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https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#1
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#2
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#3
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28070918/stereotype-threat-and-social-function-in-opioid-substitution-therapy-patients
#4
Courtney von Hippel, Julie D Henry, Gill Terrett, Kimberly Mercuri, Karen McAlear, Peter G Rendell
OBJECTIVES: People with a history of substance abuse are subject to widespread stigmatization. It seems likely that this societal disapproval will result in feelings of stereotype threat, or the belief that one is the target of demeaning stereotypes. If so, stereotype threat has the potential to contribute to functional difficulties including poor social outcomes. METHODS: Eighty drug users on opioid substitution therapy and 84 demographically matched controls completed measures of mental health and social function...
January 10, 2017: British Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28033462/the-pharmacological-heterogeneity-of-nepenthone-analogs-in-conferring-highly-selective-and-potent-%C3%AE%C2%BA-opioid-agonistic-activities
#5
Wei Li, Jian-Dong Long, Yuan-Yuan Qian, Yu Long, Xue-Jun Xu, Yu-Jun Wang, Qing Shen, Zuo-Neng Wang, Xi-Cheng Yang, Li Xiao, Hong-Peng Sun, Yu-Long Xu, Yi-Yi Chen, Qiong Xie, Yong-Hui Wang, Li-Ming Shao, Jing-Gen Liu, Zhui-Bai Qiu, Wei Fu
To develop novel analgesics with no side effects or less side effects than traditional opioids is highly demanded to treat opioid receptor mediated pain and addiction issues. Recently, κ-opioid receptor (KOR) has been established as an attractive target, although its selective agonists could bear heterogeneous pharmacological activities. In this study, we designed and synthesized two new series of nepenthone derivatives by inserting a spacer (carbonyl) between 6α,14α-endo-ethenylthebaine and the 7α-phenyl substitution of the skeleton and by substituting the 17-N-methyl group with a cyclopropylmethyl group...
January 19, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27958381/a-polymorphism-in-the-oprm1-3-untranslated-region-is-associated-with-methadone-efficacy-in-treating-opioid-dependence
#6
R C Crist, G A Doyle, E C Nelson, L Degenhardt, N G Martin, G W Montgomery, A J Saxon, W Ling, W H Berrettini
The μ-opioid receptor (MOR) is the primary target of methadone and buprenorphine. The primary neuronal transcript of the OPRM1 gene, MOR-1, contains a ~13 kb 3' untranslated region with five common haplotypes in European-Americans. We analyzed the effects of these haplotypes on the percentage of opioid positive urine tests in European-Americans (n=582) during a 24-week, randomized, open-label trial of methadone or buprenorphine/naloxone (Suboxone) for the treatment of opioid dependence. A single haplotype, tagged by rs10485058, was significantly associated with patient urinalysis data in the methadone treatment group...
December 13, 2016: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/27935442/psychosis-after-switch-in-opioid-maintenance-agonist-and-risperidone-induced-pisa-syndrome-two-critical-incidents-in-the-treatment-of-a-patient-with-dual-diagnosis
#7
Manuel Sutter, Marc Walter, Kenneth M Dürsteler, Johannes Strasser, Marc Vogel
BACKGROUND AND AIMS: Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case which illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION: We report on a 56-year old patient diagnosed with schizophrenia and opioid dependence that suffered both from a risperidone-induced Pisa syndrome and, three years later, an acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT-prolongation...
December 9, 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27933094/the-newer-opioid-agonist-treatment-with-lower-substitutive-opiate-doses-is-associated-with-better-toxicology-outcome-than-the-older-harm-reduction-treatment
#8
Jacopo V Bizzarri, Valentina Casetti, Livia Sanna, Angelo Giovanni Icro Maremmani, Luca Rovai, Silvia Bacciardi, Daria Piacentino, Andreas Conca, Icro Maremmani
BACKGROUND: Charge-free heroin use disorder treatment in Italy follows two main approaches, i.e., harm reduction treatment (HRT) strategy in community low-threshold facilities for drug addiction and opioid agonist treatment (OAT) in high-threshold facilities for opioid addiction, focusing on pharmacological maintenance according to the Dole and Nyswander strategy. We aimed to compare the impact of HRT and OAT on patient outcome, as assessed through negativity for drugs on about 1-year urinalyses...
