Opioid Prescribing Patterns and Usage Following Cochlear Implantation
Conclusion: Prescribing patterns following CI can influence recurrent opioid use in patients. Each additional tablet of hydrocodone 5 mg beyond 8 tablets/d or oxycodone 5 mg beyond 5.33 tablets/d, increases the likelihood of recurrent opioid use by 15 or 22.5%, respectively. Limiting opioids prescribed per day to no more than 40 MME could lower the likelihood of patients becoming recurrent opioid users postoperatively. (Source: Otology and Neurotology)
Source: Otology and Neurotology - July 30, 2020 Category: ENT & OMF Tags: COCHLEAR IMPLANTS Source Type: research

Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006-2017.
This report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006-2007 through 2016-2017, by selected patient and hospital characteristics and the type of opioids prescribed. Methods-Data are from the 2006-2017 National Hospital Ambulatory Medical Care Survey. The study population included all ED visits by patients aged 18 and over. The main outcome studied was opioids prescribed at ED discharge, defined using Cerner Multum's third-level therapeutic category codes for narcotic analgesics (Code 60) and narcotic-analgesic combinations (Code 191). Results-The percentage of ED vis...
Source: National health statistics reports - June 10, 2020 Category: American Health Tags: Natl Health Stat Report Source Type: research

Opioid-induced esophageal dysfunction
Purpose of review Chronic opioid use is common and can cause opioid-induced esophageal dysfunction (OIED). We will discuss the pathophysiology, diagnosis, and management of OIED. Recent findings OIED is diagnosed based on symptoms, opioid use, and manometric evidence of distal esophageal spasm, esophagogastric junction outflow obstruction, achalasia type III, or jackhammer esophagus. Chronic opioid use appears to interfere with inhibitory signals involved in control of esophageal motility, allowing for unchecked excitatory stimuli, and leading to spastic contractility and impaired esophagogastric junction relaxation. ...
Source: Current Opinion in Gastroenterology - June 9, 2020 Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research

Prescribed Opioid Use in Wisconsin 2008-2016: Findings From the Survey of the Health of Wisconsin.
CONCLUSION: These data from 2008-2016 demonstrate concerning levels of prescription opioid use and provide data on which population groups may be most vulnerable. While policies and clinical practice have changed since 2016, ongoing evaluation of prescribing practices, including consideration of behavioral health issues when prescribing opioids, is called for. PMID: 32659062 [PubMed - in process] (Source: WMJ)
Source: WMJ - June 1, 2020 Category: General Medicine Authors: Thakur T, Barnet JH, LeCaire T, Bersch A, Peppard P, Malecki K, Moberg DP Tags: WMJ Source Type: research

Opioid exposure after injury in United States trauma centers: A prospective, multicenter observational study
CONCLUSION The overall median opioid exposure was 45 MMEs per day. Despite significant differences in opioid exposure between trauma centers, the majority of variation was actually within centers. This suggests that efforts to minimize opioid exposure after injury should focus within trauma centers and not on high-level efforts to affect all trauma centers. LEVEL OF EVIDENCE Epidemiological, level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

Robotic Inguinal Hernia Repair.
CONCLUSIONS: Robotic inguinal hernia repair is safe and effective. 1) Proper training, including simulators and proctors, is necessary; 2) having the same operating room team and an interested first assistant at the OR table is very helpful; 3) the learning curve is about 50 patients; 4) postoperative narcotics are rarely more than three hydrocodone pills; 4) no fixation of the mesh is necessary, but fibrin sealant was used routinely in these patients; and 5) urinary retention is the most common postoperative issue and is best planned for by knowing the patients urinary history, use of peripheral alpha-blockers, and straig...
Source: Surgical Technology International - May 22, 2020 Category: Surgery Tags: Surg Technol Int Source Type: research

