Long-Term Efficacy of Medication-Assisted Treatment of Opioid Addiction: A Systematic Literature Review—Part 1
No abstract available
The United States continues to face a public heatlh crisis of epic proportion, with over 500,000 deaths from opioid overdoses since 2000. Medications for opioid use disorder, like buprenorphine, offer patients an effective approach to cessation. Unfortunately many barriers to use of medications for opioid use disorder exist, including insufficient number of programs offering medications for opioid use disorder, inadequate number of addiction specialists to provide these medications, and stigma surrouding patients with opioid use disorders and the medications used to treat them.
It is estimated that approximately 10% of Americans are diagnosed with a past or active substance use disorder (SUD), placing them at risk for related mortality and morbidity. However, when patients face the diagnosis of a serious illness, this new stress places them at even higher risk of substance use disorder relapse. Palliative care teams are frequently consulted to provide care to this complex and vulnerable population, however many lack the training and knowledge to safely provide this care.
Buprenorphine is widely used as a treatment for patients with opioid use disorders, but has also been shown to be an effective treatment for cancer and neuropathic pain, with unique pharmacologic properties that give it several advantages over traditional opioids. Buprenorphine is associated with less analgesic tolerance, and is less likely to cause respiratory depression and constipation than other opioids. Buprenorphine also does not cause immunosuppression, sphincter of Oddi dysfunction, or hypogonadism like traditional opioids.
Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness (e.g., cancer) or those near the end of life.
No abstract available
Funding Opportunity RFA-NS-20-028 from the NIH Guide for Grants and Contracts. The purpose of this Funding Opportunity Announcement (FOA) is to solicit cooperative agreement applications that propose clinical trials to test the comparative effectiveness of existing pharmacological therapies or devices for prevention or management of pain while reducing risk of addiction. The studies must evaluate methods to manage specific pain conditions that are within the mission and research interests of participating NIH Institutes and Centers, and evaluate interventions including medications, biologics, medical and assistive devices...
If we can say anything for certain about caring for persons in pain over the past decade is that it has prompted concern and confusion on how to provide the best care. Consider the following: Do we have an opioid epidemic or an opioid crisis in the United States? Does the difference in these words matter? What about the “other” less publicized public health crisis; chronic pain; where did that conversation go? Are opioid analgesics good or bad to treat people in pain? Should nurses be prepared in pain care, addiction care or both? What are the differences in state policies that govern and guide nursing practice...
Opioid addiction has reached epidemic proportions in the United States and it is thought that the problem started with the prescription for legal pain medications by health care professionals, particularly for treating patients who had undergone surgery. To reduce the reliance on opioids in dental pain management, increase use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjunctive techniques have emerged. The use of NSAIDs, transdermal and transmucosal patches are presented. Understanding the rational for these different approaches requires a basic knowledge of the molecular biology of dental pain.
Abstract Many adults with opioid use disorder (OUD) report that their first exposure to opioids was in the course of routine pain treatment in medical care settings. Adolescents receive opioid prescriptions with frequency, but are susceptible to a constellation of unique risks in the context of pain management. This empirical study presents the first cohort of adolescents recruited from ambulatory medical care within 72 h of their receipt of opioids to treat acute pain. The primary aim was to capture a time-sensitive report of the intersection of prescription opioid receipt and contextual risks for opioid mis...
Conclusions: DSPN is a common complication in patients with diabetes, and severely affects the quality of life of these patients. Although multiple therapies are available, the guidelines and recommendations regarding the treatment of diabetic neuropathy have failed to offer a unitary consensus, which often hinders the therapeutic options in clinical practice. PMID: 31936646 [PubMed - in process]