2016: Annals of General Psychiatry
https://www.readbyqxmd.com/read/27931232/retention-in-georgia-opioid-substitution-therapy-program-and-associated-factors
#9
Ekaterine Ruadze, Khatuna Todadze
BACKGROUND: Substance abuse has been considered as a growing challenge in Georgia that is closely linked with human immune deficiency virus (HIV) and hepatitis C transmission due to unsafe injection and other uncontrolled behaviors. Methadone maintenance therapy is one of the major treatment options for opioid-dependent individuals. It has proven efficacy in decreasing illegal opioid consumption and criminal behavior as well as reducing the level of HIV infection, mortality, HCV infection, and increasing social functioning...
December 8, 2016: Harm Reduction Journal
https://www.readbyqxmd.com/read/27927256/the-effects-of-needle-sharing-and-opioid-substitution-therapy-on-incidence-of-hepatitis-c-virus-infection-and-reinfection-in-people-who-inject-drugs
#10
C K Aitken, P A Agius, P G Higgs, M A Stoové, D S Bowden, P M Dietze
Although high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs' use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7·6 [95% confidence interval (CI) 4·8-11·9], 12·4 (95% CI 9·1-17·0) and 9·7 (95% CI 7·4-12·6) per 100 person-years, respectively...
December 8, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27923769/recombination-in-hepatitis-c-virus-is-not-uncommon-among-people-who-inject-drugs-in-kolkata-india
#11
Debanjali Gupta, Kallol Saha, Aritra Biswas, Rushna Firdaus, Monika Ghosh, Provash Chandra Sadhukhan
Recombination in RNA virus is a rare event in the survival and evolution to evade host immune system. This is increasing within high risk group population (HRG) due to super infection that occurs by continuous sharing of common drug equipment by HCV infected or HIV-HCV co-infected recurrent drug users. Recombination causes impediment to vaccine development and therapeutic intervention as standard HCV treatment is still genotype specific. Blood samples of 194 people who inject drugs (PWID) were collected from an Opioid Substitution Therapy Centre in Kolkata, India...
December 5, 2016: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/27899572/c3-symmetric-opioid-scaffolds-are-ph-responsive-dna-condensation-agents
#12
Natasha McStay, Zara Molphy, Alan Coughlan, Attilio Cafolla, Vickie McKee, Nicholas Gathergood, Andrew Kellett
Herein we report the synthesis of tripodal C3-symmetric opioid scaffolds as high-affinity condensation agents of duplex DNA. Condensation was achieved on both supercoiled and canonical B-DNA structures and identified by agarose electrophoresis, viscosity, turbidity and atomic force microscopy (AFM) measurements. Structurally, the requirement of a tris-opioid scaffold for condensation is demonstrated as both di- (C2-symmetric) and mono-substituted (C1-symmetric) mesitylene-linked opioid derivatives poorly coordinate dsDNA...
November 28, 2016: Nucleic Acids Research
https://www.readbyqxmd.com/read/27898497/medications-for-addiction-treatment-changing-language-to-improve-care
#13
Sarah E Wakeman
The term medication-assisted treatment has been widely adopted in reference to the use of opioid agonist therapy. Although it is arguably better than the older terms of replacement or substitution therapy, medication-assisted treatment implies that medications are a corollary to whatever the main part of treatment is. No other medication for other health conditions is referred to this way. It has finally been recognized that to improve care and reduce stigma, we must use medically accurate and person-first language, describing those with the disease of addiction as people with substance use disorder...
