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https://www.readbyqxmd.com/read/27933094/the-newer-opioid-agonist-treatment-with-lower-substitutive-opiate-doses-is-associated-with-better-toxicology-outcome-than-the-older-harm-reduction-treatment
#1
Jacopo V Bizzarri, Valentina Casetti, Livia Sanna, Angelo Giovanni Icro Maremmani, Luca Rovai, Silvia Bacciardi, Daria Piacentino, Andreas Conca, Icro Maremmani
BACKGROUND: Charge-free heroin use disorder treatment in Italy follows two main approaches, i.e., harm reduction treatment (HRT) strategy in community low-threshold facilities for drug addiction and opioid agonist treatment (OAT) in high-threshold facilities for opioid addiction, focusing on pharmacological maintenance according to the Dole and Nyswander strategy. We aimed to compare the impact of HRT and OAT on patient outcome, as assessed through negativity for drugs on about 1-year urinalyses...
2016: Annals of General Psychiatry
https://www.readbyqxmd.com/read/27931253/alcohol-use-in-opioid-agonist-treatment
#2
REVIEW
Seonaid Nolan, Jan Klimas, Evan Wood
Alcohol misuse among individuals receiving agonist treatment for an opioid use disorder is common and is associated with significant morbidity and mortality. At present, though substantial research highlights effective strategies for the screening, diagnosis and management of an alcohol or opioid use disorder individually, less is known about how best to care for those with a dual diagnosis especially since common treatments for opioid addiction may be contraindicated in a setting of alcohol use. This review summarizes existing research and characterizes the prevalence, clinical implications and management of alcohol misuse among individuals with opioid addiction...
December 8, 2016: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/27926654/neonatal-abstinence-syndrome-and-ethical-approaches-to-the-identification-of-pregnant-women-who-use-drugs
#3
Mishka Terplan, Howard Minkoff
The United States is experiencing an epidemic of opioid use, addiction, and neonatal abstinence syndrome. Consequentially, a great deal of public, and public health, attention has turned toward the timely recognition of pregnant women who use drugs. We explore the clinical efficacy and ethical acceptability of different methods of identification-contrasting drug testing (using biologic samples such as urine) with screening (using an instrument or questionnaire) under both universal and selective approaches within the current legal and social landscape, which is fraught with potential adverse consequences for both the woman and her child...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27920318/survey-highlights-differences-in-medicaid-coverage-for-substance-use-treatment-and-opioid-use-disorder-medications
#4
Colleen M Grogan, Christina Andrews, Amanda Abraham, Keith Humphreys, Harold A Pollack, Bikki Tran Smith, Peter D Friedmann
The Affordable Care Act requires state Medicaid programs to cover substance use disorder treatment for their Medicaid expansion population but allows states to decide which individual services are reimbursable. To examine how states have defined substance use disorder benefit packages, we used data from 2013-14 that we collected as part of an ongoing nationwide survey of state Medicaid programs. Our findings highlight important state-level differences in coverage for substance use disorder treatment and opioid use disorder medications across the United States...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27919771/the-initiation-of-chronic-opioids-a-survey-of-chronic-pain-patients-characterizing-chronic-opioid-use
#5
Catherine E Callinan, Mark D Neuman, Kim E Lacy, Claudia Gabison, Michael A Ashburn
: This study reports the results of a researcher-administered survey with 115 patients receiving chronic opioid therapy (>90 days) to obtain information regarding how chronic opioid therapy was started. Chronic opioids were started following surgery (27.0%; 95% CI:18.5-35.5) or for the treatment of acute injury-related pain (27.0%; 95% CI:18.5-35.5). Many who initiated opioid therapy after surgery reported post-operative complications (61.3%; 95% CI:50.8-71.8) and many with injury-related pain reported follow-up corrective surgery (58...
