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https://www.readbyqxmd.com/read/29664203/trends-and-patterns-of-opioid-analgesic-prescribing-regional-and-rural-urban-variations-in-kentucky-from-2012-to-2015
#1
Huong Luu, Svetla Slavova, Patricia R Freeman, Michelle Lofwall, Steven Browning, Heather Bush
PURPOSE: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. METHODS: This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012-2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures...
April 17, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29663191/older-adults-with-autism-spectrum-disorders-in-sweden-a-register-study-of-diagnoses-psychiatric-care-utilization-and-psychotropic-medication-of-601-individuals
#2
Lena Nylander, Anna Axmon, Petra Björne, Gerd Ahlström, Christopher Gillberg
In a Swedish sample of persons eligible for disability services and aged 55 years or older in 2012, persons (n = 601) with autism spectrum disorder diagnoses registered in specialist care were identified. Register data concerning diagnoses of other psychiatric disorders, psychiatric care, and psychiatric medication were reviewed. More than 60% had been in contact with psychiatric care. The majority had no intellectual disability (ID) diagnosis recorded during the study period. Apart from ID, affective disorders, anxiety and psychotic disorders were most commonly registered; alcohol/substance abuse disorders were uncommon...
April 16, 2018: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/29651781/abuse-deterrent-opioid-formulations-a-key-ingredient-in-the-recipe-to-prevent-opioid-disasters
#3
Aaron J Salwan, Nicholas E Hagemeier, Sam Harirforoosh
The US Food and Drug Administration (FDA) is encouraging the innovation of long-acting opioid formulations that are manipulation-resistant. The purpose of this commentary is to assess the benefits and limitations of abuse-deterrent opioid formulations (ADFs) and discuss their role in mitigating the current opioid epidemic. ADFs have been created with chemical properties that make it difficult for people who non-medically use prescription drugs to crush and dissolve opioid tablets, as well as by combining opioids with antagonists such as naloxone or naltrexone, which are released only when the dosage form has been manipulated or the drug is taken by a non-intended route...
April 12, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29645083/polypharmacy-and-patterns-of-prescription-medication-use-among-cancer-survivors
#4
Caitlin C Murphy, Hannah M Fullington, Carlos A Alvarez, Andrea C Betts, Simon J Craddock Lee, David A Haggstrom, Ethan A Halm
BACKGROUND: The population of cancer survivors is rapidly growing in the United States. Long-term and late effects of cancer, combined with the ongoing management of other chronic conditions, make survivors particularly vulnerable to polypharmacy and its adverse effects. In the current study, the authors examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS: Using data from the Medical Expenditure Panel Survey (MEPS), the authors matched cancer survivors (5216 survivors) with noncancer controls (19,588 controls) by age, sex, and survey year...
April 12, 2018: Cancer
https://www.readbyqxmd.com/read/29626743/examining-racial-ethnic-differences-in-patterns-of-benzodiazepine-prescription-and-misuse
#5
Benjamin Cook, Timothy Creedon, Ye Wang, Chunling Lu, Nicholas Carson, Piter Jules, Esther Lee, Margarita Alegría
BACKGROUND: Benzodiazepines (BZDs) are widely prescribed during psychiatric treatment. Unfortunately, their misuse has led to recent surges in overdose emergency visits and drug-related deaths. METHODS: Electronic health record data from a large healthcare system were used to describe racial/ethnic, sex, and age differences in BZD use and dependence. Among patients with a BZD prescription, we assessed differences in the likelihood of subsequently receiving a BZD dependence diagnosis, number of BZD prescriptions, receiving only one BZD prescription, and receiving 18 or more BZD prescriptions...
March 26, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29623562/decline-in-buprenorphine-naloxone-prescriptions-in-a-state-medicaid-population-following-formulary-conversion-from-suboxone-to-bunavail
#6
Richard Soper, Sireesh Appajosyula, Christina Deximo
INTRODUCTION: A large, statewide, fee-for-service Medicaid plan recently (October 2015) executed a complete switch from sublingual buprenorphine-naloxone [(SLBN), Suboxone® ] to buccal buprenorphine-naloxone [(BBN), Bunavail® ] on its preferred drug formulary. This complete formulary switch provided an opportunity to assess dynamic changes in prescribing patterns, patient/physician acceptance, and indices of potential misuse/diversion. METHODS: For the period January 1, 2015 through December 31, 2016, two datasets were analyzed: prescriptions and associated costs for buprenorphine-naloxone (BN) products and urine toxicology test results for patients in the Medicaid plan...
