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https://www.readbyqxmd.com/read/28454045/canadian-harm-reduction-policies-a-comparative-content-analysis-of-provincial-and-territorial-documents-2000-2015
#1
REVIEW
T Cameron Wild, Bernie Pauly, Lynne Belle-Isle, Walter Cavalieri, Richard Elliott, Carol Strike, Kenneth Tupper, Andrew Hathaway, Colleen Dell, Donald MacPherson, Caitlin Sinclair, Kamagaju Karekezi, Benjamin Tan, Elaine Hyshka
BACKGROUND: Access to harm reduction interventions among substance users across Canada is highly variable, and largely within the policy jurisdiction of the provinces and territories. This study systematically described variation in policy frameworks guiding harm reduction services among Canadian provinces and territories as part of the first national multimethod case study of harm reduction policy. METHODS: Systematic and purposive searches identified publicly-accessible policy texts guiding planning and organization of one or more of seven targeted harm reduction services: needle distribution, naloxone, supervised injection/consumption, low-threshold opioid substitution (or maintenance) treatment, buprenorphine/naloxone (suboxone), drug checking, and safer inhalation kits...
April 25, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28454044/unintended-impacts-of-regulatory-changes-to-british-columbia-methadone-maintenance-program-on-addiction-and-hiv-related-outcomes-an-interrupted-time-series-analysis
#2
M Eugenia Socías, Evan Wood, Ryan McNeil, Thomas Kerr, Huiru Dong, Jean Shoveller, Julio Montaner, M-J Milloy
BACKGROUND: In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. METHODS: Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada...
April 25, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28453948/depression-and-anxiety-among-chronic-pain-patients-receiving-prescription-opioids-and-medical-marijuana
#3
Daniel Feingold, Silviu Brill, Itay Goor-Aryeh, Yael Delayahu, Shaul Lev-Ran
BACKGROUND: High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM. METHODS: Participants were patients suffering from chronic pain treated with prescription opioids (OP,N=474), MM (N=329) or both (OPMM,N=77)...
April 21, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28453912/perceived-need-for-depression-treatment-among-persons-entering-inpatient-opioid-detoxification
#4
Michael D Stein, Olga J Santiago Rivera, Bradley J Anderson, Genie L Bailey
BACKGROUND AND OBJECTIVES: Depression is common among persons with opioid use disorder. We examined the perceived need for depression treatment (PNDT) among opioid-dependent patients and the relationship of PNDT to depression screening result. METHODS: Between May and December 2015, we surveyed consecutive persons (n = 440) seeking inpatient opioid detoxification. We used the Patient Health Questionnaire-2 (PHQ-2) to screen for depression. To assess perceived need for depression services, participants were asked, "Do you believe you should be treated for depression?" Response options were recorded into four categories: "Not Depressed (ND)," "Perceive Need for Depression Treatment (PNDT)," "Depressed/Don't Want Treatment," and "Currently Treated...
April 28, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28453469/use-of-analgesics-opioids-and-nonsteroidal-anti-inflammatory-drugs-and-dementia-related-neuropathology-in-a-community-based-autopsy-cohort
#5
Sascha Dublin, Rod L Walker, Shelly L Gray, Rebecca A Hubbard, Melissa L Anderson, Onchee Yu, Thomas J Montine, Paul K Crane, Josh A Sonnen, Eric B Larson
BACKGROUND: Opioids may influence the development of Alzheimer's disease (AD). Some studies have observed AD pathology in the brains of opioid abusers. No study has examined the association between prescription opioid use and dementia-related neuropathologic changes. OBJECTIVE: To examine the relationship between prescription opioid or NSAID use and dementia-related neuropathologic changes. METHODS: Within a community-based autopsy cohort (N = 420), we ascertained opioid and nonsteroidal anti-inflammatory drug (NSAID) use over a 10-year period from automated pharmacy data and calculated total standardized daily doses (TSDDs)...
April 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28453454/the-effect-of-intra-articular-hyaluronate-and-tramadol-injection-on-patients-with-adhesive-capsulitis-of-the-shoulder
#6
Kyung Hee Kim, Jung-Woo Suh, Ki Young Oh
BACKGROUND: Local administration of opioids causes effective analgesia without adverse effects related to the central nervous system. After the beneficial demonstration of peripheral opioid receptors in joint synovia, intra-articular opioid injections were used for pain treatment. Clinical studies have reported the safety and efficacy of hyaluronate injection in the shoulder joint of patients with osteoarthritis, periarthritis, rotator cuff tears, and adhesive capsulitis. OBJECTIVES: To estimate the efficacy of intra-articular hyaluronate and tramadol injection for adhesive capsulitis of the shoulder compared with that of intra-articular hyaluronate injection alone...
