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Opiate overdose

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https://www.readbyqxmd.com/read/29776702/naloxone-use-among-emergency-department-patients-with-opioid-overdose
#1
Catherine A Marco, William Trautman, Alexander Cook, Dennis Mann, Jordan Rasp, Oswald Perkins, Michael Ballester
BACKGROUND: Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses. OBJECTIVE: This study was undertaken to identify experiences regarding naloxone use among ED patients with opioid overdose. METHODS: This prospective survey study was conducted at an urban level I trauma center. A survey was administered to eligible ED patients after unintentional opioid overdose...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29693427/characteristics-and-experiences-of-buprenorphine-naloxone-use-among-polysubstance-users
#2
Robert Walker, T K Logan, Quintin T Chipley, Jaime Miller
BACKGROUND: With a rise in overdoses and medical emergencies related to opioids, buprenorphine-naloxone (bup-nx) is seen as a preferred treatment for opioid dependence. However, the research examining experiences with bup-nx among polysubstance users who may or may not be opioid dependent has been limited. OBJECTIVES: The purpose of the study was to examine use, characteristics of users, and experiences of bup-nx use among polysubstance users entering drug-free recovery programs...
April 25, 2018: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29693268/poisoning-severity-associated-with-a-range-of-medications-in-suicide-attempts-by-ingestion
#3
Kenneth R Conner, Timothy J Wiegand, Rachel Gorodetsky, Rachel F Schult, Kimberly Kaukeinen
There are limited data on the medical severity of suicide attempts by intentional self-poisoning (ISP) associated with ingestion of differing classes of medications and meager data on specific agents. The purpose of the study was to address these gaps. This was an analysis of a consecutive series of ISP cases ages 13 to 65 treated at a U.S. university medical center (N = 671). The outcome, poisoning severity, was dichotomized as "moderate-severe" and "low" (reference) based on a standard measure...
April 25, 2018: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/29677410/mapping-drug-overdose-demographic-and-socioeconomic-characteristics-in-the-community
#4
Brenda L Rooney, Mitchell T Voter, Christopher M Eberlein, Andrea J Schossow, Cathy L Fischer
INTRODUCTION: Drug use and drug overdose have increased at an alarming rate. OBJECTIVE: To identify demographic and neighborhood social and economic factors associated with higher risk of overdose. These findings can be used to inform development of community programs and appropriately devote resources to prevent and treat drug abuse. METHODS: The electronic health records of all patients seen in the emergency department or admitted to the hospital for a drug overdose in 2016 at Gundersen Health System in La Crosse, Wisconsin, were reviewed retrospectively...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29652682/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#5
Jack Diep, David Tian Chin, Somdatta Gupta, Faraz Syed, Ming Xiong, Jianguo Cheng
Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29649094/methadone-maintenance-treatment-a-15-year-retrospective-study-in-split-dalmatia-county-croatia
#6
Davorka Sutlovic, Zeljko Kljucevic, Livia Sliskovic, Helena Susnjar, Ivo Viskovic, Marija Definis-Gojanovic
BACKGROUND: The aim of this retrospective study is to use existing epidemiological data on patients in methadone maintenance treatment in Split Dalmatia County from 2001 to 2015 in order to evaluate the substitution treatment system and policy of opiate addicts treatment, the epidemiological trend, and risk of overdose mortality. In addition, we would like to highlight the problem of poor control of methadone therapy, and thus the possibility of selling methadone. The result is a greater number of deaths caused by methadone in people who were not in methadone therapy...
April 11, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29619569/america-s-opioid-epidemic-a-comprehensive-review-and-look-into-the-rising-crisis
#7
REVIEW
Peter S Ostling, Kelly S Davidson, Best O Anyama, Erik M Helander, Melville Q Wyche, Alan D Kaye
PURPOSE OF REVIEW: In the USA, there has been a sharp increase in heroin, prescription opiate, and illicitly manufactured fentanyl abuse with overdoses tripling since the 1990s. Several states have been deemed as "high-burden" abuse states where there is a greater proportion of synthetic opiate use. During the same period that prescription limitations were initially implemented throughout the country, the fentanyl epidemic started nationwide. RECENT FINDINGS: In the setting of data demonstrating an almost fourfold increase in overdose deaths from 1999 to 2008, states began restricting access to Food and Drug Agency (FDA) approved opioid medications...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29605706/fatal-and-non-fatal-overdose-among-opiate-users-in-south-wales-a-qualitative-study-of-peer-responses
#8
Katy Holloway, Rhian Hills, Tom May
BACKGROUND: Overdose is a major cause of death among injecting drug users in Wales. Few studies, however, have explored the overdose responses of witnesses in this context. This study applies Rhodes' concept of the 'risk environment' to examine how witnesses respond to opiate overdose. METHOD: In depth, semi-structured interviews were conducted with fifty-five participants recruited from statutory and third sector drug treatment providers operating across South Wales and from two Welsh prisons...
