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https://www.readbyqxmd.com/read/28299558/body-pushing-prescription-drugs-and-hospital-admission
#1
Roger W Byard, Michaela Kenneally
A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police...
March 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#2
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28292504/pharmacists-perceptions-regarding-the-impact-of-hydrocodone-rescheduling-on-prescription-volume-workflow-management-and-patient-outcomes
#3
Tyler J Varisco, Motolani E Ogunsanya, Jamie C Barner, Marc L Fleming
OBJECTIVES: To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling. DESIGN: A cross-sectional mail survey. SETTING: Texas community pharmacies from October to December 2015...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28280749/interprofessional-research-training-and-outreach-the-etsu-prescription-drug-abuse-misuse-working-group
#4
Robert P Pack, Angela Hagaman, Sara Warfield, Jeffry A Gray, Fred Tudiver, Arsham Alamian, Nicholas E Hagemeier
No abstract text is available yet for this article.
August 2016: International Journal of Health Sciences Education
https://www.readbyqxmd.com/read/28278146/cdc-grand-rounds-public-health-strategies-to-prevent-neonatal-abstinence-syndrome
#5
Jean Y Ko, Sara Wolicki, Wanda D Barfield, Stephen W Patrick, Cheryl S Broussard, Kimberly A Yonkers, Rebecca Naimon, John Iskander
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that most commonly occurs in infants after in utero exposure to opioids, although other substances have also been associated with the syndrome (1). NAS usually appears within 48-72 hours of birth with a constellation of clinical signs, including central nervous system irritability (e.g., tremors), gastrointestinal dysfunction (e.g., feeding difficulties), and temperature instability (1) (Box 1). Opioid exposure during pregnancy might result from clinician-approved use of prescription opioids for pain relief; misuse or abuse of prescription opioids; illicit use (e...
March 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28267061/polysubstance-use-and-misuse-or-abuse-of-prescription-opioid-analgesics-a-multi-level-analysis-of-international-data
#6
Katherine I Morley, Jason Ferris, Adam R Winstock, Michael T Lynskey
Increasing mortality and morbidity associated with opioid analgesics has led to concerns about their misuse and abuse, even when obtained via a prescription. These concerns have been most pronounced in the United States of America (USA), but limited data make it difficult to determine whether it is a problem in other countries. We investigated opioid analgesic misuse and abuse in participants from the Global Drug Survey 2015 resident in the USA (N=1,334), United Kingdom (N=1,199), France (N=1,258), Germany (N=866), and Australia (N=1,013) who had used at least one prescription opioid analgesic medication in the past year...
March 4, 2017: Pain
https://www.readbyqxmd.com/read/28264961/spreading-blame-for-prescription-drug-abuse
#7
Pooja Lagisetty
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28257549/analysis-of-intensive-care-unit-admission-and-sequelae-in-patients-intravenously-abusing-extended-release-oral-oxymorphone
#8
Matthew W Wilson, Alex K Bonnecaze, Ajay Dharod, Peter J Miller
OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28239898/early-signal-of-diverted-use-of-tropicamide-eye-drops-in-france
#9
Camille Ponté, Christian Pi, Aurore Palmaro, Emilie Jouanjus, Maryse Lapeyre-Mestre
BACKGROUND: Tropicamide is a mydriatic drug used as eye-drops for diagnostic or therapeutic purposes. From 2013, a diverted use by intravenous route has been suspected in Eastern Europe in opioids users. To recent date, no signal of a misuse has been identified in France. PURPOSE: To investigate an early signal of a diverted use of tropicamide eye drops and to collect information regarding motives of misusing and tropicamide-induced effects. METHODS: Information was obtained at 1/ regional level (Midi-Pyrénées area): reimbursement data and pharmacists' reports on suspicious requests, 2/ national level: reimbursement data and prescriptions suggesting possible abuse from the OSIAP (Ordonnances Suspectes, Indicateur d'Abus Possible) survey and 3/ international level: VigiBase® reports and Web sources...
February 27, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28239510/lidocaine-infusion-a-promising-therapeutic-approach-for-chronic-pain
#10
Enas Kandil, Emily Melikman, Bryon Adinoff
Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia. Although there are new strategies and practice guidelines to reduce opioid dependence and opioid prescription drug overdose, there has been little focus on development of opioid-sparing therapeutic approaches...
January 2017: Journal of Anesthesia & Clinical Research
https://www.readbyqxmd.com/read/28237050/characterizing-fentanyl-use-in-methadone-maintained-clients
#11
Cynthia L Arfken, Jessica Suchanek, Mark K Greenwald
AIMS: Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl. METHODS: A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan...
April 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28235415/a-systematic-review-of-health-economic-models-of-opioid-agonist-therapies-in-maintenance-treatment-of-non-prescription-opioid-dependence
#12
Mersha Chetty, James J Kenworthy, Sue Langham, Andrew Walker, William C N Dunlop
BACKGROUND: Opioid dependence is a chronic condition with substantial health, economic and social costs. The study objective was to conduct a systematic review of published health-economic models of opioid agonist therapy for non-prescription opioid dependence, to review the different modelling approaches identified, and to inform future modelling studies. METHODS: Literature searches were conducted in March 2015 in eight electronic databases, supplemented by hand-searching reference lists and searches on six National Health Technology Assessment Agency websites...
February 24, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28226337/immunoassay-based-drug-tests-are-inadequately-sensitive-for-medication-compliance-monitoring-in-patients-treated-for-chronic-pain
#13
Marion L Snyder, Corrine R Fantz, Stacy Melanson
BACKGROUND: Enzyme immunoassays (EIA) have notable limitations for monitoring therapeutic compliance in pain management. Chromatography coupled with mass spectrometry provides definitive results and superior sensitivity and specificity over traditional EIA testing. OBJECTIVE: To analyze and compare the sensitivity of EIA results together with known prescriptions to liquid chromatography-tandem mass spectrometry (LC-MS/MS) for monitoring drug use (and abuse) in patients treated for chronic pain...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#14
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
#15
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
#16
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/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#17
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28224957/-medicines-and-elderly-patients-abuse-dependency-or-attraction
#18
Pascal Menecier, Laure Menecier-Ossia
Psychotropic medicines represent, after alcohol, the second class of substances most susceptible to abuse by elderly people. It can be particularly difficult for caregivers to understand such behaviour as these are prescription-only medicines. This misuse is partly a result of older people tending to trivialise and overrate pharmaceutical drugs, ignoring the potential of non-medicinal methods and psychotherapeutic treatments. The boundaries between prescribed use, overuse, self-medication, excessive use, dependency or addiction to prescription drugs are blurred in older people...
January 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28210864/pharmacy-benefit-management-companies-do-they-create-value-in-the-us-healthcare-system
#19
Alan Lyles
Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing...
February 16, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28166464/implementation-of-a-pharmacy-consult-to-reduce-co-prescribing-of-opioids-and-benzodiazepines-in-a-veteran-population
#20
Deborah Pardo, Lacey Miller, Dana Chiulli
BACKGROUND: The dangers of co-administration of opioid pain relievers (OPRs) and benzodiazepines (BZDs) are well documented. The combination of OPRs and BZDs make up the majority of medications involved in prescription drug-related overdose and are often used concomitantly. This pattern is consistent among the Veteran population where mental health illness and substance abuse are prominent. The Veterans Health Administration implemented the Opioid Safety Initiative (OSI) aimed at improving patient safety surrounding OPRs...
February 6, 2017: Substance Abuse
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