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Opioid Epidemic

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https://www.readbyqxmd.com/read/28526967/update-on-barriers-to-pharmacotherapy-for-opioid-use-disorders
#1
REVIEW
Anjalee Sharma, Sharon M Kelly, Shannon Gwin Mitchell, Jan Gryczynski, Kevin E O'Grady, Robert P Schwartz
PURPOSE OF REVIEW: The recent heroin and prescription opioid misuse epidemic has led to a sharp increase in the number of opioid overdose deaths in the USA. Notwithstanding the availability of three FDA-approved medications (methadone, buprenorphine, and naltrexone) to treat opioid use disorder, these medications are underutilized. This paper provides an update from the recent peer-reviewed literature on barriers to the use of these medications. FINDINGS: These barriers are interrelated and can be categorized as financial, regulatory, geographic, attitudinal, and logistic...
June 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28523735/variability-in-prescription-opioid-intake-and-reinforcement-amongst-129-substrains
#2
Susan M Jimenez, Aiden F Healy, Michal A Coelho, Chelsea N Brown, Tod E Kippin, Karen K Szumlinski
Opioid abuse in the United States has reached epidemic proportions, with treatment admissions and deaths associated with prescription opioid abuse quadrupling over the past 10 years. Although genetics are theorized to contribute substantially to inter-individual variability in the development, severity, and treatment outcomes of opioid abuse/addiction, little direct preclinical study has focused on the behavioral genetics of prescription opioid reinforcement and drug-taking. Herein, we employed different 129 substrains of mice currently available from The Jackson Laboratory (129S1/SvlmJ, 129X1/SvJ, 129S4/SvJaeJ and 129P3/J) as a model system of genetic variation and assayed mice for oral opioid intake and reinforcement, as well as behavioral and somatic signs of dependence...
May 19, 2017: Genes, Brain, and Behavior
https://www.readbyqxmd.com/read/28521199/safety-profile-of-injectable-hydromorphone-and-diacetylmorphine-for-long-term-severe-opioid-use-disorder
#3
Eugenia Oviedo-Joekes, Suzanne Brissette, Scott MacDonald, Daphne Guh, Kirsten Marchand, Salima Jutha, Scott Harrison, Amin Janmohamed, Derek Z Zhang, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
AIMS: To review the safety profile of injectable hydromorphone and diacetylmorphine and explore if adverse events (AEs) or serious adverse events (SAEs) were associated with dose and patterns of attendance. METHODS: This was a non-inferiority randomized double-blind controlled trial (Vancouver, Canada) testing hydromorphone (n=100) and diacetylmorphine (n=102) for the treatment of severe opioid use disorder. Medications were delivered under the supervision of trained Registered Nurses up to three times daily...
May 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28506855/rates-and-risk-factors-for-opioid-dependence-and-overdose-after-urologic-surgery
#4
Arpeet S Shah, Robert H Blackwell, Paul C Kuo, Gopal N Gupta
INTRODUCTION: Effective pain management is a critical component of the perioperative process, with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose (ODO) among patients undergoing urologic surgery and to identify risk factors of ODO. METHODS: A retrospective review of urologic surgery from 2007-2011. Data sources included the Healthcare Cost and Utilization Project Inpatient, Ambulatory Surgery, and Emergency Department datasets...
May 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28504483/comparison-of-a-new-intranasal-naloxone-formulation-to-intramuscular-naloxone-results-from-hypothesis-generating-small-clinical-studies
#5
Brandon T Gufford, Garrett R Ainslie, John R White, Matthew E Layton, Jeannie M Padowski, Gary M Pollack, Mary F Paine
Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of intravenous, intramuscular, and a new intranasal naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to intramuscular naloxone, geometric mean [90% CI] absolute bioavailability of intranasal naloxone was modestly lower (55 [43-70] versus 41 [27-62] %), whereas average (± SE) mean absorption time was substantially shorter (74 ± 8.8 versus 6.7 ± 4.9 min). The opioid-attenuating effects of intranasal naloxone were compared to intramuscular naloxone (2 mg) after administration of oral alfentanil (4 mg) to a separate group of six healthy volunteers pre-treated with 240 ml of water or grapefruit juice...
