53,555 results match your criteria patients opioid


Multivariate pattern analysis links drug use severity to distributed cortical hypoactivity during emotional inhibitory control in opioid use disorder.

Neuroimage Clin 2021 Aug 29;32:102806. Epub 2021 Aug 29.

Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA.

Opioid use disorder (OUD) is characterized by emotional and cognitive impairements that are associated with poor treatment outcomes. The present study investigated the neural mechanism underlying emotion evaluation and inhibitory control using an affective go/no-go (AGN) task and its association with drug use severity and craving in patients with OUD. Twenty-six recently detoxified patients with OUD underwent functional magnetic resonance imaging (fMRI) while performing the AGN task that required response to frequently presented appetitive stimuli ("go") and inhibition of response to infrequently presented aversive stimuli ("no-go"). Read More

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Identifying risk factors that increase analgesic requirements at discharge among patients with burn injuries.

J Burn Care Res 2021 Sep 15. Epub 2021 Sep 15.

Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada.

Patients with burn injuries require large doses of opioids and gabapentinoids to achieve pain control and are often discharged from hospital with similar amounts. This study aimed to identify patient risk factors that increase analgesic requirements among patients with burn injuries and to determine the relationship between opioid and gabapentinoid use. Patient charts from July 1, 2015 - 2018 were reviewed retrospectively to determine analgesic requirements 24 hours before discharge. Read More

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September 2021

Persistent Postoperative Opioid Prescription Fulfillment and Peripheral Nerve Blocks for Ambulatory Shoulder Surgery: A Retrospective Cohort Study.

Anesthesiology 2021 Sep 15. Epub 2021 Sep 15.

Background: There is need to identify perioperative interventions that decrease chronic opioid use. The authors hypothesized that receipt of a peripheral nerve block would be associated with a lower incidence of persistent postoperative opioid prescription fulfillment.

Methods: This was a retrospective population-based cohort study examining ambulatory shoulder surgery patients in Ontario, Canada. Read More

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September 2021

Implementation and outcomes of enhanced recovery protocols in pediatric surgery: a systematic review and meta-analysis.

Pediatr Surg Int 2021 Sep 15. Epub 2021 Sep 15.

Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, 632002, India.

Background: This systematic review examines the feasibility and safety of implementing Enhanced recovery after Surgery (ERAS) protocols in children.

Study Design: A systematic search of Medline, PubMed, and the Cochrane library for papers describing ERAS implementation in children between January 2000 and January 2021. The systematic review was performed according to the PRISMA statement. Read More

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September 2021

Physical therapists should play a greater role in managing patients with opioid use and opioid misuse.

Subst Abus 2021 Sep 15:1-6. Epub 2021 Sep 15.

Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.

The U.S. opioid crisis necessitates that health care providers of all types work collaboratively to manage patients taking prescription opioid medications and manage those who may be misusing prescription opioids. Read More

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September 2021

Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis.

Am J Sports Med 2021 Sep 15:3635465211038233. Epub 2021 Sep 15.

Department of Surgery, University of Western Ontario, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada.

Background: Patients with complete rotator cuff tears who fail a course of nonoperative therapy can benefit from surgical repair.

Purpose: This randomized trial compared mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair.

Study Design: Randomized controlled trial; Level of evidence, 1. Read More

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September 2021

Assessment of Functional Pain Score by Comparing to Traditional Pain Scores.

Cureus 2021 Aug 3;13(8):e16847. Epub 2021 Aug 3.

Anesthesiology/Pain Management, Guthrie Clinic and Robert Packer Hospital, Sayre, USA.

Background: Pain assessments, such as the Numerical Pain Scale (NPS) and Wong-Baker FACEs (FACEs), offer methods to quantify pain with simplistic descriptions on a scale of 0-10 or facial expressions. These tools have limitations and deliver insufficient information to the provider developing a pain management plan. A new Functional Pain Scale (FPS) assesses other scopes of pain, including the loss of function in activities of daily living, sleep habits, and communication. Read More

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Impact of COVID-19 on opioid use in those awaiting hip and knee arthroplasty: a retrospective cohort study.

