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Opioid Overuse

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https://www.readbyqxmd.com/read/29774774/undertreatment-of-pain-and-low-use-of-opioids-in-latin-america
#1
César Amescua García, Joao Batista Santos Garcia, María Del Rosario Berenguel Cook, Frantz Colimon, José Alberto Flores Cantisani, Carlos Guerrero, María Del Rocío Guillén Núnez, John Jairo Hernández Castro, Durval Campos Kraychete, Argelia Lara-Solares, Osvandré Lech, María Antonieta Rico Pazos, Manuel Sempértegui Gallegos, Lizandra Pattaro Marcondes
Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries...
May 18, 2018: Pain Management
https://www.readbyqxmd.com/read/29760569/concomitant-use-of-opioid-medications-with-triptans-or-serotonergic-antidepressants-in-us-office-based-physician-visits
#2
Kyle C Molina, Kathleen A Fairman, David A Sclar
Background: Opioids are not recommended for routine treatment of migraine because their benefits are outweighed by risks of medication overuse headache and abuse/dependence. A March 2016 US Food and Drug Administration (FDA) safety communication warned of the risk of serotonin syndrome from using opioids concomitantly with 5-hydroxytryptamine receptor agonists (triptans) or serotonergic antidepressants: selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29697475/using-analgesics-for-emotional-modulation-is-associated-with-increased-distress-depression-and-risk-of-opioid-and-alcohol-misuse-initial-evaluation-and-component-analysis-of-the-reasons-for-analgesic-use-measure-raum
#3
Kevin E Vowles, Robert W Bailey, Mindy L McEntee, Melissa Pielech, Karlyn A Edwards, Lena A Bolling, W Evan Rivers
OBJECTIVES: It is important to identify aspects of analgesic use that are associated with harm in chronic pain. Historically, the focus has been patterns of use (e.g., overuse). This study evaluated another aspect of use - rather than evaluating how analgesics were being used, the primary interest was in why they were being used. METHODS: 334 analgesic using individuals with chronic pain responded to a pool of items assessing reasons for analgesic use. Measures of pain intensity, distress, depression, and opioid and alcohol misuse were also completed...
April 24, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#4
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29652953/-prescription-of-opioids-at-the-moment-of-discharge-from-an-emergency-department
#5
Matías Martínez, Luis Herrada, Ana Muñoz, Camila Chávez, Marcela Jirón
Background There is a worrisome increase in opioid prescription worldwide. Their use and overuse may cause adverse outcomes. Aim To determine incidence and characteristics of opioid prescription at discharge at an emergency department (ED). Material and Methods A prospective observational study in a random sample of adult patients attended at an ED of a teaching hospital. We reviewed medical records prescriptions for each patient to collect information about drugs prescribed, reason and medical indication of use (doses and duration)...
December 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29622502/chronic-pain-medication-management-of-older-populations-key-points-from-a-national-conference-and-innovative-opportunities-for-pharmacy-practice
#6
Julia Fiona-Maree Gilmartin-Thomas, J Simon Bell, Danny Liew, Carolyn A Arnold, Rachelle Buchbinder, Colin Chapman, Flavia Cicuttini, Malcolm Dobbin, Stephen J Gibson, Melita J Giummarra, Jenny Gowan, Benny Katz, Dan I Lubman, Matthew McCrone, Jennifer Pilgrim, Anneliese Synnot, Eleanor van Dyk, Barbara Workman, John McNeil
OBJECTIVE: Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia)...
March 19, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29584828/cms-to-improve-drug-programs-and-opioid-overuse-oversight
#7
Rita Rubin
No abstract text is available yet for this article.