March 29, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29560840/older-women-who-died-by-suicide-suicide-means-sociodemographic-and-psychiatric-risk-factors-and-other-precipitating-circumstances
#9
Namkee G Choi, Diana M DiNitto, Atami O Sagna, C Nathan Marti
BACKGROUND: US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmortem toxicology results by suicide means. METHODS: Data are from the 2005 to 2015 US National Violent Death Reporting System (N = 12,401 female decedents aged 50 years and over)...
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29537112/polydrug-epidemiology-benzodiazepine-prescribing-and-the-drug-overdose-epidemic-in-the-united-states
#10
Michael James Zoorob
BACKGROUND: Although polydrug incidents comprise a substantial proportion of overdose deaths, scholarly and popular focus has centered on prescription opiates. This study examines the role of benzodiazepine and opioid prescriptions on overdose-both individually and synergistically-using data from Medicare Part D, a source of prescription drug claims for about 35 million Americans. METHODS: Prescribing data from the Medicare Part D Public Use Files for 2013, 2014, and 2015 (approximately 3...
May 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29514413/heroin-seeking-becomes-dependent-on-dorsal-striatal-dopaminergic-mechanisms-and-can-be-decreased-by-n-acetylcysteine
#11
Ritchy Hodebourg, Jennifer E Murray, Maxime Fouyssac, Mickaël Puaud, Barry J Everitt, David Belin
The alarming increase in heroin overdoses in the USA is a reminder of the need for efficacious and novel treatments for opiate addiction. This may reflect the relatively poor understanding of the neural basis of heroin, as compared to cocaine, seeking behaviour. While cocaine reinforcement depends on the mesolimbic system, well-established cocaine seeking is dependent on dorsolateral striatum (aDLS) dopamine-dependent mechanisms which are disrupted by N-acetylcysteine, through normalisation of corticostriatal glutamate homeostasis...
March 7, 2018: European Journal of Neuroscience
https://www.readbyqxmd.com/read/29508893/correlates-of-opiate-misuse-based-on-aberrant-urine-drug-tests-for-patients-on-chronic-opiate-therapy-in-a-safety-net-academic-primary-care-clinic
#12
Smita Bakhai, Bright Thilagar, Jessica L Reynolds, Kenneth E Leonard
OBJECTIVE: Determine correlates of opiate misuse based on urine drug test (UDT) among patients on chronic opiate therapy (COT) for chronic noncancer pain. DESIGN: A cross-sectional study. SETTING: Urban, academic clinic. PARTICIPANTS: UDT performed in 206 patients on COT for at least 3 months duration within a one-year period. Patients were classified based on UDT results: (1) Appearance of Opiate Adherence: Positive UDT for prescribed opiate and negative for illicit drugs and nonprescribed control substances; (2) Opiate Misuse; Overt nonadherence: (a) Positive UDT for illicit drugs and/or nonprescribed controlled substances AND positive or negative for prescribed opiates (b) Overdose; (3) Possible opiate nonadherence: Negative for prescribed opiates and negative for illicit and nonprescribed controlled substances...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29505462/opiate-dependence-or-addiction-a-review-of-the-centers-for-disease-control-and-prevention-guidelines-for-management-of-chronic-pain
#13
Gina C Dobbs, Susanne A Fogger
In the wake of epidemic of opioid overdoses in the United States, patients who are receiving treatment for chronic pain with opioid have come under increasing scrutiny. The Centers for Disease Control and Prevention issued a guideline for managing chronic pain in 2016, which makes recommendations for opioids based on current evidence. This review will highlight key components of the guideline including differentiating addiction from dependence to assist nurses to better inform patient care in managing chronic pain...
January 2018: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/29473975/elbasvir-grazoprevir-and-sofosbuvir-for-hepatitis-c-virus-genotype-3-infection-with-compensated-cirrhosis-a-randomized-trial
#14
Graham R Foster, Kosh Agarwal, Matthew E Cramp, Sulleman Moreea, Stephen Barclay, Jane Collier, Ashley S Brown, Stephen D Ryder, Andrew Ustianowski, Daniel M Forton, Ray Fox, Fiona Gordon, William M Rosenberg, David J Mutimer, Jiejun Du, Christopher L Gilbert, Ernest Asante-Appiah, Janice Wahl, Michael N Robertson, Eliav Barr, Barbara Haber
Many direct-acting antiviral regimens have reduced activity in people with hepatitis C virus (HCV) genotype (GT) 3 infection and cirrhosis. The C-ISLE study assessed the efficacy and safety of elbasvir/grazoprevir (EBR/GZR) plus sofosbuvir (SOF) with and without ribavirin (RBV) in compensated cirrhotic participants with GT3 infection. This was a phase 2, randomized, open-label study. Treatment-naive participants received EBR/GZR + SOF + RBV for 8 weeks or EBR/GZR + SOF for 12 weeks, and peginterferon/RBV treatment-experienced participants received EBR/GZR + SOF ± RBV for 12 weeks or EBR/GZR + SOF for 16 weeks...
