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J Giordano, H Huang, J Kianto, S Das
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
Lisa B E Shields, Soraya Nasraty, Alisha D Bell, Anil N Vinayakan, Raghunath S Gudibanda, Steven T Hester, Joshua T Honaker
OBJECTIVE: Prescription opioid abuse poses a significant public health concern. House Bill 1 (HB1) was enacted in 2012 to address prescription drug abuse in Kentucky. The authors investigated the impact of HB1 on primary care providers' (PCPs) prescribing practices of Schedule II controlled substances. DESIGN: Retrospective evaluation of PCPs' prescribing practices in an adult outpatient setting. METHODS: A review of the prescribing practices for Schedule II controlled substances written by 149 PCPs...
November 2016: Journal of Opioid Management
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
Dong-Liang Chen, Yu-Hong Li, Zhi-Juan Wang, Ye-Ke Zhu
Gabapentin has been used as an adjuvant for treatment of cancer pain. Previous studies showed that opioids combined with gabapentin for management of cancer pain reduced the dosage of opioids.The objective of this study was to explore the clinical effect and patients' satisfaction of oxycontin combined with gabapentin in treatment of severe cancer pain. After titration of morphine, 60 severe cancer patients with visual analog score (VAS) more than 7 were randomly divided into trial group (n = 30) and control group (n = 30)...
October 2016: Medicine (Baltimore)
Tyler A Johnson, Laura Milan-Lobo, Tao Che, Madeline Ferwerda, Eptisam Lambo, Nicole L McIntosh, Fei Li, Li He, Nicholas Lorig-Roach, Phillip Crews, Jennifer Lynne Whistler
Opioid therapeutics are excellent analgesics, whose utility is compromised by dependence. Morphine (1) and its clinically relevant derivatives such as OxyContin® (4), Vicodin® (5) and Dilaudid® (6) are "biased" agonists at the µ opioid receptor (OR), wherein they engage G-protein signaling but poorly engage β-arrestin and the endocytic machinery. In contrast, the endorphins, met-enkephalin (14) and β-endorphin (15), endogenous peptide agonists for ORs, are more potent analgesics then 1, show reduced liability for tolerance and dependence, and engage both G-protein and β-arrestin pathways as "balanced" agonists...
October 17, 2016: ACS Chemical Neuroscience
Stevan Geoffrey Severtson, Matthew S Ellis, Steven P Kurtz, Andrew Rosenblum, Theodore J Cicero, Mark W Parrino, Michael K Gilbert, Mance E Buttram, Nabarun Dasgupta, Becki BucherBartelson, Jody L Green, Richard C Dart
BACKGROUND: The development of abuse deterrent formulations is one strategy for reducing prescription opioid misuse and abuse. A putative abuse deterrent formulation of oxycodone extended release (OxyContin(®)) was introduced in 2010. Early reports demonstrated reduced abuse and diversion, however, an analysis of social media found 32 feasible methods to circumvent the abuse deterrent mechanism. We measured trends of diversion, abuse and street price of OxyContin to assess the durability of the initial reduction in abuse...
November 1, 2016: Drug and Alcohol Dependence
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
Jeffrey Fudin, Mena Raouf, Erica L Wegrzyn
No abstract text is available yet for this article.
2016: Journal of Pain Research
Janani Kalyanam, Takeo Katsuki, Gert R G Lanckriet, Tim K Mackey
INTRODUCTION: Nonmedical use of prescription medications/drugs (NMUPD) is a serious public health threat, particularly in relation to the prescription opioid analgesics abuse epidemic. While attention to this problem has been growing, there remains an urgent need to develop novel strategies in the field of "digital epidemiology" to better identify, analyze and understand trends in NMUPD behavior. METHODS: We conducted surveillance of the popular microblogging site Twitter by collecting 11 million tweets filtered for three commonly abused prescription opioid analgesic drugs Percocet® (acetaminophen/oxycodone), OxyContin® (oxycodone), and Oxycodone...