Stigmatization of opioid addiction based on prescription, sex and age.
Abstract With opioid abuse becoming a nationwide epidemic, it is important to understand what is contributing to societal views of opioid dependence. Difference in stigmatization of drug users may exist between sexes, ages and type of drugs being used. Social perceptions may impact drug use and recovery. To assess which opioid users are stigmatized most, we administered an experimenter-created vignette that experimentally manipulated the type of opioid (Prescribed Vicodin vs. Non-prescribed Vicodin vs. heroin) as well as the sex of the opioid user (Male vs. Female) and the age of the user (23 years-old vs. 53...
Source: Addictive Behaviors - May 19, 2020 Category: Addiction Authors: Weeks C, Stenstrom DM Tags: Addict Behav Source Type: research

State Medical Cannabis Laws Associated With Reduction in Opioid Prescriptions by Orthopaedic Surgeons in Medicare Part D Cohort.
Authors: Lopez CD, Boddapati V, Jobin CM, Hickernell TR Abstract INTRODUCTION: Opioid prescriptions and abuse remain a significant national concern. Cannabinoids offer a potentially attractive nonopioid analgesic option for orthopaedic patients, and 32 US states have passed medical cannabis laws (MCLs), legalizing patient access to cannabinoids. We examine the association between implementation of state cannabis laws and prescribing patterns for opioids by orthopaedic surgeons in Medicare Part D patients between 2013 and 2017. METHODS: Using the Medicare Part D Prescription Drug Event database, we measured annu...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 16, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

IJERPH, Vol. 17, Pages 3324: Physician-Delivered Pain Neuroscience Education for Opioid Tapering: A Case Report
We describe the case of a 75-year-old female with chronic low back pain (CLBP), on opioids for more than 15 years. She presented with an acute episode of nausea, vomiting, abdominal pain, and shortness of breath. After a complete work-up, it was concluded that her presenting symptoms were likely due to her high levels of CLBP and high dose opioids. At the time of intervention, her opioid dosage was between 50–90 MME (Morphine milligram equivalent) (Norco 8 × 7.5 mg/day + Fentanyl 12 mcg patch). She was subsequently seen by the physician for seven outpatient internal medicine appointments over ni...
Source: International Journal of Environmental Research and Public Health - May 11, 2020 Category: Environmental Health Authors: Vikas Agarwal Adriaan Louw Emilio J. Puentedura Tags: Case Report Source Type: research

IJERPH, Vol. 17, Pages 3251: Prescription Opioid Distribution after the Legalization of Recreational Marijuana in Colorado
We examined the association between the legalization of recreational marijuana and prescription opioid distribution in Colorado. Utah and Maryland, two states that had not legalized recreational marijuana, were selected for comparison. Prescription data reported to the Drug Enforcement Administration for nine opioids used for pain (e.g., fentanyl, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone) and two primarily for opioid use disorder (OUD, methadone and buprenorphine) from 2007 to 2017 were evaluated. Analysis of the interval pre (2007–2012) versus post (2013–2017) marijuana lega...
Source: International Journal of Environmental Research and Public Health - May 7, 2020 Category: Environmental Health Authors: Amalie K. Kropp Lopez Stephanie D. Nichols Daniel Y. Chung Daniel E. Kaufman Kenneth L. McCall Brian J. Piper Tags: Article Source Type: research

Reduction of Drug-Drug Interaction Risk; CDC Guidelines Influence on Opiate Benzodiazepine Prescribing.
We examined the results of 1.3 million drug tests performed on patients being monitored for compliance with pain medications and substance abuse rehabilitation to determine if the 2016 CDC prescribing guidelines had any impact on opiate benzodiazepine use. We observed that the combination of the opiate drugs morphine, oxycodone, and hydrocodone with the benzodiazepine metabolites oxazepam, alphahydroxyalprazolam, and 7-aminoclonazepam showed many patients were on a combination of these drugs. This ranged from approximately 9 to 16%. There was considerable variability between opiate drug pairs, but there was a general trend...
Source: Annals of Clinical and Laboratory Science - May 1, 2020 Category: Laboratory Medicine Authors: Pesce A, Thomas R, Krock K, Tran K, Ackerman G, Nickley J Tags: Ann Clin Lab Sci Source Type: research

