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Opiate overdose

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https://www.readbyqxmd.com/read/29141653/test-of-a-workforce-development-intervention-to-expand-opioid-use-disorder-treatment-pharmacotherapy-prescribers-protocol-for-a-cluster-randomized-trial
#1
Todd Molfenter, Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden
BACKGROUND: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations' efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications...
November 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29077662/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#2
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...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29046744/clinical-and-epidemiological-characteristics-of-patients-with-acute-drug-intoxication-admitted-to-icu
#3
Jose Orsini, Nanda Din, Ershad Elahi, Anthony Gomez, Salil Rajayer, Ryan Malik, Elie Jean
Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March)...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28967362/pain-management-in-rheumatology-research-training-and-practice
#4
REVIEW
David G Borenstein, Afton L Hassett, David Pisetsky
The Pain Management Task Force of the American College of Rheumatology published a report in 2010 highlighting pain management as a fundamental aspect of clinical practice, training and research. In the interim, the consideration of pain as a focus of attention of rheumatologists and rheumatology health professionals has become even more challenging than in 2010 because of the epidemic of opiate addiction and overdose death. The characterisation of categories of pain by mechanism (e.g., inflammation, joint degeneration, abnormalities of central pain processing) can help guide treatment...
September 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28952972/acute-opiate-overdose-an-update-on-management-strategies-in-emergency-department-and-critical-care-unit
#5
Rukma Parthvi, Abhinav Agrawal, Sameer Khanijo, Adey Tsegaye, Arunabh Talwar
BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide...
September 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28940805/methods-for-delivering-the-uk-s-multi-centre-prison-based-naloxone-on-release-pilot-randomised-trial-n-alive-europe-s-largest-prison-based-randomised-controlled-trial
#6
Angela Mary Meade, Sheila Macdonald Bird, John Strang, Tracey Pepple, Laura Lea Nichols, Monica Mascarenhas, Louise Choo, Mahesh Kumar Bhikhubhai Parmar
INTRODUCTION AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin use by injection have a high risk of drug-related death in the first weeks after prison-release. The N-ALIVE trial was planned as a large prison-based randomised controlled trial (RCT) to test the effectiveness of naloxone-on-release in the prevention of fatal opiate overdoses soon after release. The N-ALIVE pilot trial was conducted to test the main trial's assumptions on recruitment of prisons and prisoners, and the logistics for ensuring that participants received their N-ALIVE pack on release...
September 21, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28885516/treating-acute-pain-in-the-opiate-dependent-patient
#7
Coleen Dever
Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28861516/cannabis-as-a-substitute-for-opioid-based-pain-medication-patient-self-report
#8
Amanda Reiman, Mark Welty, Perry Solomon
Introduction: Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. Materials and Methods: The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients...
2017: Cannabis and Cannabinoid Research
https://www.readbyqxmd.com/read/28846059/mortality-trends-among-cocaine-users-treated-between-1989-and-2013-in-northern-italy-results-of-a-longitudinal-study
#9
Raimondo Maria Pavarin, Angelo Fioritti
A total of 852 participants attending 11 centers for addiction treatment in north Italy following problems due to cocaine abuse between 1989 and 2013 were recruited. Two typologies were created: cocaine users (never heroin) (CU) and heroin and cocaine users (HCU). During the 38-year follow-up period, 4.8% of the whole cohort died. Over the whole period, tumors were the main causes of death; starting in 2010, suicide deaths became the first cause of death. Among CUs, most deaths were due to road accidents and suicide; among HCUs, most of the deaths were from opiate overdose and from cardio-circulatory system diseases...
August 28, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#10
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28768409/opiates-and-plasticity-in-the-ventral-tegmental-area
#11
Ludovic D Langlois, Fereshteh S Nugent
Opioids are among the most effective pain relievers; however, their abuse has been on the rise worldwide evident from an alarming increase in accidental opioid overdoses. This demands for an urgent increase in scientific endeavors for better understanding of main cellular mechanisms and circuits involved in opiate addiction. Preclinical studies strongly suggest that memories associated with positive and negative opioid experiences are critical in promoting compulsive opiate-seeking and opiate-taking behaviors, and relapse...
