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https://www.readbyqxmd.com/read/29245103/long-acting-intramuscular-naltrexone-for-opioid-use-disorder-utilization-and-association-with-multi-morbidity-nationally-in-the-veterans-health-administration
#1
Megan M Kelly, Erin Reilly, Timothy Quiñones, Nitigna Desai, Robert Rosenheck
BACKGROUND: Long acting intramuscular (IM) naltrexone is an effective treatment for opioid use disorder (OUD), but rates and correlates of its use have not been studied. METHODS: National administrative from the Veterans Health Administration (VHA) from Fiscal Year 2012 identified only 16 VHA facilities that prescribed IM naltrexone to 5 or more veterans diagnosed with OUD. Data from these facilities were used to identify sociodemographic, diagnostic, and service use characteristics, including use of psychotropic medication, that were characteristic of veterans who filled prescriptions for IM naltrexone...
December 2, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29244540/overcoming-impediments-to-otp-expansion-in-the-united-states-and-abroad
#2
Mark W Parrino
By all published accounts and federal government reports, the United States is experiencing a serious opioid use epidemic. Additional treatment resources are needed in order to provide access to evidence based medical care for untreated individuals with substance use disorders. The focus of this commentary is increasing access to more opioid treatment programs and overcoming the significant impediments, which block such efforts.
December 15, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29243546/changes-in-medication-use-in-a-cohort-of-patients-with-advanced-cancer-the-international-multicentre-prospective-european-palliative-care-cancer-symptom-study
#3
Kristel Paque, Monique Elseviers, Robert Vander Stichele, Koen Pardon, Marianne J Hjermstad, Stein Kaasa, Tinne Dilles, Martine De Laat, Simon Van Belle, Thierry Christiaens, Luc Deliens
BACKGROUND: Information on medication use in the last months of life is limited. AIM: To describe which medications are prescribed and deprescribed in advanced cancer patients receiving palliative care in relation to time before death and to explore associations with demographic variables. DESIGN: Prospective study, using case report forms for monthly data collection. Medication included cancer treatment and 19 therapeutic groups, grouped into four categories for: (1) cancer therapy, (2) specific cancer-related symptom relief, (3) other symptom relief and (4) long-term prevention...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29243034/application-of-pyridostigmine-in-pediatric-gastrointestinal-motility-disorders-a-case-series
#4
Mhd Louai Manini, Michael Camilleri, Rayna Grothe, Carlo Di Lorenzo
BACKGROUND: Gastrointestinal (GI) motility disorders are common in children. Treatment is challenging with limited medical and surgical options. Pyridostigmine, an acetyl cholinesterase inhibitor, increases acetylcholine at the neuromuscular junction promoting intestinal contractions. Little is known about the role and dosing of pyridostigmine in pediatric GI motility disorders. METHODS: We present a case series of children with GI dysmotility managed with oral pyridostigmine...
December 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29242972/perioperative-pain-after-robot-assisted-versus-laparoscopic-rectal-resection
#5
Rikke Tolstrup, Jonas Amstrup Funder, Liselotte Lundbech, Niels Thomassen, Lene Hjerrild Iversen
BACKGROUND: In order to improve the surgical treatment of rectal cancer, robot-assisted laparoscopy has been introduced. The robot has gained widespread use; however, the scientific basis for treatment of rectal cancer is still unclear. The aim of this study was to investigate whether robot-assisted laparoscopic rectal resection cause less perioperative pain than standard laparoscopic resection measured by the numerical rating scale (NRS score) as well as morphine consumption. METHODS: Fifty-one patients were randomized to either laparoscopic or robot-assisted rectal resection at the Department of Surgery at Aarhus University Hospital in Denmark...
December 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29241834/efficacy-and-safety-of-oral-and-transdermal-opioid-analgesics-for-musculoskeletal-pain-in-older-adults-a-systematic-review-of-randomized-placebo-controlled-trials
#6
REVIEW
Rodrigo Z Megale, Leticia A Deveza, Fiona M Blyth, Vasi Naganathan, Paulo H Ferreira, Andrew J McLachlan, Manuela L Ferreira
This systematic review with meta-analysis was performed to evaluate the efficacy and safety of using opioid analgesics in older adults with musculoskeletal pain. We searched Cochrane Library, MEDLINE, EMBASE, Web of Science, AMED, CINAHL and LILACS for randomized controlled trial with mean population age of 60 years or older, comparing the efficacy and safety of opioid analgesics with placebo for musculoskeletal pain conditions. Reviewers extracted data, assessed risk of bias and evaluated the quality of evidence using the GRADE approach...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29241428/state-targeted-funding-and-technical-assistance-to-increase-access-to-medication-treatment-for-opioid-use-disorder
#7
Amanda J Abraham, Christina M Andrews, Colleen M Grogan, Harold A Pollack, Thomas D'Aunno, Keith Humphreys, Peter D Friedmann
OBJECTIVE: As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. METHODS: This study draws from the 2013-2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs...
