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https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#1
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#2
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29222992/inflammatory-chemokine-eotaxin-1-is-correlated-with-age-in-heroin-dependent-patients-under-methadone-maintenance-therapy
#3
Hsiang-Wei Kuo, Tung-Hsia Liu, Hsiao-Hui Tsou, Ya-Ting Hsu, Sheng-Chang Wang, Chiu-Ping Fang, Chia-Chen Liu, Andrew C H Chen, Yu-Li Liu
BACKGROUND: Degeneration of central neurons and fibers has been observed in postmortem brains of heroin dependent patients. However, there are no biomarkers to predict the severity of neurodegeneration related to heroin dependence. A correlation has been reported between inflammatory C-C motif chemokine ligand 11 (CCL11, or eotaxin-1) and neurodegeneration in Alzheimer's disease. METHODS: Three-hundred-forty-four heroin dependent, Taiwanese patients under methadone maintenance treatment (MMT) were included with clinical assessment and genomics information...
November 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29189312/hypoglycemia-and-sudden-death-during-treatment-with-methadone-for-opiate-detoxification
#4
Christopher J Plescia, Peter Manu
CLINICAL FEATURES: We present a case of a middle-aged man admitted to an inpatient detoxification facility for withdrawal of intranasal heroin, alprazolam, and ethanol. The patient was placed on methadone and chlordiazepoxide tapers. Ondansetron and trazodone were prescribed as needed for symptom control. On the third hospital day, the patient was found unresponsive with blood glucose of 40 mg/dL. He had no history of glucose dysregulation. The patient was pronounced dead shortly thereafter...
November 14, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29183228/recommendations-for-buprenorphine-and-methadone-therapy-in-opioid-use-disorder-a-european-consensus
#5
Maurice Dematteis, Marc Auriacombe, Oscar D'Agnone, Lorenzo Somaini, Néstor Szerman, Richard Littlewood, Farrukh Alam, Hannu Alho, Amine Benyamina, Julio Bobes, Jean Pierre Daulouede, Claudio Leonardi, Icro Maremmani, Marta Torrens, Stephan Walcher, Michael Soyka
Management of patients with opioid use disorder (OUD) commonly includes opioid agonist therapy (OAT) as a part of an integrated treatment plan. These interventions are associated with proven benefits to the individual and society. Areas covered: The use of methadone and buprenorphine within an integrated treatment plan in the management of patients with OUD: this work provides consensus recommendation on pharmacotherapy in OUD to assist clinicians with practical decision making in this field. Expert opinion: Pharmacotherapy is recommended as part of an integrated OUD treatment approach with psychosocial interventions, with the goal of reducing risks of illicit opioid use, overdose mortality, infection with HIV or HCV, improving health, psychological and social outcomes...
November 29, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29179519/sleep-in-lonely-heroin-dependent-patients-receiving-methadone-maintenance-treatment-longer-sleep-latency-shorter-sleep-duration-lower-sleep-efficiency-and-poorer-sleep-quality
#6
Hong-Jie Li, Bao-Liang Zhong, Yan-Min Xu, Jun-Hong Zhu, Jin Lu
Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29143398/a-retrospective-cohort-study-of-the-health-of-children-prenatally-exposed-to-methadone-buprenorphine-or-naltrexone-compared-with-non-exposed-control-children
#7
Erin Kelty, Gary Hulse
BACKGROUND AND OBJECTIVES: Little is known about the health of children exposed to opioid pharmacotherapies in utero. This study aims to examine the health of children from birth to 5 years of age, who were exposed to methadone, buprenorphine, or naltrexone with non-exposed children. METHODS: Children were identified by linking the treatment records of women treated with one of the three opioid pharmacotherapies with midwife notifications. Live-born children exposed to methadone (n = 198), buprenorphine (n = 122), naltrexone (n = 67) in utero, and neonates not prenatally exposed to opioids (n = 387) born between 2001 and 2011 in Western Australia were included in the study...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29129191/alcohol-use-disorders-are-associated-with-increased-hiv-risk-behaviors-in-cocaine-dependent-methadone-patients
#8
Steven E Meredith, Carla J Rash, Nancy M Petry
People who inject drugs (PWID) are at increased risk of HIV infection. Although methadone maintenance therapy can help lower this risk, many methadone patients continue to engage in HIV risk behaviors, especially patients who use cocaine and alcohol. The purpose of the current study was to investigate relations between alcohol use disorders and HIV risk behavior in 239 cocaine-dependent methadone patients participating in a randomized controlled trial of a behavioral intervention to promote cocaine abstinence...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29120281/psychological-distress-is-correlated-with-erectile-dysfunction-among-patients-receiving-methadone-maintenance-in-taiwan
#9
Ching-Ming Cheng, Yen-Chin Lin, Kun-Chia Chang
OBJECTIVE: Although erectile dysfunction (ED) is prevalent in patients receiving long-term methadone maintenance, studies in Chinese culture exploring the relationship between psychological distress and ED are scarce. METHODS: One hundred eighty-seven male patients in methadone maintenance treatment were assessed in this cross-sectional study. Instruments included the Opiate Treatment Index (OTI) to evaluate the health-related consequences of methadone treatment and the Chinese Health Questionnaire-12 (CHQ-12) for the assessment of psychological distress, respectively...
