152,033 results match your criteria Opioid Abuse


Incidence of future arrests in adults involved in the criminal justice system with opioid use disorder receiving extended release naltrexone compared to treatment as usual.

Drug Alcohol Depend 2018 Dec 3;194:482-486. Epub 2018 Dec 3.

Department of Academic Affairs, Baystate Medical Center, 3601 Main St., Springfield, MA 01199, United States. Electronic address:

Background: Criminal justice involved (CJS) populations with opioid use disorder (OUD) have high rates of relapse, future arrests, and death upon release. While medication for OUD (MOUD) reduces opioid relapse, concerns regarding diversion and stigma limit treatment in CJS populations. Extended release naltrexone (XR-NTX), as an opioid antagonist, may be more acceptable to CJS administrators. Read More

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December 2018
3 Reads

Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users.

Cochrane Database Syst Rev 2018 Dec 5;12:CD009269. Epub 2018 Dec 5.

BC Centre on Substance Use, BC Centre for Excellence in HIV/AIDS, 611 Powell Street, Vancouver, BC, Canada, V6A 1H2.

Background: Problem alcohol use is common among people who use illicit drugs (PWID) and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opioid overdose in PWID.

Objectives: To assess the effectiveness of psychosocial interventions to reduce alcohol consumption in PWID (users of opioids and stimulants). Read More

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December 2018
5 Reads

Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery.

Cochrane Database Syst Rev 2018 Dec 3;12:CD012624. Epub 2018 Dec 3.

Department of Surgery and Anaesthesia, Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Uttoxeter New Road, Derby, UK, DE22 3DT.

Background: Postoperative pain is a common consequence of surgery and can have deleterious effects. It has been suggested that the administration of opioid analgesia before a painful stimulus may improve pain control. This can be done in two ways. Read More

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December 2018
3 Reads

Letter to the Editor: The Opioid Prescribing Scenario in Portugal from a Primary Care Perspective.

Acta Med Port 2018 Nov 30;31(11):698-699. Epub 2018 Nov 30.

Unidade de Saúde Familiar Dafundo. Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Oeiras. Portugal.

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November 2018
2 Reads

Letter to The Editor: Access to Opioids, A Global Challenge - Impressions of The Brazilian Scenario.

Authors:
Carolina Neiva

Acta Med Port 2018 Nov 30;31(11):698. Epub 2018 Nov 30.

Serviço de Cuidados Paliativos. Instituto de Assistência ao Servidor Público Estadual. São Paulo. Brazil.

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November 2018
2 Reads

Pain therapy for the elderly patient: is opioid-free an option?

Curr Opin Anaesthesiol 2018 Dec 4. Epub 2018 Dec 4.

Department of Anesthesiology and Pain Medicine, Ludwig-Maximilians University Munich.

Purpose Of Review: Chronic noncancer pain is an increasing problem in elderly because of rising life expectancy together with an increase of potentially painful medical conditions. Concomitantly, adequate treatment of elderly is often limited by coexisting diseases and polypharmacy.This review summarizes the most important specifics presented by elderly patients and discusses the pharmacological and nonpharmacological options of pain management. Read More

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December 2018

A validated workflow for drug detection in oral fluid by non-targeted liquid chromatography-tandem mass spectrometry.

Anal Bioanal Chem 2018 Dec 6. Epub 2018 Dec 6.

Institute of Legal Medicine and Core Facility Metabolomics, Medical University of Innsbruck, Muellerstr. 44, 6020, Innsbruck, Austria.

Oral fluid is recognized as an important specimen for drug testing. Common applications are monitoring in substance abuse treatment programs, therapeutic drug monitoring, pain management, workplace drug testing, clinical toxicology, and driving under the influence of drugs (DRUID). In this study, we demonstrate that non-targeted LC-MS/MS with subsequent compound identification by tandem mass spectral library search is a valuable tool for comprehensive detection and confirmation of drugs in oral fluid samples. Read More

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December 2018

HIV Physicians and Chronic Opioid Therapy: It's Time to Raise the Bar.

AIDS Behav 2018 Dec 5. Epub 2018 Dec 5.

Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA.

Clinical practice that utilizes chronic opioid therapy has been recognized as one major cause of the opioid crisis. Among patients living with HIV, the risks associated with chronic opioid therapy may be complicated by factors such as co-occurring mental health diagnoses, substance use, and economic marginalization. Improving opioid prescribing practices in HIV clinics requires attention to these and other characteristics common to HIV care. Read More

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December 2018
1 Read

Opioid Use is Associated with Higher Severity-Adjusted Episode Costs in Patients with Conservatively Managed Degenerative Joint Disease of the Back and Neck.