December 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#8
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29240318/ketamine-in-the-treatment-of-acute-pain
#9
Elina Brinck, Vesa Kontinen
Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29240048/why-patients-are-afraid-of-opioid-analgesics-study-on-opioid-perception-in-patients-treated-for-chronic-pain
#10
Michał Graczyk, Alina Borkowska, Małgorzata Krajnik
INTRODUCTION    Opiophobia is deemed one of the key barriers in effective pain management.  OBJECTIVES    The study aimed to assess overall perception of opioids in cancer patients suffering from and treated for chronic pain, as well as determine the nature of their most common, related fears.  PATIENTS AND METHODS    The study comprised 100 palliative care patients who suffered from chronic cancer or non-cancer pain. Initially, they had to complete a survey exploring their knowledge on analgesics and potential fear of using opioids...
December 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29239947/treatment-of-chronic-pain-with-various-buprenorphine-formulations-a-systematic-review-of-clinical-studies
#11
Rohit Aiyer, Amitabh Gulati, Semih Gungor, Anuj Bhatia, Neel Mehta
Clinical studies demonstrate that buprenorphine is a pharmacologic agent that can be used for the treatment of various types of painful conditions. This study investigated the efficacy of 5 different types of buprenorphine formulations in the chronic pain population. The literature was reviewed on PubMed/MEDLINE, EMBASE, Cochrane Database, clinicaltrials.gov, and PROSPERO that dated from inception until June 30, 2017. Using the population, intervention, comparator, and outcomes method, 25 randomized controlled trials were reviewed involving 5 buprenorphine formulations in patients with chronic pain: intravenous buprenorphine, sublingual buprenorphine, sublingual buprenorphine/naloxone, buccal buprenorphine, and transdermal buprenorphine, with comparators consisting of opioid analgesics or placebo...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29239777/a-content-review-of-online-naloxone-continuing-education-courses-for-pharmacists-in-states-with-standing-orders
#12
Delesha M Carpenter, Courtney A Roberts, Salisa C Westrick, Stefanie P Ferreri, Korey A Kennelty, Kevin A Look, Olufunmilola Abraham, Courtenay Wilson
BACKGROUND: Many community pharmacists are uncomfortable educating patients about naloxone, an opioid reversal agent. OBJECTIVE: To examine whether training materials prepare pharmacists to counsel patients and caregivers about naloxone, online naloxone education materials for pharmacists in the 13 states with standing orders were analyzed. METHODS: Two coders reviewed 12 naloxone training programs and extracted data for 15 topics that were clustered in four categories: background/importance, naloxone products, business/operations, and communication...
November 21, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29239347/chronic-constipation
#13
REVIEW
Michael Camilleri, Alexander C Ford, Gary M Mawe, Phil G Dinning, Satish S Rao, William D Chey, Magnus Simrén, Anthony Lembo, Tonia M Young-Fadok, Lin Chang
Chronic constipation is a prevalent condition that severely impacts the quality of life of those affected. Several types of primary chronic constipation, which show substantial overlap, have been described, including normal-transit constipation, rectal evacuation disorders and slow-transit constipation. Diagnosis of primary chronic constipation involves a multistep process initiated by the exclusion of 'alarm' features (for example, unintentional weight loss or rectal bleeding) that might indicate organic diseases (such as polyps or tumours) and a therapeutic trial with first-line treatments such as dietary changes, lifestyle modifications and over-the-counter laxatives...
December 14, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29237725/abin-1-negatively-regulates-%C3%AE-opioid-receptor-function
#14
Peilan Zhou, Jiebing Jiang, Hui Yan, Yulei Li, Junru Zhao, Xiao Wang, Ruibin Su, Zehui Gong
The μ-opioid receptor (MOR) is a Gi/o protein-coupled receptor that mediates analgesic, euphoric, and reward effects. Using a bacterial two-hybrid screen, we reported that the carboxyl tail of the rat MOR associates with A20-binding inhibitor of nuclear factor (NF)-κB (ABIN-1) (Zhou et al., 2015). This interaction was confirmed by direct protein - protein binding and co-immunoprecipitation of MOR and ABIN-1 proteins in cell lysates. Saturation binding studies showed that ABIN-1 had no effect on MOR binding...