February 2017: Addictive Behaviors
Bobbi Jo H Yarborough, Scott P Stumbo, Shannon L Janoff, Micah T Yarborough, Dennis McCarty, Howard D Chilcoat, Paul M Coplan, Carla A Green
BACKGROUND: Opioid abuse and misuse are significant public health issues. The CDC estimated 72% of pharmaceutical-related overdose deaths in the US in 2012 involved opioids. While studies of opioid overdoses have identified sociodemographic characteristics, agents used, administration routes, and medication sources associated with overdoses, we know less about the context and life circumstances of the people who experience these events. METHODS: We analyzed interviews (n=87) with survivors of opioid overdoses or family members of decedents...
October 1, 2016: Drug and Alcohol Dependence
Christopher M Jones, Pradip K Muhuri, Peter G Lurie
OBJECTIVES: The role of the opioid OxyContin in the opioid abuse epidemic has been well-documented. In 2010, OxyContin was reformulated to make it more difficult to abuse. We assessed past-year OxyContin nonmedical use among a nationally representative population and among nonmedical users of opioid pain relievers in the United States between 2006 and 2013. METHODS: Data are from the National Survey on Drug Use and Health. Prevalence estimates of past-year OxyContin nonmedical use overall and by sociodemographic, geographic, and substance use characteristics were calculated for each year, 2006 through 2013...
August 10, 2016: Clinical Journal of Pain
David C Sing, Jeffrey J Barry, Jonathan W Cheah, Thomas P Vail, Erik N Hansen
BACKGROUND: Opioid therapy is an increasingly used modality for treatment of musculoskeletal pain despite multiple associated risks. The purpose of this study was to evaluate how preoperative opioid use affects early outcomes after total joint arthroplasty. METHODS: A total of 174 patients undergoing total joint arthroplasty were matched by age, gender, and procedure into 3 groups stratified by preoperative opioid use (nonuser, short acting [eg, Vicodin], long acting [eg, Oxycontin])...
September 2016: Journal of Arthroplasty
Beatrice Setnik, Carl L Roland, Glenn Pixton, Lynn Webster
Abuse liability studies usually measure drug liking using 100-mm visual analog scales (VAS), presented as unipolar (liking measured on entire scale) or bipolar (liking and disliking measured with a neutral midpoint). These 2 types of VAS were compared using drug liking ratings from a randomized double-blind crossover study of immediate-release and controlled-release oxycodone in 2 cohorts of nondependent recreational opioid users. Cohort 1 (n = 19) received intact oxycodone 40 mg, intact OxyContin(®) 40 and 80 mg, crushed OxyContin(®) 40 mg, and placebo, while cohort 2 (n = 16) received intact oxycodone 20, 40, and 80 mg and placebo...
February 2017: Journal of Clinical Pharmacology
Howard D Chilcoat, Paul M Coplan, Venkatesh Harikrishnan, Louis Alexander
BACKGROUND: Doctor-shopping (obtaining prescriptions from multiple prescribers/pharmacies) for opioid analgesics produces a supply for diversion and abuse, and represents a major public health issue. METHODS: An open cohort study assessed changes in doctor-shopping in the U.S. for a brand extended release (ER) oxycodone product (OxyContin) and comparator opioids before (July, 2009 to June, 2010) versus after (January, 2011 to June, 2013) introduction of reformulated brand ER oxycodone with abuse-deterrent properties, using IMS LRx longitudinal data covering >150 million patients and 65% of retail U...
August 1, 2016: Drug and Alcohol Dependence
Theodore J Cicero
From teenagers dying from heroin overdoses to crime tied to Vicodin and OxyContin addiction to road fatalities in which sedatives and muscle relaxants are involved, 20,000 deaths in the United States in 2014 were attributed to problems associated with narcotics and prescription drug use. Our author, whose research involves the neurobiological basis of drug addiction, traces the history and evolution of narcotics and leans on his clinical experience to discuss why certain drugs are powerful, addicting-and dangerous...