Pharmacoeconomics 2018 Dec 6. Epub 2018 Dec 6.

Clinical Data Services and Analytics, UnitedHealthcare, 9700 Health Care Lane, Minnetonka, MN, 55343, USA.

Background: Opioid use and misuse are urgent health issues. Previous studies suggest that opioid use increases healthcare resource use but severity adjustment is lacking.

Objective: The objective of this study was to evaluate the severity-adjusted cost difference between opioid users and non-users among patients with conservatively managed degenerative joint disease of the spine within a large commercial health plan population in the United States. Read More

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December 2018
1 Read

The Influence of Endogenous Opioids on the Relationship between Testosterone and Romantic Bonding.

Hum Nat 2018 Dec 5. Epub 2018 Dec 5.

Department of Psychology, Oklahoma State University, Stillwater, OK, 74078-3064, USA.

The endogenous opioid system has received attention and extensive research for its effects on reward, pleasure, and pain. However, relative to other neurochemicals, such as oxytocin, vasopressin and dopamine, the function of opioids in regulating human attachment, sociosexuality, and other aspects of human sociality has not received much consideration. For example, nonapeptides (oxytocin and vasopressin) have been extensively studied in animals and humans for their possible roles in mother-offspring attachment, romantic attachment, fatherhood, and social cognition. Read More

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December 2018

Synergistic interaction between the agonism of cebranopadol at nociceptin/orphanin FQ and classical opioid receptors in the rat spinal nerve ligation model.

Pharmacol Res Perspect 2018 Dec 28;6(6):e00444. Epub 2018 Nov 28.

Translational Science and Intelligence Grünenthal GmbH Aachen Germany.

Cebranopadol (trans-6'-fluoro-4',9'-dihydro--dimethyl-4-phenyl-spiro[cyclohexane-1,1'(3'H)-pyrano[3,4-b]indol]-4-amine) is a novel analgesic nociceptin/orphanin FQ opioid peptide (NOP) and classical opioid receptor (MOP, DOP, and KOP) agonist with highly efficacious and potent activity in a broad range of rodent models of nociceptive, inflammatory, and neuropathic pain as well as limited opioid-type side effects such as respiratory depression. This study was designed to explore contribution and interaction of NOP and classical opioid receptor agonist components to cebranopadol analgesia in the rat spinal nerve ligation (SNL) model. Assessing antihypersensitive activity in SNL rats intraperitoneal (IP) administration of cebranopadol resulted in ED values of 3. Read More

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December 2018
1 Read

Impact of opioid dose reduction on individuals with chronic pain: results of an online survey.

J Pain Res 2018 8;11:2769-2779. Epub 2018 Nov 8.

Collegium Pharmaceutical Inc., Canton, MA, USA.

Background: In 2016, the Centers for Disease Control and Prevention (CDC) released a guideline on opioid prescribing for primary care physicians. Patients with chronic pain receiving long-term opioid therapy were surveyed to assess the incidence and impact of opioid dose reduction following this guideline's promulgation.

Methods: Members of an advocacy organization for people with chronic pain were invited to participate in a 16-item, anonymous, online survey conducted in September/October 2017. Read More

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November 2018
2 Reads

Gender, genetics, and analgesia: understanding the differences in response to pain relief.

J Pain Res 2018 8;11:2729-2739. Epub 2018 Nov 8.

Department of Anesthesia, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA,

Genetic variations and gender contribute significantly to the large interpatient variations in opioid-related serious adverse effects and differences in pain relief with other analgesics. Opioids are the most commonly used analgesics to relieve moderate-to-severe postoperative pain. Narrow therapeutic index and unexplained large interpatient variations in opioid-related serious adverse effects and analgesia negatively affect optimal perioperative outcomes. Read More

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November 2018

Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials.

J Pain Res 2018 2;11:2633-2643. Epub 2018 Nov 2.

Department of Anesthesiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China,

Background: Pregabalin (PGB) and gabapentin (GBP) are current and emerging drugs in the field of pre-emptive preoperative analgesia. However, the role of PGB or GBP in acute postoperative pain management still remains elusive.

