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https://www.readbyqxmd.com/read/28425103/remains-of-care-opioid-substitution-treatment-in-the-post-welfare-state
#1
Anna Leppo, Riikka Perälä
This article examines how the amplified role of pharmaceutical substances in addiction treatment affects the everyday realisation of care, particularly the relationship between workers and patients, in so called austere environments. Theoretically the article draws firstly on the literature that links pharmaceuticalisation to the neoliberal undoing of central public structures and institutions of care, and secondly on Anne-Marie Mol's concept of the logic of care. Based on an ethnographic analysis of the everyday life at a Finnish opioid substitution treatment clinic we show the mechanisms through which the realisation of pharmacotherapy can, in the current political climate, result in a very narrow understanding of drug problems and minimal human contact between patients and professionals...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28419528/an-updated-synthesis-of-11-c-carfentanil-for-positron-emission-tomography-pet-imaging-of-the-%C3%AE-opioid-receptor
#2
Joseph E Blecha, Bradford D Henderson, Brian G Hockley, Henry F VanBrocklin, Jon-Kar Zubieta, Alexandre F DaSilva, Michael R Kilbourn, Robert A Koeppe, Peter J H Scott, Xia Shao
[(11) C]Carfentanil ([(11) C]CFN) is a selective radiotracer for in vivo positron emission tomography (PET) imaging studies of the μ-opioid system that, in our laboratories, is synthesized by methylation of the corresponding carboxylate precursor with [(11) C]MeOTf, and purified using a C2 solid-phase extraction cartridge. Changes in the commercial availability of common C2 cartridges have necessitated future-proofing the synthesis of [(11) C]CFN to maintain reliable delivery of the radiotracer for clinical imaging studies...
April 17, 2017: Journal of Labelled Compounds & Radiopharmaceuticals
https://www.readbyqxmd.com/read/28414496/impaired-psychomotor-function-and-plasma-methadone-and-levo-alpha-acetylmethadol-laam-concentrations-in-opioid-substitution-patients
#3
David A L Newcombe, Andrew A Somogyi, Felix Bochner, Jason M White
Tolerance to the psychomotor impairing effects of opioid drugs is expected to develop with repeated dosing, but may be incomplete. The relationship between plasma opioid concentration and psychomotor function in opioid-dependent patients was examined to determine whether impairment was more likely at the time of highest plasma drug concentration. Sixteen patients participating in a cross-over trial comparing methadone and LAAM completed a tracking task (OSPAT) 11 times over the dosing-interval for methadone (24-hrs) and LAAM (48-hrs)...
April 17, 2017: Experimental and Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28407106/rapid-decline-in-hiv-incidence-among-persons-who-inject-drugs-during-a-fast-track-combination-prevention-program-after-an-hiv-outbreak-in-athens
#4
Vana Sypsa, Mina Psichogiou, Dimitrios Paraskevis, Georgios Nikolopoulos, Chrissa Tsiara, Dimitra Paraskeva, Katerina Micha, Meni Malliori, Anastasia Pharris, Lucas Wiessing, Martin Donoghoe, Samuel Friedman, Don Des Jarlais, Georgios Daikos, Angelos Hatzakis
Background.: A "seek-test-treat" intervention (ARISTOTLE) was implemented in response to an outbreak of human immunodeficiency virus (HIV) infection among persons who inject drugs (PWID) in Athens. We assess trends in HIV incidence, prevalence, risk behaviors and access to prevention/treatment. Methods.: Methods included behavioral data collection, provision of injection equipment, HIV testing, linkage to opioid substitution treatment (OST) programs and HIV care during 5 rounds of respondent-driven sampling (2012-2013)...