Drug Enforcement Agency 2014 Hydrocodone Rescheduling Rule and Opioid Dispensing after Surgery
Background In 2014, the U.S. Drug Enforcement Agency reclassified hydrocodone from Schedule III to Schedule II of the Controlled Substances Act, resulting in new restrictions on refills. The authors hypothesized that hydrocodone rescheduling led to decreases in total opioid dispensing within 30 days of surgery and reduced new long-term opioid dispensing among surgical patients.Methods The authors studied privately insured, opioid-na ïve adults undergoing 10 general or orthopedic surgeries between 2011 and 2015. The authors conducted a differences-in-differences analysis that compared overall opioid dispensing beforeve...
Source: Anesthesiology - April 15, 2020 Category: Anesthesiology Source Type: research

Prospective Study of Acute Opioid Use After Adolescent Anterior Cruciate Ligament Reconstruction Shows No Effect From Patient- or Surgical-Related Factors.
CONCLUSION: Patients take most pain medication during the first postoperative week after adolescent ACLR, although patient and surgical variables had no notable influence on pill consumption. LEVEL OF EVIDENCE: Level IV, case series. PMID: 32213778 [PubMed - in process] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 29, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Provider Characteristics Associated With Outpatient Opioid Prescribing After Surgery
Objective: To characterize differences in postoperative opioid prescribing across surgical, nonsurgical, and advanced practice providers. Background: There is a critical need to identify best practices around perioperative opioid prescribing. To date, differences in postoperative prescribing among providers are poorly understood. Methods: This is a retrospective multicenter analysis of commercial insurance claims from a statewide quality collaborative. We identified 15,657 opioid-naïve patients who underwent a range of surgical procedures between January 2012 and October 2015 and filled an opioid prescription ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Response to opioids is dependent on sociability levels
This study suggests that socially exploring animals are more sensitive to the sensitizing effects of opioids. In contrast, opioids have greater effects on the stress and pain systems of socially avoiding animals. Thus, the underlying mechanisms for developing OUD might differ in individuals with various sociability levels. (Source: Behavioural Pharmacology)
Source: Behavioural Pharmacology - March 14, 2020 Category: Drugs & Pharmacology Tags: Research Reports Source Type: research

Determination of structural factors affecting binding to mu, kappa and delta opioid receptors.
Abstract Addiction is a complex behavioral phenomenon in which naturally occurring or synthetic chemicals modulate the response of the reward system through their binding to a variety of neuroreceptors, resulting in compulsive substance-seeking and use despite harmful consequences to the individual. Among these, the opioid receptor (OR) family and more specifically, the mu-opioid receptor (MOR) subtype plays a critical role in the addiction to powerful prescription and illicit drugs such as hydrocodone, oxycodone, fentanyl, cocaine, and methamphetamine (Contet et al. in Curr Opin Neurobiol 14(3):370-378, 2004). Co...
Source: Archives of Toxicology - February 27, 2020 Category: Toxicology Authors: Slavov S, Mattes W, Beger RD Tags: Arch Toxicol Source Type: research

Objective Quantification of Opioid Usage After Thyroid Surgery
Conclusion: Recent multimodality anesthesia research appears promising to dramatically reduce or even eliminate the need for opioid prescriptions upon postoperative discharge. [...] Thieme Revinter Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: International Archives of Otorhinolaryngology)
Source: International Archives of Otorhinolaryngology - February 7, 2020 Category: ENT & OMF Authors: Agnew, Andrew Carroll, Sean Fornelli, Rick Schell, Stephen Steehler, Kirk Tags: Original Research Source Type: research