Materials And Methods: We conducted a comprehensive literature search of articles published by December 3, 2017. Read More

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November 2018

Intravenous buprenorphine/naloxone and concomitant oral pregabalin misuse: a case report.

Neuropsychiatr Dis Treat 2018 9;14:3033-3035. Epub 2018 Nov 9.

Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey,

Opioid misuse and dependence are major medical and social concerns worldwide. Buprenorphine/naloxone combination (BNC) is a drug that has misuse potential and is used to treat opioid dependence, including buprenorphine and naloxone. Buprenorphine shows its pharmacological effects by binding to opioid receptors. Read More

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November 2018
2 Reads

Non-nociceptive roles of opioids in the CNS: opioids' effects on neurogenesis, learning, memory and affect.

Nat Rev Neurosci 2018 Dec 5. Epub 2018 Dec 5.

Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, CA, USA.

Mortality due to opioid use has grown to the point where, for the first time in history, opioid-related deaths exceed those caused by car accidents in many states in the United States. Changes in the prescribing of opioids for pain and the illicit use of fentanyl (and derivatives) have contributed to the current epidemic. Less known is the impact of opioids on hippocampal neurogenesis, the functional manipulation of which may improve the deleterious effects of opioid use. Read More

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December 2018
1 Read

Combating escalating harms associated with pharmaceutical opioid use in Australia: the POPPY II study protocol.

BMJ Open 2018 Dec 4;8(12):e025840. Epub 2018 Dec 4.

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia.

Introduction: Opioid prescribing has increased 15-fold in Australia in the past two decades, alongside increases in a range of opioid-related harms such as opioid dependence and overdose. However, despite concerns about increasing opioid use, extramedical use and harms, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms.

Methods And Analysis: We will form a cohort of all adult residents in New South Wales (NSW), Australia, who initiated prescribed opioids from 2002 using Pharmaceutical Benefits Scheme dispensing records. Read More

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December 2018
1 Read

Identifying patient-important outcomes in medication-assisted treatment for opioid use disorder patients: a systematic review protocol.

BMJ Open 2018 Dec 4;8(12):e025059. Epub 2018 Dec 4.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

Introduction: Illicit opioid use has become a national crisis in Canada, with over 65 000 people seeking treatment for opioid use disorder (OUD) in Ontario and British Columbia alone. Medication-assisted treatment (MAT) is a common treatment for OUD. There is substantial variability in treatment outcomes used to evaluate effectiveness of MAT, making it difficult to establish clinically and scientifically relevant treatment effect. Read More

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December 2018
2 Reads
2.063 Impact Factor

Modifying emergency department electronic prescribing for outpatient opioid analgesia.

Emerg Med Australas 2018 Dec 3. Epub 2018 Dec 3.

Emergency Medicine, Austin Health, Melbourne, Victoria, Australia.

Objectives: The aim of this study was to examine how changing the electronic ordering sequences for opioid analgesics affected ED outpatient prescribing, and subsequent unused opioid tablets remaining in the community available for diversion.

Methods: A descriptive before and after study in adult patients prescribed an opioid analgesic by an ED prescriber for use in the outpatient setting. The hospital electronic prescribing system (FirstNet™) was modified to include smaller quantities of opioid analgesics for discharge. Read More

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December 2018

Remission from chronic opioid use-Studying environmental and socio-economic factors on recovery (RECOVER): Study design and participant characteristics.

Contemp Clin Trials 2018 Nov 30. Epub 2018 Nov 30.

Indivior Inc., 10710 Midlothian Turnpike, Suite 430, Richmond, VA 23235, United States. Electronic address:

Few opioid use disorder (OUD) treatment studies measure meaningful life changes during long-term recovery, focusing instead on retention and abstinence. Here, we report on the design and participant characteristics of the RECOVER Study, a study exploring life changes in persons with OUD for up to 24 months following participation in a Phase III trial evaluating buprenorphine extended-release monthly injection for subcutaneous use (known as RBP-6000 during development). This multisite, observational, cohort study tracks clinical, environmental, and socio-economic changes using self-administered assessments, urine drug screens (UDS), and public databases. Read More

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November 2018
1 Read

Trends in Drug Use-Associated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017: A Study of Statewide Discharge Data.

Ann Intern Med 2018 Dec 4. Epub 2018 Dec 4.

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (A.J.S., D.L.R.).