April 6, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29621962/maternal-hair-and-neonatal-meconium-to-assess-gestational-consumption-and-prenatal-exposure-to-drugs-of-abuse-and-psychoactive-drugs
#7
Francesco Paolo Busardo, Laura Almeida, Laura Cortes, Sally Sabraa, Marta Muniesaa, Oscar Garcia-Algara, Maria Dolores Gomez-Roiga
BACKGROUND: In the last two decades, the consumption of drugs of abuse among women of childbearing age has experienced a significant increase and results from analyses of surveys concerning maternal intake of psychoactive prescription drugs during pregnancy indicate that the rates of intake are increasing each year. Analyses of biological matrices such as maternal hair and neonatal meconium have recently been used for assessment of gestational consumption and consequent prenatal exposure to drugs of abuse in high-risk groups of women METHODS: Maternal hair and neonatal meconium were analyzed by validated chromatographic mass spectrometric methodologies to disclose gestational use of drugs of abuse and psychoactive prescription drugs and consequent prenatal exposure in a cohort of 513 mother-newborn dyads at the Sant Joan de Déu Barcelona Hospital, Spain, during 2012- 2013...
April 5, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29619569/america-s-opioid-epidemic-a-comprehensive-review-and-look-into-the-rising-crisis
#8
REVIEW
Peter S Ostling, Kelly S Davidson, Best O Anyama, Erik M Helander, Melville Q Wyche, Alan D Kaye
PURPOSE OF REVIEW: In the USA, there has been a sharp increase in heroin, prescription opiate, and illicitly manufactured fentanyl abuse with overdoses tripling since the 1990s. Several states have been deemed as "high-burden" abuse states where there is a greater proportion of synthetic opiate use. During the same period that prescription limitations were initially implemented throughout the country, the fentanyl epidemic started nationwide. RECENT FINDINGS: In the setting of data demonstrating an almost fourfold increase in overdose deaths from 1999 to 2008, states began restricting access to Food and Drug Agency (FDA) approved opioid medications...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29615715/blocking-interleukin-4-enhances-efficacy-of-vaccines-for-treatment-of-opioid-abuse-and-prevention-of-opioid-overdose
#9
Megan Laudenbach, Federico Baruffaldi, Christine Robinson, Philipp Carter, Davis Seelig, Carly Baehr, Marco Pravetoni
Vaccines offer an option to treat heroin and prescription opioid abuse and prevent fatal overdoses. Opioid vaccines elicit antibodies that block opioid distribution to the brain and reduce opioid-induced behavioral effects and toxicity. The major limitation to the translation of addiction vaccines is that efficacy is observed only in subjects achieving optimal drug-specific serum antibody levels. This study tested whether efficacy of a vaccine against oxycodone is increased by immunomodulators targeting key cytokine signaling pathways involved in B and T cell lymphocyte activation...
April 3, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29608768/a-randomized-double-blind-double-dummy-placebo-controlled-intranasal-human-abuse-potential-study-of-oxycodone-arir-a-novel-immediate-release-abuse-deterrent-formulation
#10
Lynn R Webster, Matthew Iverson, Carmela Pantaleon, Michael D Smith, Eric R Kinzler, Stefan Aigner
Objective: Prescription opioid abuse continues to be a public health concern. Oxycodone ARIR is an immediate-release (IR) oxycodone tablet composed of multiple overlapping barriers that deter manipulation of the tablet for non-oral abuse. Design: This randomized, double-blind, double-dummy, active- and placebo-controlled, four-way crossover, intranasal human abuse potential study assessed the pharmacodynamics and pharmacokinetics of crushed intranasal oxycodone ARIR compared with crushed intranasal IR oxycodone and intact oral oxycodone ARIR...
March 28, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29602278/dark-classics-in-chemical-neuroscience-methamphetamine
#11
Thomas J Abbruscato, Paul C Trippier
Methamphetamine has the second highest prevalence of drug abuse after cannabis, with estimates of 35 million users worldwide. The (S)-(+)-enantiomer is the illicit drug, active neurostimulant and eutomer, while the (R)-(-)-enantiomer is contained in over the counter decongestants. While designated a schedule II drug in 1970, (S)-(+)-methamphetamine is available by prescription for the treatment of attention-deficit disorder and obesity. The illicit use of (S)-(+)-methamphetamine results in the sudden 'rush' of stimulation to the motivation, movement, pleasure and reward centers in the brain, caused by rapid release of dopamine...
March 30, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29596405/overdose-deaths-involving-opioids-cocaine-and-psychostimulants-united-states-2015-2016
#12
Puja Seth, Lawrence Scholl, Rose A Rudd, Sarah Bacon
During 1999‒2015, 568,699 persons died from drug overdoses in the United States.* Drug overdose deaths in the United States increased 11.4% from 2014 to 2015 resulting in 52,404 deaths in 2015, including 33,091 (63.1%) that involved an opioid. The largest rate increases from 2014 to 2015 occurred among deaths involving synthetic opioids other than methadone (synthetic opioids) (72.2%) (1). Because of demographic and geographic variations in overdose deaths involving different drugs (2,3),† CDC examined age-adjusted death rates for overdoses involving all opioids, opioid subcategories (i...