April 12, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28404135/incidence-risk-factors-and-prevention-of-hepatitis-c-reinfection-a-population-based-cohort-study
#5
Nazrul Islam, Mel Krajden, Jean Shoveller, Paul Gustafson, Mark Gilbert, Jane A Buxton, Jason Wong, Mark W Tyndall, Naveed Zafar Janjua
BACKGROUND: People remain at risk of reinfection with hepatitis C virus (HCV), even after clearance of the primary infection. We identified factors associated with HCV reinfection risk in a large population-based cohort study in British Columbia, Canada, and examined the association of opioid substitution therapy and mental health counselling with reinfection. METHODS: We obtained data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for HCV or HIV at the British Columbia Centre for Disease Control Public Health Laboratory during 1990-2013 (when data were available)...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28397700/narcotic-bowel-syndrome
#6
REVIEW
Adam D Farmer, Jayne Gallagher, Caroline Bruckner-Holt, Qasim Aziz
Narcotic bowel syndrome is characterised by worsening abdominal pain in the context of escalating or continuous opioid therapy. Although narcotic bowel syndrome is rarely diagnosed, given the current epidemic of opioid use, it is likely to be under-recognised. The underlying pathophysiological mechanisms of narcotic bowel syndrome are incompletely understood; however, opioid-induced hyperalgesia is likely to be a central facet. The putative mechanisms of hyperalgesia include activation of bimodal opioid regulatory systems, counter-regulatory mechanisms, neuroinflammation, opioid facilitation, and interactions of the N-methyl D-aspartate receptor with opioids at the level of the spinal cord...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28376505/six-year-outcome-of-opioid-maintenance-treatment-in-heroin-dependent-patients-results-from-a-naturalistic-study-in-a-nationally-representative-sample
#7
Michael Soyka, Jens Strehle, Jürgen Rehm, Gerhard Bühringer, Hans-Ulrich Wittchen
BACKGROUND: In many countries, the opioid agonists, buprenorphine and methadone, are licensed for maintenance treatment of opioid dependence. Many short-term studies have been performed, but little is known about long-term effects. Therefore, this study described over 6 years (1) mortality, retention and abstinence rates and (2) changes in concomitant drug use and somatic and mental health. METHODS: A prevalence sample of n = 2,694 maintenance patients, recruited from a nationally representative sample of n = 223 substitution doctors, was evaluated in a 6-year prospective-longitudinal naturalistic study...
April 5, 2017: European Addiction Research
https://www.readbyqxmd.com/read/28375418/unexpected-serious-cardiac-arrhythmias-in-the-setting-of-loperamide-abuse
#8
Somwail Rasla, Amy St Amand, Marina K Garas, Amr El Meligy, Taro Minami
Loperamide (Imodium) is a non-prescription opioid receptor agonist available over-the-counter for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, central nervous system and respiratory depression, and cardiotoxicity. There is an emerging trend in its use among drug abusers for its euphoric effects or for self-treatment of opioid withdrawal. We report a case of ventricular dysrhythmias associated with loperamide abuse in a 28-year-old man who substituted loperamide for the opioids that he used to abuse...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28372506/substitution-of-medical-cannabis-for-pharmaceutical-agents-for-pain-anxiety-and-sleep
#9
Brian J Piper, Rebecca M DeKeuster, Monica L Beals, Catherine M Cobb, Corey A Burchman, Leah Perkinson, Shayne T Lynn, Stephanie D Nichols, Alexander T Abess
A prior epidemiological study identified a reduction in opioid overdose deaths in US states that legalized medical cannabis (MC). One theory to explain this phenomenon is a potential substitution effect of MC for opioids. This study evaluated whether this substitution effect of MC for opioids also applies to other psychoactive medications. New England dispensary members ( n = 1,513) completed an online survey about their medical history and MC experiences. Among respondents that regularly used opioids, over three-quarters (76...