Alleviation of Pain After Femur and Tibia Shaft Fractures Using Nothing Stronger Than Codeine and Tramadol
Conclusions: Alleviation of pain can be achieved in most patients with femoral and tibial shaft fractures, including multiply injured patients, with one-on-one patient support and by using nothing stronger than codeine and tramadol. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - January 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Opioid prescription use in patients with interstitial cystitis
ConclusionsA significant number of patients with IC are treated with opioids. Although the overall number of opioid prescriptions associated with IC had declined, the prescription rate per IC diagnosis had not. As part of the national initiative to reduce opioid use, our data suggest that IC treatment strategies should be examined. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - January 24, 2020 Category: OBGYN Source Type: research

Surgeon-Administered Nerve Block During Rotator Cuff Repair Can Promote Recovery with Little or No Post-operative Opioid Use
ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR. (Source: HSS Journal)
Source: HSS Journal - January 22, 2020 Category: Orthopaedics Source Type: research

Nephrotoxicity in a Patient With Inadequate Pain Control: Potential Role of Pharmacogenetic Testing for Cytochrome P450 2D6 and Apolipoprotein L1
A case is presented which demonstrates the perils of opioid inefficacy and how pharmacogenomic testing may have prevented nonsteroidal anti-inflammatory drug (NSAID)-induced nephrotoxicity and progression to chronic kidney disease (CKD). A 62 year-old female with back pain was treated with tramadol and hydrocodone; however, neither proved effective. Consequently, to control her pain, she resorted to cocaine, marijuana, and high dose nonsteroidal anti-inflammatory drugs (NSAIDs). She eventually developed CKD. To identify CKD contributors, she underwent genotyping for Apolipoprotein L1 (APOL1), a known risk factor of CKD, as...
Source: Frontiers in Pharmacology - January 8, 2020 Category: Drugs & Pharmacology Source Type: research

Evaluation of Hydrocodone/Acetaminophen for Pediatric Laceration Repair: A Randomized Trial
Conclusion: Adjuvant oral hydrocodone/acetaminophen is more effective than placebo in reducing pain in children younger than 8 years undergoing topical lidocaine–treated laceration repair, but it does not decrease pain or anxiety in older children. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II. (Source: Plastic and Reconstructive Surgery)
Source: Plastic and Reconstructive Surgery - December 24, 2019 Category: Cosmetic Surgery Tags: Pediatric/Craniofacial: Original Articles Source Type: research

Discussion: Evaluation of Hydrocodone/Acetaminophen for Pediatric Laceration Repair: A Randomized Trial
No abstract available (Source: Plastic and Reconstructive Surgery)
Source: Plastic and Reconstructive Surgery - December 24, 2019 Category: Cosmetic Surgery Tags: Pediatric/Craniofacial: Original Articles Source Type: research

Initial Opioid Prescriptions Predict Continued Narcotic Use: Analysis of 24,594 Reduction Mammaplasty Patients
Conclusions: The probability of refilling prescription opioids is increased by nonmodifiable risk factors, such as age. However, modifiable risk factors exist as well, most notably the amount of narcotic prescribed during the perioperative period. Overprescribing was found to be common in the reduction mammaplasty patient population. Limiting outpatient opioid exposure to a range of 15 to 59 daily morphine milligram equivalents (e.g., 5 mg of hydrocodone every 6 hours) during the perisurgical period may reduce the probability that the surgeon will need to prescribe further narcotics. Further studies are needed to validat...
Source: Plastic and Reconstructive Surgery - December 24, 2019 Category: Cosmetic Surgery Tags: Breast: Original Articles Source Type: research

