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Opioid Epidemic

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https://www.readbyqxmd.com/read/28930612/genetic-addiction-risk-score-gars-%C3%A2-a-predictor-of-vulnerability-to-opioid-dependence
#1
Kenneth Blum, Amanda L C Chen, Panayotis K Thanos, Marcelo Febo, Zsolt Demetrovics, Kristina Dushaj, Abraham Kovoor, David Baron, David E Smith, Alphonso Kenison Roy Iii, Lyle Fried, Thomas J H Chen, Edwin Chapman, Edward Modestino, Bruce Steinberg, Rajendra D Badgaiyan
The interaction of neurotransmitters and genes that control the release of dopamine is the Brain Reward Cascade (BRC). Variations within the BRC, whether genetic or epigenetic, may predispose individuals to addictive behaviors and altered pain tolerance. This discussion authored by a group of concerned scientists and clinicians examines the Genetic Addiction Risk Score (GARS), the first test to accurately predict vulnerability to pain, addiction, and other compulsive behaviors, defined as Reward Deficiency Syndrome (RDS)...
January 1, 2018: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/28929914/the-conundrum-of-opioid-tapering-in-long-term-opioid-therapy-for-chronic-pain-a-commentary
#2
Ajay Manhapra, Albert A Arias, Jane C Ballantyne
BACKGROUND: In response to the opioid epidemic and new guidelines, many patients on high-dose long term opioid therapy (LTOT) for chronic pain are getting tapered off opioids. As a result, a unique clinical challenge is emerging: while many on LTOT have poor pain control, functional decline, psychiatric instability, aberrancies and misuse, these issues may often worsen with opioid tapering. Currently, a clear explanation and practical guidance on how to manage this perplexing clinical scenario is lacking...
September 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28925644/how-family-physicians-can-combat-the-opioid-epidemic
#3
Jennifer L Middleton
No abstract text is available yet for this article.
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28923194/the-association-between-insomnia-and-prescription-opioid-use-results-from-a-community-sample-in-northeast-florida
#4
Mirsada Serdarevic, Vicki Osborne, Catherine W Striley, Linda B Cottler
OBJECTIVE: The current analysis examines whether opioid use is associated with insomnia in a community sample, as the consequences of the growing epidemic of prescription opioid use continue to cause public health concern. STUDY DESIGN: A cross-sectional study including 8433 members in a community outreach program, HealthStreet, in Northeast Florida. METHODS: Community Health Workers (CHWs) assessed health information, including use of opioids (i...
October 2017: Sleep Health
https://www.readbyqxmd.com/read/28921667/polysubstance-use-among-adolescents-in-a-low-income-rural-community-latent-classes-for-middle-and-high-school-students
#5
Roderick A Rose, Caroline B R Evans, Paul R Smokowski, Matthew O Howard, Katie L Stalker
PURPOSE: Rural communities are currently being impacted by a nationwide epidemic of prescription opioid misuse. Rural adolescent substance users may be at substantial risk for later addiction to these and other drugs. METHODS: This study uses Latent Class Analysis to identify subtypes of polysubstance users among a sample of 7,074 rural adolescents. Separate models were estimated for middle- and high-school youth. Predictive validity was estimated using cumulative ordinal logistic regression of the classes on a set of youth and family characteristics...
September 18, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28920715/the-mixed-message-behind-medication-assisted-treatment-for-substance-use-disorder
#6
Sean M Robinson, Bryon Adinoff
The gap between treatment utilization and treatment need for substance use disorders (SUDs) remains a significant concern in our field. While the growing call to bridge this gap often takes the form of more treatment services and/or better integration of existing services, this perspective proposes that more effective labels for and transparent descriptions of existing services would also have a meaningful impact. Adopting the perspective of a consumer-based health-care model (wherein treatments and services are products and patients are consumers) allows us to consider how labels like Addiction-focused Medical Management, Medication-Assisted Treatment, Medication-Assisted Therapy, and others may actually be contributing to the underutilization problem rather than alleviating it...
September 18, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28916995/effects-of-environmental-enrichment-on-self-administration-of-the-short-acting-opioid-remifentanil-in-male-rats
#7
Rebecca S Hofford, Jonathan J Chow, Joshua S Beckmann, Michael T Bardo
BACKGROUND: Opioid abuse is a major problem around the world. Identifying environmental factors that contribute to opioid abuse and addiction is necessary for decreasing this epidemic. In rodents, environmental enrichment protects against the development of low dose stimulant self-administration, but studies examining the effect of enrichment and isolation (compared to standard housing) on the development of intravenous opioid self-administration have not been conducted. The present study investigated the role of environmental enrichment on self-administration of the short-acting μ-opioid remifentanil...
September 15, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28894357/advances-in-the-delivery-of-buprenorphine-for-opioid-dependence
#8
REVIEW
Richard N Rosenthal, Viral V Goradia
Opioid use disorders (OUDs) have long been a global problem, but the prevalence rates have increased over 20 years to epidemic proportions in the US, with concomitant increases in morbidity and all-cause mortality, but especially opioid overdose. These increases are in part attributable to a several-fold expansion in the prescription of opioid pain medications over the same time period. Opioid detoxification and psychosocial treatments alone have each not yielded sufficient efficacy for OUD, but μ-opioid receptor agonist, partial agonist, and antagonist medications have demonstrated the greatest overall benefit in OUD treatment...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28889218/opioid-use-following-gynecologic-and-pelvic-reconstructive-surgery
#9
Lekha S Hota, Hussein A Warda, Miriam J Haviland, Frances M Searle, Michele R Hacker
INTRODUCTION AND HYPOTHESIS: Opioid use, addiction, and overdose are a growing epidemic in the USA. Our objective was to determine whether the amount of opioid medication prescribed following gynecologic and pelvic reconstructive surgery is insufficient, adequate, or in excess. We hypothesized that we were overprescribing postoperative opioids. METHODS: Participants who were at least 18 years old and underwent gynecologic and/or pelvic reconstructive surgery from April through August 2016 were eligible to participate...
