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https://www.readbyqxmd.com/read/28735039/frequency-and-correlates-of-sleep-disturbance-in-methadone-and-buprenorphine-maintained-patients
#1
Kelly E Dunn, Patrick H Finan, D Andrew Tompkins, Eric C Strain
BACKGROUND: Opioid use disorder (OUD) is a significant public health problem, and opioid maintenance treatment (OMT) on methadone or buprenorphine is a common approach. This study characterized sleep impairment in patients maintained on methadone or buprenorphine, and evaluated its association with psychiatric and medical comorbidities. METHODS: Participants (N=185) maintained on methadone (N=125) or buprenorphine (N=60) for OUD completed the Medical Outcomes Study Sleep Scale (MOS) to provide a point-prevalence assessment of sleep impairment...
July 14, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28733101/patterns-of-physician-prescribing-for-opioid-maintenance-treatment-in-ontario-canada-in-2014
#2
Qi Guan, Wayne Khuu, Sheryl Spithoff, Tara Kiran, Meldon Kahan, Mina Tadrous, Diana Martins, Pamela Leece, Tara Gomes
BACKGROUND: Despite concerns surrounding high patient volumes in methadone clinics, little is known about the practice patterns of opioid maintenance therapy (OMT) providers in Ontario. We examined the distribution of these services and how physician characteristics differ based on prescribing volume. METHODS: We conducted a cross-sectional study among prescribers of methadone or buprenorphine to Ontario public drug beneficiaries in 2014 by stratifying physicians into low- (lower 50%), moderate- (51-89%) and high-volume (top 10%) prescribers...
July 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28733097/injectable-naltrexone-oral-naltrexone-and-buprenorphine-utilization-and-discontinuation-among-individuals-treated-for-opioid-use-disorder-in-a-united-states-commercially-insured-population
#3
Jake R Morgan, Bruce R Schackman, Jared A Leff, Benjamin P Linas, Alexander Y Walley
We investigated prescribing patterns for five opioid use disorder (OUD) medications: 1) injectable naltrexone, 2) oral naltrexone, 3) sublingual or oralmucosal buprenorphine/naloxone, 4) sublingual buprenorphine, and 5) transdermal buprenorphine in a nationally representative claims-based database (Truven Health MarketScan®) of commercially insured individuals in the United States. We calculated the prevalence of OUD in the database for each year from 2010 to 2014 and the proportion of diagnosed patient months on OUD medication...
July 3, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28730328/comparative-study-of-the-efficacy-of-transdermal-buprenorphine-patches-and-prolonged-release-tramadol-tablets-for-postoperative-pain-control-after-spinal-fusion-surgery-a-prospective-randomized-controlled-non-inferiority-trial
#4
Ho-Joong Kim, Hyo Sae Ahn, Yunjin Nam, Bong-Soon Chang, Choon-Ki Lee, Jin S Yeom
PURPOSE: To compare the efficacy of a transdermal buprenorphine patch (5, 10, 15, and 20 μg/h) with that of oral tramadol (150, 200, 250, and 300 mg) for postoperative pain control after single level spinal fusion surgery. METHODS: The present study (ClinicalTrials.gov, number NCT02416804) was a prospective, randomized controlled non-inferiority trial designed to determine the efficacy of buprenorphine TDS for alleviating postoperative pain following patient controlled analgesia (PCA) in persons underwent a single level posterior lumbar interbody fusion surgery through 1:1 allocation...
July 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28727661/comparison-of-post-cesarean-section-opioid-analgesic-requirements-in-women-with-opioid-use-disorder-treated-with-methadone-or-buprenorphine
#5
Annmarie L Vilkins, Sarah M Bagley, Kristen A Hahn, Florencia Rojas-Miguez, Elisha M Wachman, Kelley Saia, Daniel P Alford
OBJECTIVE: Buprenorphine is a highly effective treatment for opioid use disorders, but its continuation in the perioperative setting remains controversial, unlike the accepted practice of perioperative methadone continuation. METHODS: We conducted a retrospective cohort study from 2006 to 2014 comparing post-cesarean section opioid analgesic requirements of women with opioid use disorders treated with methadone or buprenorphine. Preoperative, intraoperative, and postoperative opioid requirements (morphine equivalent dose [MED]), postoperative complications, and length of stay were compared between the methadone and buprenorphine groups...
