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Opioid Epidemic

Grace Chai, Jing Xu, James Osterhout, Mark A Liberatore, Kathleen L Miller, Carolyn Wolff, Marisa Cruz, Peter Lurie, Gerald Dal Pan
BACKGROUND: The opioid epidemic, driven in part by increased prescribing, is a public health emergency. This study examines dispensed prescription patterns and approvals of new opioid analgesic products to investigate whether the introduction of these new drugs increases prescribing. METHODS: Prescribing patterns based on dispensed prescription claims from the U.S. retail setting were assessed with new brand and generic opioid analgesic products approved in the United States from 1997 through 2015...
March 20, 2018: Anesthesiology
Suresh Mohan, Neil Bhattacharyya
Objectives To recognize current opioid prescription patterns in otolaryngology and determine changes in rates of outpatient opioid prescribing over time. Study Design Cross-sectional analysis of national survey database. Setting Ambulatory care settings in the United States. Subjects and Methods The National Ambulatory Medical Care Survey from 2006 to 2013 was analyzed for outpatient otolaryngology visits. The rate of opioid medication prescribing was determined with patient and visit characteristics associated with an opioid prescription, including corresponding diagnoses...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Nalini Vadivelu, Alice M Kai, Gopal Kodumudi, Dan Haddad, Vijay Kodumudi, Niketh Kuruvilla, Alan David Kaye, Richard D Urman
PURPOSE OF REVIEW: In the present investigation, current literature on the relationship between substance abuse and pain is evaluated in order to improve clinical management and its implications on the increasingly challenging chronic pain and substance abuse epidemic. The relationship between substance abuse and chronic pain are evaluated, and this review provides recommendations on the management of this special patient population. RECENT FINDINGS: Currently, there are limited guidelines for prescribing opioids and other analgesics in the chronic pain population...
March 19, 2018: Current Pain and Headache Reports
Mary Bates
The opioid epidemic is dominating news headlines and inspiring greater calls for political action in the United States. While opioid addiction isn't a new issue, its devastating consequences are now being felt across the country. "What's got everybody's attention is that so many people are dying," says Dr. Richard Ries (Figure 1), director of the University of Washington School of Medicine?s addictions divisions and medical director of the Outpatient Addictions Program at Harborview Medical Center, Seattle...
March 2018: IEEE Pulse
Brian J Piper, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Stephanie D Nichols
INTRODUCTION: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade. METHODS: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents...
March 9, 2018: American Journal of Preventive Medicine
Lauren Brinkley-Rubinstein, Nickolas Zaller, Sarah Martino, David H Cloud, Erin McCauley, Andrew Heise, David Seal
The United States (US) is in the midst of an epidemic of opioid use; however, overdose mortality disproportionately affects certain subgroups. For example, more than half of state prisoners and approximately two-thirds of county jail detainees report issues with substance use. Overdose is one of the leading causes of mortality among individuals released from correctional settings. Even though the criminal justice (CJ) system interacts with a disproportionately high number of individuals at risk of opioid use and overdose, few CJ agencies screen for opioid use disorder (OUD)...
February 24, 2018: Addictive Behaviors
Amin A Ramzan, Stacy Fischer, Mary K Buss, Renata R Urban, Bruce Patsner, Linda R Duska, Christine M Fisher, Carolyn Lefkowits
As the only oncologists that provide both medical and surgical care, gynecologic oncologists encounter an exceptionally broad range of indications for prescribing opioids in clinical situations ranging from management of acute post-operative pain to chronic cancer-related pain to end-of-life care. While opioids are essential to the practice of gynecologic oncology, they can also have significant side effects and can be misused. Due to the explosive growth of opioid prescriptions and opioid-related overdoses and deaths during the first decade of the 21st century, there has been a recent concerted public health effort to prevent and treat opioid misuse through both legislation and education [1]...
March 12, 2018: Gynecologic Oncology
Michael James Zoorob
BACKGROUND: Although polydrug incidents comprise a substantial proportion of overdose deaths, scholarly and popular focus has centered on prescription opiates. This study examines the role of benzodiazepine and opioid prescriptions on overdose-both individually and synergistically-using data from Medicare Part D, a source of prescription drug claims for about 35 million Americans. METHODS: Prescribing data from the Medicare Part D Public Use Files for 2013, 2014, and 2015 (approximately 3...
March 14, 2018: Pharmacoepidemiology and Drug Safety
Anna Lembke, Keith Humphreys
No abstract text is available yet for this article.
March 13, 2018: Academic Psychiatry
V Lew, E McKay, M Maze
Introduction: For a drug that has been omnipresent for nearly 200 years, nitrous oxide's (N2O) future seems less certain than its illustrious past. Environmental concerns are coming to the fore and may yet outweigh important clinical benefits. Sources of data: After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered. Areas of agreement: The analgesic and anaesthetic advantages of N2O remain despite a plethora of newer agents...
