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https://www.readbyqxmd.com/read/28543418/reconciling-patient-safety-and-epistemic-humility-an-ethical-use-of-opioid-treatment-plans
#1
Anita Ho
In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about "the requirements entailed by undergoing opioid therapy," rather than as contractual agreements to alter patients' individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28537967/nortriptyline-enhances-morphine-conditioned-place-preference-in-neuropathic-rats-role-of-the-central-noradrenergic-system
#2
Wenli Mi, Shuxing Wang, Zerong You, Grewo Lim, Michael F McCabe, Hyangin Kim, Lucy Chen, Jianren Mao
BACKGROUND: Combination drug therapy is commonly used to treat chronic pain conditions such as neuropathic pain, and antidepressant is often used together with opioid analgesics. While rewarding is an intrinsic property of opioid analgesics, it is unknown whether the use of an antidepressant would influence opioid reward, which may contribute to opioid addiction. In this study, we examined whether nortriptyline (a tricyclic antidepressant and a first-line medication for neuropathic pain) would enhance the morphine rewarding property in both naive and chronic constriction sciatic nerve injury (CCI) rats...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28533165/analgesic-conopeptides-targeting-g-protein-coupled-receptors-reduce-excitability-of-sensory-neurons
#3
REVIEW
Mahsa Sadeghi, Jeffrey R McArthur, Rocio K Finol-Urdaneta, David J Adams
Conotoxins (conopeptides) are a diverse group of peptides isolated from the venom of marine cone snails. Conus peptides modulate pain by interacting with voltage-gated ion channels and G protein-coupled receptors (GPCRs). Opiate drugs targeting GPCRs have long been used, nonetheless, many undesirable side effects associated with opiates have been observed including addiction. Consequently, alternative avenues to pain management are a largely unmet need. It has been shown that various voltage-gated calcium channels (VGCCs) respond to GPCR modulation...
May 19, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28525291/the-state-of-opioid-agonist-therapy-in-canada-20-years-after-federal-oversight
#4
Joseph K Eibl, Kristen Morin, Esa Leinonen, David C Marsh
Opioid agonist therapy was introduced in Canada in 1959 with the use of methadone for the treatment of opioid dependence. The regulation of methadone was the responsibility of Health Canada until 1995, when oversight was transferred to the provincial health systems. During the more than 20 years since the federal health authority transferred oversight of methadone to the provincial level, methadone programming has evolved differently in every province. The landscape of opioid dependence treatment is varied across the country, with generally increasing treatment capacity in all provinces and dramatic increases in some...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28502248/how-do-private-health-plans-manage-specialty-behavioral-health-treatment-entry-and-continuing-care
#5
Amity E Quinn, Sharon Reif, Elizabeth L Merrick, Constance M Horgan, Deborah W Garnick, Maureen T Stewart
OBJECTIVE: This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. METHODS: The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28501676/does-the-implementation-of-evidence-based-and-culturally-competent-practices-reduce-disparities-in-addiction-treatment-outcomes
#6
Erick G Guerrero, Bryan R Garner, Benjamin Cook, Yinfei Kong
RATIONALE: Research is limited on the extent to which implementation of evidence-based and culturally responsive practices reduces outcome disparities in substance use disorder treatment. We examined the role of contingency management treatment (CMT), medication-assisted treatment (MAT), and culturally competent practices on Mexican Americans' rate of successful completion of treatment. METHODS: We analyzed a concatenated dataset from 153 publicly funded substance use disorder treatment programs in Los Angeles County, California, in 2011 and 2013...
May 9, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28493263/pattern-of-addiction-and-its-relapse-among-habitual-drug-abusers-in-lahore-pakistan
#7
Sadia Batool, Iram Manzoor, Shamaila Hassnain, Aslam Bajwa, Muslim Abbas, Maha Mahmood, Hina Sohail
This study assessed the pattern of drug abuse and the reasons for relapse of addiction among male drug addicts seeking rehabilitative services in different centres in Lahore, Pakistan. A cross-sectional survey was conducted on male drug abusers from April to December 2016. Nonprobability purposive sampling was done to collect a sample of 119 participants. A structured questionnaire and in-depth interviews were used for data collection. Out of 119 participants, 71.4% were in the age group 15-35 years. Educational levels were low in the majority, with 68...
