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https://www.readbyqxmd.com/read/29758542/fentanyl-self-testing-outside-supervised-injection-settings-to-prevent-opioid-overdose-do-we-know-enough-to-promote-it
#1
Catherine R McGowan, Magdalena Harris, Lucy Platt, Vivian Hope, Tim Rhodes
Since 2013, North America has experienced a sharp increase in unintentional fatal overdoses: fentanyl, and its analogues, are believed to be primarily responsible. Currently, the most practical means for people who use drugs (PWUD) to avoid or mitigate risk of fentanyl-related overdose is to use drugs in the presence of someone who is in possession of, and experienced using, naloxone. Self-test strips which detect fentanyl, and some of its analogues, have been developed for off-label use allowing PWUD to test their drugs prior to consumption...
May 11, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29751889/gender-and-geographical-inequalities-in-fatal-drug-overdose-in-iran-a-province-level-study-in-2006-and-2011
#2
Mehran Rostami, Mohammad Karamouzian, Ardeshir Khosravi, Shahab Rezaeian
AIM: We aimed to compare the fatal drug overdose rates in Iran in 2006 and 2011. METHODS: This analysis was performed based on data on fatal drug overdose cases from the Iranian death registration system. The crude and adjusted rates per 100,000 populations for geographical regions stratified by gender and age groups were calculated using the 2006 and 2011 census of Iranian population. Annual percentage change was calculated to examine annual changes of fatal drug overdose rates across different regions...
June 2018: Spatial and Spatio-temporal Epidemiology
https://www.readbyqxmd.com/read/29678675/towards-tailored-management-of-malignant-brain-tumors-with-nanotheranostics
#3
REVIEW
Juan Aparicio-Blanco, Ana-Isabel Torres-Suárez
Malignant brain tumors still represent an unmet medical need given their rapid progression and often fatal outcome within months of diagnosis. Given their extremely heterogeneous nature, the assumption that a single therapy could be beneficial for all patients is no longer plausible. Hence, early feedback on drug accumulation at the tumor site and on tumor response to treatment would help tailor therapies to each patient's individual needs for personalized medicine. In this context, at the intersection between imaging and therapy, theranostic nanomedicine is a promising new technique for individualized management of malignant brain tumors...
April 17, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29660732/safe-and-unsafe-spaces-non-fatal-overdose-arrest-and-receptive-syringe-sharing-among-people-who-inject-drugs-in-public-and-semi-public-spaces-in-baltimore-city
#4
Kyle Hunter, Ju Nyeong Park, Sean T Allen, Patrick Chaulk, Taeko Frost, Brian W Weir, Susan G Sherman
The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing...
April 13, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29628190/prognostic-utility-of-initial-lactate-in-patients-with-acute-drug-overdose-a-validation-cohort
#5
Randy Cheung, Robert S Hoffman, David Vlahov, Alex F Manini
STUDY OBJECTIVE: Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a larger, distinct patient population with acute drug overdose. METHODS: This observational, prospective, cohort study was conducted during 5 years at 2 urban teaching hospitals...
April 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29627712/accurate-identification-of-opioid-overdose-deaths-using-coronial-data
#6
Amanda Roxburgh, Jennifer L Pilgrim, Wayne D Hall, Lucinda Burns, Louisa Degenhardt
INTRODUCTION: Defining drug-related mortality is complex as these deaths can include a wide range of diseases and circumstances. This paper outlines a method to identify deaths that are directly due to fatal opioid toxicity (i.e. overdose), utilising coronial data. MATERIALS AND METHODS: The National Coronial Information System (NCIS), an online coronial database containing information on all deaths that are reported to a coroner in Australia, is used to develop methods to more accurately identify opioid overdose deaths...
March 26, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29625609/lay-responder-naloxone-access-and-good-samaritan-law-compliance-postcard-survey-results-from-20-indiana-counties
#7
Dennis P Watson, Bradley Ray, Lisa Robison, Philip Huynh, Emily Sightes, La Shea Walker, Krista Brucker, Joan Duwve
BACKGROUND: To reduce fatal drug overdoses, two approaches many states have followed is to pass laws expanding naloxone access and Good Samaritan protections for lay persons with high likelihood to respond to an opioid overdose. Most prior research has examined attitudes and knowledge among lay responders in large metropolitan areas who actively use illicit substances. The present study addresses current gaps in knowledge related to this issue through an analysis of data collected from a broader group of lay responders who received naloxone kits from 20 local health departments across Indiana...