March 1, 2018: British Medical Bulletin
Nathaniel M Rickles, Amy L Huang, Michelle B Gunther, Winney J Chan
BACKGROUND: Prescription opioid abuse has rapidly increased in recent years and is now considered a national epidemic by the United States government. Community pharmacies are at the forefront of opioid abuse, given their role in dispensing opioid prescriptions. Despite this role, however, there are few known guidelines to help community pharmacists navigate the process of detecting and managing prescription opioid abuse. OBJECTIVES: To develop and evaluate a candidate guideline, based on clinical experience and existing literature, to help community pharmacists monitor and manage potential opioid prescription abuse...
February 21, 2018: Research in Social & Administrative Pharmacy: RSAP
Christopher Keane, James E Egan, Mary Hawk
BACKGROUND: Opioid overdose deaths in the US rose dramatically in the past 16 years, creating an urgent national health crisis with no signs of immediate relief. In 2017, the President of the US officially declared the opioid epidemic to be a national emergency and called for additional resources to respond to the crisis. Distributing naloxone to community laypersons and people at high risk for opioid overdose can prevent overdose death, but optimal distribution methods have not yet been pinpointed...
March 7, 2018: International Journal on Drug Policy
Enrique Gomez-Pomar, Loretta P Finnegan
Neonatal abstinence syndrome (NAS) refers to a constellation of signs that are present in some newborn infants resulting from the abrupt cessation of passive transfer of maternal opioids used during pregnancy. The classic NAS refers to infants born to mothers who used opioids during pregnancy, but the term has broadened to include infants whose mothers have used or abused other psychoactive substances during pregnancy that contribute to the expression of the syndrome. Pregnant women who use opioids do so illicitly, and/or as medically prescribed for pain relief, and/or as medication assisted treatment for opioid dependence...
2018: Frontiers in Pediatrics
Alana M Vivolo-Kantor, Puja Seth, R Matthew Gladden, Christine L Mattson, Grant T Baldwin, Aaron Kite-Powell, Michael A Coletta
INTRODUCTION: From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination. METHODS: Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016-September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics...
March 9, 2018: MMWR. Morbidity and Mortality Weekly Report
Athir Morad, Salia Farrokh, Alexander Papangelou
PURPOSE OF REVIEW: Pain management in neurocritical care is a subject often avoided because of concerns over the side-effects of analgesics and the potential to cause additional neurological injury with treatment. The sedation and hypercapnia caused by opioids have been feared to mask the neurological examination and contribute to elevations in intracranial pressure. Nevertheless, increasing attention to patient satisfaction has sparked a resurgence in pain management. As opioids have remained at the core of analgesic therapy, the increasing attention to pain has contributed to a growing epidemic of opioid dependence...
April 2018: Current Opinion in Critical Care
Puja Seth, Rose A Rudd, Rita K Noonan, Tamara M Haegerich
No abstract text is available yet for this article.
April 2018: American Journal of Public Health
Robinder Bahniwal, Jarrett Sell, Abdul Waheed
OBJECTIVE: Determine patient recall, attitudes, and perceptions of their pain contract in a family medicine resident out-patient clinic. DESIGN: A cross-sectional study design using a telephone survey to all eligible subjects who signed a hardcopy pain contract from August 29, 2014 to May 19, 2016 at a resident outpatient clinic. SETTING: Penn State Hershey Family and Community Medicine Residency clinic. PARTICIPANTS: All patients who signed a hardcopy pain contract at the practice site who met specific inclusion criteria...
January 2018: Journal of Opioid Management
S Tahseen, H Shahnawaz, U Riaz, F M Khanzada, A Hussain, W Aslam, M von Euler-Chelpin
SETTING: Pakistan is a high tuberculosis (TB) burden country, moving from low human immunodeficiency virus (HIV) prevalence to a concentrated epidemic driven primarily by people who inject drugs (PWID). The Antiretroviral Treatment Adherence Unit (AAU) in Islamabad, Pakistan, is a residential facility that offers combined treatment for opioid dependence and HIV. OBJECTIVE AND DESIGN: This retrospective study was conducted to assess TB prevalence among HIV-infected PWID referred to the AAU and to evaluate the diagnostic value of cough as a screening symptom...
February 1, 2018: International Journal of Tuberculosis and Lung Disease
Alan M Jette
No abstract text is available yet for this article.
March 1, 2018: Physical Therapy
Gina C Dobbs, Susanne A Fogger
In the wake of epidemic of opioid overdoses in the United States, patients who are receiving treatment for chronic pain with opioid have come under increasing scrutiny. The Centers for Disease Control and Prevention issued a guideline for managing chronic pain in 2016, which makes recommendations for opioids based on current evidence. This review will highlight key components of the guideline including differentiating addiction from dependence to assist nurses to better inform patient care in managing chronic pain...
January 2018: Journal of Addictions Nursing
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