December 2, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27917870/high-frequency-stimulation-of-the-subthalamic-nucleus-blocks-compulsive-like-re-escalation-of-heroin-taking-in-rats
#6
Carrie L Wade, Marsida Kallupi, Daniel O Hernandez, Emmanuel Breysse, Giordano de Guglielmo, Elena Crawford, George F Koob, Paul Schweitzer, Christelle Baunez, Olivier George
Opioid addiction, including addiction to heroin, has dramatically increased in the last decade. The cost and pervasiveness of heroin addiction, including resistance to recovery from addiction, provide a compelling basis for developing novel therapeutic strategies. Deep brain stimulation may represent a viable alternative strategy for the treatment of intractable heroin addiction particularly in individuals who are resistant to traditional therapies. Here, we provide preclinical evidence of the therapeutic potential of high-frequency stimulation of the subthalamic nucleus (STN HFS) for heroin addiction...
December 5, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27909988/predicting-the-abuse-liability-of-entactogen-class-new-and-emerging-psychoactive-substances-via-preclinical-models-of-drug-self-administration
#7
Shawn M Aarde, Michael A Taffe
Animal models of drug self-administration are currently the gold standard for making predictions regarding the relative likelihood that a recreational drug substance will lead to continued use and addiction. Such models have been found to have high predictive accuracy and discriminative validity for a number of drug classes including ethanol, nicotine, opioids, and psychostimulants such as cocaine and methamphetamine. Members of the entactogen class of psychostimulants (drugs that produce an "open mind state" including feelings of interpersonal closeness, intimacy and empathy) have been less frequently studied in self-administration models...
December 2, 2016: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/27898497/medications-for-addiction-treatment-changing-language-to-improve-care
#8
Sarah E Wakeman
The term medication-assisted treatment has been widely adopted in reference to the use of opioid agonist therapy. Although it is arguably better than the older terms of replacement or substitution therapy, medication-assisted treatment implies that medications are a corollary to whatever the main part of treatment is. No other medication for other health conditions is referred to this way. It has finally been recognized that to improve care and reduce stigma, we must use medically accurate and person-first language, describing those with the disease of addiction as people with substance use disorder...
November 24, 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#9
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#10
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#11
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27895520/effectiveness-of-social-work-intervention-with-a-systematic-approach-to-improve-general-health-in-opioid-addicts-in-addiction-treatment-centers
#12
Ghoncheh Raheb, Esmat Khaleghi, Amir Moghanibashi-Mansourieh, Ali Farhoudian, Robab Teymouri
PURPOSE: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. PATIENTS AND METHODS: This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups...
2016: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/27886657/receipt-of-addiction-treatment-as-a-consequence-of-a-brief-intervention-for-drug-use-in-primary-care-a-randomized-trial
#13
Theresa W Kim, Judith Bernstein, Debbie M Cheng, Christine Lloyd-Travaglini, Jeffrey H Samet, Tibor P Palfai, Richard Saitz
BACKGROUND AND AIMS: Screening, brief intervention and 'referral to treatment' programs have been widely promoted as US federal policy. Little is known about the efficacy of the RT component (referral to treatment) of brief intervention for motivating patients with unhealthy drug use identified by screening to use addiction treatment. This study aimed to compare receipt of addiction treatment following two types of brief intervention for drug use vs a no-intervention control group among primary care patients screening positive for drug use...
November 25, 2016: Addiction
https://www.readbyqxmd.com/read/27882998/dopamine-and-opioid-neurotransmission-in-behavioral-addictions-a-comparative-pet-study-in-pathological-gambling-and-binge-eating
#14
Joonas Majuri, Juho Joutsa, Jarkko Johansson, Valerie Voon, Kati Alakurtti, Riitta Parkkola, Tuuli Lahti, Hannu Alho, Jussi Hirvonen, Eveliina Arponen, Sarita Forsback, Valtteri Kaasinen
Although behavioral addictions share many clinical features with drug addictions, they show strikingly large variation in their behavioral phenotypes (such as in uncontrollable gambling or eating). Neurotransmitter function in behavioral addictions is poorly understood but has important implications in understanding its relationship with substance use disorders and underlying mechanisms of therapeutic efficacy. Here, we compare opioid and dopamine function between two behavioral addiction phenotypes: pathological gambling (PG) and binge eating disorder (BED)...