May 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28492960/dual-diagnosis-in-depression-treatment-recommendations
#8
Judit Tirado Muñoz, Adriana Farré, Joan Mestre-Pintó, Nestor Szerman, Marta Torrens
Comorbidity between substance use disorders (SUD) and major depression (MD) is the most common dual pathology in the field of addiction to substances and has prevalence rates ranging between 12% and 80%, which complicates the response to treatment and worsens the prognosis of patients. Differentiating between diagnoses of induced depressive episodes and primary depressive episodes concurrent to substance use is especially relevant for therapeutic management. This article presents the state of the art of the currently available pharmacologic treatments of comorbid depression in patients with SUD, taking into account the safety and risk of abuse of antidepressant drugs...
April 12, 2017: Adicciones
https://www.readbyqxmd.com/read/28492129/codeine-misuse-and-dependence-in-south-africa-perspectives-of-addiction-treatment-providers
#9
Charles D H Parry, Eileen Rich, Marie Claire Van Hout, Paolo Deluca
BACKGROUND: General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. OBJECTIVES: To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. METHOD: Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28489458/toxicokinetics-of-ibogaine-and-noribogaine-in-a-patient-with-prolonged-multiple-cardiac-arrhythmias-after-ingestion-of-internet-purchased-ibogaine
#10
Marieke Henstra, Liza Wong, Abdel Chahbouni, Noortje Swart, Cor Allaart, Ferdi Sombogaard
BACKGROUND: Ibogaine is an agent that has been evaluated as an unapproved anti-addictive agent for the management of drug dependence. Sudden cardiac death has been described to occur secondary to its use. We describe the clinical effects and toxicokinetics of ibogaine and noribogaine in a single patient. For this purpose, we developed a LC-MS/MS-method to measure ibogaine and noribogaine plasma-concentrations. We used two compartments with first order absorption. CASE DETAILS: The maximum concentration of ibogaine was 1...
July 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28481614/providing-intensive-addiction-housing-case-management-to-homeless-veterans-enrolled-in-addictions-treatment-a-randomized-controlled-trial
#11
Carol A Malte, Koriann Cox, Andrew J Saxon
This study sought to determine whether homeless veterans entering Veterans Affairs (VA) substance use treatment randomized to intensive addiction/housing case management (AHCM) had improved housing, substance use, mental health, and functional outcomes and lower acute health care utilization, compared to a housing support group (HSG) control. Homeless veterans (n = 181) entering outpatient VA substance use treatment were randomized to AHCM and HSG and received treatment for 12 months. AHCM provided individualized housing, substance use and mental health case management, life skills training, and community outreach...
May 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/28481603/comprehensive-services-delivery-and-emergency-department-use-among-chronically-homeless-adults
#12
David T Moore, Robert A Rosenheck
Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28476274/correlates-of-three-year-outpatient-medical-care-use-among-rural-stimulant-users
#13
Michael A Cucciare, Xiaotong Han, Christine Timko, Nickolas Zaller, Kristina M Kennedy, Brenda M Booth
Outpatient medical care (OMC) settings are a care context in which effective management of unhealthy substance use can occur. However, no studies have documented rates of OMC use and characteristics of OMC use among rural substance users. This study sought to examine the rates and frequency of OMC use in a sample of rural drug users over a three-year period. We also explored characteristics of participants associated with use of OMCs over time. Data were collected from June 2005 to September 2007 from a natural history study of 710 stimulant users living in rural communities...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28476269/barriers-to-and-facilitators-of-pharmacotherapy-for-alcohol-use-disorder-in-va-residential-treatment-programs
#14
Andrea K Finlay, Laura S Ellerbe, Jessie J Wong, Christine Timko, Anna D Rubinsky, Shalini Gupta, Thomas R Bowe, Jennifer L Burden, Alex H S Harris
Among US military veterans, alcohol use disorder (AUD) is prevalent and in severe cases patients need intensive AUD treatment beyond outpatient care. The Department of Veterans Affairs (VA) delivers intensive, highly structured addiction and psychosocial treatment through residential programs. Despite the evidence supporting pharmacotherapy among the effective treatments for AUD, receipt of these medications (e.g., naltrexone, acamprosate) among patients in residential treatment programs varies widely. In order to better understand this variation, the current study examined barriers and facilitators to use of pharmacotherapy for AUD among patients in VA residential treatment programs...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28474305/analgesic-use-by-ageing-and-elderly-patients-with-chronic-non-malignant-pain-a-qualitative-study
#15
Mary-Claire Kennedy, Grainne Cousins, Martin C Henman
Background Analgesics are used in the management of chronic non-malignant pain (CNMP), a condition which is highly prevalent among older adults. CNMP may not only be physically distressing but also complicated by psychosocial and economic factors. An individual's perception and use of analgesics may be influenced by a range of factors such as perceptions of risk or benefits, ability to purchase medication or access to non-pharmacological therapies or specialist care. Objective The aim of this study was to describe the perceptions and experiences of analgesics by ageing and elderly individuals with CNMP and identify factors that influence their use...
