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https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#1
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#2
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226334/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-2
#3
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Donald E Jones, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent in the United States and worldwide. The consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. The risk for misuse of prescribed opioids is much higher in patients with chronic pain, especially those with concurrent substance use and /or mental health disorders. Several reasons can account for the occurrence of opioid abuse and misuse, including self-medication, use for reward, compulsive use related to addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226333/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-1
#4
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent both in this country and worldwide. Consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self-medication, use for reward, compulsive use because of addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225502/associations-between-prospective-symptom-changes-and-slow-wave-activity-in-patients-with-internet-gaming-disorder-a-resting-state-eeg-study
#5
Yeon Jin Kim, Jun-Young Lee, Sohee Oh, Minkyung Park, Hee Yeon Jung, Bo Kyung Sohn, Sam-Wook Choi, Dai Jin Kim, Jung-Seok Choi
The identification of the predictive factors and biological markers associated with treatment-related changes in the symptoms of Internet gaming disorder (IGD) may provide a better understanding of the pathophysiology underlying this condition. Thus, the present study aimed to identify neurophysiological markers associated with symptom changes in IGD patients and to identify factors that may predict symptom improvements following outpatient treatment with pharmacotherapy. The present study included 20 IGD patients (mean age: 22...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28202384/implementing-take-home-naloxone-in-an-urban-community-pharmacy
#6
Joshua L Akers, Ryan N Hansen, Ryan D Oftebro
OBJECTIVE: Morbidity and mortality associated with opioid use have increased across the nation, growing into what can only be described as an epidemic. SETTING: In Washington State between 2002 and 2004, the statewide death rate attributed to any opioid was 6.6 per 100,000 people, but between 2011 and 2013 it increased to 8.6 per 100,000 people. Pharmacies provide a unique access point for harm reduction services to patients due to their ease of accessibility in the community...
February 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28202070/social-capital-and-job-satisfaction-among-substance-abuse-treatment-employees
#7
Andreas Tsounis, Dimitris Niakas, Pavlos Sarafis
BACKGROUND: Job satisfaction is an important predictor for management and clinical ratios. Although it is accepted that is affected by many aspects, the influence of social capital remains to be determined. The main purpose of the article is to examine the relationship between job satisfaction and individual social capital for employees offering services in the treatment of addiction. METHODS: A cross-sectional study was conducted on 239 employees from 14 therapeutic programs at KETEA (Therapy Center for Dependent Individuals in Greece) (KETHEA)...
February 15, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28191917/newborn-birth-weight-of-pregnant-women-on-methadone-or-buprenorphine-maintenance-treatment-a-national-contingency-management-approach-trial
#8
Einat Peles, Anat Sason, Shaul Schreiber, Miriam Adelson
BACKGROUND AND OBJECTIVES: Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights. METHODS: A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed...
February 13, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28191264/mindfulness-based-relapse-prevention-for-stimulant-dependent-adults-a-pilot-randomized-clinical-trial
#9
Suzette Glasner-Edwards, Larissa J Mooney, Alfonso Ang, Hélène Chokron Garneau, Emily Hartwell, Mary-Lynn Brecht, Richard A Rawson
In light of the known associations between stress, negative affect, and relapse, mindfulness strategies hold promise as a means of reducing relapse susceptibility. In a pilot randomized clinical trial, we evaluated the effects of Mindfulness Based Relapse Prevention (MBRP), relative to a health education control condition (HE) among stimulant dependent adults receiving contingency management. All participants received a 12-week contingency management (CM) intervention. Following a 4-week CM-only lead in phase, participants were randomly assigned to concurrently receive MBRP (n=31) or HE (n=32)...
