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https://www.readbyqxmd.com/read/29142795/comorbid-post-traumatic-stress-disorder-and-opioid-dependence
#1
Rikinkumar S Patel, Ahmed Elmaadawi, Suhayl Nasr, John Haskin
Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29130348/tryptophan-containing-non-cationizable-opioid-peptides-a-new-chemotype-with-unusual-structure-and-in-vivo-activity
#2
Rossella De Marco, Luca Gentilucci
Recently, a new family of opioid peptides containing tryptophan came to the spotlight for the absence of the fundamental protonable tyramine 'message' pharmacophore. Structure-activity relationship investigations led to diverse compounds, characterized by different selectivity profiles and agonist or antagonist effects. Substitution at the indole of Trp clearly impacted peripheral/central antinociceptivity. These peculiarities prompted to gather all the compounds in a new class, and to coin the definition 'Tryptophan-Containing Non-Cationizable Opioid Peptides', in short 'TryCoNCOPs'...
November 13, 2017: Future Medicinal Chemistry
https://www.readbyqxmd.com/read/29125226/loperamide-cardiotoxicity-a-brief-review
#3
REVIEW
Tamer Akel, Soad Bekheit
Loperamide is a popular antidiarrheal medication that has been used for many years. It is currently gaining more attention among healthcare professionals due to its increasing potential for side effects. At present, it is considered safe enough to be sold over the counter. In contrast with other opioid agonists, loperamide is a peripherally acting μ-receptor agonist exerting its effects mainly on the myenteric plexus of the gastrointestinal longitudinal muscle layer. It decreases peristalsis and fluid secretion resulting in longer gastrointestinal transit time...
November 10, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29120973/acute-intoxications-and-fatalities-from-illicit-fentanyl-and-analogues-an-update
#4
Simona Pichini, Renata Solimini, Paolo Berretta, Roberta Pacifici, Francesco Paolo Busardò
Illicit fentanyl and its analogues are very dangerous synthetic opioids, with high abuse potential and severe adverse effects including coma and death. They are used as adulterants in street heroin, cocaine, and methamphetamine, or as heroin substitutes sold to unaware users with a high risk of overdoses. Fentanyl and its analogues have also been identified in counterfeit medicinal products, such as oxycodone, hydrocodone, and alprazolam tablets, or as components of speedball mixtures together with cocaine or other stimulants...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29097248/large-proportion-of-people-who-inject-drugs-are-susceptible-to-hepatitis-b-results-from-a-bio-behavioural-study-in-eight-german-cities
#5
J M Haussig, S Nielsen, M Gassowski, V Bremer, U Marcus, B Wenz, N Bannert, C T Bock, R Zimmermann
BACKGROUND: People who inject drugs (PWID) are at high risk of hepatitis B virus (HBV) infection by sharing needles and drug use paraphernalia. In Germany, no routine surveillance of HBV prevalence and vaccination coverage among PWID exists. METHODS: Socio-demographic and behavioural data were collected between 2011 and 2014 through face-to-face interviews during a bio-behavioural survey of PWID recruited in eight German cities. Dried blood spots (DBS) prepared with capillary blood were tested for HBV markers...
October 30, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29091486/postoperative-pain-management-following-carpal-tunnel-release-a-prospective-cohort-evaluation
#6
Andrew Miller, Nayoung Kim, Benjamin Zmistowski, Asif M Ilyas, Jonas L Matzon
BACKGROUND: Managing postoperative pain in hand surgery is important for both patients and surgeons. However, there is growing concern over prescription opioid abuse. We hypothesized: (1) that pain medications after carpal tunnel release (CTR) surgery are over-prescribed; and (2) that opioids are unnecessary in the majority of patients. METHODS: We prospectively studied 2 demographically similar patient cohorts receiving either opioid or tramadol for CTR performed by 2 hand surgery fellowship-trained orthopedic surgeons over a 1-year period...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29091359/-opioid-dependence-treatment-in-general-practice
#7
Gaëtan Conti, Laurianne Mer, Ghazi Kardous, Olivier Pasche
Opioid dependence causes numerous comorbidities primary care physicians have often to deal with. We currently have alternative substitution treatments available in Switzerland for opioid dependent patients, all of whom are known to be effective in treating and preventing the consequences of this addiction. Some of the known medications have a narrow therapeutic range that may hinder the prescription. This article attempts to offer the primary care physician tools and knowledge, based on the most recent recommendations, in order to optimize the management of opioid dependent patients...