May 15, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28500694/trends-of-neonatal-abstinence-syndrome-epidemic-and-maternal-risk-factors-in-florida
#6
Xi Wang, Yanmin Zhu, Chintan V Dave, Adel A Alrwisan, Stacy A Voils, Almut G Winterstein
OBJECTIVE: This study aimed to examine secular trends of (i) maternal prescription opioid use in late pregnancy, (ii) neonatal abstinence syndrome (NAS) stratified by late maternal prescription opioid use, and (iii) maternal risk factors among NAS deliveries. METHODS: Women with a live birth who were enrolled 90 days before and 30 days after delivery in Florida Medicaid Analytic Extract billing records linked to birth certificates from 2000 to 2010 were identified for the study...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28494762/the-north-american-opioid-epidemic-current-challenges-and-a-call-for-treatment-as-prevention
#7
Devesh Vashishtha, Maria Luisa Mittal, Daniel Werb
There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care...
May 12, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28493425/law-enforcement-derived-data-on-gabapentin-diversion-and-misuse-2002-2015-diversion-rates-and-qualitative-research-findings
#8
Mance E Buttram, Steven P Kurtz, Richard C Dart, Zachary R Margolin
PURPOSE: Recent limited epidemiologic and case reports suggest that gabapentin is being misused, especially among prescription opioid misusers. However, no apparent studies have reported data from law enforcement on the diversion and misuse of gabapentin. METHODS: Case report data are drawn from a quarterly survey of prescription drug diversion completed by a national sample of law enforcement and regulatory agencies who engage in drug diversion investigations. Rates of gabapentin diversion per 100 000 population were calculated for each quarter from 2002 through 2015...
May 10, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28491463/-pro-dopamine-regulation-kb220z%C3%A2-as-a-long-term-therapeutic-modality-to-overcome-reduced-resting-state-dopamine-tone-in-opiate-opioid-epidemic-in-america
#9
K Blum, F Marcelo, K Dushaj, L Fried, R D Badgaiyan
Since it is known that relapse, morality, and hospitalizations have been tied to the presence of the Dopamine D2 Receptor A1 allele, as one example, and carriers of this gene variant have a proclivity to favor amino-acid therapy, it seems intuitive that the incorporation of modalities to provide a balance and or restoration of hypodopaminergia should be considered as a front-line tactic to overcome the current American opiate/opioid epidemic, saving millions from death and unwanted locked-in-addiction. If we continue down the prim road path of fighting addiction to narcotics with narcotics, we are doomed to fail...
September 2016: Journal of Systems and Integrative Neuroscience
https://www.readbyqxmd.com/read/28489491/risk-factors-for-symptoms-of-prescription-opioid-misuse-do-older-adults-differ-from-younger-adult-patients
#10
Gerald Cochran, Daniel Rosen, Rebecca M McCarthy, Rafael J Engel
Limited research is available regarding the health risks associated with opioid medication misuse among middle age (50-64 years) and older adults (65 and older). Understanding the misuse symptom risk profiles of these populations has potential to advance the national opioid epidemic response. A survey was conducted in four community pharmacies in southwestern Pennsylvania among adult, non-cancer patients filling opioid medications (N = 318) regarding opioid medication misuse symptoms and misuse risk factors...
May 10, 2017: Journal of Gerontological Social Work
https://www.readbyqxmd.com/read/28485763/dynamiken-i-f%C3%A3-rskrivningen-av-opioider-i-sverige-2000%C3%A2-2015-markanta-omf%C3%A3-rdelningar-inom-opioidgruppen-men-ingen-%C3%A2-epidemi%C3%A2
#11
Emmanuel Bäckryd, Markus Heilig, Mikael Hoffmann
Opioid prescription changes in Sweden 2000-2015 In contrast to the well-established »opioid epidemic« in the US, very little is known about how the prescription of opioids in Sweden has developed during the last decade. Aggregated data from the open Statistical database of the Swedish Board of Health and Welfare were analyzed descriptively. The yearly prevalence of opioid prescription did not change 2006-2015, but there were dramatic shifts in the choice of opioids. During this period, dextropropoxyphene was pulled off the market...
