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opioid maintenance treatment

Taylor McLinden, Erica E M Moodie, Anne-Marie Hamelin, Sam Harper, Carmine Rossi, Sharon L Walmsley, Sean B Rourke, Curtis Cooper, Marina B Klein, Joseph Cox
BACKGROUND: Severe food insecurity (FI) is common among individuals living with HIV-hepatitis C virus (HCV) co-infection. We hypothesize that the injection of opioids is partly responsible for the association between injection drug use and severe FI. Therefore, this analysis examines whether methadone maintenance treatment for opioid dependence is associated with a lower risk of severe FI. METHODS: We used biannual data from the Canadian Co-infection Cohort (N = 608, 2012-2015)...
February 20, 2018: Drug and Alcohol Dependence
Igam Bagra, Vijay Krishnan, Ravindra Rao, Alok Agrawal
OBJECTIVES: Use of various psychoactive substances can influence outcomes of patients on opioid agonist treatment (OAT). While use of alcohol and cocaine has shown to adversely affect OAT results, associated cannabis use shows mixed results. This study aimed to assess the pattern of cannabis use among opioid-dependent patients maintained on buprenorphine. Additionally, the study compared the dose of buprenorphine, opioid-related craving and withdrawals, productivity, and also quality of life between those with and without recent (past 90-day) cannabis use...
March 14, 2018: Journal of Addiction Medicine
Farhana Sakloth, S Stevens Negus
Pharmacotherapy to treat stimulant use disorders continues to be an unmet medical need. Some evidence supports both the role of opioids in mediating abuse-related amphetamine effects and the potential utility of opioid antagonists as therapeutic candidates for treating amphetamine abuse. This study used intracranial self-stimulation (ICSS) to evaluate effects of exposure to and termination of naltrexone maintenance on rewarding amphetamine effects in an ICSS procedure in rats. Morphine and cocaine were included as positive and negative controls, respectively...
March 12, 2018: Experimental and Clinical Psychopharmacology
Terril L Verplaetse, Kelly E Moore, Brian P Pittman, Walter Roberts, Lindsay M Oberleitner, Philip H Smith, Kelly P Cosgrove, Sherry A McKee
Background: Stress contributes to the development and maintenance of substance use disorders (SUD), with some research suggesting that the impact of stress on SUD is greater in women. However, this has yet to be evaluated in a national dataset, across major substances of abuse. Methods: Using data from the newly available U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 3; n =36,309) we evaluated relationships among past year stressful life events (0 or 1 vs...
January 2018: Chronic Stress
Sascha R A Alles, Peter A Smith
Injury to or disease of the nervous system can invoke chronic and sometimes intractable neuropathic pain. Many parallel, interdependent, and time-dependent processes, including neuroimmune interactions at the peripheral, supraspinal, and spinal levels, contribute to the etiology of this "disease of pain." Recent work emphasizes the roles of colony-stimulating factor 1, ATP, and brain-derived neurotrophic factor. Excitatory processes are enhanced, and inhibitory processes are attenuated in the spinal dorsal horn and throughout the somatosensory system...
April 2018: Pharmacological Reviews
Ira J Gottlieb, Deborah R Tunick, Randall J Mack, Stewart W McCallum, Campbell P Howard, Alex Freyer, Wei Du
Objective: This randomized, double-blind, placebo-controlled study evaluated the safety and efficacy of an intravenous (IV) nanocrystal formulation of meloxicam in subjects with moderate-to-severe pain following a standardized unilateral bunionectomy. Methods: Fifty-nine subjects aged 18-72 years were randomized to receive doses of either 30 mg (n=20) or 60 mg (n=20) meloxicam IV or placebo (n=19), administered once daily as bolus IV injections over 15-30 seconds (two or three doses)...
2018: Journal of Pain Research
Srini Chary
Methadone for pain management in this article describes briefly pain, methadone as a Level 3 World Health Organization ladder opioid in the context of India and rest of the world, as well as the relationship to past, present, and future possibilities of pain management. Acute pain is proportional to the injury most of the times, and such proportionality may not exist in chronic pain. Pain management over decades has changed because of knowledge and availability of molecules and compounds to reduce chronic pain...