November 9, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/29108376/pain-of-methadone-maintained-heroin-addicts-lonelier-individuals-feel-more-intense-pain
#10
Fu Li, Yan-Min Xu, Jun-Hong Zhu, Jin Lu, Bao-Liang Zhong
Managing pain in patients with heroin addiction is challenging, because most pain medications are addictive. A promising way to relieve pain of heroin addicts is to identify and address modifiable psychosocial factors associated with pain. This study examined the association between loneliness and pain intensity in Chinese heroin addicts receiving methadone maintenance treatment (MMT). A consecutive sample of 603 heroin addicts were recruited from three MMT clinics in Wuhan, China. Loneliness was assessed with a single question, and socio-demographic and clinical data were collected with a standardized questionnaire...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29108361/loneliness-and-its-impact-on-quality-of-life-in-chinese-heroin-dependent-patients-receiving-methadone-maintenance-treatment
#11
Ying-Jia Yang, Yan-Min Xu, Wen-Cai Chen, Jun-Hong Zhu, Jin Lu, Bao-Liang Zhong
To date, no studies have examined loneliness in Chinese patients with substance use disorders. This study determined the prevalence and socio-demographic and clinical correlates of loneliness and its impact on quality of life (QOL) in Chinese heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT). A total of 603 HDPs were consecutively recruited from three city-owned MMT clinics in Wuhan, China, and administered with a standardized questionnaire to collect socio-demographic and clinical data...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29105663/exacerbated-craving-in-the-presence-of-stress-and-drug-cues-in-drug-dependent-patients
#12
Kenzie L Preston, William J Kowalczyk, Karran A Phillips, Michelle L Jobes, Massoud Vahabzadeh, Jia-Ling Lin, Mustapha Mezghanni, David H Epstein
In addiction, risk factors for craving and use include stress and drug-related cues. Stress and cues have additive or more-than-additive effects on drug seeking in laboratory animals, but, surprisingly, seem to compete with one another (ie, exert less-than-additive effects) in human laboratory studies of craving. We sought heretofore elusive evidence that human drug users could show additive (or more-than-additive) effects of stress and cues on craving, using ecological momentary assessment (EMA). Outpatients (N=182) maintained on daily buprenorphine or methadone provided self-reports of stress, craving, mood, and behavior on electronic diaries for up to 16 weeks...
November 6, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29101087/methadone-as-first-line-opioid-in-cancer-pain-management-a-systematic-review
#13
REVIEW
Sebastiano Mercadante, Eduardo Bruera
AIM: The objective of this review was to assess the existent evidence for the use of methadone as first line therapy in cancer pain management. METHODS: A systematic literature search on MedLine, Embase databases was carried out from each data base, setting up the date to 30 August 2017 Studies were included if methadone was a first line drug as a step 3 of WHO analgesic ladder, or at low doses (step 2), if they were conducted in adult patients with cancer pain, if they contained outcomes on pain and opioid-related adverse effects...
October 31, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#14
REVIEW
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29016868/efficacy-and-safety-of-lubiprostone-in-patients-with-opioid-induced-constipation-phase-3-study-results-and-pooled-analysis-of-the-effect-of-concomitant-methadone-use-on-clinical-outcomes
#15
Egilius L H Spierings, Douglas A Drossman, Byron Cryer, M Mazen Jamal, Taryn Losch-Beridon, Shadreck M Mareya, Martin Wang
Objective: The efficacy and safety of oral lubiprostone for relieving symptoms of opioid-induced constipation (OIC) in patients with chronic noncancer pain were evaluated in a randomized, double-blind, placebo-controlled study. These data were also pooled with those from two similar phase 3 studies to explore the effects of methadone on treatment response. Methods: In the primary study, adults with OIC (fewer than three spontaneous bowel movements [SBMs] per week) were randomized to receive lubiprostone 24 mcg or placebo twice daily for 12 weeks...