February 23, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29357115/differences-in-mortality-in-a-cohort-of-cocaine-use-disorder-patients-with-concurrent-alcohol-or-opiates-disorder
#15
Esther Colell, Antònia Domingo-Salvany, Albert Espelt, Oleguer Parés-Badell, M Teresa Brugal
AIMS: To study mortality in a cohort of cocaine use disorder patients, and compare results in those with concurrent alcohol or opiates disorder. DESIGN, SETTING AND PARTICIPANTS: A cohort of 10 539 cocaine use disorder individuals entering drug treatment in public out-patient centres in the city of Barcelona was followed from 1997 to 2011. Participants were divided at baseline into three groups: those with only cocaine use disorder (CUD), those with cocaine and alcohol use disorder but not opioid (CAUD) and those with cocaine and opioid use disorder (COUD)...
January 22, 2018: Addiction
https://www.readbyqxmd.com/read/29301012/diagnosis-of-heroin-overdose-in-an-8-year-old-boy-reliable-contribution-of-toxicological-investigations
#16
M Soichot, S Julliand, J Filatriau, A Hurbain, E Bourgogne, A Mihoubi, H Gourlain, B Delhotal-Landes
Toxicological investigations are often required by clinicians in comatose patients with suspected poisoning. However, the usefulness of toxicological analyses to support a diagnosis of acute poisoning is debated among clinicians and the interpretation of laboratory tests is challenging given the wide diversity of analytical techniques available. We report the case of an 8-year-old boy who was admitted to an intensive care unit with severe respiratory depression and neurological impairment. In order to formulate appropriate hypothesizes about the diagnosis and circumstances of intoxication, clinicians consulted toxicologists for a comprehensive toxicological screening...
December 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29299212/risk-factors-of-mortality-due-to-acute-opium-poisoning-a-report-from-the-largest-intoxication-referral-center-in-iran
#17
Sahar Rismantab-Sani, Babak Soltani, Siamak Soltani, Azadeh Memarian
Background: Studies have shown that Iran has a high rate of opiate abuse and the most prevalently used is opium. This study was aimed to evaluate risk factors in patients with acute opium intoxication who referred to Loghman Hakim Hospital, Tehran, Iran, in 2011. Methods: A total number of 383 patients with acute opium overdose, who were referred to the Emergency Department of Loghman Hakim Hospital in Tehran during 2011, were enrolled into this descriptive, cross-sectional study...
April 2017: Addiction & Health
https://www.readbyqxmd.com/read/29279787/acute-chest-syndrome-in-children-with-sickle-cell-disease
#18
REVIEW
Shilpa Jain, Nitya Bakshi, Lakshmanan Krishnamurti
Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29233952/epidemiological-study-of-mortality-rate-from-alcohol-and-illicit-drug-abuse-in-iran
#19
Seyed Mohammad Sadegh Ghoreishi, Fatemeh Shahbazi, Seyed Davood Mirtorabi, Mohammad Reza Ghadirzadeh, Seyed Saeed Hashemi Nazari
BACKGROUND: The estimate of mortality associated with illicit opiate use provides useful information to those directing and monitoring local, national and international policies and programs. This study investigated the epidemiology of mortality due to the illegal consumption of narcotics and psychotropic substances in the Iran to provide evidence-based public health data for useful programs and actions aimed at preventing drug-related mortality. STUDY DESIGN: A cross-sectional study...
October 14, 2017: Journal of Research in Health Sciences
https://www.readbyqxmd.com/read/29228122/tennessee-s-in-state-vulnerability-assessment-for-a-rapid-dissemination-of-hiv-or-hcv-infection-event-utilizing-data-about-the-opioid-epidemic
#20
Michael Rickles, Peter F Rebeiro, Lindsey Sizemore, Paul Juarez, Mitchell Mutter, Carolyn Wester, Melissa McPheeters
Background: Knowing which factors contribute to county-level vulnerability to an HIV/Hepatitis C (HCV) outbreak, and which counties are most vulnerable, guide public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HCV/HIV outbreak vulnerability. Methods: Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC)...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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