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https://www.readbyqxmd.com/read/29049123/impact-of-enhanced-recovery-after-surgery-and-opioid-free-anesthesia-on-opioid-prescriptions-at-discharge-from-the-hospital-a-historical-prospective-study
#1
Delara Brandal, Michelle S Keller, Carol Lee, Tristan Grogan, Yohei Fujimoto, Yann Gricourt, Takashige Yamada, Siamak Rahman, Ira Hofer, Kevork Kazanjian, Jonathan Sack, Aman Mahajan, Anne Lin, Maxime Cannesson
BACKGROUND: The United States is in the midst of an opioid epidemic, and opioid use disorder often begins with a prescription for acute pain. The perioperative period represents an important opportunity to prevent chronic opioid use, and recently there has been a paradigm shift toward implementation of enhanced recovery after surgery (ERAS) protocols that promote opioid-free and multimodal analgesia. The objective of this study was to assess the impact of an ERAS intervention for colorectal surgery on discharge opioid prescribing practices...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049121/opioids-for-the-treatment-of-chronic-pain-mistakes-made-lessons-learned-and-future-directions
#2
Jane C Ballantyne
An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause of the "epidemic" of prescription opioid abuse in the United States. Yet, an examination of the statistics that led the US Centers for Disease Control and Prevention to declare that prescription opioid abuse had reached epidemic levels shows that the abuse occurrences and deaths are arising outside the hospital or hospice setting, which strongly implicates the outpatient use of opioids to treat chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#3
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#4
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049112/america-s-opioid-epidemic-supply-and-demand-considerations
#5
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/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#6
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048972/new-persistent-opioid-use-among-patients-with-cancer-after-curative-intent-surgery
#7
Jay Soong-Jin Lee, Hsou Mei Hu, Anthony L Edelman, Chad M Brummett, Michael J Englesbe, Jennifer F Waljee, Jeffrey B Smerage, Jennifer J Griggs, Hari Nathan, Jacqueline S Jeruss, Lesly A Dossett
Purpose The current epidemic of prescription opioid misuse has increased scrutiny of postoperative opioid prescribing. Some 6% to 8% of opioid-naïve patients undergoing noncancer procedures develop new persistent opioid use; however, it is unknown if a similar risk applies to patients with cancer. We sought to define the risk of new persistent opioid use after curative-intent surgery, identify risk factors, and describe changes in daily opioid dose over time after surgery. Methods Using a national data set of insurance claims, we identified patients with cancer undergoing curative-intent surgery from 2010 to 2014...
October 19, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29048960/machine-learning-to-detect-prescription-opioid-abuse-promotion-and-access-via-twitter
#8
Tim K Mackey, Janani Kalyanam, Takeo Katsuki, Gert Lanckriet
OBJECTIVES: To deploy a methodology accurately identifying tweets marketing the illegal online sale of controlled substances. METHODS: We first collected tweets from the Twitter public application program interface stream filtered for prescription opioid keywords. We then used unsupervised machine learning (specifically, topic modeling) to identify topics associated with illegal online marketing and sales. Finally, we conducted Web forensic analyses to characterize different types of online vendors...
October 19, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29048952/increasing-availability-of-illicit-and-prescription-opioids-among-people-who-inject-drugs-in-a-canadian-setting-2010-2014
#9
Joel Ho, Kora DeBeck, M-J Milloy, Huiru Dong, Evan Wood, Thomas Kerr, Kanna Hayashi
BACKGROUND: Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade. OBJECTIVE: We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada. METHODS: Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone)...
October 19, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29048520/pain-acceptance-as-a-predictor-of-medical-utilization-and-school-absenteeism-in-adolescents-with-chronic-pain
#10
Michelle A Clementi, Grace S Kao, Evelyn Monico
Objective: Identifying factors contributing to high medical utilization and productivity loss is important, given the high cost of pediatric chronic pain. The current study examined chronic pain acceptance as a predictor of medical utilization and school absenteeism in adolescents with chronic pain. Methods: In all, 122 adolescents (aged 12-21 years) with chronic pain and their parents/guardians completed questionnaires assessing medical visits (past 6 months), medication usage, and number of school absences (past month)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29047196/to-what-extent-do-data-from-pharmaceutical-claims-under-estimate-opioid-analgesic-utilisation-in-australia
#11
Natasa Gisev, Sallie-Anne Pearson, Emily A Karanges, Briony Larance, Nicholas A Buckley, Sarah Larney, Timothy Dobbins, Bianca Blanch, Louisa Degenhardt
PURPOSE: Although pharmaceutical claims are an essential data source for pharmacoepidemiological studies, these data potentially under-estimate opioid utilisation. Therefore, this study aimed to quantify the extent to which pharmaceutical claims from Australia's national medicines subsidy programs (Pharmaceutical Benefits Scheme [PBS] and Repatriation Schedule of Pharmaceutical Benefits [RPBS]) under-estimate prescription-only and total national opioid utilisation across time and for different opioids...
October 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29045696/group-visits-for-overdose-education-and-naloxone-distribution-in-primary-care-a-pilot-quality-improvement-initiative
#12
Juliette F Spelman, Stephanie Peglow, Amy R Schwartz, Lucille Burgo-Black, Katelyn McNamara, William C Becker
Objective: Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care. Design: Quality improvement intervention among two primary care clinics...