April 6, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29621965/analytical-approaches-in-fatal-intoxication-cases-involving-new-synthetic-opioids
#8
Enrico Gerace, Alberto Salomone, Marco Vincenti
BACKGROUND: Synthetic opioids are compounds that were created to act on the opioid receptors. Novel synthetic opioids include various analogs of fentanyl (e.g., acetylfentanyl, acryloylfentanyl, carfentanil, furanylfentanyl, 4-fluorobutyrylfentanyl or ocfentanil) and newly emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45, and U-47700. In the last years, these drugs have rapidly emerged on the recreational drug market, and their abuse has been increasing worldwide...
April 5, 2018: Current Pharmaceutical Biotechnology
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/29605706/fatal-and-non-fatal-overdose-among-opiate-users-in-south-wales-a-qualitative-study-of-peer-responses
#10
Katy Holloway, Rhian Hills, Tom May
BACKGROUND: Overdose is a major cause of death among injecting drug users in Wales. Few studies, however, have explored the overdose responses of witnesses in this context. This study applies Rhodes' concept of the 'risk environment' to examine how witnesses respond to opiate overdose. METHOD: In depth, semi-structured interviews were conducted with fifty-five participants recruited from statutory and third sector drug treatment providers operating across South Wales and from two Welsh prisons...
March 29, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29560596/review-of-case-narratives-from-fatal-overdoses-associated-with-injectable-naltrexone-for-opioid-dependence
#11
Roxanne Saucier, Daniel Wolfe, Nabarun Dasgupta
INTRODUCTION: An extended-release injectable naltrexone suspension (Vivitrol® ) was approved in USA in 2010 for the prevention of relapse to opioid dependence. Concerns, raised at the time of approval, about rebound overdose risk following the last dose, have not been adequately studied. We sought to determine the time period of concern for fatal overdose associated with Vivitrol. METHODS: We performed a retrospective case review of Vivitrol spontaneous reports (October 2010-March 2016) in the US Food and Drug Administration Adverse Event Reporting System via the Freedom of Information Act...
March 20, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29558943/hospitalization-among-street-involved-youth-who-use-illicit-drugs-in-vancouver-canada-a-longitudinal-analysis
#12
Derek C Chang, Launette Rieb, Ekaterina Nosova, Yang Liu, Thomas Kerr, Kora DeBeck
BACKGROUND: Street-involved youth who use illicit drugs are at high risk for health-related harms; however, the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population. METHODS: From January 2005 to May 2016, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada...
March 20, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29558283/amount-of-naloxone-used-to-reverse-opioid-overdoses-outside-of-medical-practice-in-a-city-with-increasing-illicitly-manufactured-fentanyl-in-illicit-drug-supply
#13
Alice Bell, Alex S Bennett, T Stephen Jones, Maya Doe-Simkins, Leslie D Williams
BACKGROUND: Illicitly manufactured fentanyl (IMF) prevalence has increased. However, there is uncertainty about naloxone dose(s) used by nonmedical bystanders to reverse opioid overdoses in the context of increasing IMF. METHODS: We used community naloxone distribution program data about naloxone doses and fatal opioid overdoses from the Allegheny County Medical Examiner. From January 2013 to December 2016, staff interviewed participants who administered naloxone in response to 1,072 overdoses...
March 20, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29556194/when-the-safe-alternative-is-not-that-safe-tramadol-prescribing-in-children
#14
REVIEW
Frédérique Rodieux, Laszlo Vutskits, Klara M Posfay-Barbe, Walid Habre, Valérie Piguet, Jules A Desmeules, Caroline F Samer
Children represent a vulnerable population in which management of nociceptive pain is complex. Drug responses in children differ from adults due to age-related differences. Moreover, therapeutic choices are limited by the lack of indication for a number of analgesic drugs due to the challenge of conducting clinical trials in children. Furthermore the assessment of efficacy as well as tolerance may be complicated by children's inability to communicate properly. According to the World Health Organization, weak opioids such as tramadol and codeine, may be used in addition to paracetamol and ibuprofen for moderate nociceptive pain in both children and adults...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29554591/prevalence-of-gabapentin-in-drug-overdose-postmortem-toxicology-testing-results
#15
Svetla Slavova, Alison Miller, Terry L Bunn, Jessica R White, David Kirschke, Tom Light, Daniel Christy, Gary Thompson, Ruth Winecker
BACKGROUND: The goal of this study was to establish and compare baseline data on the prevalence of gabapentin identified through postmortem toxicology testing among drug overdose decedents in several geographically diverse states/jurisdictions with differing levels of drug overdose fatality burdens in 2015. METHODS: Death certificates and postmortem toxicology result reports from five U.S. jurisdictions were used to identify residents who died from drug overdoses in year 2015 and to calculate prevalence rates of gabapentin in postmortem toxicology by jurisdiction...