September 2015: Cerebrum: the Dana Forum on Brain Science
Joseph J Palamar, Jenni A Shearston, Charles M Cleland
BACKGROUND: Nonmedical opioid use has become a major public health concern due to increases in treatment admissions, overdoses, and deaths. Use has also been linked to heroin initiation. Reliable data on nonmedical opioid use are needed to continue to inform prevention. OBJECTIVE: To determine the prevalence and correlates of discordant self-report of nonmedical use of opioids in a national sample. METHODS: Utilizing a nationally representative sample of 31,149 American high school seniors in the Monitoring the Future study (2009-2013), discordant responses between self-reported 12-month nonmedical opioid use and self-reported 12-month nonmedical Vicodin and OxyContin use (reporting Vicodin/OxyContin use, but not reporting "opioid" use) were assessed...
September 2016: American Journal of Drug and Alcohol Abuse
Christopher Sankey, Beatrice Setnik, Zoltan Harsanyi, Ken Michalko, Zejiang Yang, Pierre Geoffroy
OBJECTIVE: Emerging data are demonstrating that tamper-resistant opioids may play an important role in changing prescription opioid abuse behaviors. This study was a chart review to examine if the reformulation of OxyContin® into a version with tamper-resistant properties (OxyNEO®) had an impact on oxycodone-positive urine drug screens (UDSs) in opioid-dependent patients receiving methadone maintenance therapy (MMT). DESIGN: The historical element of this study examined 250 eligible charts from patients on MMT who had data during the time periods when only OxyContin was available (baseline period), during the transition to OxyNEO, and when only OxyNEO was available...
May 2016: Journal of Opioid Management
Theodore J Cicero, Matthew S Ellis, Zachary A Kasper
The introduction of extended-release opioid analgesics helped initiate an epidemic of prescription opioid abuse in the United States. To make access to the drug by crushing or dissolution more difficult, abuse-deterrent formulations (ADFs) of OxyContin (Purdue Pharma, Stamford, CT) and Opana ER (Endo Pharmaceuticals Inc., Malvern, PA), which use the same foundation technology (Intac, Grunenthal, Aachen, Germany), were introduced in 2010 and 2012, respectively. To examine their relative effectiveness, we used a structured survey of 12,124 individuals entering treatment for opioid use disorder followed by a more focused online survey with a subset of these patients (N = 129) using both structured and open-ended questions...
June 2016: Pain
Shannon L Janoff, Nancy A Perrin, Paul M Coplan, Howard D Chilcoat, Cynthia I Campbell, Carla A Green
BACKGROUND: Addiction, overdoses and deaths resulting from prescription opioids have increased dramatically over the last decade. In response, several manufacturers have developed formulations of opioids with abuse-deterrent properties. For many of these products, the Food and Drug Administration (FDA) recognized the formulation with labeling claims and mandated post-marketing studies to assess the abuse-deterrent effects. In response, we assess differences in rates of opioid-related overdoses and poisonings prior to and following the introduction of a formulation of OxyContin® with abuse-deterrent properties...
2016: BMC Pharmacology & Toxicology
P M Coplan, H D Chilcoat, S F Butler, E M Sellers, A Kadakia, V Harikrishnan, J D Haddox, R C Dart
An extended-release opioid analgesic (OxyContin, OC) was reformulated with abuse-deterrent properties to deter abuse. This report examines changes in abuse through oral and nonoral routes, doctor-shopping, and fatalities in 10 studies 3.5 years after reformulation. Changes in OC abuse from 1 year before to 3 years after OC reformulation were calculated, adjusted for prescription changes. Abuse of OC decreased 48% in national poison center surveillance systems, decreased 32% in a national drug treatment system, and decreased 27% among individuals prescribed OC in claims databases...
September 2016: Clinical Pharmacology and Therapeutics
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