Patterns in opioid prescription in the United States by region and prescribers over a 4-year period.
Authors: Bigal LM, Bibeau K, Dumbar S Abstract BACKGROUND: As determinants of the opioid epidemic are several, describing patterns of opioid prescription over time is of importance. OBJECTIVE: To characterize the prescribing patterns of opioids per US region and physician specialty from 2012 to 2015. METHODS: Truven Health Analytics MarketScan® Databases were used to obtain data on opioid prescription rates per US region and physician specialty for the years 2012-2015. Opioids included in the study are tramadol, hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl. RESULTS: Starting...
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid prescribing practices in a pediatric burn tertiary care facility: Is it time to change?
Publication date: Available online 18 December 2019Source: BurnsAuthor(s): Asif Khan, Mihir Parikh, Abu Minhajuddin, Timothy Williams, Ruth Abrams, Enas Kandil, Aditee AmbardekarAbstractOpioids are the mainstay therapy in burned adults. Little data in the pediatric burn population exists that elucidates opioid prescribing practices. The primary purpose of this report is to quantify opioid and non-opioid analgesic use in pediatric burn patients admitted to a tertiary referral burn center. A retrospective audit of hospital charts and discharge records for patients
Source: Burns - December 18, 2019 Category: Dermatology Source Type: research

Opioid Prescribing Among Adults With Disabilities in the United States After the 2014 Federal Hydrocodone Rescheduling Regulation.
CONCLUSIONS: The 2014 federal rescheduling of hydrocodone was associated with only minor changes in overall and potentially high-risk opioid-prescribing rates. Neither state variation in long-term prescribing nor beneficiary characteristics explained the changes in persistently high opioid-prescribing rates among adults with disabilities after the 2014 regulation. Future studies should examine patient and provider characteristics underlying the persistent high-risk prescribing patterns in this population. PMID: 31835012 [PubMed - in process] (Source: Public Health Reports)
Source: Public Health Reports - December 14, 2019 Category: International Medicine & Public Health Tags: Public Health Rep Source Type: research

Multicenter study on the effect of nonsteroidal anti ‐inflammatory drugs on postoperative pain after endoscopic sinus and nasal surgery
ConclusionNSAID use was introduced into the practices of 5 practicing rhinologists and 1 facial plastic surgeon. No bleeding complications were seen. Both pain and overall opioid usage were reduced significantly. (Source: International Forum of Allergy and Rhinology)
Source: International Forum of Allergy and Rhinology - December 13, 2019 Category: Allergy & Immunology Authors: Arthur W. Wu, Evan S. Walgama, Ege Gen ç, Jonathan Y. Ting, Elisa A. Illing, Taha Z. Shipchandler, Thomas S. Higgins Tags: ORIGINAL ARTICLE Source Type: research

Response to Propoxyphene Market Withdrawal: Analgesic Substitutes, Doses, and Adverse Events
Conclusions: After propoxyphene market withdrawal, many individuals experienced abrupt discontinuation of opioids. Policymakers might consider supporting appropriate treatment transitions and monitoring responses following drug withdrawals. (Source: Medical Care)
Source: Medical Care - December 12, 2019 Category: Health Management Tags: Original Article Source Type: research

Opioid Prescribing Trends in Women Following Mastectomy or Breast-Conserving Surgery Before and After the 2014 Federal Reclassification of Hydrocodone.
CONCLUSION: Surgically treated breast cancer patients are less likely to receive short- and long-term opioid prescriptions following the implementation of hydrocodone rescheduling. Further studies on the potential impact of federal policy on cancer patient pain management are needed. IMPLICATIONS FOR PRACTICE: Clinicians and researchers with diverse perspectives should be included as stakeholders during policy development for restricting opioid prescriptions. Stakeholders can identify potential unintended consequences early and help identify methods to mitigate concerns, specifically as it relates to policy that influ...
Source: The Oncologist - December 4, 2019 Category: Cancer & Oncology Authors: Gibson DC, Chou LN, Raji MA, Baillargeon JG, Kuo YF Tags: Oncologist Source Type: research

A multimodal analgesic protocol reduced opioid use/misuse after third molar surgery
ConclusionsOutcomes suggest that implementation of a multimodal analgesic protocol with third molar surgery may be effective in reducing use and misuse of opioid drugs. (Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology)
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - November 29, 2019 Category: ENT & OMF Source Type: research