July 19, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28724496/effects-of-time-and-storage-conditions-on-the-chemical-and-microbiologic-stability-of-diluted-buprenorphine-for-injection
#6
Johnathan M DenHerder, Ralph L Reed, Jennifer L Sargent, Gerd Bobe, Jan F Stevens, Helen E Diggs
Buprenorphine is a partial μ-opioid agonist used for analgesia. Due to the small size of laboratory rodents, buprenorphine HCl is typically diluted 10- or 20-fold with a sterile diluent, such as saline, for accurate dosing. Protocols for preparing and storing diluted buprenorphine vary by institution, and little published information is available regarding stability and beyond-use dating of specific buprenorphine preparations. The purpose of this study was to determine the chemical and microbiologic stability of diluted buprenorphine stored for a maximum of 180 d...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28724492/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#7
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures. Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Our laboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination, for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity), nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28724151/assessment-of-addiction-medicine-training-in-family-medicine-residency-programs-a-cera-study
#8
Sebastian Tong, Roy Sabo, Rebecca Aycock, Ramakrishna Prasad, Rebecca Etz, Anton Kuzel, Alex Krist
BACKGROUND AND OBJECTIVES: Substance use disorder (SUD) is a widespread problem but physicians may feel inadequately prepared to provide addiction care. We sought to assess current addiction medicine curricula in US family medicine residencies (FMRs) and evaluate barriers to improving or implementing addiction medicine curricula. METHODS: Questions regarding addiction medicine training were added to the December 2015 Council of Academic Family Medicine Educational Research Alliance (CERA) survey to US FMR program directors to evaluate each FMR's curriculum, potential workforce production, perceived barriers to improving or implementing curricula and faculty training in addiction medicine...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#9
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28723256/quantitative-testing-of-buprenorphine-and-norbuprenorphine-to-identify-urine-sample-spiking-during-office-based-opioid-treatment
#10
Joji Suzuki, Jennifer Zinser, Mohammed Issa, Claudia Rodriguez
BACKGROUND: Patients may spike urine samples with buprenorphine during office-based opioid treatment to simulate adherence to prescribed buprenorphine, potentially to conceal diversion of medications. However, routine immunoassay screens do not detect instances of spiking, as these would simply result in a positive result. We report on our clinic's experience using quantitative urine testing for buprenorphine and norbuprenorphine to facilitate the identification of urine spiking. METHODS: This is a retrospective chart review of 168 consecutive patients enrolled in outpatient buprenorphine treatment at an urban academic medical setting between May 2013 and August 2014...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#11
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28718693/effects-of-sedation-with-dexmedetomidine-and-buprenorphine-on-echocardiographic-variables-blood-pressure-and-heart-rate-in-healthy-cats
#12
Einar Johard, Anna Tidholm, Ingrid Ljungvall, Jens Häggström, Katja Höglund
Objectives Sedative agents are occasionally used to enable echocardiographic examination when screening cats for heart disease, such as hypertrophic cardiomyopathy (HCM). Owing to their haemodynamic effects, sedative agents may alter echocardiographic measurements. The aim of the study was to evaluate the effects of the sedative combination dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure (BP) and heart rate (HR) in healthy cats. Methods Fifty healthy, client-owned cats were prospectively recruited and included after physical examination...
July 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28715848/patient-outcomes-in-dose-reduction-or-discontinuation-of-long-term-opioid-therapy-a-systematic-review
#13
Joseph W Frank, Travis I Lovejoy, William C Becker, Benjamin J Morasco, Christopher J Koenig, Lilian Hoffecker, Hannah R Dischinger, Steven K Dobscha, Erin E Krebs
Background: Expert guidelines recommend reducing or discontinuing long-term opioid therapy (LTOT) when risks outweigh benefits, but evidence on the effect of dose reduction on patient outcomes has not been systematically reviewed. Purpose: To synthesize studies of the effectiveness of strategies to reduce or discontinue LTOT and patient outcomes after dose reduction among adults prescribed LTOT for chronic pain. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library from inception through April 2017; reference lists; and expert contacts...