November 24, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27882209/marketed-new-drug-delivery-systems-for-opioid-agonists-antagonists-administration-a-rapid-overview
#15
REVIEW
Hoda Soltani, Abbas Pardakhty
Novel drug delivery systems for controlled-release of opioid agonists as a long time painkillers or opioid antagonists for opium, heroin, and alcohol addiction are under development or in clinical use today. In this article, the field of "new drug delivery systems" is momentarily reviewed from the viewpoint of the marketed opioid agonists/antagonists dosage forms today.
April 2016: Addiction & Health
https://www.readbyqxmd.com/read/27880633/diversion-alert-1-year-evaluation-across-northern-new-england-2013-2014
#16
Sarah Levin Martin, Clare Desrosiers
This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert's impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients' care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert...
November 23, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/27873121/challenges-to-treatment-of-chronic-pain-and-addiction-during-the-opioid-crisis
#17
REVIEW
Daniel Krashin, Natalia Murinova, Mark Sullivan
Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society...
December 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27871198/-it-is-easier-for-me-to-shoot-up-stigma-abandonment-and-why-hiv-positive-drug-users-in-russia-fail-to-link-to-hiv-care
#18
Tetiana Kiriazova, Karsten Lunze, Anita Raj, Natalia Bushara, Elena Blokhina, Evgeny Krupitsky, Carly Bridden, Dmitry Lioznov, Jeffrey H Samet, Allen L Gifford
Many HIV-positive people who inject drugs (PWID) globally are not receiving HIV care. This represents a major challenge among key populations to end the global HIV epidemic. This qualitative study explored the process and associated barriers of linking HIV-positive PWID who are in addiction treatment to HIV care in St. Petersburg, Russia. We conducted three focus groups and seven semi-structured interviews with participants in the LINC ("Linking Infectious and Narcology Care") project at addiction and HIV hospitals in St...
November 22, 2016: AIDS Care
https://www.readbyqxmd.com/read/27865008/biosynthesis-of-the-psychotropic-plant-diterpene-salvinorin-a-discovery-and-characterization-of-the-salvia-divinorum-clerodienyl-diphosphate-synthase
#19
Kyle A Pelot, Rod Mitchell, Moonhyuk Kwon, David M Hagelthorn, Jacob F Wardman, Angela Chiang, Jörg Bohlmann, Dae-Kyun Ro, Philipp Zerbe
Salvia divinorum commonly known as diviner's sage, is an ethnomedicinal plant of the mint family (Lamiaceae). S. divinorum is rich in clerodane-type diterpenoids, which accumulate predominantly in leaf glandular trichomes. The main bioactive metabolite, salvinorin A, is the first non-nitrogenous natural compound known to function as an opioid-receptor agonist, and is undergoing clinical trials for potential use in treating neuropsychiatric diseases and drug addictions. We report here the discovery and functional characterization of two S...
November 19, 2016: Plant Journal: for Cell and Molecular Biology
https://www.readbyqxmd.com/read/27857051/elevation-of-the-acth-cortisol-ratio-in-female-opioid-dependent-patients-a-biomarker-of-aging-and-correlate-of-metabolic-and-immune-activation
#20
(no author information available yet)
BACKGROUND: Whilst the hypothalamic-pituitary-adrenal (HPA) Axis is a major stress axis, and is necessarily perturbed in opioid dependency, and stress is a major contributor to aging mechanisms, the HPA axis has not been studied in opioid dependency in an age-dependent manner. OBJECTIVE: Hypothesis - Differences in age dependent levels of HPA components. DESIGN: Cross-sectional comparison of general medical and opioid dependent patients (ODP, GMP)...
September 18, 2016: Neuro Endocrinology Letters
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