Opioid Safety and Concomitant Benzodiazepine Use in End-Stage Renal Disease Patients.
Conclusions: Concurrent benzodiazepine use is common and associated with higher risk of hospitalization due to opioid overdose. Possible opioid-associated hospital admission rate is 4-5 times bigger in ESRD population than general population. Current safety classification of opioids in these patients is misleading, and even drugs considered safe based on pharmacokinetic data are associated with moderate to very high risk of hospitalization. We propose a risk-stratified classification of opioids and suggest starting to use them in all ESRD patients. PMID: 31772694 [PubMed - in process] (Source: Pain Research and Management)
Source: Pain Research and Management - November 29, 2019 Category: Anesthesiology Authors: Ruchi R, Bozorgmehri S, Ozrazgat-Baslanti T, Segal MS, Shukla AM, Mohandas R, Kumar S Tags: Pain Res Manag Source Type: research

A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC2 Randomized Controlled Trial.
CONCLUSIONS: The study found that the EMC2 tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge. PMID: 31742823 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)
Source: Accident and Emergency Nursing - November 19, 2019 Category: Emergency Medicine Authors: McCarthy DM, Curtis LM, Courtney DM, Cameron KA, Lank PM, Kim HS, Opsasnick LA, Lyden AE, Gravenor SJ, Russell AM, Eifler MR, Hur SI, Rowland ME, Walton SM, Montague E, Kim KA, Wolf MS Tags: Acad Emerg Med Source Type: research

Prescribing patterns before and after a non-fatal drug overdose using Tennessee's controlled substance monitoring database linked to hospital discharge data
Publication date: Available online 6 November 2019Source: Preventive MedicineAuthor(s): Shanthi Krishnaswami, Sutapa Mukhopadhyay, Melissa McPheeters, Sarah J. NechutaAbstractWe performed a statewide evaluation of prescribing patterns of controlled substances (CS) before and after an overdose, using Tennessee's Hospital Discharge Data System and the Controlled Substance Monitoring Database (CSMD). Adults' first non-fatal overdose discharges either from the emergency department (ED) or inpatient (IP) stay occurring between 2013 and 2016 were linked to prescriptions in the CSMD. The difference in the proportion of patients f...
Source: Preventive Medicine - November 6, 2019 Category: International Medicine & Public Health Source Type: research

Pharmacological strategies in multimodal analgesia for adults scheduled for ambulatory surgery
Purpose of review The present review aims to propose pharmacological strategies to enhance current clinical practices for analgesia in ambulatory surgical settings and in the context of the opioid epidemic. Recent findings Each year, a high volume of patients undergoes ambulatory surgery worldwide. The multimodal analgesia proposed to ambulatory patients must provide the best analgesic effect and patient satisfaction while respecting the rules of safety for ambulatory surgery. The role of nurses, anesthesiologists, and surgeons around said surgery is to relieve suffering, achieve early mobilization and patient satisfa...
Source: Current Opinion in Anaesthesiology - November 5, 2019 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research

Assessment of the Utility of the Oral Fluid and Plasma Proteomes for Hydrocodone Exposure.
CONCLUSIONS: We present an assessment of the oral fluid and plasma proteome following hydrocodone administration, which demonstrates the potential of oral fluid as a noninvasive sample that may reveal features of hydrocodone in opioid use, and with additional study, may be useful for other opioids and in settings of misuse. PMID: 31677050 [PubMed - as supplied by publisher] (Source: Journal of Medical Toxicology)
Source: Journal of Medical Toxicology - November 1, 2019 Category: Toxicology Authors: Deatherage Kaiser BL, Jacobs JM, Schepmoes AA, Brewer HM, Webb-Robertson BM, Valtier S, Bebarta VS, Adkins JN Tags: J Med Toxicol Source Type: research