May 4, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28467154/how-do-people-who-frequently-attend-emergency-departments-for-alcohol-related-reasons-use-view-and-experience-specialist-addiction-services
#16
Thomas Parkman, Joanne Neale, Ed Day, Colin Drummond
BACKGROUND: People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. OBJECTIVES: This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. METHODS: We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom...
May 3, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28464942/-getting-out-of-downtown-a-longitudinal-study-of-how-street-entrenched-youth-attempt-to-exit-an-inner-city-drug-scene
#17
Rod Knight, Danya Fast, Kora DeBeck, Jean Shoveller, Will Small
BACKGROUND: Urban drug "scenes" have been identified as important risk environments that shape the health of street-entrenched youth. New knowledge is needed to inform policy and programing interventions to help reduce youths' drug scene involvement and related health risks. The aim of this study was to identify how young people envisioned exiting a local, inner-city drug scene in Vancouver, Canada, as well as the individual, social and structural factors that shaped their experiences...
May 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28459476/an-osteopathic-approach-to-chronic-pain-management
#18
John A Jerome
Chronic pain reduces quality of life and productivity, costing billions in health care dollars and lost revenue. Physicians routinely prescribe opioids, which has led to opioid addiction and overdose. The US surgeon general recommends nonpharmacologic treatment for patients with chronic pain. A paradigm shift is necessary for patients to partner with physicians to take control of their own health. This article outlines the cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies that osteopathic physicians can integrate in their treatment of patients with chronic pain...
May 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28446611/unraveling-amino-acid-residues-critical-for-allosteric-potentiation-of-%C3%AE-4-3-%C3%AE-2-2-type-nicotinic-acetylcholine-receptor-responses
#19
Ze-Jun Wang, Farah Deba, Tasnim S Mohamed, David C Chiara, Kara Ramos, Ayman K Hamouda
Neuronal nicotinic acetylcholine receptors (nAChRs) are promising drug targets to manage several neurological disorders and nicotine addiction. Growing evidence indicates that positive allosteric modulators (PAMs) of nAChRs improve pharmacological specificity by binding to unique sites present only in a subpopulation of nAChRs. Furthermore, nAChR PAMs such as NS9283 and CMPI have been shown to potentiate responses of (α4)3(β2)2 but not (α4)2(β2)3 nAChR isoforms. This selective potentiation underlines that the α4:α4 interface, which is present only in the (α4)3(β2)2 nAChR, is an important and promising drug target...
April 26, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28444659/new-psychoactive-substances-nps-a-challenge-for-the-addiction-treatment-services
#20
Norbert Scherbaum, F Schifano, Udo Bonnet
Over the last few years, hundreds of new psychoactive substances (NPS) have been identified in Europe. Apart from some herbal compounds, NPS mainly include synthetic cannabinoids and a range of new synthetic stimulants (e. g., cathinones). Synthetic NPS are often developed whilst modifying the basic chemical (e. g., phenethylamine or tryptamine) structure. Although the pharmacology and toxicology of most NPS are hardly known, they are being offered, especially online, as "bath salts," as "incense mixtures," or under other misleading labels...
May 2017: Pharmacopsychiatry
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