Background: Drug use-associated infective endocarditis (DUA-IE) is increasing as a result of the opioid epidemic. Infective endocarditis may require valve surgery, but surgical treatment of DUA-IE has invoked controversy, and the extent of its use is unknown.

Objective: To examine hospitalization trends for DUA-IE, the proportion of hospitalizations with surgery, patient characteristics, length of stay, and charges. Read More

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December 2018

Opioid analgesic use and patient-reported pain outcomes after rhinologic surgery.

Int Forum Allergy Rhinol 2018 Dec 3. Epub 2018 Dec 3.

Department of Otolaryngology-Head and Neck Surgery, Department of Anesthesiology, New York-Presbyterian Hospital-Weill Cornell Medicine, New York, NY.

Background: Opioid-based analgesics are routinely prescribed after elective rhinologic surgery. Balancing appropriate pain management while avoiding overprescription necessitates an evidence-based approach.

Methods: Patients undergoing elective rhinologic surgery, including endoscopic sinus surgery (ESS), septoplasty, or ESS with septoplasty, were prospectively enrolled. Read More

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December 2018
1 Read

Can postoperative massage therapy reduce pain and anxiety in cardiac surgery patients?

Interact Cardiovasc Thorac Surg 2018 Dec 1. Epub 2018 Dec 1.

Department of Vascular Surgery, Countess of Chester, Chester, UK.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, 'In patients undergoing cardiac surgery, is postoperative massage therapy effective in reducing pain, anxiety and physiological parameters?'. Altogether, 287 papers were found using the reported search, of which 7 papers represented the best evidence to answer the clinical question. Read More

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December 2018
1 Read

Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse.

JAMA Intern Med 2018 Dec 3. Epub 2018 Dec 3.

Division of Gastroenterology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Importance: Through prescription writing, dental clinicians are a potential source of initial opioid exposure and subsequent abuse for adolescents and young adults.

Objective: To examine the association between index dental opioid prescriptions from dental clinicians for opioid-naive adolescents and young adults in 2015 and new persistent use and subsequent diagnoses of abuse in this population.

Design, Setting, And Participants: This retrospective cohort study examined outpatient opioid prescriptions for patients aged 16 to 25 years in the Optum Research Database in 2015. Read More

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December 2018
1 Read

Recommending buprenorphine for pain management.

Pain Manag 2018 Dec 3. Epub 2018 Dec 3.

Faculty of Medicine, Douglas Research Centre, McGill University, Montreal, Canada.

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December 2018
8 Reads

Progress in noninvasive, abortive neuromodulation therapy for treating acute pain in primary headache disorders.

Pain Manag 2018 Dec 3. Epub 2018 Dec 3.

Department of Anesthesiology & Critical Care Medicine, Division of Pain Medicine. The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 21287.

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December 2018
1 Read

Optimization and Pharmacological Characterization of Receptor-Mediated G Activation in Postmortem Human Prefrontal Cortex.

Basic Clin Pharmacol Toxicol 2018 Dec 3. Epub 2018 Dec 3.

Laboratory of Neuropharmacology, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of the Balearic Islands (UIB), and Institut d'investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain.

The biochemical abnormalities in transmembrane signal transduction mediated through G protein-coupled receptors (GPCRs) have been postulated as underlying pathophysiology of psychiatric diseases such as schizophrenia and mood disorders. In the present study, the experimental conditions of agonist-induced [ S]GTPγS binding in postmortem human brain membranes were optimized, and the responses induced by a series of agonists were pharmacologically characterized. The [ S]GTPγS binding assay was performed in postmortem human prefrontal cortical membranes by means of filtration techniques, and standardized as to GDP concentration, membrane protein content, MgCl and NaCl concentrations in assay buffer, incubation period, and effect of white matter contamination. Read More

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December 2018

Effects of chronic fentanyl administration on behavioral characteristics of mice.

Neuropsychopharmacol Rep 2018 Dec 1. Epub 2018 Dec 1.

Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan.

Background: Fentanyl, a synthetic opioid categorized as a narcotic analgesic, has a 100- to 200-fold stronger effect than most opioids, such as morphine. Fatal accidents due to chronic use and abuse of fentanyl are a worldwide social problem. One reason for the abuse of fentanyl is its psychostimulant effects that could induce behavioral changes. Read More

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December 2018

Increased cocaine reward in offspring of females exposed to morphine during adolescence.

Psychopharmacology (Berl) 2018 Nov 30. Epub 2018 Nov 30.

