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https://www.readbyqxmd.com/read/29145774/predicting-the-risk-of-opioid-use-disorder-based-on-early-maladaptive-schemas
#1
Somayeh Zamirinejad, Seyed Kaveh Hojjat, Alireza Moslem, Vahideh MoghaddamHosseini, Arash Akaberi
Substance use is a globally devastating social problem. Early maladaptive schemas (EMSs) are inefficient mechanisms leading directly or indirectly to psychological distress. The current study aimed to assess the role of EMSs in predicting opioid use disorder. The cross-sectional study was conducted in 2013 in Bojnurd at northeast of Iran on 60 male opioid users who received Methadone Maintenance Treatment (MMT) and 60 control males. The opioid users were selected randomly from MMT clinics and control subjects were selected and matched with opioid users using demographic variables...
November 1, 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/29140822/optimizing-pregnancy-treatment-interventions-for-moms-opti-mom-a-pilot-study
#2
Gerald T Cochran, Valerie Hruschak, Walitta Abdullah, Elizabeth Krans, Antoine B Douaihy, Stephanie Bobby, Rachel Fusco, Ralph Tarter
OBJECTIVES: The public health burden of opioid use disorder (OUD) among pregnant women has significantly increased in recent years. The Optimizing Pregnancy Treatment Interventions for Moms study was a pilot project that examined the feasibility of a patient navigation (PN) intervention model to reduce substance use and improve mental health, quality of life, and to increase engagement with treatment services among pregnant women with OUD. METHODS: A 1-group repeated-measures pilot study was conducted with treatment-seeking pregnant women with opioid dependence initiating buprenorphine maintenance treatment...
November 14, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29135769/medicaid-coverage-of-methadone-maintenance-and-the-use-of-opioid-agonist-therapy-among-pregnant-women-in-specialty-treatment
#3
Marcus A Bachhuber, Pooja K Mehta, Laura J Faherty, Brendan Saloner
BACKGROUND: Opioid agonist therapy (OAT) is the standard of care for pregnant women with opioid use disorder (OUD). Medicaid coverage policies may strongly influence OAT use in this group. OBJECTIVE: To examine the association between Medicaid coverage of methadone maintenance and planned use of OAT in the publicly funded treatment system. RESEARCH DESIGN: Retrospective cross-sectional analysis of treatment admissions in 30 states extracted from the Treatment Episode Data Set (2013 and 2014)...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29130600/opioid-dependence-and-pregnancy-in-early-twentieth-century-america
#4
Nathan Tauger
BACKGROUND AND AIMS: Research on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of "crack babies," turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today...
November 11, 2017: Addiction
https://www.readbyqxmd.com/read/29130474/interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#5
REVIEW
Christopher Eccleston, Emma Fisher, Kyla H Thomas, Leslie Hearn, Sheena Derry, Cathy Stannard, Roger Knaggs, R Andrew Moore
BACKGROUND: This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29127135/traditional-chinese-medicine-facilitated-treatments-may-relieve-anxiety-symptoms-during-drug-switching-from-methadone-to-buprenorphine-naloxone-for-treating-opioid-dependence
#6
Kai-Chiang Yu, Han-Ting Wei, Yuh-Hsiang Yeh, Chung-Hua Hsu
This study investigated a 51-year-old married man with a history of heroin dependence who underwent methadone maintenance treatment for 7 years. He received traditional Chinese medicine (TCM)-facilitated treatments and switched from methadone to buprenorphine/naloxone. Strong anxiety symptoms were observed during the initial stage; therefore, we prescribed a combination of Chaihu-Shugan-San, Zhi Bai Di Huang and Chin-Gin-Kuan-Ming decoction as the major herbal synergic regimen to relieve the symptoms of opioid withdrawal, anxiety and insomnia...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29120275/ethnic-differences-in-psychosocial-factors-in-methadone-maintenance-hmong-versus-non-hmong
#7
Gavin Bart
Little is known about the characteristics of U.S.-based Asian populations undergoing methadone maintenance treatment for opioid use disorders. We evaluated psychosocial factors in 76 Hmong and 130 non-Hmong on methadone maintenance for at least two months in a single urban methadone maintenance clinic. Assessments included the Addiction Severity Index 5th Edition, the Symptom Checklist-90, and the Structured Clinical Interview for DSM-IV Axis I Disorders. The Hmong were older, predominately male, and on lower doses of methadone than the non-Hmong...
