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https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#1
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28220474/buprenorphine-for-managing-opioid-withdrawal
#2
REVIEW
Linda Gowing, Robert Ali, Jason M White, Dalitso Mbewe
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the endpoint of substitution treatment. OBJECTIVES: To assess the effects of buprenorphine versus tapered doses of methadone, alpha2-adrenergic agonists, symptomatic medications or placebo, or different buprenorphine regimens for managing opioid withdrawal, in terms of the intensity of the withdrawal syndrome experienced, duration and completion of treatment, and adverse effects...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28213673/individual-placement-and-support-ips-for-methadone-maintenance-therapy-patients-a-pilot-randomized-controlled-trial
#3
Carrie E Lones, Gary R Bond, Mark P McGovern, Kathryn Carr, Teresa Leckron-Myers, Tim Hartnett, Deborah R Becker
Individual Placement and Support (IPS) is an evidence-based employment model for people with severe mental illness, but it has not been evaluated for clients enrolled in substance abuse treatment programs. This study evaluated the effectiveness of IPS for people with opioid use disorders enrolled in an opioid treatment program. Within a randomized controlled experiment, 45 patients receiving methadone maintenance therapy were assigned to either IPS or a 6-month waitlist. The waitlist group received IPS after 6 months...
February 17, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28186837/methadone-and-corrected-qt-prolongation-in-pain-and-palliative-care-patients-a-case-control-study
#4
Katherine M Juba, Tina M Khadem, David J Hutchinson, Jack E Brown
BACKGROUND: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. OBJECTIVE: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28177515/methadone-for-cancer-pain
#5
REVIEW
Alexander B Nicholson, Graeme R Watson, Sheena Derry, Philip J Wiffen
BACKGROUND: This is an updated review originally published in 2004 and first updated in 2007. This version includes substantial changes to bring it in line with current methodological requirements. Methadone is a synthetic opioid that presents some challenges in dose titration and is recognised to cause potentially fatal arrhythmias in some patients. It does have a place in therapy for people who cannot tolerate other opioids but should be initiated only by experienced practitioners. This review is one of a suite of reviews on opioids for cancer pain...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28156619/a-randomized-controlled-trial-rct-of-2-dose-ratios-for-conversion-from-parenteral-to-oral-methadone-in-patients-with-cancer-pain
#6
Josep Porta-Sales, Maria Nabal-Vicuña, Leyre Diez-Porres, Jaume Canal, Alberto Alonso-Babarro, Yolanda Vilches, Silvia Llorens, Mireia Sanllorente, Silvia Perez-Pujol, Eduardo Bruera
: 206 Background: Methadone (M) is frequently used for severe cancer pain using the parenteral and oral route. The most commonly used dose ratio (DR) parenteral: oral is 1:2. However, methadone is highly bioavailable and a lower ratio might result in similar analgesia with less toxicity. The main objective of this RCT is to compare success and side effects with 2 ratios of parenteral to oral M: 1:2 vs 1:1.2 in hospitalized patients with cancer pain. METHODS: Inpatients with cancer pain well controlled with parenteral M requiring rotation to the oral route...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156445/evaluation-of-the-japanese-opioid-conversion-ratio-for-switching-to-methadone-for-cancer-pain-control
#7
Sachiko Okayama, Yoshito Yoshikawa, Yoshio Kobayashi
: 196 Background: In Japan, oral administration of methadone was approved for patients with cancer pain in March 2013. As methadone exhibits complex pharmacokinetics with individual differences and rare but serious adverse effects, methadone is only prescribed as a fourth-line drug by cancer pain specialists, who must start methadone according to the following table and must not increase methadone dose within 7 days. AIMS: To assess the validity of the Japanese opioid conversion ratio...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28063398/brain-derived-neurotrophic-factor-bdnf-and-oxidative-stress-in-heroin-dependent-male-patients-undergoing-methadone-maintenance-treatment
#8
Meng-Chang Tsai, Tiao-Lai Huang
Brain-derived neurotrophic factor (BDNF) and oxidative stress may play a role in patients with heroin dependence. The aim of this study was to investigate the serum levels and activities of BDNF and oxidative stress markers, such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCC), and 8-hydroxy 2'-deoxyguanosine (8-OHdG), in heroin-dependent patients undergoing methadone maintenance treatment (MMT). 60 heroin-dependent male MMT patients and 30 healthy males were recruited for this study...