November 24, 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/27870477/ascending-single-dose-double-blind-placebo-controlled-safety-study-of-noribogaine-in-opioid-dependent-patients
#14
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/27846264/hepatitis-c-treatment-uptake-among-patients-who-have-received-opioid-substitution-treatment-a-population-based-study
#15
Håvard Midgard, Jørgen G Bramness, Svetlana Skurtveit, John W Haukeland, Olav Dalgard
BACKGROUND AND AIMS: There is limited data on hepatitis C (HCV) treatment uptake among people who inject drugs including individuals receiving opioid substitution treatment (OST). We aimed to calculate cumulative HCV treatment uptake, estimate annual treatment rates, and identify factors associated with HCV treatment among individuals who have received OST in Norway. METHODS: This observational study was based on linked data from The Norwegian Prescription Database and The Norwegian Surveillance System for Communicable Diseases between 2004 and 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27845298/daclatasvir-plus-sofosbuvir-with-or-without-ribavirin-in-real-world-patients-with-hiv-hcv-coinfection-and-advanced-liver-disease
#16
Jürgen K Rockstroh, Patrick Ingiliz, Jörg Petersen, Markus Peck-Radosavljevic, Tania M Welzel, Marc Van der Valk, Yue Zhao, Maria Jesus Jimenez Exposito, Stefan Zeuzem
BACKGROUND: HIV/HCV-coinfected patients respond just as well to modern direct-acting antiviral HCV therapy as HCV-monoinfected patients. However, clinical data for all-oral HCV treatments are sparse in HIV/HCV-coinfected patients with an advanced stage of liver cirrhosis. METHODS: A subanalysis of efficacy and safety for a daclatasvir (DCV) and sofosbuvir (SOF) regimen, with or without ribavirin (RBV), was undertaken in HIV/HCV-coinfected patients with advanced liver disease and no other treatment options enrolled into a European DCV compassionate use programme...
November 15, 2016: Antiviral Therapy
https://www.readbyqxmd.com/read/27834915/opioid-substitution-treatment-planning-in-a-disaster-context-perspectives-from-emergency-management-and-health-professionals-in-aotearoa-new-zealand
#17
Denise Blake, Antonia Lyons
Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster...
November 10, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27784231/effect-of-oral-methadone-on-ecg-characteristics-and-endocrine-hormonal-changes-and-their-inter-relationship
#18
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/27780105/initiation-into-prescription-opioid-injection-and-associated-trends-in-heroin-use-among-people-who-use-illicit-drugs
#19
Stephanie Lake, M-J Milloy, Huiru Dong, Kanna Hayashi, Evan Wood, Thomas Kerr, Kora DeBeck
OBJECTIVES: Prescription opioid (PO) injection among people who use illicit drugs (PWUD) is an ongoing concern, yet little is known about drug use trajectories associated with initiating PO injection, including potential associations with heroin use. This study aimed to identify predictors of PO injection initiation among PWUD, and examine trends in heroin use before and after initiating PO injection. METHODS: Data were merged from three cohorts of PWUD recruited between September 2005 and November 2015...
December 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27775955/depression-anxiety-and-stress-among-people-with-chronic-hepatitis-c-virus-infection-and-a-history-of-injecting-drug-use-in-new-south-wales-australia
#20
Emmanuel Fortier, Maryam Alavi, Julie Bruneau, Michelle Micallef, Jacinta Perram, Sanjeev Sockalingam, Adrian J Dunlop, Annie C Balcomb, Carolyn A Day, Carla Treloar, Nicky Bath, Paul S Haber, Gregory J Dore, Jason Grebely
OBJECTIVE: The aims of this study were to assess symptoms of depression, anxiety, and stress and associated sociodemographic factors among people living with chronic hepatitis C virus (HCV) infection with a history of injecting drug use and to assess the association between symptoms of depression, anxiety, or stress and HCV treatment intent, specialist assessment, or treatment uptake. METHODS: The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings was an observational cohort study evaluating the provision of HCV assessment and treatment among people with chronic HCV and a history of injecting drug use, recruited from 9 community health centers and opioid substitution therapy (OST) clinics (New South Wales, Australia)...
October 21, 2016: Journal of Addiction Medicine
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