November 9, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/29116878/evaluation-of-methadone-treatment-in-malaysia-findings-from-the-malaysian-methadone-treatment-outcome-study-mytos
#8
Norsiah Ali, Salina Abd Aziz, Salmah Nordin, Norliza Che Mi, Norni Abdullah, V Paranthaman, Maimunah Mahmud, Anne Yee, Mahmoud Danaee
BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005. OBJECTIVE: To evaluate the effectiveness of MMT. METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20...
November 8, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29112519/methadone-versus-buprenorphine-for-opioid-use-dependence-and-risk-of-neonatal-abstinence-syndrome
#9
Lara S Lemon, Steve N Caritis, Raman Venkataramanan, Robert W Platt, Lisa M Bodnar
BACKGROUND: Our objective was to estimate the association between methadone and neonatal abstinence syndrome compared with buprenorphine using a probabilistic bias analysis to account for unmeasured confounding by severity of addiction. METHODS: We used a cohort of live-born infants exposed in utero to methadone or buprenorphine for maternal opioid maintenance therapy at Magee-Womens Hospital in Pittsburgh, PA from 2013-2015 (n=716). We determined exposure and outcome status using pharmacy billing claims...
November 6, 2017: Epidemiology
https://www.readbyqxmd.com/read/29096661/willingness-to-receive-intravenous-buprenorphine-treatment-in-opioid-dependent-people-refractory-to-oral-opioid-maintenance-treatment-results-from-a-community-based-survey-in-france
#10
Perrine Roux, Daniela Rojas Castro, Khadim Ndiaye, Laélia Briand Madrid, Virginie Laporte, Marion Mora, Gwenaelle Maradan, Stéphane Morel, Bruno Spire, Patrizia Carrieri
BACKGROUND: Injectable opioids are an interesting option for people who inject drugs (PWID) that do not respond to oral Opioid Maintenance Treatment (OMT). To date, intravenous (IV) buprenorphine - a safer drug than full-opioid agonists in terms of overdose risk - has never been tested in a clinical trial on opioid dependence. We designed a survey to better understand the profile of PWID eligible for IV buprenorphine, and their willingness to receive it. METHODS: This cross-sectional community-based national survey was conducted through face-to-face interviews (in low-threshold and addiction care services) and online questionnaires (on https://psychoactif...
November 2, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29096016/opioid-use-disorders-medication-assisted-treatment-and-the-role-of-the-laboratory
#11
Roger L Bertholf, Gary M Reisfield
Urine drug testing is an essential component in the evaluation and management of individuals with opioid use disorders, including those on buprenorphine or methadone maintenance therapies. Notwithstanding its centrality in adherence monitoring, studies have shown that clinicians have important knowledge deficiencies regarding the ordering and interpretation of drug tests. In this review, we discuss the scope and frequency of testing, the advantages and disadvantages of immunoassay- (presumptive) and liquid chromatograph-mass spectrometry- (definitive) based techniques, indications for definitive testing, medical necessity, and other considerations...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29089014/methadone-maintenance-treatment-for-older-adults-cost-and-logistical-considerations
#12
Brandi P Cotton, William Culbertson Bryson, Martha L Bruce
In a demographic shift, older adults now comprise an increasing proportion of those receiving methadone maintenance treatment (MMT) for opioid use disorder. A study of MMT recipients in New York City suggests that 13% of the population is over 60 years of age. Adults ages 50-59 are among the largest age demographic, evidence that the number of older adults receiving MMT will continue to increase. Because medical comorbidities, cognitive impairment, and neurobehavioral changes often accumulate with age, older adults on MMT become increasingly vulnerable...
November 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29073311/expanding-treatment-opportunities-for-hospitalized-patients-with-opioid-use-disorders
#13
Daniel Winetsky, Robert M Weinrieb, Jeanmarie Perrone
The prevalence of opioid use disorders (OUDs) is rising across the United States. Patients with OUDs are often hospitalized for medical conditions other than addiction, such as infection, injury, or pregnancy. These hospital admissions provide an opportunity for healthcare providers to initiate opioid agonist therapy with methadone or buprenorphine. Randomized trials have demonstrated the superior effectiveness of this treatment strategy, but its adoption by hospital providers has been slow. A number of barriers have impeded its implementation, including misperceptions about the regulation of opioid prescribing, limited resources for the transition to community- based treatment, and a lack of familiarity among clinicians about the appropriate initiation and dose adjustment of these opioid agonists for maintenance therapy...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29054032/constipation-and-other-common-symptoms-reported-by-women-and-men-in-methadone-and-buprenorphine-maintenance-treatment
#14
Paul S Haber, Mahmoud Elsayed, David Espinoza, Nicholas Lintzeris, Anne-Sophie Veillard, Richard Hallinan
BACKGROUND: Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. METHOD: Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist...