July 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28953686/poor-sleep-quality-is-significantly-associated-with-low-sexual-satisfaction-in-chinese-methadone-maintained-patients
#16
Hui-Shi Zhang, Yan-Min Xu, Jun-Hong Zhu, Bao-Liang Zhong
Sleep disturbance negatively affects sexual function. Sleep problem and sexual dysfunction are common in methadone-maintained patients; however, their association is understudied in this patient population.This study examined the association between sleep quality and sexual satisfaction in Chinese patients receiving methadone maintenance treatment (MMT).This was a cross-sectional study. A total of 480 MMT patients who had sex with their sex partners within 1 month before the survey were recruited from 3 MMT clinics in Wuhan, China...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28947995/significantly-more-intense-pain-in-methadone-maintained-patients-who-are-addicted-to-nicotine
#17
Lian-Zhong Liu, Lin-Xiang Tan, Yan-Min Xu, Xue-Bing Liu, Wen-Cai Chen, Jun-Hong Zhu, Jin Lu, Bao-Liang Zhong
Pain and cigarette smoking are very common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT) and both have substantial negative effects on HDPs' physical and mental health. Nevertheless, very few studies have assessed the relationship between the two in HDPs. This study examined the association between pain intensity and smoking in Chinese methadone-maintained HDPs. A total of 603 HDPs were consecutively recruited from three MMT clinics in Wuhan, China, and administered with a socio-demographic and drug use questionnaire, a smoking questionnaire concerning average number of cigarettes smoked daily and Heaviness of Smoking Index, and Zung's Self-rating Depression Scale...
September 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28942704/why-people-who-inject-drugs-voluntarily-transition-off-methadone-in-ukraine
#18
Julia Rozanova, Ruthanne Marcus, Faye S Taxman, Martha J Bojko, Lynn Madden, Scott O Farnum, Alyona Mazhnaya, Sergii Dvoriak, Frederick L Altice
Methadone maintenance therapy (MMT) treats opioid use disorder among people who inject drugs (PWID). To understand why PWID may voluntarily discontinue MMT, we analyzed data from 25 focus groups conducted in five Ukrainian cities from February to April 2013 with 199 participants who were currently, previously, or never on MMT. Using constant comparison method, we uncovered three themes explaining why PWID transition off MMT: (a) purposeful resistance to rigid social control associated with how MMT is delivered and to power asymmetries in provider-patient relationships, (b) self-management of a PWID's "wounded identity" that is common in socially stigmatized and physically sick persons-MMT serves as a reminder of their illness, and (c) the quest for a "normal life" uninterrupted by daily MMT site visits, harassment, and time inefficiencies, resources, and social capital...
September 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28923720/rosa-damascena-oil-improved-methadone-related-sexual-dysfunction-in-females-with-opioid-use-disorder-under-methadone-maintenance-therapy-%C3%A2-results-from-a-double-blind-randomized-and-placebo-controlled-trial
#19
Vahid Farnia, Faeze Tatari, Mostafa Alikhani, Katayoun Yazdchi, Moshen Taghizadeh, Dena Sadeghi Bahmani, Hassan Karbasizadeh, Edith Holsboer-Trachsler, Serge Brand
BACKGROUND: Methadone maintenance therapy (MMT) is provided to patients with opioid use disorder (OUD). However, as with all opioids, methadone impacts negatively on sexual function. To counter this, Rosa Damascena oil (RDO) has been used successfully for opioid-dependent male patients under MMT and with methadone-related sexual dysfunction (MRSD). In the present study, we tested the possible influence of RDO on sexual function and sex hormones of opioid-dependent female patients undergoing MMT and with MRSD...
December 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28918267/compulsivity-in-opioid-dependence
#20
Serenella Tolomeo, Keith Matthews, Douglas Steele, Alex Baldacchino
OBJECTIVE: This study aimed to investigate the relationship between compulsivity versus impulsivity and structural MRI abnormalities in opioid dependence. METHOD: We recruited 146 participants: i) patients with a history of opioid dependence due to chronic heroin use (n=24), ii) heroin users stabilised on methadone maintenance treatment (n=48), iii) abstinent participants with a history of opioid dependence due to heroin use (n=24) and iv) healthy controls (n=50)...
September 14, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
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