May 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29553984/averting-opioid-induced-respiratory-depression-without-affecting-analgesia
#16
Albert Dahan, Rutger van der Schrier, Terry Smith, Leon Aarts, Monique van Velzen, Marieke Niesters
The ventilatory control system is highly vulnerable to exogenous administered opioid analgesics. Particularly respiratory depression is a potentially lethal complication that may occur when opioids are overdosed or consumed in combination with other depressants such as sleep medication or alcohol. Fatalities occur in acute and chronic pain patients on opioid therapy and individuals that abuse prescription or illicit opioids for their hedonistic pleasure. One important strategy to mitigate opioid-induced respiratory depression is cotreatment with nonopioid respiratory stimulants...
May 2018: Anesthesiology
https://www.readbyqxmd.com/read/29538652/frequently-used-drug-types-and-alcohol-involvement-in-intentional-drug-overdoses-in-ireland-a-national-registry-study
#17
Caroline Daly, Eve Griffin, Darren M Ashcroft, Roger T Webb, Ivan J Perry, Ella Arensman
Background: Intentional drug overdose (IDO) is the most common form of hospital-treated self-harm, yet no national study has systematically classified the range of drugs involved using a validated system. We aimed to determine the profile of patients engaging in overdose, to identify drugs frequently used and to quantify the contributions of multiple drug use and alcohol involvement. Methods: Between 2012 and 2014, the National Self-Harm Registry, Ireland recorded 18 329 presentations of non-fatal IDO to Irish emergency departments...
March 12, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29537112/polydrug-epidemiology-benzodiazepine-prescribing-and-the-drug-overdose-epidemic-in-the-united-states
#18
Michael James Zoorob
BACKGROUND: Although polydrug incidents comprise a substantial proportion of overdose deaths, scholarly and popular focus has centered on prescription opiates. This study examines the role of benzodiazepine and opioid prescriptions on overdose-both individually and synergistically-using data from Medicare Part D, a source of prescription drug claims for about 35 million Americans. METHODS: Prescribing data from the Medicare Part D Public Use Files for 2013, 2014, and 2015 (approximately 3...
May 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29498021/prescribed-dose-of-opioids-and-overdose-a-systematic-review-and-meta-analysis-of-unintentional-prescription-opioid-overdose
#19
REVIEW
Adeleke D Adewumi, Samantha A Hollingworth, Joemer C Maravilla, Jason P Connor, Rosa Alati
BACKGROUND: The rate of an unintentional drug overdose involving prescription opioids continues to rise. An understanding of the threshold dose and dose(s) associated with unintentional prescription opioid overdose will help to mitigate this epidemic. OBJECTIVE: The objective of this systematic review is to systematically synthesise and meta-analyse studies on doses of prescription opioids and ascertain the doses of opioids that are associated with increased risk of severe opioid poisoning or mortality...
February 2018: CNS Drugs
https://www.readbyqxmd.com/read/29492246/an-update-on-the-safety-of-current-therapies-for-alzheimer-s-disease-focus-on-rivastigmine
#20
REVIEW
Rita Khoury, Jayashree Rajamanickam, George T Grossberg
Alzheimer's disease (AD) is the most common cause of major neurocognitive disorders worldwide. Despite all research efforts, therapeutic options for AD are still limited to two drug classes: cholinesterase inhibitors (ChEIs) and the NMDA-receptor antagonist memantine. Donepezil, rivastigmine and galantamine are the three ChEIs FDA-approved as first-line treatment for AD. Although they share the same mode of action, they differ in terms of their pharmacologic characteristics and route of administration, which can impact their safety and tolerability profile...
March 2018: Therapeutic Advances in Drug Safety
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