December 13, 2017: Molecular Pharmacology
https://www.readbyqxmd.com/read/29236562/from-narcotic-to-normalizer-the-misperception-of-methadone-treatment-and-the-persistence-of-prejudice-and-bias
#15
Joycelyn Sue Woods, Herman Joseph
This article concentrates on methadone maintenance as a normalizer for the impairments of opioid addiction, and the misunderstandings of it as a substitute for heroin that continues an opiate addiction. Methadone treatment was developed by Drs. Dole, Nyswander, and Kreek. Their cutting-edge theory transformed the way that opioid addiction is perceived and their work changed methadone from a narcotic to withdraw addicts to a medication that is a maintenance normalizer for a chronic condition. Their extensive research involved the physiological and sociological normalizing effects of methadone and medical safety of the medication (Dole & Nyswander, 1967)...
December 13, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29234968/a-cross-national-analysis-of-the-association-between-years-of-implementation-of-opioid-substitution-treatments-and-drug-related-deaths-in-europe-from-1995-to-2013
#16
Phillip L Marotta, Charlotte A McCullagh
Data at the individual-level provide evidence that opioid substitution treatment (OST) programs protect against mortality for opioid dependent populations. Prior research has not examined the merits of national implementation of opioid substitution programs for reducing mortality at the country-level. This study elucidates longitudinal associations between country-level implementation of opioid substitution treatment programs on mortality rates of drug related deaths (DRD) from 1995 to 2013 in 30 European nations...
December 12, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29231916/-the-use-of-transdermal-fentanyl-in-the-treatment-of-patients-suffering-from-chronic-non-cancer-pain-case-reports
#17
Tatiana Pietrzyńska, Łukasz Pietrzyński
The use of strong opioids for the treatment of chronic non-cancer pain (CNCP) has gained undisputed acceptance among specialists and should be considered when other pharmacological treatments are not effective or cause serious side effects. However, drugs from the third step of analgesic ladder still raise concerns among doctors and patients in the case of long-term therapy. A CASE REPORT: The authors present reports of three cases of patients with CNCP caused by musculoskeletal disorders and numerous comorbidities...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29231613/-effects-of-electroacupuncture-on-expression-of-%C3%AE-opioid-receptor-in-nucleus-ceruleus-in-rats-with-bone-cancer-pain-morphine-tolerance
#18
Taofang Fu, Lingling Wang, Junying Du, Feng Chen, Junfan Fang, Yi Liang, Jianqiao Fang
OBJECTIVE: To observe the effects of electroacupuncture (EA) on pain behavior in rats with bone cancer pain and morphine tolerance, and to explore partial action mechanism. METHODS: Forty-two SD healthy female rats were randomly divided into a sham operation group (7 rats), a bone cancer pain group (8 rats), a morphine tolerance group (9 rats), an EA group (9 rats) and a sham EA group (9 rats). The rats in the sham operation group were treated with injection of phosphate buffer saline at medullary cavity of left-side tibia, and the rats in the remaining groups were injected with MRMT-1 breast cancer cells...
May 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29230890/effects-of-analgesics-on-bone-mineral-density-a-longitudinal-analysis-of-the-prospective-swan-cohort-with-three-group-matching-weights
#19
Kazuki Yoshida, Zhi Yu, Gail A Greendale, Kristine Ruppert, Yinjuan Lian, Sara K Tedeschi, Tzu-Chieh Lin, Sebastien Haneuse, Robert J Glynn, Sonia Hernández-Díaz, Daniel H Solomon
PURPOSE: To examine the effects of analgesics on bone mineral density (BMD), which have not been examined in a longitudinal study with multiple measurements. METHODS: We investigated changes in BMD associated with new use of analgesics in a prospective longitudinal cohort of mid-life women. BMD and medication use were measured annually. We compared BMD among new users of acetaminophen, NSAIDs, and opioids. Adjustment for baseline covariates was conducted through propensity score matching weights...
December 12, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29229491/could-cannabis-liberalisation-lead-to-wider-changes-in-drug-policies-and-outcomes
#20
Brendan Hughes, Lucas Wiessing, Don Des Jarlais, Paul Griffiths
Cannabis policies are changing in some countries. This may have consequences that extend beyond cannabis-specific outcomes, such as an impact on the consumption patterns of other substances. Changes in cannabis policies may also influence policy responses to other drugs, as countries re-assess the balance between law enforcement and public health objectives. If this happens, it could have important health and social consequences, especially in those countries where a 'war on drugs' policy perspective has inhibited investment in evidence based responses in areas such as treatment and harm reduction...
December 8, 2017: International Journal on Drug Policy
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