March 30, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29582394/comparative-rates-of-mortality-and-serious-adverse-effects-among-commonly-prescribed-opioid-analgesics
#13
David L Murphy, Jacob A Lebin, Stevan G Severtson, Heather A Olsen, Nabarun Dasgupta, Richard C Dart
INTRODUCTION: The epidemic of prescription opioid overdose and mortality parallels the dispensing rates of prescription opioids, and the availability of increasingly potent opioid analgesics. OBJECTIVE: The common assumption that more potent opioid analgesics are associated with higher rates of adverse outcomes has not been adequately substantiated. We compared the rate of serious adverse events among commonly prescribed opioid analgesics of varying potency. METHODS: Serious adverse events (SAEs; defined as death, major medical effect, or hospitalization) resulting from exposure to tablets containing seven opioid analgesics (oxycodone, hydrocodone, morphine, hydromorphone, oxymorphone, tapentadol, and tramadol) captured by the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS® ) System Poison Center Program were evaluated from 2010 through 2016...
March 26, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29574756/oxycodone-induced-tolerance-to-respiratory-depression-reversal-by-ethanol-pregabalin-and-protein-kinase-c-inhibition
#14
Rob Hill, William L Dewey, Eamonn Kelly, Graeme Henderson
BACKGROUND AND PURPOSE: Oxycodone, a prescription opioid, is a major drug of abuse, especially in the USA, and contributes significantly to opioid overdose deaths each year. Overdose deaths result primarily from respiratory depression. We have studied respiratory depression by oxycodone and have characterized how tolerance develops on prolonged exposure to the drug. We have investigated the role of protein kinase C (PKC) in maintaining tolerance and have examined whether ethanol or pregabalin reverse oxycodone-induced tolerance EXPERIMENTAL APPROACH: Respiration was measured in male CD-1 mice by whole body plethysmography...
March 25, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29574296/novel-prodrug-prx-p4-003-selectively-activated-by-gut-enzymes-may-reduce-the-risk-of-iatrogenic-addiction-and-abuse
#15
Sandeep T Patil, Ron H Bihovsky, Steven A Smith, William Z Potter, Valentino J Stella
OBJECTIVES: Prescription stimulants are vulnerable to oral and parenteral abuse. Intravenous forms of abuse may be most detrimental due to an enhanced risk of dependence, overdose, and infectious diseases. Our objective was to discover an orally active prodrug of a stimulant that would not be easily converted to its parent when injected, thus hindering intravenous abuse. METHODS: Following an initial analysis of stimulant structures, the fencamfamine isomer [(-)-FCF; (N-ethyl-3-phenylbicyclo[2...
March 2, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29570773/the-fda-s-approach-to-the-prescription-opioid-problem
#16
Janet Woodcock, Douglas C Throckmorton
Our nation's ongoing prescription opioid abuse crisis, amounting to over 78 billion dollars in health and social costs annually,1 is a critical priority for the US Food and Drug Administration (FDA). As a part of our mission to support the safe and effective use of prescription medicines, the FDA is taking a fresh look at potential scientific and regulatory actions we can take to address this crisis.
March 23, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29560840/older-women-who-died-by-suicide-suicide-means-sociodemographic-and-psychiatric-risk-factors-and-other-precipitating-circumstances
#17
Namkee G Choi, Diana M DiNitto, Atami O Sagna, C Nathan Marti
BACKGROUND: US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmortem toxicology results by suicide means. METHODS: Data are from the 2005 to 2015 US National Violent Death Reporting System (N = 12,401 female decedents aged 50 years and over)...
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29560070/optimal-implementation-of-prescription-drug-monitoring-programs-in-the-emergency-department
#18
REVIEW
Joshua W Elder, Garrett DePalma, Jesse M Pines
The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29559866/intelligent-clinical-decision-support-to-improve-safe-opioid-management-of-chronic-noncancer-pain-in-primary-care
#19
Eboni G Price-Haywood, Wanda Robinson, Jewel Harden-Barrios, Jeffrey Burton, Todd Burstain
Background: Opioid prescription drug abuse is a major public health concern. Healthcare provider prescribing patterns, especially among non-pain management specialists, are a major factor. Practice guidelines recommend what to do for safe opioid prescribing but do not provide guidance on how to implement best practices. Methods: We describe the implementation of electronic medical record clinical decision support (EMR CDS) for opioid management of chronic noncancer pain in an integrated delivery system...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/29559202/psychosocial-correlates-of-clinicians-prescription-drug-monitoring-program-utilization
#20
John A Pugliese, Garen J Wintemute, Stephen G Henry
INTRODUCTION: The purpose of this study is to extend prior research on barriers to use of a prescription drug monitoring program by examining psychosocial correlates of intended use among physicians and pharmacists. METHODS: Overall, 1,904 California physicians and pharmacists responded to a statewide survey (24.1% response rate) from August 2016 to January 2017. Participants completed an online survey examining attitudes toward prescription drug misuse and abuse, prescribing practices, prescription drug monitoring program design and ease of use, professional obligations, and normative beliefs regarding prescription drug monitoring program use...
March 17, 2018: American Journal of Preventive Medicine
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