August 16, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28734637/-asthma-and-heroin-use
#12
REVIEW
Michel Underner, Jean Perriot, Gérard Peiffer, Nematollah Jaafari
INTRODUCTION: Heroin use can be responsible for many respiratory complications including asthma. OBJECTIVES: Systematic literature review of data on asthma in heroin users. DOCUMENTARY SOURCES: Medline(®), on the period 1980-2017 with the following keywords: keywords: "asthma" or "bronchospasm" and "heroin" or "opiate" or "opiates", limits "title/abstract"; the selected languages were English or French. Among 97 articles, 67 abstracts have given use to a dual reading to select 23 studies...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28726606/opiate-injection-associated-skin-soft-tissue-and-vascular-infections-england-uk-1997-2016
#13
Dan Lewer, Magdalena Harris, Vivian Hope
In England, UK, hospital admissions caused by bacterial infections associated with opioid use have increased annually since 2012, after 9 years of decline, mirroring trends in overdose deaths. The increase occurred among persons of both sexes and in all age groups and suggests preventive measures need reviewing.
August 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28692390/use-of-emergency-department-data-to-monitor-and-respond-to-an-increase-in-opioid-overdoses-in-new-hampshire-2011-2015
#14
Elizabeth R Daly, Kenneth Dufault, David J Swenson, Paul Lakevicius, Erin Metcalf, Benjamin P Chan
OBJECTIVES: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. METHODS: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire's syndromic surveillance ED data system by querying for (1) chief complaint text related to the words "fentanyl," "heroin," "opiate," and "opioid" and (2) opioid-related International Classification of Diseases ( ICD) codes...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28654870/twenty-years-of-take-home-naloxone-for-the-prevention-of-overdose-deaths-from-heroin-and-other-opioids-conception-and-maturation
#15
REVIEW
Rebecca McDonald, Nancy D Campbell, John Strang
BACKGROUND: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy...
May 25, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28605020/report-of-increasing-overdose-deaths-that-include-acetyl-fentanyl-in-multiple-counties-of-the-southwestern-region-of-the-commonwealth-of-pennsylvania-in-2015-2016
#16
Jessica B Dwyer, Jennifer Janssen, Todd M Luckasevic, Karl E Williams
Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405...
June 12, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28593192/intravenous-heroin-induces-rapid-brain-hypoxia-and-hyperglycemia-that-precede-brain-metabolic-response
#17
Ernesto Solis, Keaton T Cameron-Burr, Yavin Shaham, Eugene A Kiyatkin
Heroin use and overdose have increased in recent years as people transition from abusing prescription opiates to using the cheaper street drug. Despite a long history of research, many physiological effects of heroin and their underlying mechanisms remain unknown. Here, we used high-speed amperometry to examine the effects of intravenous heroin on oxygen and glucose levels in the nucleus accumbens (NAc) in freely-moving rats. Heroin within the dose range of human drug use and rat self-administration (100-200 μg/kg) induced a rapid, strong, but transient drop in NAc oxygen that was followed by a slower and more prolonged rise in glucose...
May 2017: ENeuro
https://www.readbyqxmd.com/read/28543087/death-due-to-complications-of-bowel-obstruction-following-raw-poppy-seed-ingestion
#18
Leah M Schuppener, Robert F Corliss
Eating poppy seeds can cause a positive urine drug screen, but it is unknown whether ingesting large quantities can result in opiate intoxication or toxicity. A 54-year-old woman with intractable vomiting was found unresponsive at home and later pronounced dead. At autopsy, a cast-like large bowel obstruction composed of poppy seeds was identified. Postmortem blood morphine level was < 10 ng/mL. Cause of death was determined to be complications of a bowel obstruction secondary to poppy seed ingestion. Deaths related to eating poppy seeds have not been described in the literature...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28521781/telling-our-stories-heroin-assisted-treatment-and-snap-activism-in-the-downtown-eastside-of-vancouver
#19
Susan Boyd, Dave Murray, Donald MacPherson
BACKGROUND: This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#20
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
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