October 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29051703/buprenorphine-naloxone-maintenance-therapy-an-observational-retrospective-report-on-the-effect-of-dose-on-18%C3%A2-months-retention-in-an-office-based-treatment-program
#15
Theodore V Parran, A G Mace, Yael J Dahan, Christopher A Adelman, Mykola Kolganov
CONTEXT AND OBJECTIVE: Buprenorphine has been available with few reports of the dose range necessary to adequately maintain patients. We report on the effect of 8 mg/d versus 16 mg/d of buprenorphine on long-term patient retention in office-based opioid maintenance (OBOMT). DESIGN SETTING AND PARTICIPANTS: Case series, at an urban hospital-based primary care clinic providing OBOMT to 157 opiate-dependent, low socioeconomic status, uninsured, nonhomeless patients...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/29040826/maintenance-on-naltrexone-amphetamine-decreases-cocaine-vs-food-choice-in-male-rhesus-monkeys
#16
Megan J Moerke, Matthew L Banks, Kejun Cheng, Kenner C Rice, S Stevens Negus
BACKGROUND: Cocaine use disorder remains a significant public health issue for which there are no FDA-approved pharmacotherapies. Amphetamine maintenance reduces cocaine use in preclinical and clinical studies, but the mechanism of this effect is unknown. Previous studies indicate a role for endogenous opioid release and subsequent opioid receptor activation in some amphetamine effects; therefore, the current study examined the role of mu-opioid receptor activation in d-amphetamine treatment effects in an assay of cocaine-vs-food choice...
December 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28988103/opioid-tapering-in-patients-with-prescription-opioid-use-disorder-a-retrospective-study
#17
Kehua Zhou, Peng Jia, Swati Bhargava, Yong Zhang, Taslima Reza, Yuan Bo Peng, Gary G Wang
BACKGROUND AND AIMS: Opioid use disorder (OUD) refers to a maladaptive pattern of opioid use leading to clinically significant impairment or distress. OUD causes, and vice versa, misuses and abuse of opioid medications. Clinicians face daily challenges to treat patients with prescription opioid use disorder. An evidence-based management for people who are already addicted to opioids has been identified as the national priority in the US; however, options are limited in clinical practices...
October 4, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28987324/toll-like-receptors-and-their-role-in-persistent-pain
#18
REVIEW
Michael J Lacagnina, Linda R Watkins, Peter M Grace
One of the fundamental mechanisms whereby the innate immune system coordinates inflammatory signal transduction is through Toll-like receptors (TLRs), which function to protect and defend the host organism by initiating inflammatory signaling cascades in response to tissue damage or injury. TLRs are positioned at the neuroimmune interface, and accumulating evidence suggests that the inflammatory consequences of TLR activation on glia (including microglia and astrocytes), sensory neurons, and other cell types can influence nociceptive processing and lead to states of exaggerated and unresolved pain...
October 4, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28976288/the-%C3%AE-opioid-receptor-nonsynonymous-variant-118a-g-is-associated-with-prolonged-abstinence-from-heroin-without-agonist-treatment
#19
Orna Levran, Einat Peles, Matthew Randesi, Joel Correa da Rosa, Miriam Adelson, Mary Jeanne Kreek
AIM: This study assesses whether opioid-related gene variants contribute to reduced vulnerability to relapse to heroin in persons who are not treated with μ-opioid receptor agonist. METHODS: Genotypes of 71 SNPs, in nine genes, were analyzed for association with long-term abstinence in former heroin-dependents of European/Middle Eastern ancestry, either without agonist treatment (n = 129) or in methadone maintenance treatment (n = 922). RESULTS: The functional OPRM1 nonsynonymous SNP rs1799971 (118A>G) showed significant association with long-term abstinence (Ppermutation  = 0...
October 4, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28968622/treating-pain-in-an-established-patient-sifting-through-the-guidelines
#20
Alan L Gordon, Seamus L Connolly
The CDC Guideline for Prescribing Opioids for Chronic Pain, published last March, provided major steps toward bringing the medical community together to address the opioid epidemic in the U.S. However, the Guideline focuses primarily on treatment of new inductions into opioid therapy for pain. Physicians may have difficulty figuring out how to apply the CDC's recommendations to patients who are already receiving opioid maintenance therapy for chronic pain. Patients already maintained on opioids for chronic pain should not be subjected to abrupt cessation or rapid tapers, and the CDC's Guideline confirms this...
October 2, 2017: Rhode Island Medical Journal
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