February 2017: Mindfulness
https://www.readbyqxmd.com/read/28165272/systematic-review-of-smart-recovery-outcomes-process-variables-and-implications-for-research
#10
Alison K Beck, Erin Forbes, Amanda L Baker, Peter J Kelly, Frank P Deane, Anthony Shakeshaft, David Hunt, John F Kelly
Clinical guidelines recommend Self-Management and Recovery Training (SMART Recovery) and 12-step models of mutual aid as important sources of long-term support for addiction recovery. Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predominant 12-step approach. A similarly rigorous exploration of SMART Recovery has yet to be undertaken. We aim to address this gap by providing a systematic overview of the evidence for SMART Recovery in adults with problematic alcohol, substance, and/or behavioral addiction, including (i) a commentary on outcomes assessed, process variables, feasibility, current understanding of mental health outcomes, and (ii) a critical evaluation of the methodology...
February 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/28164407/volatility-and-change-in-chronic-pain-severity-predict-outcomes-of-treatment-for-prescription-opioid-addiction
#11
Matthew J Worley, Keith G Heinzerling, Steven Shoptaw, Walter Ling
BACKGROUND AND AIMS: Buprenorphine-naloxone (BUP-NLX) can be used to manage prescription opioid addiction among persons with chronic pain, but post-treatment relapse is common and difficult to predict. This study estimated whether changes in pain over time and pain volatility during BUP-NLX maintenance would predict opioid use during the taper BUP-NLX taper. DESIGN: Secondary analysis of a multisite clinical trial for prescription opioid addiction, using data obtained during a 12-week BUP-NLX stabilization and 4-week BUP-NLX taper...
February 5, 2017: Addiction
https://www.readbyqxmd.com/read/28156454/evaluating-the-prognostic-effect-of-a-pain-classification-system-in-patients-with-advanced-cancer
#12
Kimberson Cochien Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane D Liu, Eduardo Bruera
: 95 Background: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between increasing sum of negative ECS-CP features and achievement of good pain control at first follow up visit at an outpatient palliative care clinic. METHODS: Initial and follow up clinical information of 409 eligible supportive care outpatients such as patient demographics, ECS-CP assessment, morphine equivalent daily dose (MEDD), opioid rotation, Edmonton Symptom Assessment Score (ESAS), and personalized pain goal (PPG) were retrospectively reviewed and analyzed...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152337/how-states-are-tackling-the-opioid-crisis
#13
Shalini Wickramatilake, Julia Zur, Norah Mulvaney-Day, Melinda Campopiano von Klimo, Elizabeth Selmi, Henrick Harwood
OBJECTIVES: We used data from the 2015 National Association of State Alcohol and Drug Abuse Directors Web-based questionnaire and other sources to demonstrate the range and scope of state initiatives being used to deal with the opioid crisis in the United States. METHODS: State alcohol and drug agency directors and designated senior agency managers responded to the questionnaire, which asked respondents about recent opioid-related state-level public health initiatives at their agencies...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28144196/changes-in-professionals-attitudes-and-approaches-to-parents-in-the-drug-and-alcohol-treatment
#14
Evdokia Missouridou, Despina Esseridou
BACKGROUND: Parental involvement with drug and alcohol services remains limited. AIM: to illuminate changes in addiction professionals' subjective attitudes and approaches of parents over time in their career. METHODS: Overall, twenty seven drug and alcohol professionals participated in the study. RESULTS: Themes depicting changes on therapists' attitudes, beliefs and experiences of working with the families of their clients are 'Redefining therapeutic role and expectations', 'Increased understanding and acceptance', 'Finding the right distance in relationships', 'Ability to contain feelings and experiences', 'Being selective in collaborations with professionals', 'Empathy for coworkers and increased collaboration'...