BMJ Qual Saf 2021 Sep 14. Epub 2021 Sep 14.

Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Background: COVID-19 has had a detrimental impact on access to hip and knee arthroplasty surgery. We set out to examine whether this had a subsequent impact on preoperative opioid prescribing rates for those awaiting surgery.

Methods: Data regarding patient demographics and opioid utilisation were collected from the electronic health records of included patients at a large university teaching hospital. Read More

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September 2021

Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study.

BMJ Support Palliat Care 2021 Sep 14. Epub 2021 Sep 14.

Rambam Health Care Campus, Haifa, Israel.

Background: Various jurisdictions have legalised medical cannabis (MC) for use in chronic pain treatment. The objective of this study was to determine if the use of MC is related to a reduction in the use of prescription opioids and other prescription medications and healthcare services.

Methods: A retrospective cohort study was conducted using the medical files of 68 Israeli patients with chronic pain using MC. Read More

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September 2021

Legal System Involvement and Opioid-Related Overdose Mortality in U.S. Department of Veterans Affairs Patients.

Am J Prev Med 2021 Sep 11. Epub 2021 Sep 11.

Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs, Ann Arbor, Michigan.

Introduction: Opioid-related overdose risks are elevated after incarceration. The rates of opioid-related overdose mortality have risen in recent years, including among Veterans Health Administration patients. To inform Veteran overdose prevention, this study evaluates whether opioid-related overdose risks differ for Veterans Health Administration patients with versus those without indicators of legal system involvement. Read More

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September 2021

Patterns of real-world opioid prescribing in Australian general practice (2013-18).

Aust J Prim Health 2021 Sep 15. Epub 2021 Sep 15.

Little is known about private-market opioid prescribing and how Australian opioid policies impact prescribing across public and private markets in Australia. We aimed to investigate publicly subsidised and private-market opioid prescribing from 2013 to 2018. We used prescribing records from MedicineInsight, an Australian primary care database, to examine trends in prescriptions for non-injectable opioid formulations from October 2013 to September 2018. Read More

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September 2021

Long-Term Opioid Use in Post-Surgical Management of Patients With Head and Neck Cancer.

Ann Otol Rhinol Laryngol 2021 Sep 14:34894211045771. Epub 2021 Sep 14.

Boston University School of Medicine, Boston, MA, USA.

Objective: This study aims to identify clinical and socioeconomic factors associated with long-term, post-surgical opioid use in the head and neck cancer population.

Methods: A single center retrospective study was conducted including patients diagnosed with head and neck cancer between January 1, 2014 and July 1, 2019 who underwent primary surgical management. The primary outcome measure was continued opioid use 6 months after treatment completion. Read More

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September 2021

How Physician Workforce Shortages Are Hampering the Response to the Opioid Crisis.

Psychiatr Serv 2021 Sep 15:appips202000565. Epub 2021 Sep 15.

Department of Population Health, Section on Tobacco, Alcohol, and Drug Use, New York University Grossman School of Medicine, New York City (McNeely, Schatz, Appleton); Office of Behavioral Health, New York City Health + Hospitals, New York City (Schatz); Columbia University Medical Center (Olfson) and Department of Psychiatry (Williams), Columbia University, New York City; New York State Psychiatric Institute, New York City (Williams).

The United States is experiencing an unprecedented opioid crisis, with a record of about 93,000 opioid-involved overdose deaths in 2020, which requires rapid and substantial scaling up of access to effective treatment for opioid use disorder. Only 18% of individuals with opioid use disorder receive evidence-based treatment, and strategies to increase access are hindered by a lack of treatment providers. Using a case study from the largest municipal hospital system in the United States, the authors describe the effects of a workforce shortage on health system responses to the opioid crisis. Read More

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September 2021

Thoracic Paravertebral Block Ameliorates Postoperative Delirium in Geriatric Patients.