Tufts University Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA, 01536, USA.

Rationale: A growing body of evidence demonstrates that environmental exposures can impact the physiology and behavior of subsequent generations. We have previously demonstrated reduced morphine self-administration in the F1 and F2 offspring of female rats exposed to morphine during adolescence.

Objectives: The current study was designed to determine whether attenuated self-administration for a substance not in the opioid class is also observed in the F1 progeny of adolescent morphine exposed females. Read More

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November 2018
1 Read

Treatment of an HIV-affected adolescent with heroin dependence in a low-income country: A clinical case study from Zambia.

Addict Behav Rep 2018 Dec 25;8:170-175. Epub 2018 Sep 25.

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America.

Introduction: Although the World Health Organization (WHO) has recommended guidelines for the treatment of opioid dependence, there are myriad challenges to successfully implementing such guidelines in resource constrained settings, such as in low and middle-income countries (LMICs). To highlight these challenges, this paper presents a clinical case study of an adolescent study participant in a randomized controlled trial comparing two counseling programs in Lusaka, Zambia.

Case Description: This 15 year-old male reported smoking marijuana and heroin daily, and injecting heroin monthly (while needle sharing). Read More

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December 2018

Complemental analysis about postoperative opioid consumption between video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) for early-stage lung cancer.

J Thorac Dis 2018 Oct;10(10):E764-E765

Service d'Anesthésie et de Réanimation, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université, Marseille 13015, France.

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October 2018
2 Reads

Evaluation of Prophylactic and Therapeutic Effects of Tramadol and Tramadol Plus Magnesium Sulfate in an Acute Inflammatory Model of Pain and Edema in Rats.

Front Pharmacol 2018 16;9:1326. Epub 2018 Nov 16.

Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Inflammatory pain is the most commonly treated clinical pain, since it develops following trauma or surgery, and accompanies rheumatic or arthritic diseases. Tramadol is one of the most frequently used opioid analgesics in acute and chronic pain of different origin. Magnesium is a widely used dietary supplement that was recently shown to be a safe analgesic drug in different models of inflammatory pain. Read More

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November 2018

Opioid-Related Harms: Simplistic Solutions to the Crisis Ineffective and Cause Collateral Damage.

Health Serv Insights 2018 25;11:1178632918813321. Epub 2018 Nov 25.

St. Paul's Hospital, Hospice Palliative Care Program, Providence Health Care, Vancouver, BC, Canada.

The narrative of the opioid crisis is that ill-informed and careless prescribing by physicians has led to increases in opioid-related harms including overdose deaths. Focusing on reducing the access to prescribed opioids without treating substance use disorder has led to increases in use of heroin and illicitly produced fentanyl. Overall prescribing of opioids has declined causing collateral damage to those who use opioids appropriately to reduce pain and improve function. Read More

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November 2018
1 Read

Rhode Island Domestic Violence Shelter Policies, Practices, and Experiences Pertaining to Survivors With Opioid Use Disorder: Results of a Qualitative Study.

Subst Abuse 2018 27;12:1178221818812895. Epub 2018 Nov 27.

Departments of Medicine and Pediatrics, School of Medicine, Boston University, Boston, MA, USA.

The purpose of this study was to fill a gap in the existing research by exploring policies and practices of domestic violence shelters in one US state pertaining to clients with opioid use disorders (OUDs), as well as documenting some of their experiences providing services to those clients. We used semi-structured key informant interviews to gather information about Rhode Island shelter practices and policies pertaining to OUD-relevant topics and make meaning of shelter workers' experiences with clients with OUDs. One researcher conducted all 30-min, telephone interviews. Read More

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November 2018

Evidence of a PPARγ-mediated mechanism in the ability of Withania somnifera to attenuate tolerance to the antinociceptive effects of morphine.

Pharmacol Res 2018 Nov 29. Epub 2018 Nov 29.

Dept. of Pharmacy and Biotechnology, Alma Mater Studiorum - University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.

Notwithstanding the experimental evidence indicating Withania somnifera Dunal roots extract (WSE) ability to prolong morphine-elicited analgesia, the mechanisms underlying this effect are largely unknown. With the aim of evaluating a PPARγ-mediated mechanism in such WSE effects, we verified the ability of the PPARγ antagonist GW-9662 to modulate WSE actions. Further, we evaluated the influence of GW-9662 upon WSE / morphine interaction in SH-SY5Y cells since we previously reported that WSE hampers the morphine-induced μ-opioid receptor (MOP) receptor down-regulation. Read More

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November 2018
1 Read

Test-retest reliability of the Newest Vital Sign health literacy instrument: In-person and remote administration.

