice-with-enhanced-activity-of-the-endogenous-opioid-system
#15
Piotr Poznanski, Anna Lesniak, Michal Korostynski, Klaudia Szklarczyk, Marzena Lazarczyk, Piotr Religa, Magdalena Bujalska-Zadrozny, Bogdan Sadowski, Mariusz Sacharczuk
The opioid system modulates the central reinforcing effects of ethanol and participates in the etiology of addiction. However, the pharmacotherapy of ethanol dependence targeted on the opioid system is little effective and varies due to individual patients' sensitivity. In the present study, we used two mouse lines with high (HA) and low (LA) activity of the endogenous opioid system to analyze the effect of opioid receptor blockade on ethanol drinking behavior. We found that LA and HA lines characterized by divergent magnitudes of swim stress-induced analgesia also differ in ethanol intake and preference...
March 18, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28319052/a-tail-of-opioid-receptor-variants
#16
Stephanie Puig, Howard B Gutstein
Opioids are the gold-standard treatment for severe pain. However, potentially life-threatening side effects decrease the safety and effectiveness of these compounds. The addiction liability of these drugs has led to the current epidemic of opioid abuse in the US. Extensive research efforts have focused on trying to dissociate the analgesic properties of opioids from their undesirable side effects. Splice variants of the mu opioid receptor (MOR), which mediates opioid actions, have unique pharmacological properties and anatomic distributions that make them attractive candidates for therapeutic pain relief...
March 20, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28315549/substance-abuse-and-addiction-implications-for-pain-management-in-patients-with-cancer%C3%A2
#17
Yu-Ping Chang
BACKGROUND: Substance use disorders (SUDs) are chronic diseases that may complicate the nursing care of patients with cancer, affecting their ability to adhere to treatment protocols, responses to cancer pain, and use of opioids for analgesia. OBJECTIVES: This article explores how the presence of an SUD may affect oncology nursing care and pain management. METHODS: The PubMed and CINAHL® databases were searched for articles from 1980-2016 using the keywords cancer, cancer pain, addiction, substance abuse, and alcoholism...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28302862/arresting-the-development-of-addiction-the-role-of-%C3%AE-arrestin2-in-drug-abuse
#18
Kirsten A Porter-Stransky, David Weinshenker
The protein β-arrestin2 (βarr2) directly interacts with receptors and signaling pathways that mediate the behavioral effects of drugs of abuse, making it a prime candidate for therapeutic interventions. βarr2 drives desensitization and internalization of G protein-coupled receptors, including dopamine, opioid, and cannabinoid receptors, and can also trigger G protein-independent intracellular signaling. βarr2 mediates several drug-induced behaviors, but the relationship is complex and dependent on the type of behavior (e...
March 16, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28302509/binding-mode-analyses-of-nap-derivatives-as-mu-opioid-receptor-selective-ligands-through-docking-studies-and-molecular-dynamics-simulation
#19
Huiqun Wang, Saheem A Zaidi, Yan Zhang
Mu opioid receptor selective antagonists are highly desirable because of their utility as pharmacological probes for receptor characterization and functional studies. Furthermore, the mu opioid receptors act as an important target in drug abuse and addiction treatment. Previously, we reported NAP as a novel lead compound with high selectivity and affinity towards the mu opioid receptor. Based on NAP, we have synthesized its derivatives and further characterized their binding affinities and selectivity towards the receptor...
March 6, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28301370/debate-are-benzodiazepines-appropriate-treatments-for-patients-with-substance-use-disorders-yes
#20
Tae Woo Park
Benzodiazepines are a controversial treatment for anxiety in patients with substance use disorders. Concerns include risk of addiction, overdose, and diversion. But benzodiazepines are among the most effective and well-tolerated treatments for anxiety, and are safe for the majority of patients who take them. Though not appropriate for all cases, particularly in those with an active opioid use disorder, benzodiazepines should be considered as a treatment for patients with substance use disorders after careful weighing of benefits and harms...
March 2017: Journal of Addiction Medicine
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