Thorac Cardiovasc Surg 2021 Sep 14. Epub 2021 Sep 14.

Department of Anesthesia, Xuzhou Cancer Hospital, Xuzhou City, Jiangsu Province, China.

Objectives:  Thoracic surgery often causes postoperative delirium (POD) in geriatric patients. This study aimed to explore the effect of ultrasound-guided continuous thoracic paravertebral block (UG-TPVB) on POD in geriatric patients undergoing pulmonary resection.

Methods:  Total 128 patients who underwent pulmonary resection were randomly allocated to either the conventional patient-controlled analgesia (PCA) group or the UG-TPVB group ( = 64 per group). Read More

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September 2021

Opioids Cause Sex-Specific Vascular Changes via Cofilin-Extracellular Signal-Regulated Kinase Signaling: Female Mice Present Higher Risk of Developing Morphine-Induced Vascular Dysfunction than Male Mice.

J Vasc Res 2021 Sep 14:1-11. Epub 2021 Sep 14.

Department of Physiology and Pharmacology, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio, USA.

Recent studies have shown that chronic use of prescription or illicit opioids leads to an increased risk of cardiovascular events and pulmonary arterial hypertension. Indices of vascular age and arterial stiffness are also shown to be increased in opioid-dependent patients, with the effects being more marked in women. There are currently no studies investigating sex-specific vascular dysfunction in opioid use, and the mechanisms leading to opioid-induced vascular damage remain unknown. Read More

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September 2021

One third of people who inject drugs are at risk of incomplete treatment for Staphylococcus aureus bacteraemia: A retrospective medical record review.

Int J Infect Dis 2021 Sep 11. Epub 2021 Sep 11.

St Vincent's Hospital Sydney, 390 Victoria St Darlinghurst, NSW, Australia 2010; National Centre for Clinical Research on Emerging Drugs (NCCRED), UNSW Sydney, NSW, Australia 2031.

Staphylococcus aureus bacteraemia (SAB) is often a complication of injecting drug use, and is associated with high morbidity and mortality. We report on the first audit of inpatient parenteral treatment of SAB completion among people who inject drugs (PWID) in Australia. Of 198 patients admitted with SAB 106 were analysed. Read More

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September 2021

Opioid treatment programs, telemedicine and COVID-19: A scoping review.

Subst Abus 2021 Sep 14:1-8. Epub 2021 Sep 14.

Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, BICC, Portland, OR, USA.

Methadone and buprenorphine are effective medications for opioid use disorder (MOUD) that are highly regulated in the United States. The on-going opioid crisis, and more recently COVID-19, has prompted reconsideration of these restrictions in order to sustain and improve treatment access, with renewed interest in telemedicine. We reviewed the evidence on use of telemedicine interventions and applicability to MOUD policy changes in the post-COVID-19 treatment landscape. Read More

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September 2021

Intrathecal Drug Delivery for the Treatment of Cancer-Associated Chronic Pain in Children.

Neuromodulation 2021 Sep 14. Epub 2021 Sep 14.

Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Objectives: Management of refractory cancer-associated pain can be particularly challenging. Regional anesthesia is an alternative modality to treat acute and chronic refractory pain. Intrathecal (IT) drug delivery of opioids and other adjuncts has been used to treat refractory cancer-associated pain. Read More

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September 2021

Opioid agonist treatment and patient outcomes during the COVID-19 pandemic in south east Sydney, Australia.

Drug Alcohol Rev 2021 Sep 14. Epub 2021 Sep 14.

Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.

Introduction: In early 2020, many services modified their delivery of opioid treatment in response to the COVID-19 pandemic, to limit viral spread and maintain treatment continuity. We describe the changes to treatment and preliminary analysis of the association with patients' substance use and well-being.