March 2017: Psychiatry Research
https://www.readbyqxmd.com/read/27927519/a-rapid-recovery-pathway-for-adolescent-idiopathic-scoliosis-that-improves-pain-control-and-reduces-time-to-inpatient-recovery-after-posterior-spinal-fusion
#9
Alex L Gornitzky, John M Flynn, Wallis T Muhly, Wudbhav N Sankar
STUDY DESIGN: Retrospective comparative cohort. OBJECTIVES: To determine if a standardized multimodal analgesic and rehabilitation protocol (rapid recovery pathway [RRP]) in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) could improve pain control, reduce opioid-related complications, and expedite early mobilization. BACKGROUND: Several reports have described postoperative recovery pathways for AIS patients undergoing PSF that shorten length of stay (LOS) without reporting the impact such pathways might have on patients' pain or quality of recovery...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27870477/ascending-single-dose-double-blind-placebo-controlled-safety-study-of-noribogaine-in-opioid-dependent-patients
#10
Paul Glue, Gavin Cape, Donna Tunnicliff, Michelle Lockhart, Fred Lam, Noelyn Hung, C Tak Hung, Sarah Harland, Jane Devane, R S Crockett, John Howes, Borje Darpo, Meijian Zhou, Holger Weis, Lawrence Friedhoff
Ibogaine is a psychoactive substance that may reduce opioid withdrawal symptoms. This was the first clinical trial of noribogaine, ibogaine's active metabolite, in patients established on methadone opioid substitution therapy (OST). In this randomized, double-blind, placebo-controlled single ascending-dose study, we evaluated the safety, tolerability, and pharmacokinetics of noribogaine in 27 patients seeking to discontinue methadone OST who had been switched to morphine during the previous week. Noribogaine doses were 60, 120, or 180 mg (n = 6/dose level) or matching placebo (n = 3/dose level)...
November 2016: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/27821595/cannabis-exposure-as-an-interactive-cardiovascular-risk-factor-and-accelerant-of-organismal-ageing-a-longitudinal-study
#11
Albert Stuart Reece, Amanda Norman, Gary Kenneth Hulse
OBJECTIVES: Many reports exist of the cardiovascular toxicity of smoked cannabis but none of arterial stiffness measures or vascular age (VA). In view of its diverse toxicology, the possibility that cannabis-exposed patients may be ageing more quickly requires investigation. DESIGN: Cross-sectional and longitudinal, observational. Prospective. SETTING: Single primary care addiction clinic in Brisbane, Australia. PARTICIPANTS: 11 cannabis-only smokers, 504 tobacco-only smokers, 114 tobacco and cannabis smokers and 534 non-smokers...
November 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27809831/tailoring-a-brief-intervention-for-illicit-drug-use-and-alcohol-use-in-irish-methadone-maintained-opiate-dependent-patients-a-qualitative-process
#12
Catherine Darker, Brion Sweeney, Eamon Keenan, Lucy Whiston, Rolande Anderson, Joe Barry
BACKGROUND: The World Health Organization (WHO) recommend the tailoring of a brief intervention (BI) programme of research to ensure that it is both culturally and contextually appropriate for the country and the environment in which it is being tested. The majority of BI research has been conducted with non-opioid dependent participants. The current study developed a tailored BI for illicit drug use and alcohol use to a methadone maintained opioid dependent polydrug using cohort of patients...
November 3, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27806509/effectiveness-of-community-reinforcement-and-family-training-craft-on-quality-of-life-and-depression-in-families-with-drug-abuse
#13
Hossein Assadbeigi, Abbas Pourshahbaz, Parvaneh Mohamadkhani, Ali Farhoudian
Drug abuse as a biological, psychological, and social problem affect all life aspects including quality of life and cause socio-psychological problems. This study aimed to evaluate the effectiveness of community reinforcement and family training (CRAFT) Method on quality of life and depression in family members of substance abusers. This was a quasi-experimental study with control group in which the pre-test and post-test were used. In the present study, two experimental groups (CRAFT and Nar-Anon) and a control group were used using the purposive sampling selected from the family members of substance abusers who referred to the methadone treatment clinic in Tehran...
July 12, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27784231/effect-of-oral-methadone-on-ecg-characteristics-and-endocrine-hormonal-changes-and-their-inter-relationship
#14
Shokoufeh Bonakdaran, Mahdi Hassan Zadeh Daloee, Ali Akhoondpoor Manteghi, Mina Akbarirad, Abdollah Firoozi, Fatemeh Akbarirad
INTRODUCTION: Methadone is the most common opioid in use for opioid substitution therapy. The Relation of methadone and electrocardiographic findings is nearly well known while the relationship between its electrocardiographic indexes and hormonal changes are not well recognized. OBJECTIVE: To evaluate the hormonal changes in patients who are taking methadone maintenance treatment (MMT) and its effects on electrocardiographic indexes, in comparison with healthy control groups...