October 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29044015/-argentina-enacts-first-law-on-medical-use-of-the-cannabis-plant-history-and-perspectives
#13
Eduardo L De Vito
In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly...
2017: Medicina
https://www.readbyqxmd.com/read/29043922/barriers-and-facilitators-to-dispensing-of-intranasal-naloxone-by-pharmacists
#14
Ludmila N Bakhireva, Adriana Bautista, Sandra Cano, Shikhar Shrestha, Amy M Bachyrycz, Theresa H Cruz
BACKGROUND: While misuse of prescription opioids has reached epidemic proportions, pharmacy-based preventive services to combat this epidemic are limited. The aims of this study were to identify barriers and facilitators to the dispensing of intranasal naloxone (INN) by pharmacists in New Mexico. METHODS: For this mixed methods study, a qualitative component (focus group) informed the development of a quantitative component (electronic survey) distributed to all pharmacists registered with the New Mexico Board of Pharmacy and practicing in the state...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29037885/national-trends-and-outcomes-of-cardiac-arrest-in-opioid-overdose
#15
Ankit Sakhuja, Matthew Sztajnkrycer, Saraschandra Vallabhajosyula, Wisit Cheungpasitporn, Richard Patch, Jacob Jentzer
AIM: To investigate the epidemiology and outcomes of cardiac arrests associated with opioid overdoses. Recent data suggest that drug overdoses are responsible for more deaths than motor vehicle crashes or firearms in the United States each year, with opioids being involved in majority of drug overdose deaths. Despite the potential for opioids to cause cardiac arrest, few studies have examined this association. PATIENTS AND METHODS: Using data from National (Nationwide) Inpatient Sample database from years 2000-2013, we identified hospitalizations with drug overdoses using ICD-9-CM codes...
October 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/29036680/factors-associated-with-opioid-initiation-in-oef-oif-ond-veterans-with-traumatic-brain-injury
#16
Teresa J Hudson, Jacob T Painter, Laura E Gressler, Liya Lu, J Silas Williams, Brenda M Booth, Bradley C Martin, Mark D Sullivan, Mark J Edlund
Objective: These analyses examined opioid initiation and chronic use among Iraq (OIF) and Afghanistan (OEF/OND) veterans with a new diagnosis of traumatic brain injury (TBI) in the Veterans Health Administration (VHA). Methods: Data were obtained from national VHA data repositories. Analyses included OEF/OIF/OND veterans with a new TBI diagnosis in 2010-2012 who used the VHA at least twice, had not received a VHA opioid prescription in the 365 days before diagnosis, and had at least 365 days of data available after TBI diagnosis...
September 26, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29034687/predictors-of-placement-of-inpatient-palliative-care-consult-orders-among-patients-with-breast-lung-and-colon-cancer-in-a-safety-net-hospital-system
#17
Lauren N Smith, Ramona L Rhodes, Lei Xuan, Ethan A Halm
BACKGROUND: The provision of palliative and end-of-life care to patients who are underrepresented and underserved provides unique challenges and opportunities. OBJECTIVES: To examine predictors of placement of inpatient palliative care consult orders among patients with breast, lung, and colorectal cancer hospitalized in a safety net hospital in 2010. METHODS: Simple and multivariable logistic regression of data on selected patients with cancer was performed to identify predictors of placement of inpatient palliative care consult orders...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29033460/mortality-and-morbidity-in-the-21-st-century
#18
Anne Case, Angus Deaton
We build on and extend the findings in Case and Deaton (2015) on increases in mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century. Increases in all-cause mortality continued unabated to 2015, with additional increases in drug overdoses, suicides, and alcohol-related liver mortality, particularly among those with a high-school degree or less. The decline in mortality from heart disease has slowed and, most recently, stopped, and this combined with the three other causes is responsible for the increase in all-cause mortality...
2017: Brookings Papers on Economic Activity
https://www.readbyqxmd.com/read/29032024/characteristics-of-self-inflicted-drug-overdose-deaths-in-north-carolina
#19
Anna E Austin, Scott K Proescholdbell, Kathleen E Creppage, Alex Asbun
BACKGROUND: Drug overdose mortality is a major public health concern in the United States, with prescription opioids contributing substantially to recent increases in drug overdose deaths. Compared to unintentional drug overdose deaths, relatively little data describes intentional self-inflicted drug overdose deaths (i.e., suicide by drug overdose). The aim of this study was to examine the characteristics of self-inflicted drug overdose deaths, overall and in comparison to unintentional drug overdose deaths...
October 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29030938/opioid-use-disorder-and-misuse-a-review-of-the-epidemiology-and-medical-implications-for-pediatric-anesthesiologists
#20
REVIEW
Emily Knipper, Caleb J Banta-Green, Nathalia Jimenez
This educational review presents an overview of opioid use disorder, misuse and overdose among adolescents, and the clinical implications for anesthesiologists. It provides definitions, discusses the epidemiology worldwide, (focusing on North America), and emphasizes the clinical implications of patients with chronic opioid exposure, including perioperative pain management, as well as opioid overdose and prolonged use of opioids after acute exposure. In the USA, opioid use disorder and negative outcomes related to opioids rose dramatically from 1999-2010; concomitantly heroin use and fatal overdoses have increased as heroin use is associated with the disordered use of licit opioids...
November 2017: Paediatric Anaesthesia
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