July 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28701461/opioid-use-disorder-and-type-2-diabetes-mellitus-effect-of-participation-in-buprenorphine-naloxone-substitution-programs-on-glycemic-control
#14
Devon Tilbrook, Jeffrey Jacob, Pierre Parsons, Craig Edwards, Kassandra Loewen, Len Kelly
OBJECTIVE: To measure the effect of buprenorphine-naloxone as opioid substitution therapy on glycemic control in patients with type 2 diabetes mellitus and opioid use disorder. DESIGN: Retrospective cohort study and secondary data analysis. SETTING: Northwestern Ontario. PARTICIPANTS: Patients with diabetes receiving opioid substitution therapy, as well as patients with diabetes only, who live in 6 remote First Nations communities...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#15
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
July 12, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28699096/hepatitis-c-cascade-of-care-among-pregnant-women-on-opioid-agonist-pharmacotherapy-attending-a-comprehensive-prenatal-program
#16
Kimberly Page, Lawrence Leeman, Steven Bishop, Sandra Cano, Ludmila N Bakhireva
Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype...
July 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28698151/the-effects-of-methamphetamine-and-buprenorphine-and-their-interaction-on-anxiety-like-behavior-and-locomotion-in-male-rats
#17
Farshid Etaee, Masoumeh Asadbegi, Zahra Taslimi, Siamak Shahidi, Abdolrahman Sarihi, Sara Soleimani Asl, Alireza Komaki
Methamphetamine (Meth) abuse and dependence are major global problems. Most of previous studies showed that Meth is anxiogenic. While buprenorphine (Bup) is used to treat anxiety-related behaviors, the effects of Meth in combination with Bup on anxiety-like behavior are unclear. In this study, we examined the effects of these drugs on anxiety-like behavior with the elevated plus maze (EPM) and open field (OF) tests, which are widely used to assess anxiety-like behavior in small rodents. Forty male Wistar rats were divided into four groups: sham, Meth, Bup, and Bup+Meth...
July 8, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28694273/barriers-rural-physicians-face-prescribing-buprenorphine-for-opioid-use-disorder
#18
C Holly A Andrilla, Cynthia Coulthard, Eric H Larson
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective, office-based, medication-assisted treatment, but 60.1% of rural counties in the United States lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States and found that those who were not actively prescribing buprenorphine reported significantly more barriers than those who were, regardless of whether they were treating the maximum number of patients their waiver allowed...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694272/mortality-associated-with-time-in-and-out-of-buprenorphine-treatment-in-french-office-based-general-practice-a-7-year-cohort-study
#19
Julie Dupouy, Aurore Palmaro, Mélina Fatséas, Marc Auriacombe, Joëlle Micallef, Stéphane Oustric, Maryse Lapeyre-Mestre
In France, most cases of opioid use disorder are treated with buprenorphine by general practitioners in private practice. Using reimbursement data of a representative sample of the French population, Echantillon Généraliste des Bénéficiaires, we investigated mortality during periods when patients were in and out of treatment in a cohort of 713 new users of buprenorphine having a mean (SD) follow-up of 4.5 (1.5) years. The mortality rate was 0.63 per 100 person-years (95% CI, 0.40-0.85) overall. In a multivariate Cox regression model, compared with being in treatment, being out of treatment was associated with a markedly increased risk of death (hazard ratio = 29...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28688108/a-physiologically-based-pharmacokinetic-modeling-approach-to-predict-buprenorphine-pharmacokinetics-following-intravenous-sublingual-administration
#20
Hari V Kalluri, Hongfei Zhang, Steve N Caritis, Raman Venkataramanan
INTRODUCTION: Opioid dependence is associated with high morbidity and mortality. Buprenorphine(BUP) is approved by the FDA to treat opioid dependence. There is a lack of clear consensus on appropriate dosing of BUP due to inter-patient physiological differences in absorption/disposition, subjective response assessment and other patient comorbidities. The objective of this study is to build and validate robust physiologically-based-pharmacokinetic(PBPK) models for intravenous(IV) and Sublingual(SL) BUP as a first-step to optimize BUP pharmacotherapy...
July 8, 2017: British Journal of Clinical Pharmacology
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