September 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28887019/are-we-still-prescribing-opioids-for-osteoarthritis
#10
David E DeMik, Nicholas A Bedard, S Blake Dowdle, Robert A Burnett, Michael A McHugh, John J Callaghan
BACKGROUND: The United States is in the midst of an opioid epidemic. These medications continue to be used to manage pain associated with osteoarthritis, despite mounting evidence questioning the benefits. The rate at which opioids are prescribed for osteoarthritis is largely unknown. We sought to identify rates of opioid prescriptions for osteoarthritis and identify factors associated with higher rates of prescribing. METHODS: We queried the Humana, Inc. administrative claims database from 2007 to 2014...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28885516/treating-acute-pain-in-the-opiate-dependent-patient
#11
Coleen Dever
Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28884995/the-opioid-epidemic-what-can-surgeons-do-about-it
#12
Saurabh Saluja, Don Selzer, John G Meara, Kathleen Heneghan, John M Daly
No abstract text is available yet for this article.
July 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28874942/effect-of-a-no-superuser-opioid-prescription-policy-on-ed-visits-and-statewide-opioid-prescription
#13
Zachary P Kahler, Paul I Musey, Jason T Schaffer, Annelyssa N Johnson, Christian C Strachan, Charles M Shufflebarger
INTRODUCTION: The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED) based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol's effect on superusers' annual ED visits. Secondary outcomes included a quantitative evaluation of statewide opioid prescriptions for these patients, unique prescribers of controlled substances, and ancillary testing...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28862884/opioid-prescribing-patterns-by-obstetrics-and-gynecology-residents-in-the-united-states
#14
Adam D Baruch, Daniel McBurney Morgan, Vanessa K Dalton, Carolyn Swenson
BACKGROUND: Despite the opioid epidemic in the U.S., little data exist to guide postoperative opioid prescribing in Obstetrics & Gynecology (Ob/Gyn). OBJECTIVE: To describe Ob/Gyn resident opioid prescription patterns in the U.S. and assess influential factors. METHODS: An anonymous survey was emailed to Ob/Gyn residents in the U.S. between January-February 2015. Respondents reported the typical number of discharge narcotic tablets prescribed following six common procedures...
September 1, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28859050/overdose-deaths-related-to-fentanyl-and-its-analogs-ohio-january-february-2017
#15
Raminta Daniulaityte, Matthew P Juhascik, Kraig E Strayer, Ioana E Sizemore, Kent E Harshbarger, Heather M Antonides, Robert R Carlson
Ohio is experiencing unprecedented loss of life caused by unintentional drug overdoses (1), with illicitly manufactured fentanyl (IMF) emerging as a significant threat to public health (2,3). IMF is structurally similar to pharmaceutical fentanyl, but is produced in clandestine laboratories and includes fentanyl analogs that display wide variability in potency (2); variations in chemical composition of these drugs make detection more difficult. During 2010-2015, unintentional drug overdose deaths in Ohio increased 98%, from 1,544 to 3,050...
September 1, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28858693/trends-in-average-days-supply-of-opioid-medications-in-medicaid-and-commercial-insurance
#16
Ali Bonakdar Tehrani, Rachel Mosher Henke, Mir M Ali, Ryan Mutter, Tami L Mark
OBJECTIVES: To calculate trends in adult average days' supply for six commonly prescribed opioids: hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, and tapentadol to assess whether physicians changed prescribing practices at the time of the intensifying epidemic. METHODS: We used 2005-2015 Truven Health MarketScan Commercial Claims and Encounters data to measure trends in opioid average days' supply among commercially insured individuals and 2005-2014 MarketScan Multi-State Medicaid data to measure trends in opioid average days' supply among Medicaid beneficiaries...
August 19, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28857933/the-opioid-epidemic-postoperative-pain-management-strategies-in-orthopaedics
#17
Joseph T Labrum, Asif M Ilyas
No abstract text is available yet for this article.
August 29, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28846839/the-opioid-epidemic-weaves-its-way-through-the-transplant-community
#18
EDITORIAL
L C Pullen
No abstract text is available yet for this article.
September 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28842930/medication-assisted-opioid-treatment-prescribers-in-federally-qualified-health-centers-capacity-lags-in-rural-areas
#19
Emily B Jones
PURPOSE: This study explores correlates of on-site availability of substance use disorder treatment services in federally qualified health centers, including buprenorphine treatment that is critical to addressing the opioid epidemic. METHODS: We employed descriptive and multivariable analyses with weighted 2010 Assessment of Behavioral Health Services survey data and the 2010 Uniform Data System. FINDINGS: In 2010, 47.6% of health centers provided on-site substance use disorder treatment, 12...
August 26, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28832871/reframing-the-opioid-epidemic-as-a-national-emergency
#20
Lawrence O Gostin, James G Hodge, Sarah A Noe
No abstract text is available yet for this article.
August 23, 2017: JAMA: the Journal of the American Medical Association
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