March 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29560069/cannabinoid-hyperemesis-syndrome-public-health-implications-and-a-novel-model-treatment-guideline
#8
Jeff Lapoint, Seth Meyer, Charles K Yu, Kristi L Koenig, Roneet Lev, Sayone Thihalolipavan, Katherine Staats, Christopher A Kahn
Introduction: Cannabinoid hyperemesis syndrome (CHS) is an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers. Patients often present to the emergency department (ED) repeatedly and undergo extensive evaluations including laboratory examination, advanced imaging, and in some cases unnecessary procedures. They are exposed to an array of pharmacologic interventions including opioids that not only lack evidence, but may also be harmful...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29530747/use-of-intravenous-acetaminophen-in-postoperative-pain-management-after-partial-and-full-bony-impacted-third-molar-extractions-a-randomized-double-blind-controlled-trial
#9
Isabel Atencio, Max Beushausen, John J Kowalczyk, Andres Flores-Hidalgo, Nora F Fino, Dale A Baur
PURPOSE: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use. MATERIALS AND METHODS: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29505419/depression-effects-on-long-term-prescription-opioid-use-abuse-and-addiction
#10
Mark Sullivan
OBJECTIVES: Treatment guidelines discourage long-term opioid treatment for patients with chronic pain and major depression, but this treatment occurs commonly, producing higher daily doses, longer duration, and more adverse events. METHODS: Review of prospective cohort, retrospective cohort, and other observational studies of the relation between depression and opioid use, abuse, and addiction. RESULTS: Depressed patients initiate opioid therapy slightly more often than non-depressed patients, but are twice as likely to transition to long-term use...
March 2, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29485950/estimating-the-direct-costs-of-outpatient-opioid-prescriptions-a-retrospective-analysis-of-data-from-the-rhode-island-prescription-drug-monitoring-program
#11
Hilary Aroke, Ashley Buchanan, Xuerong Wen, Peter Ragosta, Jennifer Koziol, Stephen Kogut
BACKGROUND: Overuse and misuse of prescription opioids is associated with increased morbidity and mortality and places a significant cost burden on health systems. OBJECTIVE: To estimate annual statewide spending for prescription opioids in Rhode Island. METHODS: A cross-sectional study of opioids dispensed from retail pharmacies using data from the Rhode Island Prescription Drug Monitoring Program (PDMP) was performed. The study sample consisted of 651,227 opioid prescriptions dispensed to 197,062 patients between January 1, 2015, and December 31, 2015...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29484686/predictors-of-gabapentin-overuse-with-or-without-concomitant-opioids-in-a-commercially-insured-u-s-population
#12
Alyssa M Peckham, Kirk E Evoy, Jordan R Covvey, Leslie Ochs, Kathleen A Fairman, David A Sclar
OBJECTIVE: Research suggests the medical consequences of gabapentin overuse depend on whether gabapentin is abused alone or with opioids to potentiate an opioid "high." The objective of this study was to assess predictors of gabapentin overuse with or without concomitant opioids. METHODS: Data were obtained from the Truven Health MarketScan® Commercial Claims and Encounters database for 2013 through 2015. Eligibility criteria were gabapentin utilization, with or without opioids, for 120 days or longer throughout a 12-month observation period...
April 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29342356/the-dark-side-of-total-synthesis-strategies-and-tactics-in-psychoactive-drug-production
#13
Schuyler A Chambers, Jenna M DeSousa, Eric D Huseman, Steven D Townsend
Humankind has used and abused psychoactive drugs for millennia. Formally, a psychoactive drug is any agent that alters cognition and mood. The term "psychotropic drug" is neutral and describes the entire class of substrates, licit and illicit, of interest to governmental drug policy. While these drugs are prescribed for issues ranging from pain management to anxiety, they are also used recreationally. In fact, the current opioid epidemic is the deadliest drug crisis in American history. While the topic is highly politicized with racial, gender, and socioeconomic elements, there's no denying the toll drug mis- and overuse is taking on this country...
January 17, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29232762/review-article-best-practice-management-of-low-back-pain-in-the-emergency-department-part-1-of-the-musculoskeletal-injuries-rapid-review-series
#14
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Low back pain (LBP) is a common presentation to the ED, and a frequent cause of disability globally. The ED management is often associated with high rates of imaging, misuse and overuse of pharmacology and subsequent financial implications. Given this, improved quality of care for patients with LBP in ED is essential. This rapid review investigated best practice for the assessment and management of LBP in the ED. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2015...