April 21, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28449379/naloxone-rescheduling-in-australia-processes-implementation-and-challenges-with-supply-of-naloxone-as-a-pharmacist-only-over-the-counter-medicine
#7
Angelo Pricolo, Suzanne Nielsen
ISSUES: Numerous studies and systematic reviews have concluded that naloxone for take-home use is an effective intervention to reduce overdose morbidity and mortality, with few side effects and no abuse potential. One barrier to supply is that naloxone has traditionally been a prescription medication. In May 2015, the Therapeutic Goods Administration of Australia announced the intention to down-schedule naloxone when used for the treatment of opioid overdose, enabling sale in pharmacies without a prescription...
April 27, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28449262/predictive-mechanisms-linking-brain-opioids-to-chronic-pain-vulnerability-and-resilience
#8
REVIEW
Anthony Kenneth Peter Jones, Christopher Andrew Brown
Chronic pain is a major global healthcare problem that is currently inadequately treated. In addition, the current use of opioids for treatment has reached far beyond the paucity of evidence for long-term benefits relative to risks. Benefit-risk models for opioid and non-opioid treatments would benefit from a rational, mechanism-based understanding of neuroplastic and neurochemical contributions to chronic pain. Here we evaluate the findings and limitations of representative research investigating brain neuroplasticity and neurochemistry in chronic pain...
April 27, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#9
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28447766/supervised-dosing-with-a-long-acting-opioid-medication-in-the-management-of-opioid-dependence
#10
REVIEW
Rosella Saulle, Simona Vecchi, Linda Gowing
BACKGROUND: Opioid dependence (OD) is an increasing clinical and public health problem worldwide. International guidelines recommend opioid substitution treatment (OST), such as methadone and buprenorphine, as first-line medication treatment for OD. A negative aspect of OST is that the medication used can be diverted both through sale on the black market, and the unsanctioned use of medications. Daily supervised administration of medications used in OST has the advantage of reducing the risk of diversion, and may promote therapeutic engagement, potentially enhancing the psychosocial aspect of OST, but costs more and is more restrictive on the client than dispensing for off-site consumption...
April 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28446883/in-vitro-and-in-vivo-profile-of-ppl-101-and-ppl-103-mixed-opioid-partial-agonist-analgesics-with-low-abuse-potential
#11
Taline V Khroyan, Andrea Cippitelli, Nicholas Toll, John A Lawson, William Crossman, Willma E Polgar, Lawrence Toll
Opiates are still the most effective and widely used treatments for acute and chronic pain. However, the problems associated with morphine and other standard opioid analgesics severely limit their effectiveness in the clinic. PPL-101 and PPL-103 derived from morphine and morphinan ring systems contain a chiral N-substituent, which confers it with a unique combination of high-binding affinities and partial agonist activities at mu, delta, and kappa opioid receptors, leading to unique in vivo pharmacology compared to other conventional opioids...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28446438/opioid-substitution-treatment-is-linked-to-reduced-risk-of-death-in-opioid-use-disorder
#12
EDITORIAL
Ajay Manhapra, Robert Rosenheck, David A Fiellin
No abstract text is available yet for this article.
April 26, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28446428/mortality-risk-during-and-after-opioid-substitution-treatment-systematic-review-and-meta-analysis-of-cohort-studies
#13
Luis Sordo, Gregorio Barrio, Maria J Bravo, B Iciar Indave, Louisa Degenhardt, Lucas Wiessing, Marica Ferri, Roberto Pastor-Barriuso
Objective To compare the risk for all cause and overdose mortality in people with opioid dependence during and after substitution treatment with methadone or buprenorphine and to characterise trends in risk of mortality after initiation and cessation of treatment.Design Systematic review and meta-analysis.Data sources Medline, Embase, PsycINFO, and LILACS to September 2016.Study selection Prospective or retrospective cohort studies in people with opioid dependence that reported deaths from all causes or overdose during follow-up periods in and out of opioid substitution treatment with methadone or buprenorphine...
April 26, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28445930/opioids-modulators-of-angiogenesis-in-wound-healing-and-cancer
#14
REVIEW
Martina Ondrovics, Andrea Hoelbl-Kovacic, Daniela Alexandra Fux
Opioids are potent drugs that are widely used to control wound or cancer pain. Increasing evidence suggest that opioids mediate clinically relevant effects that go beyond their classical role as analgesics. Of note, opioids appear to modulate angiogenesis - a process that is critical in wound healing and cancer progression. In this review, we focus on pro- and anti-angiogenic facets of opioids that arise from the activation of individual opioid receptors and the usage of individual concentrations or application routes...