January 2018: Indian Journal of Palliative Care
Anne Yee, Huai Seng Loh, Chong Guan Ng, Ahmad Hatim Sulaiman
Low sexual desire (SD) is not life threatening, but its negative impact on the quality of life and intimacy of a relationship among the patients on methadone maintenance therapy (MMT) is significant. This cross-sectional study involved 183 men on MMT who were interviewed and who completed the Malay version of the SDI-2 (SDI-2-BM), the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) and World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) questionnaires. Findings showed 32...
February 1, 2018: American Journal of Men's Health
Danielle Horyniak, Steffanie A Strathdee, Brooke S West, Meredith Meacham, Gudelia Rangel, Tommi L Gaines
INTRODUCTION: Little is known about the cessation of injecting drug use (IDU) among people who inject drugs (PWID) in low and middle-income settings, where access to effective interventions for reducing drug use (e.g., opioid substitution treatment; OST), may be limited. We measured the incidence and identified predictors of IDU cessation among a cohort of PWID in Tijuana, Mexico. METHODS: Data were drawn from 621 participants in Proyecto El Cuete IV, a prospective cohort of PWID recruited in 2011 and interviewed biannually to 2016...
February 21, 2018: Drug and Alcohol Dependence
Iuliia Makarenko, Alyona Mazhnaya, Ruthanne Marcus, Iryna Pykalo, Lynn Madden, Sergii Filippovich, Sergii Dvoriak, Frederick L Altice
Ongoing drug use during opioid agonist treatment (OAT) negatively affects treatment and health outcomes, and increases treatment dropout. This study aimed to examine correlates of concurrent illicit drug use among OAT patients in Ukraine. A random sample of 434 patients currently on OAT receiving buprenorphine (BMT) or methadone maintenance treatment (MMT) from five cities in Ukraine were assessed for factors associated with self-reported concurrent illicit drug use during OAT using a multivariable logistic regression...
April 2018: Journal of Substance Abuse Treatment
Patrick Tran, John A Sturgeon, Aneesha Nilakantan, Alyssa Foote, Sean Mackey, Kevin Johnson
Objective: There is an extensive relationship between chronic pain and depression; however, there is less research examining whether pain-specific factors, such as pain intensity, predict depression, above and beyond the role of normative factors, such as positive emotions. The current study characterized the independent contributions of pain intensity, pain catastrophizing, and a trait measure of happiness to self-rated depressive symptoms. Methods: We recruited and enrolled 70 volunteers across 3 groups of participants: two groups of patients with current low back pain (one group on opioids and one group opioid-naïve), and individuals in a methadone maintenance treatment program...
December 2017: Journal of Applied Biobehavioral Research
Anjali Varma, Mamta Sapra, Ali Iranmanesh
Objective The USA is in the midst of an opioid crisis. Understanding the impact of opioids and commonly used treatments for opioid dependence is essential for clinicians and researchers in order to educate and treat the nation's growing population with opioid use disorders. As a relatively new treatment for opioid dependence, buprenorphine is gaining popularity to the extent of becoming not only a preferred approach to the maintenance of opiate addiction, but also an option for chronic pain management. The purpose of this report is to review the available evidence on the endocrine effects of buprenorphine, particularly as it relates to the hypothalamic-pituitary-gonadal (HPG) axis, which is controversial and not fully defined...
February 17, 2018: Hormone Molecular Biology and Clinical Investigation
Lynn M Madden, Scott O Farnum, Kathryn F Eggert, Andrew R Quanbeck, Robert Freeman, Samuel A Ball, Richard S Schottenfeld, Julia M Shi, Mary Ellen Savage, Declan T Barry
AIMS: To retrospectively examine patient and programmatic outcomes following the development and implementation of an "open-access" model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. DESIGN: Medical and administrative records were abstracted to compare data for one year before and 9 years after initiating the implementation of an open-access treatment model in May 2007...
February 17, 2018: Addiction
Milad Parpouchi, Akm Moniruzzaman, Stefanie N Rezansoff, Angela Russolillo, Julian M Somers
Background: Methadone maintenance treatment (MMT) has important protective effects related to reduced illicit opioid use, infectious disease transmission, and overdose mortality. Adherence to MMT has not been examined among homeless people. We measured MMT adherence and reported relevant characteristics among homeless adults experiencing mental illness in Vancouver, British Columbia, Canada. Material and methods: Homeless adults living with mental illness who had received MMT prior to the baseline interview of the Vancouver At Home study ( n = 78) were included in analyses...