October 26, 2016: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/27770163/biliary-and-pancreatic-ductal-dilation-in-patients-on-methadone-maintenance-therapy
#15
David D B Bates, Dorathy Tamayo-Murillo, Steven Kussman, Adam Luce, Christina A LeBedis, Jorge A Soto, Stephan W Anderson
PURPOSE: To determine whether the diameter of intrahepatic and extrahepatic bile ducts and pancreatic ducts in patients on methadone maintenance therapy is increased when compared with control subjects. METHODS: Between January 1, 2000 and March 15, 2013, a total of 97 patients (mean age 49.9, range 22-79, 65 male, 32 female) were identified who were receiving chronic methadone maintenance therapy (MMT) when they underwent imaging with abdominal MRI or a contrast-enhanced abdominopelvic CT...
October 21, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27754734/successful-treatment-of-opioid-refractory-cancer-pain-with-short-course-low-dose-ketamine
#16
Julie M Waldfogel, Suzanne Nesbit, Steven P Cohen, Sydney M Dy
Opioids remain the mainstay of treatment for severe cancer pain, but up to 20% of patients have persistent or refractory pain despite rapid and aggressive opioid titration, or develop refractory pain after long-term opioid use. In these scenarios, alternative agents and mechanisms for analgesia should be considered. This case report describes a 28-year-old man with metastatic pancreatic neuroendocrine cancer with severe, intractable pain despite high-dose opioids including methadone and a hydromorphone patient-controlled analgesia (PCA)...
December 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27748174/positive-neonatal-urine-comprehensive-drug-screen-low-birth-weight-and-withdrawal-symptoms-in-a-neonatal-unit-a-case-control-study
#17
Kam Lun Hon, Michael Ho Ming Chan, Ming Him James Ng, Chi Cheung Ho, Yin Ching Kathy Tsang, Wing Hung Tam, Chung Shun Ho
OBJECTIVE: Maternal drug abuse may influence neonatal outcomes. We compared neonatal outcomes of patients with urine screened positive for commonly abused drugs (CAD) versus those who were screened negative, and reviewed the pattern of drugs detected at a university teaching hospital. METHODS: Urine samples collected from babies with suspected illicit drug exposure who were admitted to the neonatal unit were sent for comprehensive drug screen (CDS) performed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS)...
October 10, 2016: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/27740713/tincture-of-opium-for-treating-opioid-dependence-a-systematic-review-of-safety-and-efficacy
#18
REVIEW
Mohammadali Nikoo, Nooshin Nikoo, Sanam Javid Anbardan, Afshar Amiri, Marc Vogel, Fiona Choi, Amir Ali Sepehry, Amir Hooshang Bagheri Valoojerdi, Kerry Jang, Christian Schütz, Shahin Akhondzadeh, Michael Krausz
BACKGROUND AND AIMS: Recently, there has been a growing interest in using opium tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication. METHODS: We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation and Theses Database, Iran Medex, clinicaltrials.gov and who.int/trialsearch) with no language or publication date limitations...
October 14, 2016: Addiction
https://www.readbyqxmd.com/read/27730106/impact-of-a-methadone-maintenance-program-on-an-aboriginal-community-a-qualitative-study
#19
Michel Landry, Nadia Veilleux, Julie-Eve Arseneault, Saneea Abboud, André Barrieau, Mathieu Bélanger
BACKGROUND: Methadone maintenance treatment programs implemented in Aboriginal communities have proven to be beneficial for the control of opioid addiction and its associated consequences, but the perceptions and opinions of different community members about these programs remain elusive. The goal of this study was to determine the perceptions of members of a First Nation community in New Brunswick, Canada, on the implementation of a methadone maintenance treatment program and its effects on the community...
July 2016: CMAJ Open
https://www.readbyqxmd.com/read/27670244/psychostimulant-drugs-for-cocaine-dependence
#20
REVIEW
Xavier Castells, Ruth Cunill, Clara Pérez-Mañá, Xavier Vidal, Dolors Capellà
BACKGROUND: Cocaine dependence is a severe disorder for which no medication has been approved. Like opioids for heroin dependence, replacement therapy with psychostimulants could be an effective therapy for treatment. OBJECTIVES: To assess the effects of psychostimulants for cocaine abuse and dependence. Specific outcomes include sustained cocaine abstinence and retention in treatment. We also studied the influence of type of drug and comorbid disorders on psychostimulant efficacy...
September 27, 2016: Cochrane Database of Systematic Reviews
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