May 2, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28481656/multiple-naloxone-administrations-among-emergency-medical-service-providers-is-increasing
#12
Mark Faul, Peter Lurie, Jeremiah M Kinsman, Michael W Dailey, Charmaine Crabaugh, Scott M Sasser
BACKGROUND: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. METHODS: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs)...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28480247/infectious-disease-id-learning-unit-what-the-id-clinician-needs-to-know-about-buprenorphine-treatment-for-opioid-use-disorder
#13
Amanda A Westlake, Mark P Eisenberg
In the context of an escalating opioid epidemic, infectious disease clinicians increasingly treat the infectious complications of injection drug use. In this learning unit, we review the history, pharmacology, and clinical use of buprenorphine as maintenance therapy for opioid use disorder, and we describe the process by which clinicians can obtain a buprenorphine waiver.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28480087/rhodotorula-endogenous-endophthalmitis-a-novel-harbinger-of-the-injection-drug-epidemic-in-the-united-states
#14
Preston M Luong, Basilio Kalpakian, Lawrence J Jaeger, Timothy Lahey, Christopher B Chapman, Michael E Zegans
Endogenous endophthalmitis is a rare but feared infectious ocular complication of injection drug use (IDU). The recent opioid epidemic in the United States threatens to increase the incidence of this disease. We report the first case of endogenous endophthalmitis in the United States caused by the emerging fungal pathogen Rhodotorula in an injection drug user which led to no light perception vision (NLP). Worldwide experience with Rhodotorula endogenous endophthalmitis is limited, but existing cases suggest infection by this particular fungal genus has a grim prognosis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28479631/curbing-prescription-opioid-dependency
#15
(no author information available yet)
An epidemic of overdoses and deaths from opioids is fuelled by increased prescribing and sales in North America. Tatum Anderson reports.
May 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/28474345/impact-of-pharmacists-assisting-with-prescribing-and-undertaking-medication-review-on-oxycodone-prescribing-and-supply-for-patients-discharged-from-surgical-wards
#16
T Tran, S E Taylor, A Hardidge, D Findakly, P Aminian, R A Elliott
WHAT IS KNOWN AND OBJECTIVES: Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. METHODS: A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study...
May 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28459909/inpatient-management-of-opioid-use-disorder-a-review-for-hospitalists
#17
REVIEW
Jesse Theisen-Toupal, Matthew V Ronan, Amber Moore, Elana S Rosenthal
The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28458170/down-in-the-valley-trajectories-of-injection-initiation-among-young-injectors-in-california-s-central-valley
#18
Jennifer L Syvertsen, Catherine E Paquette, Robin A Pollini
BACKGROUND: Injection drug use initiation represents a critical point of public health intervention, as injection increases risk for blood borne infections including Hepatitis C and HIV. In this paper, we explore pathways to injection initiation among youth (≤30) in the rural context of California's Central Valley, where rates of injection drug use are among the highest in the nation. METHODS: We draw on semi-structured qualitative interviews with 20 young injectors to examine drug use histories, including the factors that participants associated with their transition to injection drug use...
April 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28456473/continuing-links-between-substance-use-and-hiv-highlight-the-importance-of-nursing-roles
#19
Sherry Deren, Madeline Naegle, Holly Hagan, Danielle C Ompad
Links between HIV and substance use were identified early in the U.S. HIV epidemic. People who use drugs are at risk of HIV infection through shared injection equipment and risky sexual behaviors. In addition, substance use has negative health consequences for people living with HIV. The prescription opioid misuse epidemic, linked to injection drug use, hepatitis C infection, and HIV, poses a new threat to declining HIV rates. We reviewed evidence-based interventions that decrease HIV risk in people who use drugs (needle/syringe programs, medication-assisted treatment, engagement in HIV care, and preexposure prophylaxis/postexposure prophylaxis)...
March 24, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28450608/s-t-policy-forum-examines-evolving-opioid-epidemic
#20
Kathleen O'Neil
No abstract text is available yet for this article.
April 28, 2017: Science
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