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Chronic Opioids

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https://www.readbyqxmd.com/read/28722815/influence-of-morphine-and-naloxone-on-pain-modulation-in-rheumatoid-arthritis-chronic-fatigue-syndrome-fibromyalgia-and-controls-a-double-blind-randomized-placebo-controlled-cross-over-study
#1
Linda Hermans, Jo Nijs, Patrick Calders, Luc De Clerck, Greta Moorkens, Guy Hans, Sofie Grosemans, Tine Roman De Mettelinge, Joanna Tuynman, Mira Meeus
BACKGROUND: Impaired pain inhibitory and enhanced pain facilitatory mechanisms are repeatedly reported in patients with central sensitization pain. However, the exact effects of frequently prescribed opioids on central pain modulation are still unknown. METHODS: A randomized, double-blind, placebo-controlled cross-over trial was carried out. Ten CFS/FM patients, 11 RA patients and 20 controls were randomly allocated to the experimental (10 mg morphine or 0.2 mg/ml Naloxone) and placebo (2 ml Aqua) group...
July 19, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#2
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/28721344/exploring-patient-characteristics-and-barriers-to-hepatitis-c-treatment-in-patients-on-opioid-substitution-treatment-attending-a-community-based-fibro-scanning-clinic
#3
Des Crowley, Walter Cullen, Eamon Laird, John S Lambert, Tina Mc Hugh, Carol Murphy, Marie Claire Van Hout
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is a major public health issue. There is substandard uptake in HCV assessment and treatment among people who inject drugs (PWID). Community fibroscanning is used to assess disease severity and target treatment. METHODS: A survey was administered to a cohort of chronically HCV infected patients attending a community fibroscanning clinic. Questions targeted diagnosis of HCV, suitability, willingness and barriers to engagement in treatment...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#4
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28719507/the-relationship-between-chronic-pain-and-neurocognitive-function-a-systematic-review
#5
Diana M Higgins, Aaron M Martin, Dewleen G Baker, Jennifer J Vasterling, Victoria Risbrough
OBJECTIVE: Understanding the relationship between chronic pain and neurocognition has important implications for the assessment and treatment of pain. This paper provides an overview of the current literature examining the neurocognition-chronic pain relationship and suggests future avenues of research, along with a discussion of clinical implications of the literature findings. Consideration of potential moderators and mediators of this relationship, as well as a brief discussion of the importance of future research in special populations at particular risk for these problems, are also a focus of this paper...
July 17, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28719458/acupuncture-for-chronic-pain-an-update-and-critical-overview
#6
Changshik Yin, Thomas E Buchheit, Jongbae J Park
PURPOSE OF REVIEW: Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain. RECENT FINDINGS: Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719427/opioid-reduction-following-interventional-procedures-for-chronic-pain-a-synthesis-of-the-evidence
#7
Dermot P Maher, Steven P Cohen
The past decade has witnessed the tremendous growth of procedures to treat chronic pain, which has resulted in increased third-party scrutiny. Although most of these procedures appear to be associated with significant pain relief, at least in the short and intermediate term, their ability to improve secondary outcome measures, including function and work status is less clear-cut. One of these secondary outcome measures that has garnered substantial interest in the pain and general medical communities is whether interventions can reduce opioid intake, which is associated with significant risks that in most cases outweigh the benefits in the long term...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#8
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28717823/-interdisciplinary-pain-assessment-in-the-hospital-setting-merely-a%C3%A2-door-opener-to-multimodal-pain-therapy
#9
E Sens, M Mothes-Lasch, J F Lutz
BACKGROUND: Chronic pain is characterized by a complex interaction of somatic, mental and social factors. Assessing these factors in patients with chronic pain is vital during the diagnostic work-up and when making a structured treatment plan. Interdisciplinary pain assessment (ISA) is the most promising method to deal with these challenges. This article presents our experience in performing pain assessments in the hospital setting and also illustrates the characteristic features of chronic pain patients undergoing such assessments...
July 17, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28715848/patient-outcomes-in-dose-reduction-or-discontinuation-of-long-term-opioid-therapy-a-systematic-review
#10
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/28711636/factors-influencing-long-term-opioid-use-among-opioid-na%C3%A3-ve-patients-an-examination-of-initial-prescription-characteristics-and-pain-etiologies
#11
Anuj Shah, Corey J Hayes, Bradley C Martin
The relationships of characteristics of the initial opioid prescription and pain etiology with the probability of opioid discontinuation were explored in this retrospective cohort study using health insurance claims data from a nationally representative database of commercially insured patients in the U.S. We identified 1,353,902 persons aged ≥14 with no history of cancer or substance abuse, with new opioid use episodes and categorized them into 11 mutually exclusive pain etiologies. Cox Proportional Hazards models were estimated to identify factors associated with time to opioid discontinuation...