November 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29080808/model-projections-on-the-impact-of-hcv-treatment-in-the-prevention-of-hcv-transmission-among-people-who-inject-drugs-in-europe
#8
Hannah Fraser, Natasha K Martin, Henrikki Brummer-Korvenkontio, Patrizia Carrieri, Olav Dalgard, John Dillon, David Goldberg, Sharon Hutchinson, Marie Jauffret-Roustide, Martin Kåberg, Amy A Matser, Mojca Matičič, Havard Midgard, Viktor Mravcik, Anne Øvrehus, Maria Prins, Jens Reimer, Geert Robaeys, Bernd Schulte, Daniela K van Santen, Ruth Zimmermann, Peter Vickerman, Matthew Hickman
BACKGROUND: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical to eliminating HCV in Europe. We estimate impact of current and scaled-up HCV treatment with and without scaling-up opioid substitution therapy (OST) and needle and syringe programmes (NSP) across Europe over the next 10 years. METHODS: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST and NSP coverage from 11 European settings...
October 25, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29074410/global-regional-and-country-level-coverage-of-interventions-to-prevent-and-manage-hiv-and-hepatitis-c-among-people-who-inject-drugs-a-systematic-review
#9
Sarah Larney, Amy Peacock, Janni Leung, Samantha Colledge, Matthew Hickman, Peter Vickerman, Jason Grebely, Kostyantyn V Dumchev, Paul Griffiths, Lindsey Hines, Evan B Cunningham, Richard P Mattick, Michael Lynskey, John Marsden, John Strang, Louisa Degenhardt
BACKGROUND: People who inject drugs (PWID) are a key population affected by the global HIV and hepatitis C virus (HCV) epidemics. HIV and HCV prevention interventions for PWID include needle and syringe programmes (NSP), opioid substitution therapy (OST), HIV counselling and testing, HIV antiretroviral therapy (ART), and condom distribution programmes. We aimed to produce country-level, regional, and global estimates of coverage of NSP, OST, HIV testing, ART, and condom programmes for PWID...
October 23, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/29065873/high-variability-of-tb-hiv-hepatitis-c-treatment-and-opioid-substitution-therapy-among-prisoners-in-germany
#10
Jana Müller, Daniel Schmidt, Christian Kollan, Marc Lehmann, Viviane Bremer, Ruth Zimmermann
BACKGROUND: In Germany, medical care of prisoners is completely separated from extramural health care. The extent and quality of medical care among prisoners in Germany are therefore largely unknown. We performed a secondary data analysis of pharmacy sales data for tuberculosis (TB), HIV, hepatitis C (HCV) and opioid substitution treatment (OST) delivered to prisons in 11 federal states (FS) in Germany between 01/2012 and 03/2013. The aims of this study were to assess (i) the treatment availability for the selected diseases and OST in German prisons, (ii) the proportion of prisoners treated per FS and overall for TB, HIV, HCV and OST during the study period...
October 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29064909/pexacerfont-as-a-crf1-antagonist-for-the-treatment-of-withdrawal-symptoms-in-men-with-heroin-methamphetamine-dependence-a-randomized-double-blind-placebo-controlled-clinical-trial
#11
Mohammad-Javad Morabbi, Emran Razaghi, Ehsan Moazen-Zadeh, Hamideh Safiaghdam, Mohamad R Zarrindast, Nasim Vousoghi, Shahin Akhondzadeh
We assessed the efficacy of pexacerfont, a CRF1 antagonist, for the treatment of withdrawal symptoms. In this randomized, double-blind, placebo-controlled clinical trial, male patients with amphetamine or opioid dependence, on the basis of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR), in the age range 18-55 years, received either pexacerfont or placebo (300, 200, and 100 mg/day in the first, second, and third week, respectively). No antidepressants, behavioral interventions, or substitution therapy were administered...
October 23, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29054032/constipation-and-other-common-symptoms-reported-by-women-and-men-in-methadone-and-buprenorphine-maintenance-treatment
#12
Paul S Haber, Mahmoud Elsayed, David Espinoza, Nicholas Lintzeris, Anne-Sophie Veillard, Richard Hallinan
BACKGROUND: Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. METHOD: Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist...
October 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29053268/synthesis-pharmacology-and-molecular-docking-studies-on-6-desoxo-n-methylmorphinans-as-potent-%C3%AE-opioid-receptor-agonists
#13
Maria Dumitrascuta, Tanila Ben Haddou, Elena Guerrieri, Stefan M Noha, Lea Schläfer, Helmut Schmidhammer, Mariana Spetea
Position 6 of the morphinan skeleton plays a key role in the μ-opioid receptor (MOR) activity in vitro and in vivo. We describe the consequence of the 6-carbonyl group deletion in N-methylmorphinan-6-ones 1-4 on ligand-MOR interaction, signaling, and antinociception. While 6-desoxo compounds 1a, 2a, and 4a show similar profiles to their 6-keto counterparts, the 6-desoxo-14-benzyloxy substituted 3a displays significantly increased MOR binding and agonist potency and a distinct binding mode compared with its analogue 3...
November 3, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29026458/safe-opioid-prescription-a-smart-on-fhir-approach-to-clinical-decision-support
#14
Shyamashree Sinha, Mark Jensen, Sarah Mullin, Peter L Elkin
Background Prescription opioid pain medication overuse, misuse and abuse have been a significant contributing factor in the opioid epidemic. The rising death rates from opioid overdose have caused healthcare practitioners and researchers to work on optimizing pain therapy and limiting the prescriptions for pain medications. The state of New York has implemented a prescription drug monitoring program(PDMP), amended public health law to limit the prescription of opioids for acute pain and utilized the resources of the state and county health departments to help in curbing this epidemic...