December 2016: Materia Socio-medica
https://www.readbyqxmd.com/read/28141727/-media-addiction-in-a-10-year-old-boy
#15
Scott Brown, Michael A Scharf, Cristina Bustos, Denise Chavira, Martin T Stein
Bryan is a 10-year-old boy who is brought to his pediatrician by his parents with concerns about oppositional behaviors. Bryan's parents report that he has always been hyperactive and oppositional since a very young age. He has been previously diagnosed with attention-deficit hyperactivity disorder and has been treated with appropriate stimulant medications for several years; however, despite this, his parents feel increasingly unable to manage his difficult behaviors. He refuses to do chores or follow through with household routines...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28135843/a-randomized-controlled-trial-of-ethyl-glucuronide-based-contingency-management-for-outpatients-with-co-occurring-alcohol-use-disorders-and-serious-mental-illness
#16
Michael G McDonell, Emily Leickly, Sterling McPherson, Jordan Skalisky, Debra Srebnik, Frank Angelo, Roger Vilardaga, Jenny R Nepom, John M Roll, Richard K Ries
OBJECTIVE: The authors examined whether a contingency management intervention using the ethyl glucuronide (EtG) alcohol biomarker resulted in increased alcohol abstinence in outpatients with co-occurring serious mental illnesses. Secondary objectives were to determine whether contingency management was associated with changes in heavy drinking, treatment attendance, drug use, cigarette smoking, psychiatric symptoms, and HIV-risk behavior. METHOD: Seventy-nine (37% female, 44% nonwhite) outpatients with serious mental illness and alcohol dependence receiving treatment as usual completed a 4-week observation period and were randomly assigned to 12 weeks of contingency management for EtG-negative urine samples and addiction treatment attendance, or reinforcement only for study participation...
January 31, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28125446/inpatient-gamma-hydroxybutyrate-detoxification-a-case-report-describing-day-to-day-therapeutic-management
#17
Louis von Theobald, Morgane Rousselet, Jennyfer Cholet, Hélène Debar, David Boels, Caroline Victorri-Vigneau, Marie Grall-Bronnec
BACKGROUND: Gamma-hydroxybutyrate (GHB) is a synthetic drug increasingly used by consumers of psychoactive substances. The sought after psychoactive effects of GHB have resulted in an increase in recreational use in Europe. GHB is considered to have a high dependence potential, and abrupt discontinuation after long-term use can result in a severe withdrawal syndrome. Despite a large number of publications related to GHB withdrawal and detoxification, to date, no evidence-based protocol or consensual international therapeutic guidelines are available (over and above the administration of benzodiazepines)...
January 25, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28103678/an-advance-in-prescription-opioid-vaccines-overdose-mortality-reduction-and-extraordinary-alteration-of-drug-half-life
#18
LETTER
Atsushi Kimishima, Cody J Wenthur, Bin Zhou, Kim D Janda
Prescription opioids (POs) such as oxycodone and hydrocodone are highly effective medications for pain management, yet they also present a substantial risk for abuse and addiction. The consumption of POs has been escalating worldwide, resulting in tens of thousands of deaths due to overdose each year. Pharmacokinetic strategies based upon vaccination present an attractive avenue to suppress PO abuse. Herein, the preparation of two active PO vaccines is described that were found to elicit high-affinity antiopioid antibodies through a structurally congruent drug-hapten design...
20, 2017: ACS Chemical Biology
https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-non-heroin-opioid-overdoses-experience-at-an-academic-medical-center
#19
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Marin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and non-heroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. DESIGN: Retrospective cohort study. SETTING: Large, academic medical center. PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a non-heroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28092969/problem-internet-use-and-internet-gaming-disorder-a-survey-of-health-literacy-among-psychiatrists-from-australia-and-new-zealand
#20
Pravin Dullur, Phillipa Hay
OBJECTIVES: Research is limited on psychiatrists' opinions on the concepts of Internet Gaming Disorder (IGD) and Problematic Internet Use (PIU). We aimed to assess health literacy among psychiatrists on IGD/PIU. METHODS: A self-report survey was administered online to members of the Royal Australia and New Zealand College of Psychiatrists (RANZCP) ( n=289). RESULTS: The majority (93.7%) were familiar with the concepts of IGD/PIU. The majority (78...
January 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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