July 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28708674/chemotherapy-induced-peripheral-neuropathy-a-review-of-recent-findings
#12
Peggy Y Kim, Carrie E Johnson
PURPOSE OF REVIEW: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, frequently chronic condition characterized by pain and decreased function. Given the growing number of cancer survivors and an increasing recognition of opioid therapy limitations, there is a need for critical analysis of the literature in directing an informed and thoughtful approach for the management of painful CIPN. RECENT FINDINGS: A PubMed search for 'chemotherapy-induced peripheral neuropathy AND pain' identifies 259 publications between 1 January 2016 and 31 March 2017...
July 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#13
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28705543/oral-multimodal-analgesia-for-total-joint-arthroplasty
#14
Gregory J Golladay, Karl R Balch, David F Dalury, Jibanananda Satpathy, William A Jiranek
BACKGROUND: Oral multimodal analgesia for hip and knee arthroplasty is increasingly used as part of enhanced recovery protocols designed to minimize early postoperative pain and to facilitate early discharge, while minimizing undesirable side effects related to single-agent opioid administration. METHODS: This article is a review of previously published data evaluating the use of various oral medications in the management of postoperative pain after lower extremity arthroplasty and was presented as part of a symposium at the November 2016 AAHKS Annual Meeting...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28702731/chronic-cold-stress-modulates-the-function-of-peritoneal-macrophages-in-vivo
#15
S V Gein, I L Sharav'eva
On day 7 of chronic cold stress, concentration of corticosterone in plasma was established to increase, zymosan-induced production of reactive oxygen species was activated, and IL-10 synthesis by macrophages was enhanced regardless of the opiate receptor blockade. Increase in the concentration of corticosterone was independent of the blockade of opioid receptors, whereas the zymosan-induced increase in the production of oxygen radicals and activation of the spontaneous production of IL-10 was blocked in mice by naloxone...
May 2017: Doklady Biological Sciences: Proceedings of the Academy of Sciences of the USSR, Biological Sciences Sections
https://www.readbyqxmd.com/read/28701291/patterns-of-user-engagement-with-the-mobile-app-manage-my-pain-results-of-a-data-mining-investigation
#16
Quazi Abidur Rahman, Tahir Janmohamed, Meysam Pirbaglou, Paul Ritvo, Jane M Heffernan, Hance Clarke, Joel Katz
BACKGROUND: Pain is one of the most prevalent health-related concerns and is among the top 3 most common reasons for seeking medical help. Scientific publications of data collected from pain tracking and monitoring apps are important to help consumers and healthcare professionals select the right app for their use. OBJECTIVE: The main objectives of this paper were to (1) discover user engagement patterns of the pain management app, Manage My Pain, using data mining methods; and (2) identify the association between several attributes characterizing individual users and their levels of engagement...
July 12, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28700371/total-pancreatectomy-for-recurrent-acute-and-chronic-pancreatitis-a-critical-review-of-patient-selection-criteria
#17
Mahya Faghih, Francisco Garcia Gonzalez, Martin A Makary, Vikesh K Singh
PURPOSE OF REVIEW: Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. RECENT FINDINGS: The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition...
July 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28699698/reduced-dosing-and-liability-in-methadone-maintenance-treatment-by-targeting-oestrogen-signal-for-morphine-addiction
#18
Yao-Chang Chiang, Ruey-Yun Wang, Chieh-Liang Huang, Shue-Hwa Chen, Wen-Jing Ho, Hsien-Yuan Lane, Ing-Kang Ho, Hwei-Ting Yang, Wen-Lung Ma
Methadone maintenance treatment (MMT) is the major tapering therapy for morphine addictive patients. There have gender differences reported in response to MMT. This study discovered that the estrogen-response element single nucleotide polymorphism (ERE-SNP; rs16974799, C/T) of cytochrome 2B6 gene (cyp2b6; methadone catabolic enzyme) responded differently to MMT dosing. Oestradiol was associated with high MMT dosing, high enantiomer (R- or S-) of 2-ethylidene-1,5-dimethyl-3,3-dipheny-pyrrolidine (EDDP; methadone metabolite) to methadone ratio and increased drug-seeking behaviour, implicating oestradiol-CYP-EDDP/methadone axis decreasing MMT efficacy...
July 12, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28699416/interview-with-david-tauben-university-of-washington-chief-of-the-division-of-pain-medicine
#19
David Tauben
Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28699380/addressing-the-barriers-related-with-opioid-therapy-for-management-of-chronic-pain-in-india
#20
Gur Prasad Dureja, Paramanand N Jain, Muralidhar Joshi, Ashok Saxena, Gautam Das, Jaishid Ahdal, Prashant Narang
India has a high prevalence of chronic disorders which may be associated with persistent pain. Despite the availability of multiple treatment options, chronic pain is largely untreated and contributes to disability and mortality. Medical consumption of opioids remains low due to various barriers that prevent access to opioids for patients and healthcare practitioners. Stringent regulatory provisions outlined in the Narcotic Drugs and Psychotropic Substances Act (1985) have been major deterrents to adequate opioid use...
July 12, 2017: Pain Management
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