2017: Online Journal of Public Health Informatics
https://www.readbyqxmd.com/read/28993073/the-use-of-cannabis-in-response-to-the-opioid-crisis-a-review-of-the-literature
#15
Marianne Beare Vyas, Virginia T LeBaron, Aaron M Gilson
BACKGROUND: A staggering number of Americans are dying from overdoses attributed to prescription opioid medications (POMs). In response, states are creating policies related to POM harm reduction strategies, overdose prevention, and alternative therapies for pain management, such as cannabis (medical marijuana). However, little is known about how the use of cannabis for pain management may be associated with POM use. PURPOSE: The purpose of this article is to examine state medical cannabis (MC) use laws and policies and their potential association with POM use and related harms...
September 21, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28987019/patterns-of-substance-use-and-mortality-risk-in-a-cohort-of-hard-to-reach-polysubstance-users
#16
Linn Gjersing, Anne Line Bretteville-Jensen
AIMS: To examine the mortality risk in a cohort of "hard-to-reach" polysubstance users and its putative associations with substance use. Specifically, we estimated all-cause mortality risk as a function of individual substance use indicators, and then as a function of their complex, "real-life" patterns as identified through Latent Class Analysis (LCA). DESIGN: Prospective cohort study among street-and low-threshold-service-recruited polysubstance users included between September and November 2013 and followed through the National Cause of Death Registry until 31 October 2015...
October 7, 2017: Addiction
https://www.readbyqxmd.com/read/28986540/reactive-metabolites-of-acetaminophen-activate-and-sensitize-the-capsaicin-receptor-trpv1
#17
Mirjam J Eberhardt, Florian Schillers, Esther M Eberhardt, Linus Risser, Jeanne de la Roche, Christine Herzog, Frank Echtermeyer, Andreas Leffler
The irritant receptor TRPA1 was suggested to mediate analgesic, antipyretic but also pro-inflammatory effects of the non-opioid analgesic acetaminophen, presumably due to channel activation by the reactive metabolites parabenzoquinone (pBQ) and N-acetyl-parabenzoquinonimine (NAPQI). Here we explored the effects of these metabolites on the capsaicin receptor TRPV1, another redox-sensitive ion channel expressed in sensory neurons. Both pBQ and NAPQI, but not acetaminophen irreversibly activated and sensitized recombinant human and rodent TRPV1 channels expressed in HEK 293 cells...
October 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28981253/high-throughput-screening-method-for-systematic-surveillance-of-drugs-of-abuse-by-multisegment-injection-capillary-electrophoresis-mass-spectrometry
#18
Alicia DiBattista, Dianne Rampersaud, Howard Lee, Marcus Kim, Philip Britz-McKibbin
New technologies are urgently required for reliable drug screening given a worldwide epidemic of prescription drug abuse and its devastating socioeconomic impacts on public health. Primary screening of drugs of abuse (DoA) currently relies on immunoassays that are prone to bias and are not applicable to detect an alarming array of psychoactive stimulants, tranquilizers, and synthetic opioids. These limitations impact patient safety when monitoring for medication compliance, drug substitution, or misuse/abuse and require follow-up confirmatory testing by more specific yet lower throughput instrumental methods...
November 7, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28962652/perceived-benefits-of-the-hepatitis-c-peer-educators-a-qualitative-investigation
#19
A W Batchelder, L Cockerham-Colas, D Peyser, S P Reynoso, I Soloway, A H Litwin
BACKGROUND: Although opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment. In addition to HCV treatment-access barriers, substance-using patients may be reluctant to pursue treatment because of wariness of the medical system, lack of knowledge, or stigma related to HCV treatment. Implementation of a formal peer education program is one model of reducing provider- and patient-level barriers to HCV treatment, by enhancing mutual trust and reducing stigma...
September 29, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28962604/estimating-the-number-of-people-who-inject-drugs-in-australia
#20
Sarah Larney, Matthew Hickman, Rebecca Guy, Jason Grebely, Gregory J Dore, Richard T Gray, Carolyn A Day, Jo Kimber, Louisa Degenhardt
BACKGROUND: Injecting drug use is associated with considerable morbidity and mortality. Estimates of the size of the population of people who inject drugs are critical to inform service planning and estimate disease burden due to injecting drug use. We aimed to estimate the size of the population of people who inject drugs in Australia. METHODS: We applied a multiplier method which used benchmark data (number of people in opioid substitution therapy (OST) on a snapshot day in 2014) and multiplied it by a factor derived from the prevalence of current OST among people who inject drugs participating in the Australian Needle and Syringe Program Survey in 2014...
September 29, 2017: BMC Public Health
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