February 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29195750/partnership-healthplan-of-california-addressing-opioid-overuse-with-behavioral-design-principles
#15
Joshua M Liao, Amanda Hodlofski, Robert Moore, Amol S Navathe
No abstract text is available yet for this article.
November 28, 2017: Healthcare
https://www.readbyqxmd.com/read/29101861/clinical-characteristics-and-overuse-patterns-of-medication-overuse-headache-retrospective-case-series-study
#16
Karolis Kluonaitis, Elena Petrauskiene, Kristina Ryliskiene
According to Eurolight project's results, frequency of medication overuse headache in Lithuania is similar to other European countries. However, data on the characteristics of the disorder is lacking. OBJECTIVE: The aim was to analyze clinical characteristics and overuse patterns of patients with medication overuse headache. PATIENTS AND METHODS: Retrospective study was conducted in out-patient department of university hospital. 57.0% of the patients were from Vilnius and 43...
December 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29049112/america-s-opioid-epidemic-supply-and-demand-considerations
#17
REVIEW
David J Clark, Mark A Schumacher
America is in the midst of an opioid epidemic characterized by aggressive prescribing practices, highly prevalent opioid misuse, and rising rates of prescription and illicit opioid overdose-related deaths. Medical and lay public sentiment have become more cautious with respect to prescription opioid use in the past few years, but a comprehensive strategy to reduce our reliance on prescription opioids is lacking. Addressing this epidemic through reductions in unnecessary access to these drugs while implementing measures to reduce demand will be important components of any comprehensive solution...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29026458/safe-opioid-prescription-a-smart-on-fhir-approach-to-clinical-decision-support
#18
Shyamashree Sinha, Mark Jensen, Sarah Mullin, Peter L Elkin
Background Prescription opioid pain medication overuse, misuse and abuse have been a significant contributing factor in the opioid epidemic. The rising death rates from opioid overdose have caused healthcare practitioners and researchers to work on optimizing pain therapy and limiting the prescriptions for pain medications. The state of New York has implemented a prescription drug monitoring program(PDMP), amended public health law to limit the prescription of opioids for acute pain and utilized the resources of the state and county health departments to help in curbing this epidemic...
2017: Online Journal of Public Health Informatics
https://www.readbyqxmd.com/read/29025135/current-perspective-on-the-use-of-opioids-in-perioperative-medicine-an-evidence-based-literature-review-national-survey-of-70-000-physicians-and-multidisciplinary-clinical-appraisal
#19
Jonathan S Jahr, Sergio D Bergese, Ketan R Sheth, Nicholas M Bernthal, Hung S Ho, Nicoleta Stoicea, Christian C Apfel
Objective: Opioids represent an important analgesic option for physicians managing acute pain in surgical patients. Opioid management is not without its drawbacks, however, and current trends suggest that opioids might be overused in the United States. An expert panel was convened to conduct a clinical appraisal regarding the use of opioids in the perioperative setting. Methods: The clinical appraisal consisted of the review, presentation, and assessment of current published evidence as it relates to the statement "Opioids are not overused in the United States, even though opioid adjunct therapy achieves greater pain control with less risk...
August 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28956286/all-cause-and-drug-related-medical-events-associated-with-overuse-of-gabapentin-and-or-opioid-medications-a-retrospective-cohort-analysis-of-a-commercially-insured-us-population
#20
Alyssa M Peckham, Kathleen A Fairman, David A Sclar
INTRODUCTION: Overuse of gabapentin and/or opioids occurs in a small percentage of patients at > 3-fold labeled dosages. Gabapentin may potentiate opioid effects. OBJECTIVE: The aim was to assess patient harm, defined as use of inpatient hospital (IPH) or emergency department (ED) services, associated with overuse of gabapentin with or without concomitant overuse of opioids. DATA SOURCE: Data were sourced from the Truven Health MarketScan® Commercial Claims and Encounters database, for the years 2013-2015...
February 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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