December 2017: Addictive Behaviors Reports
Paul Kurdyak, Binu Jacob, Juveria Zaheer, Benedikt Fischer
OBJECTIVE: To describe recent trends and patterns in methadone maintenance treatment (MMT) practice regionally and over time in the province of Ontario. DESIGN: Population-based descriptive study using health administrative data between September 1, 2011, and December 31, 2014. SETTING: Ontario. PARTICIPANTS: All active MMT-prescribing physicians and patients receiving MMT in the study period. MAIN OUTCOME MEASURES: Characteristics of MMT-prescribing physicians, including age, sex, specialty type, practice region, and practice volume; characteristics of patients receiving MMT, including age, sex, neighbourhood income, and region of residence...
February 2018: Canadian Family Physician Médecin de Famille Canadien
Blanka Nechanská, Viktor Mravčík, Svetlana Skurtveit, Ingunn Olea Lund, Roman Gabrhelík, Anders Engeland, Marte Handal
BACKGROUND AND AIMS: Opioid maintenance treatment (OMT) is recommended to opioid dependent females during pregnancy. However, it is not clear which medication should be preferred. We aimed to compare neonatal outcomes after prenatal exposure to methadone (M) and buprenorphine (B) in two European countries. DESIGN: Nationwide register-based cohort study using personalized IDs assigned to all citizens for data linkage. SETTING: The Czech Republic (2000-2014) and Norway (2004-2013)...
February 14, 2018: Addiction
Lauren Brinkley-Rubinstein, Michelle McKenzie, Alexandria Macmadu, Sarah Larney, Nickolas Zaller, Emily Dauria, Josiah Rich
Recently, incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is an effective way to address opioid use disorder and prevent overdose; however, few jails and prisons in the United States initiate or continue people who are incarcerated on MMT. In the current study, the 12 month outcomes of a randomized control trial in which individuals were provided MMT while incarcerated at the Rhode Island Department of Corrections (RIDOC) are assessed. An as-treated analysis included a total of 179 participants-128 who were, and 51 who were not, dosed with methadone the day before they were released from the RIDOC...
January 31, 2018: Drug and Alcohol Dependence
Lara S Lemon, Ashley Naimi, Steve N Caritis, Robert W Platt, Raman Venkataramanan, Lisa M Bodnar
BACKGROUND: Pregnant women treated with methadone as opioid maintenance therapy are more likely than women treated with buprenorphine to deliver preterm. Preterm birth is associated with less risk of neonatal abstinence syndrome (NAS). We sought to assess the role of preterm birth as a mediator of the relationship between in utero exposure to methadone and NAS compared with buprenorphine. METHODS: We studied 716 women receiving methadone or buprenorphine and delivering liveborn infants at Magee-Womens Hospital, Pittsburgh, Pennsylvania (2013-15)...
January 26, 2018: Paediatric and Perinatal Epidemiology
Andrew Quanbeck, Randall T Brown, Aleksandra E Zgierska, Nora Jacobson, James M Robinson, Roberta A Johnson, Brienna M Deyo, Lynn Madden, Wen-Jan Tuan, Esra Alagoz
BACKGROUND: This paper reports on the feasibility, acceptability, and effectiveness of an innovative implementation strategy named "systems consultation" aimed at improving adherence to clinical guidelines for opioid prescribing in primary care. While clinical guidelines for opioid prescribing have been developed, they have not been widely implemented, even as opioid abuse reaches epidemic levels. METHODS: We tested a blended implementation strategy consisting of several discrete implementation strategies, including audit and feedback, academic detailing, and external facilitation...
January 25, 2018: Implementation Science: IS
(no author information available yet)
The Comprehensive Addiction and Recovery Act (CARA) of 2016, which became law on July 22, 2016, amended the Controlled Substances Act (CSA) to expand the categories of practitioners who may, under certain conditions on a temporary basis, dispense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treatment or detoxification treatment. Separately, the Department of Health and Human Services, by final rule effective August 8, 2016, increased to 275 the maximum number of patients that a practitioner may treat for opioid use disorder without being separately registered under the CSA for that purpose...
January 23, 2018: Federal Register
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