Patient Educ Couns 2018 Nov 22. Epub 2018 Nov 22.

Department of Emergency Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA. Electronic address:

Objective: To determine the reliability of the Newest Vital Sign (NVS) administered via telephone by examining test-retest properties of the measure.

Methods: Data were obtained from a randomized controlled trial promoting opioid safe use. Participants were 18 or older and English-speaking. Read More

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November 2018

Influence of preoperative opioid use on postoperative outcomes and opioid use after arthroscopic rotator cuff repair.

J Shoulder Elbow Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:

Background: Recent orthopedic research has questioned the effect of opioid use on surgical outcomes. This study investigated this in the context of arthroscopic rotator cuff repair. We hypothesized that preoperative opioid use would be associated with inferior outcomes and greater postoperative opioid requirements. Read More

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November 2018

Problematic use of prescription opioid: Classification and effective treatments.

Med Clin (Barc) 2018 Nov 27. Epub 2018 Nov 27.

Unidad de Conductas Adictivas, Servicio de Psiquiatría, Complejo Hospitalario de Toledo, SESCAM, Toledo, España. Electronic address:

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November 2018

Withholding Urinary Catheters in Children Receiving Patient-Controlled Analgesia for Appendicitis.

J Surg Res 2019 Jan 17;233:100-103. Epub 2018 Aug 17.

Department of Surgery, The Children's Mercy Hospital, Kansas City, Missouri. Electronic address:

Background: In some institutions, urinary catheters (UCs) have been placed in all patients receiving opioid patient-controlled analgesia (PCA) because of the increased incidence of urinary retention. Our institutional data demonstrated no UC replacements in 48 children who had PCA for perforated appendicitis who had their catheters removed before discontinuation of the PCA. As part of a quality improvement initiative, we discontinued the practice of requiring UC with PCA for perforated appendicitis. Read More

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January 2019

A Prospective, Randomized, Double-Blinded Controlled Trial Comparing Ibuprofen and Acetaminophen Versus Hydrocodone and Acetaminophen for Soft Tissue Hand Procedures.

J Hand Surg Am 2018 Nov 27. Epub 2018 Nov 27.

Department of Orthopaedic Surgery, Penn State Hershey Medical Center, Hershey, PA.

Purpose: To compare the efficacy of opioid versus nonopioid analgesic regimens after elective, soft tissue hand surgery. We hypothesized that there would be no difference in patient-perceived pain relief between these 2 groups.

Methods: This prospective, randomized, double-blinded controlled trial included patients undergoing elective soft tissue hand procedures (carpal tunnel release, trigger finger release, first dorsal compartment release, or ganglion cyst excision). Read More

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November 2018

Lessons learnt from establishing a high dose opioid review clinic for people living with HIV.

Pain Manag 2018 Dec 3. Epub 2018 Dec 3.

Consultant in Palliative Medicine, Department of Palliative Care, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK.

People living with HIV represent a unique aging population, living with a chronic condition associated with significant pain. A number take high dose, long-term opioids to manage moderate to severe chronic pain, presenting specific risks. This article highlights the size and impact of this problem and outlines the service objectives and set up of a specialist clinic to manage people living with HIV on high dose opioids, alongside its successes and learning points. Read More

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December 2018

Dexmedetomidine Use in a Tertiary Care NICU: A Descriptive Study.

Ann Pharmacother 2018 Dec 3:1060028018812089. Epub 2018 Dec 3.

2 Department of Peditrics, University of Calgary, Calgary, AB, Canada.

Background: Continuous infusions of dexmedetomidine are increasingly used for sedation in critically ill pediatric patients. Emerging data suggest potential benefits when used for sedation in neonates, including reduced sedative requirements and earlier enteral feeds.

Objective: To describe the use, adverse effects, and signs of withdrawal in a cohort of neonates receiving dexmedetomidine, the majority of whom were receiving concomitant opioids. Read More

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December 2018

Deep Brain Stimulation Surgery without Sedation.

Stereotact Funct Neurosurg 2018 Dec 5:1-9. Epub 2018 Dec 5.

