Exploring the use of extended release opioids at shortened dosing intervals in people with chronic pain and high risk medication or substance use

This study took place in the Interprofessional Pain and Addiction Recovery Clinic, a specialty ambulatory clinic at the Centre for Addiction and Mental Health in Toronto, Canada for adults with chronic pain and a diagnosis or suspicion of substance use disorder.Method This was a retrospective cross-sectional study. Data were collected from records of patients with assessments completed in the years 2012 –2017 (n  =  210).Main outcome measure Proportion of patients using extended release opioids at shortened intervals.Results Sixty-one percent of individuals using extended release opioids (n  =  78) were using them at shortened intervals. This use was associated with a higher daily morphine equivalent dose (533 mg vs 236 mg,p 
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research

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More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage. In recent decades, there has been an overreliance on the prescription of opioids for chronic pain, contributing to a significant and alarming epidemic of opioid overdose deaths and addiction. Innovative scientific solutions to develop non-opioid, non-addictive alternative treatment options are thus urgently needed. One of the goals of the Helping to End Addiction Long-term (HEAL) Initiative is to accelerate the discovery and preclinical development of new medications and devices t...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage. In recent decades, there has been an overreliance on the prescription of opioids for chronic pain, contributing to a significant and alarming epidemic of opioid overdose deaths and addiction. Innovative scientific solutions to develop non-opioid, non-addictive alternative treatment options are thus urgently needed. One of the goals of the Helping to End Addiction Long-term (HEAL) Initiative is to accelerate the discovery and preclinical development of new medications and devices t...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
Authors: Shahi N, Patchett-Marble R Abstract The prevalence of opioid abuse has reached an epidemic level. National guidelines recommend safer opioid prescribing practices, including potentially monitoring patients with urine drug testing (UDT). There is limited research evidence sur-rounding the use of UDT in the context of chronic noncancer pain (CNCP). We evaluated the efficacy of systematic, randomized UDT to detect and manage opioid misuse among patients with CNCP in primary care. The Marathon Family Health Team (MFHT) designed and implemented a clinic-wide, randomized UDT program called the HARMS (High-yield ...
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
AbstractOpioid-related death and overdose have now reached epidemic proportions. In response to this public health crisis, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-term InitiativeSM, or NIH HEAL InitiativeSM, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. Herein, we describe two NIH HEAL Initiative programs to accelerate development of non-opioid, non-addictive pain treatments: The Preclinical Screening Platform for Pain (PSPP) and Early Phase Pain Investigation Clinical Network (EPPIC-Net). These resources are pro...
Source: Neurotherapeutics - Category: Neurology Source Type: research
Abstract Chronic pain is considered a public health crisis due to its high prevalence, impact, costs, and disparities in pain prevalence and treatment. In parallel, drug overdose, particularly due to opioids, has become an epidemic in the United States, prompting a public health crisis concerning harms associated with both prescribed opioid therapy for chronic pain and illicit opioid use. The purpose of this special issue is to highlight state-of-the-art psychological research that addresses the combined issues of chronic pain and harms associated with opioids. Articles included in this special issue focus on 2 re...
Source: The American Psychologist - Category: Psychiatry & Psychology Authors: Tags: Am Psychol Source Type: research
DISCUSSION: The ORT is not useful in identifying acute pain surgical patients at risk for aberrant behavior. An educational video increased awareness of, but not compliance with, safe S&D of UOT. Opioid overprescription continues to contribute to opioid misuse. PMID: 32762470 [PubMed - as supplied by publisher]
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
AbstractThere is overwhelming evidence that the opioid crisis —which has cost hundreds of thousands of lives and trillions of dollars (and counting)—has been created or exacerbated by webs of influence woven by several pharmaceutical companies. These webs involve health professionals, patient advocacy groups, medical professional societies, research univer sities, teaching hospitals, public health agencies, policymakers, and legislators. Opioid companies built these webs as part of corporate strategies of influence that were designed to expand the opioid market from cancer patients to larger groups of patients ...
Source: Journal of Bioethical Inquiry - Category: Medical Ethics Source Type: research
In the United States, more than 100 million people suffer from chronic pain. Among patients presenting for surgery, about one in four have chronic pain. Acute perioperative pain management in this population is challenging because many patients with chronic pain require long-term opioids for the management of this pain, which may result in tolerance, physical dependence, addiction, and opioid-induced hyperalgesia. These challenges are compounded by the ongoing opioid epidemic that has resulted in calls for a reduction in opioid use, with a concurrent increase in the number of patients with chronic opioid exposure presenting for surgery.
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: Continuing Education Source Type: research
This article aims to summarize practical considerations for acute postoperative pain management in patients with chronic pain conditions. A patient-centered acute pain management plan, including nonopioid analgesics, regional anesthesia, and careful selection of opioid medications, can lead to adequate analgesia and satisfaction with care. Also, a meticulous rotation from one opioid to another may decrease opioid requirement, increase analgesic effectiveness, and improve satisfaction with care. PMID: 32660812 [PubMed - as supplied by publisher]
Source: Journal of Perianesthesia Nursing - Category: Nursing Authors: Tags: J Perianesth Nurs Source Type: research
We describe the historical use of opioids and the scope of the current opioid crisis, review the differences between dependence and addiction, and the private and public sectors response to pain management and highlight the issue of adolescent vulnerability. We conclude with a proposal for future directions that address both public and patient health needs.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Jorge A. Gálvez Source Type: research
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