April 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28445097/phase-iib-randomized-double-blind-placebo-controlled-study-of-naldemedine-for-the-treatment-of-opioid-induced-constipation-in-patients-with-cancer
#15
Nobuyuki Katakami, Koji Oda, Katsunori Tauchi, Ken Nakata, Katsunori Shinozaki, Takaaki Yokota, Yura Suzuki, Masaru Narabayashi, Narikazu Boku
Purpose This randomized, double-blind, multicenter study aimed to determine the dose of naldemedine, a peripherally-acting μ-opioid receptor antagonist, for future trials by comparing the efficacy and safety of three doses of naldemedine versus placebo in patients with cancer and opioid-induced constipation. Methods Patients ≥ 18 years old with cancer, an Eastern Cooperative Oncology Group performance status ≤ 2, who had been receiving a stable regimen of opioid analgesics for ≥ 2 weeks, had at least one constipation symptom despite laxative use, and no more than five spontaneous bowel movements (SBMs) during the past 14 days, were randomly assigned (1:1:1:1) to oral, once-daily naldemedine 0...
April 26, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28443705/severity-of-withdrawal-symptoms-plasma-oxytocin-levels-and-treatment-outcome-in-heroin-users-undergoing-acute-withdrawal
#16
Kakia Nikolaou, Dorothea Kapoukranidou, Samuel Ndungu, Georgios Floros, Leda Kovatsi
Pre-clinical studies show that, following chronic opioid exposure, oxytocin neurons exhibit over-excitation upon withdrawal, causing an increase in oxytocin brain and plasma levels. Relevant clinical data on humans are scarce. This study investigates the opioid withdrawal stress effect on oxytocin plasma levels in humans. We evaluated 57 male chronic heroin users in a residential detoxification program. We determined plasma oxytocin levels by ELISA and measured the stress effects of withdrawal using the COWS scale for opioid withdrawal, the VAS scale for craving, and the Hamilton scales for anxiety and depression on the second day of admission...
April 26, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28443503/kratom-and-future-treatment-for-the-opiods-addiction-and-chroic-pain-periculo-beneficium
#17
Ismaliza Ismail, Suzaily Wahab, Hatta Sidi, Srijit Das, Loo Jiann Lin, Rosdinom Razali
Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated...
April 25, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28442580/ethanol-reversal-of-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-hydrocodone
#18
Joanna C Jacob, Justin L Poklis, Hamid I Akbarali, Graeme Henderson, William L Dewey
This study compared the development of tolerance and its reversal by ethanol of two orally-bioavailable prescription opioids, oxycodone and hydrocodone, to that of morphine. Oxycodone (s.c) was significantly more potent in the mouse tail withdrawal assay than either morphine or hydrocodone. Oxycodone was also significantly more potent in this assay than hydrocodone when administered orally. Tolerance was seen following chronic subcutaneous administration of each of the three drugs and by the chronic administration of oral oxycodone, but not following the chronic oral administration of hydrocodone...
April 25, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28442370/modulation-of-drug-choice-by-extended-drug-access-and-withdrawal-in-rhesus-monkeys-implications-for-negative-reinforcement-as-a-driver-of-addiction-and-target-for-medications-development
#19
REVIEW
S Stevens Negus, Matthew L Banks
Chronic drug exposure is hypothesized to recruit negative reinforcement processes that increase the magnitude and alter the mechanisms of drug reinforcement. Candidate substrates of negative reinforcement include increased signaling via stress-related neurotransmitters such as corticotropin releasing factor (CRF, acting at CRF receptors) or dynorphin (acting at kappa opioid receptors) and/or decreased signaling via reward-related neurotransmitters such as dopamine. Determinants of drug reinforcement can be examined with choice procedures, in which subjects choose between a drug of interest (e...
April 22, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28441707/fentanyl-inhibits-tumorigenesis-from-human-breast-stem-cells-by-inducing-apoptosis
#20
Nadir Kocak, Filiz Ozen, Ibrahim Halil Yildirim, Yagmur Duran
Fentanyl is an opioid analgesic that it is widely used in cancer patients. Since there have been reports of effects of analgesic medications on the recurrence and development of resistance to treatment, influences of of fentanyl on MCF-7 and HEK293 cells were evaluated. Cell viability and apoptosis were assessed by MTT assay and flow cytometry, respectively. Gene expression analysis was performed by quantitative real-time PCR assay for the Oct4, Sox2 and Nanog genes as stem cell markers and Bax, Bcl2, and p53 genes as apoptosis markers...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
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