Center for Deep Brain Stimulation, University Hospital Regensburg, Regensburg,

Background: Sedatives and opioids used during deep brain stimulation (DBS) surgery interfere with optimal target localization and add to side effects and risks, and thus should be minimized.

Objective: To retrospectively test the actual need for sedatives and opioids when cranial nerve blocks and specific therapeutic communication are applied.

Methods: In a case series, 64 consecutive patients treated with a strong rapport, constant contact, non-verbal communication and hypnotic suggestions, such as dissociation to a "safe place," reframing of disturbing noises and self-confirmation, were compared to 22 preceding patients under standard general anaesthesia or conscious sedation. Read More

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December 2018
1 Read

Opioid tapering and weaning protocols in pediatric critical care units: a systematic review.

Rev Assoc Med Bras (1992) 2018 Oct;64(10):909-915

Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo (SP), Brasil.

Objective: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly. Read More

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October 2018
1 Read

Prevention and Treatment of Opioid Misuse and Addiction: A Review.

JAMA Psychiatry 2018 Dec 5. Epub 2018 Dec 5.

National Institute on Drug Abuse, Rockville, Maryland.

Importance: More than 42 000 Americans died of opioid overdoses in 2016, and the fatalities continue to increase. This review analyzes the factors that triggered the opioid crisis and its further evolution, along with the interventions to manage and prevent opioid use disorder (OUD), which are fundamental for curtailing the opioid crisis.

Observations: Opioid drugs are among the most powerful analgesics but also among the most addictive. Read More

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December 2018
5 Reads

Trends and Outcomes of Cardiovascular Surgery in Patients With Opioid Use Disorders.

JAMA Surg 2018 Dec 5. Epub 2018 Dec 5.

Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Importance: Persistent opioid use is currently a major health care crisis. There is a lack of knowledge regarding its prevalence and effect among patients undergoing cardiac surgery.

Objective: To characterize the national population of cardiac surgery patients with opioid use disorder (OUD) and compare outcomes with the cardiac surgery population without OUD. Read More

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December 2018

Time-Driven Activity-Based Costing to Identify Patients Incurring High Inpatient Cost for Total Shoulder Arthroplasty.

J Bone Joint Surg Am 2018 Dec;100(23):2050-2056

Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, Massachusetts.

Background: As payment models shift toward a focus on value, an accurate understanding of surgical costs and preoperative correlates of high-cost patients is important for effective implementation of cost-saving strategies. This study used time-driven activity-based costing (TDABC) to explore inpatient cost of total shoulder arthroplasty (TSA) and to identify preoperative characteristics of high-cost patients.

Methods: Using TDABC, we calculated the cost of inpatient care for 415 patients undergoing elective primary TSA between 2016 and 2017. Read More

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December 2018
2 Reads

EXPERIMENTAL STUDY OF PAIN-RELIEVING MECHANISMS OF 4-[4-OXO-(4H)-QUINAZOLIN-3-YL]-BENZOIC ACID (PK-66 COMPOUND).

Georgian Med News 2018 Oct(283):148-154

1Vinnytsia National M. Pirogov Memorial Medical University; 2Zaporizhzhya State Medical University, Ukraine.

An in-depth study of the pharmacological properties of 4-[4-oxo-(4h)-quinazolin-3-yl]-benzoic acid as an analgesic agent established that it had a sufficiently high analgesic effect on models of somatic and neuropathic pain syndromes. Study objective was to study the mechanisms of analgesic action of PK-66 compound in rats using the pharmacological analysis. We evaluated the mechanisms of analgesic effect of PK-66 (1 mg/kg, intraperitoneal) compound on the thermal irritation model on Hours 1, 2, 4 and 6 after administration of study compounds. Read More

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October 2018
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THE RELATIONSHIP BETWEEN THERMAL PAIN SENSATION, FREE TESTOSTERONE, TRPV1, MOR LEVELS AND VARIOUS DEGREES OF HOSTILITY IN YOUNG HEALTHY MALES.

Georgian Med News 2018 Oct(283):109-114

Tbilisi State Medical University, Department of Physiology, Georgia.

Large number of studies consider gonadal hormones as factors influencing pain perception by changing the activity of nociceptive and antinociceptive systems. Recent studies indicate that testosterone, along with some other gonadal hormones, plays a key role in the regulation of TRPV1 and MOR expression. In addition, some works focus on the relationship between pain sensation and hostility indices, as well as their interaction with gonadal hormones. Read More

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October 2018
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