March 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28363796/structure-constrained-endomorphin-analogs-display-differential-antinociceptive-mechanisms-in-mice-after-spinal-administration
#10
Yuan Wang, Jingjing Zhou, Xin Liu, Long Zhao, Zhaojuan Wang, Xianghui Zhang, Kezhou Wang, Linqing Wang, Rui Wang
We previously reported a series of novel endomorphin analogs with unnatural amino acid modifications. These analogs display good binding affinity and functional activity toward the μ opioid receptor (MOP). In the present study, we further investigated the spinal antinociceptive activity of these compounds. The analogs were potent in several nociceptive models. Opioid antagonists and antibodies against several endogenous opioid peptides were used to determine the mechanisms of action of these peptides. Intrathecal pretreatment with naloxone and β-funaltrexamine (β-FNA) effectively inhibited analog-induced analgesia, demonstrating that activity of the analogs is regulated primarily through MOP...
March 29, 2017: Peptides
https://www.readbyqxmd.com/read/28345206/treatment-with-direct-acting-antiviral-agents-of-hepatitis-c-virus-infection-in-injecting-drug-users-a-prospective-study
#11
Lucio Boglione, Simone Mornese Pinna, Amedeo De Nicolò, Jessica Cusato, Giuseppe Cariti, Giovanni Di Perri, Antonio D'Avolio
In this prospective study, we evaluated the effectiveness and tolerability of novel therapies against hepatitis C virus (HCV) in a cohort of PWID enrolled at our centre from April 2015 to July 2016. In this analysis, a total of 174 patients were included: 11 (6.3%) were treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) containing regimens, 163 (93.7%) with IFN-free treatments. RBV has been used in 70 patients (40.2%); 59 (33.9%) patients were in opioid substitution therapy (OST) with methadone or buprenorphine...
March 26, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28327378/gender-related-psychopathology-in-opioid-use-disorder-results-from-a-representative-sample-of-italian-addiction-services
#12
Beniamino Leone, Marco Di Nicola, Lorenzo Moccia, Mauro Pettorruso, Luisa De Risio, Giuseppe Nucara, Lorenzo Zamboni, Antonino Callea, Luigi Janiri, Mauro Cibin, Fabio Lugoboni
AIMS: Gender and psychiatric comorbidity seem to influence patients' inter-individual response to Opioid Substitution Treatments (OST) in Opioid Use Disorder (OUD) management. The aim of the study was to assess psychopathological dimensions in an Italian sample of OUD individuals entering a methadone/buprenorphine maintenance program; secondary, we evaluated the possible gender-specific differences within the psychopathological profiles. METHODS: In a cross-sectional study, we recruited 1052 (792 male; 260 female) OUD subjects receiving OST...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28325527/collaborative-pharmacist-prescribing-within-the-opioid-substitution-treatment-program-in-south-australia-patient-and-pharmacist-views
#13
Phuong-Phi Le, Annette Braunack-Mayer, Caroline Laurence
There is a shortage of medical practitioners able and/or willing to prescribe OST. This qualitative study investigated an alternative model of care where by pharmacists co-prescribed with an accredited doctor for OST patients. Semi-structured face-to-face interviews with 14 OST patients were conducted at a state government drug and alcohol clinic about their views on pharmacist prescribing OST for them. In the second phase of the study, three focus group interviews with 18 pharmacists were conducted to explore their views on a policy proposal which would allow them to co-prescribe for OST patients...
February 27, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28323752/impact-of-opioid-substitution-therapy-on-the-hiv-prevention-benefit-of-antiretroviral-therapy-for-people-who-inject-drugs
#14
Christinah Mukandavire, Andrea Low, Gitau Mburu, Adam Trickey, Margaret T May, Charlotte F Davies, Clare E French, Katharine J Looker, Tim Rhodes, Lucy Platt, Andy Guise, Matthew Hickman, Peter Vickerman
OBJECTIVE: A recent meta-analysis suggested that opioid substitution therapy (OST) increased uptake of antiretroviral treatment (ART) and HIV viral suppression. We modelled whether OST could improve the HIV prevention benefit achieved by ART among people who inject drugs (PWID). METHODS: We modelled how introducing OST could improve the coverage of ART across a PWID population for different baseline ART coverage levels. Using existing data on how yearly HIV-transmission risk is related to HIV plasma viral load, changes in the level of viral suppression across the population were used to project the relative reduction in yearly HIV-transmission risk achieved by ART, with or without OST, compared with if there was no ART - defined here as the prevention effectiveness of ART...