Methods: A pre-post comparison of treatment conditions and patient self-reported outcomes using data extracted from electronic medical records in the 5 months before (December 2019-April 2020) and after (May 2020-September 2020) changes were implemented in three public treatment services in South Eastern Sydney Local Health District. Read More

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September 2021

Intrathecal Morphine for Analgesia in Minimally Invasive Cardiac Surgery: A Randomized, Placebo-controlled, Double-blinded Clinical Trial.

Anesthesiology 2021 Sep 14. Epub 2021 Sep 14.

Background: Intrathecal morphine decreases postoperative pain in standard cardiac surgery. Its safety and effectiveness have not been adequately evaluated in minimally invasive cardiac surgery. The authors hypothesized that intrathecal morphine would decrease postoperative morphine consumption after minimally invasive cardiac surgery. Read More

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September 2021

A case report of satisfactory post-left knee replacement pain control after switching from oxycodone to buprenorphine.

J Opioid Manag 2021 ;17(7):179-182

Salem VA Medical Center, Salem, Virginia.

This case report demonstrates using buprenorphine 32 mg to achieve adequate pain control after a total knee replacement. The patient stopped buprenorphine 48 hours before surgery. He was prescribed 150 tablets of oxycodone 5 mg. Read More

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September 2021

Perioperative outcomes for patients on chronic buprenorphine undergoing spine surgery: A case series.

J Opioid Manag 2021 ;17(7):171-177

Department of Anesthesia and Perioperative Care, University of California, San Francisco.

Objective: Pain management following spine surgery can be challenging as patients routinely suffer from chronic pain and opioid tolerance. The increasing popularity of buprenorphine use for pain management in this population may further complicate perioperative pain management due to the limited efficacy of other opioids in the presence of buprenorphine. This study describes perioperative management and outcomes in patients on chronic buprenorphine who underwent elective inpatient spine surgery. Read More

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September 2021

Rapid microinduction of sublingual buprenorphine from methadone in an outpatient setting: "A case series".

J Opioid Manag 2021 ;17(7):167-170

Department of Psychiatry and Behavioral Sciences, University of Kansas Health System, Kansas City, Kansas. ORCID: https://orcid.org/0000-0003-4209-591X.

Buprenorphine (BPN), FDA approved for opioid use disorder (OUD), requires an induction protocol for the patient in mild to moderate withdrawal. This can be problematic in outpatient practice due to complicated medical management. An emerging technique in literature uses a novel approach, called microinduction. Read More

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September 2021

Facilitating discontinuation of intravenous opioids by -concurrent use of sublingual buprenorphine with rapid microdosing -induction: A pain management case study.

J Opioid Manag 2021 ;17(7):153-158

Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

We report a case in which sublingual buprenorphine was used to help transition a patient off intravenous (IV) opioid analgesics medications post-multiple abdominal procedures. Intravenous opioids are commonly used in inpatient surgical pain management for patients with severe pain who are unable to take oral medications. Typically, a short course of IV analgesics is used, followed by transition to oral analgesic regimen. Read More

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September 2021

Adverse effects of regulation on buprenorphine prescribing and its impact on the treatment of opioid use disorder.

J Opioid Manag 2021 ;17(7):133-139

Mercy Health - St Elizabeth - Youngstown Hospital, Youngstown, Ohio.

Problem: Drug addiction and misuse is a medical and societal problem that has exacted a heavy toll on the United States, and, indeed, the world. In the United States, opioids are currently the main driver of drug overdose deaths. Despite the proven safety and efficacy of medically assisted therapy (MAT) using buprenorphine for the treatment of opioid use disorder (OUD), as well as the fact that its use is regulated by US Federal Law, many states have enacted separate and often burdensome regulations that restrict the prescribing of buprenorphine beyond those required by the US Drug Enforcement Agency (DEA) under the provisions of the DATA 2000 Act, and unnecessarily reduce the availability of effective treatment of OUD in those states. Read More

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September 2021

Review of the adaptations in opioid agonist treatment during the COVID-19 pandemic: Focus on buprenorphine-based treatment.