May 15, 2017: AIDS
https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#15
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28318893/design-and-characterization-of-opioid-ligands-based-on-cycle-in-macrocycle-scaffold
#16
Anna Adamska-Bartłomiejczyk, Rossella De Marco, Luca Gentilucci, Alicja Kluczyk, Anna Janecka
The study reports on a series of novel cyclopeptides based on the structure Tyr-[d-Lys-Phe-Phe-Asp]NH2, a mixed mu and kappa opioid receptor agonist with low nanomolar affinity, in which Phe(4) residue was substituted by cyclic amino acids, such as Pro or its six-membered surrogates, piperidine-2-, 3- or 4-carboxylic acids (Pip, Nip and Inp, respectively). All derivatives exhibited high mu- and moderate delta-opioid receptor affinity, and almost no binding to the kappa-opioid receptor. Conformational analysis suggested that the cis conformation of the peptide bond Phe(3)-Xaa(4) influences receptor selectivity through the control of the position of Phe(3) side chain...
February 28, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28314512/modulation-of-opioid-receptor-affinity-and-efficacy-via-n-substitution-of-9%C3%AE-hydroxy-5-3-hydroxyphenyl-morphan-synthesis-and-computer-simulation-study
#17
Phong M Truong, Sergio A Hassan, Yong-Sok Lee, Theresa A Kopajtic, Jonathan L Katz, Aaron M Chadderdon, John R Traynor, Jeffrey R Deschamps, Arthur E Jacobson, Kenner C Rice
The enantiomers of a variety of N-alkyl-, N-aralkyl-, and N-cyclopropylalkyl-9β-hydroxy-5-(3-hydroxyphenyl)morphans were synthesized employing cyanogen bromide and K2CO3 to improve the original N-demethylation procedure. Their binding affinity to the μ-, δ-, and κ-opioid receptors (ORs) was determined and functional (GTPγ(35)S) assays were carried out on those with reasonable affinity. The 1R,5R,9S-enantiomers (1R,5R,9S)-(-)-5-(3-hydroxyphenyl)-2-(4-nitrophenethyl)-2-azabicyclo[3.3.1]nonan-9-ol (1R,5R,9S-16), (1R,5R,9S)-(-) 2-cinnamyl-5-(3-hydroxyphenyl)-2-azabicyclo[3...
March 1, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28303199/hiv-aids-in-the-south-east-asia-region-progress-and-challenges
#18
EDITORIAL
Razia Pendse, Somya Gupta, Dongbao Yu, Swarup Sarkar
The South-East Asia region, with 11 member states, has an estimated 3.5 million people living with HIV (PLHIV). More than 99% of PLHIV live in five countries where HIV prevalence among the population aged 15-49 remains low but is between 2% and 29% among key populations. Since 2010, the region has made progress to combat the epidemic. Mature condom programmes exist in most countries but opioid substitution therapy, and needle and syringe exchange programmes need to be scaled up. HIV testing is recommended nationwide in four countries and is prioritised in high prevalence areas or for key populations in the rest...
November 28, 2016: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#19
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28281354/integrated-opioid-substitution-therapy-and-hiv-care-a-qualitative-systematic-review-and-synthesis-of-client-and-provider-experiences
#20
Andy Guise, Maureen Seguin, Gitau Mburu, Susie McLean, Pippa Grenfell, Zahed Islam, Sergii Filippovych, Happy Assan, Andrea Low, Peter Vickerman, Tim Rhodes
People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts...
March 10, 2017: AIDS Care
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