J Opioid Manag 2021 ;17(7):119-131

Department of Psychiatry, Drug Deaddiction & Treatment Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India. ORCID: https://orcid.org/0000-0002-3643-5984. Corresponding author email:

Background: Availability and access to opioid agonist treatment (OAT) are limited despite its evidence of effectiveness in treating opioid use disorders (OUDs). COVID-19 pandemic has inadvertently exacerbated the problems of restricted access to OAT and, at the same time, has increased odds of harm due to opioid use.

Objectives: We examined (a) adaptations conceived or implemented in the buprenorphine (BPN)-based OAT service delivery at the national, regional, or local level during the COVID-19 pandemic and (b) the impact of such transformations on the quantitative and qualitative aspects of service delivery. Read More

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September 2021

The divided dose approach to perioperative buprenorphine -management in patients with opioid use disorder.

J Opioid Manag 2021 ;17(7):101-107

Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York.

There is limited evidence and no clear consensus suggesting best practices for perioperative buprenorphine management in patients with opioid use disorder. As such, we aimed to develop a standardized perioperative management approach with the goals of (1) optimizing perioperative analgesia, (2) minimizing relapse risk, (3) setting expectations for patients and clinicians, (4) achieving prescribing consistency and mitigating risk among clinicians not familiar with perioperative buprenorphine management, and (5) maintaining continuity throughout care transitions. An interprofessional expert focus group convened to develop a consensus algorithm based upon buprenorphine's unique pharmacologic features and published perioperative management recommendations. Read More

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September 2021

Geographic analysis of military health system (MHS) buprenorphine prescribers and patients.

J Opioid Manag 2021 ;17(7):87-100

Georgetown University School of Medicine, Program Director Pain Fellowship, Walter Reed National Military Medical Center, Bethesda, Maryland.

Objective: To demonstrate the prevalence of opioid use disorder (OUD) in the military health system (MHS), geographically map OUD patients and providers, and offer policy recommendations to help increase buprenorphine waiver prescribing.

Design: This study was a retrospective review of data from the MHS records. Deidentified records of MHS OUD patients receiving buprenorphine were utilized. Read More

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September 2021

Patient satisfaction with clinic-based medication pick up: Addressing pharmacy-level challenges to buprenorphine access.

J Opioid Manag 2021 ;17(7):77-86

Cordant Health Solutions, Denver, Colorado.

Introduction: Pharmacy-level challenges that exist for patients when seeking to fill buprenorphine prescriptions at traditional retail pharmacies can result in a less than optimal treatment experience. High patient satisfaction with treatment for opioid use disorder (OUD), which for oral buprenorphine treatment includes the necessary step of obtaining medication after being prescribed, is associated with positive health outcomes and, therefore, is of great clinical interest. The objective of this study was to examine patient satisfaction when participating in a pharmacy program that coordinated buprenorphine delivery and provision to patients at office visits instead of requiring patients to fill their prescriptions at local pharmacies. Read More

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September 2021

A history of opioid abuse: Why buprenorphine is superior for the management of opioid use disorder and pain.

J Opioid Manag 2021 ;17(7):43-50

Pain Management Division, Westchester Medical Center, Valhalla, New York. ORCID: https://orcid.org/0000-0002-9030-2314.

Opioid abuse represents a public health crisis that has significant associated morbidity and mortality. Since beginning in the early 1990's, the opioid abuse epidemic has been difficult to control due to regulatory, economic, and psychosocial factors that have perpetuated its existence. This era of opioid abuse has been punctuated by three distinct rises in mortality, precipitated by unique public health problems that needed to be addressed. Read More

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September 2021