Prevalence of illicit and prescribed neuropsychiatric drugs in three communities in Kentucky using wastewater-based epidemiology and Monte Carlo simulation for the estimation of associated uncertainties
In this study, the prevalence of 10 illicit and 19 prescribed psychoactive drugs of potential abuse was determined utilizing wastewater-based epidemiology, and compared in two adjoined urban communities and a rural community. This is the first application of the Monte Carlo simulation method to account multiple uncertainties and propagation of errors associated with the individual parameter of wastewater based epidemiological estimations in the U.S. A significantly higher prevalence of cocaine [3830 (mean difference, MD: 2960) mg/d/1000 people] was found in the central business district while the per-capita consumption rat...
Source: Journal of Hazardous Materials - October 16, 2019 Category: Environmental Health Source Type: research

The Deadly Trio: Heroin, FentaNYL, and Carfentanil
Opioid dependence is a public health epidemic; the United States is experiencing an unprecedented number of opioid-related deaths.1 Opioids are the primary drugs associated with deaths from overdose and include prescription pain relievers, such as oxyCODONE (OxyCONTIN), HYDROcodone (Vicodin), and methadone.2 The availability and use of prescription pain relievers has increased over the last several decades in the US. In 2017, there were 11.4 million persons aged 12 years or older in the previous year who used opioids in the US, most of whom used prescription pain relievers. (Source: Journal of Emergency Nursing: JEN)
Source: Journal of Emergency Nursing: JEN - October 11, 2019 Category: Nursing Authors: Deborah Salani, Mary Mckay, Martin Zdanowicz Tags: Clinical Source Type: research

Implementation of a Multi-Modal Pain Regimen to Decrease Inpatient Opioid Exposure After Injury
Publication date: Available online 1 October 2019Source: The American Journal of SurgeryAuthor(s): Shuyan Wei, Charles Green, Van Thi Thanh Truong, John Howell, Stephanie Martinez Ugarte, Rondel Albarado, Ethan A. Taub, David E. Meyer, Sasha D. Adams, Michelle K. McNutt, Laura J. Moore, Bryan A. Cotton, Lillian S. Kao, Charles E. Wade, John B. Holcomb, John A. HarvinAbstractIntroductionIn 2013, we implemented a pill-based, multi-modal pain regimen (MMPR) in order to decrease in-hospital opioid exposure after injury at our trauma center. We hypothesized that the MMPR would decrease inpatient oral morphine milligram equivale...
Source: The American Journal of Surgery - October 1, 2019 Category: Surgery Source Type: research

Regional Differences in the Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017.
Conclusions-The drugs most frequently involved in drug overdose deaths in 2017 varied by HHS region. Understanding the regional differences can help inform local prevention and policy efforts. PMID: 32501207 [PubMed - as supplied by publisher] (Source: Natl Vital Stat Rep)
Source: Natl Vital Stat Rep - October 1, 2019 Category: Statistics Authors: Hedegaard H, Bastian BA, Trinidad JP, Spencer MR, Warner M Tags: Natl Vital Stat Rep Source Type: research

Current Opioid Prescribing Patterns after Microdirect Laryngoscopy.
CONCLUSIONS: In this study, over 90% of practicing physicians surveyed are prescribing opioids after MDL, though many are also prescribing non-opioid analgesia as well. Further studies should be completed to investigate the needs of patients following MDL in order to allow physicians to selectively and appropriately prescribe opioid analgesia postoperatively. PMID: 31559860 [PubMed - as supplied by publisher] (Source: The Annals of Otology, Rhinology, and Laryngology)
Source: The Annals of Otology, Rhinology, and Laryngology - September 27, 2019 Category: ENT & OMF Authors: Huston MN, Kamizi R, Meyer TK, Merati AL, Giliberto JP Tags: Ann Otol Rhinol Laryngol Source Type: research

Is it Time to Relegate Routine Opioid Prescriptions to the Oral Surgery Archives?
The end of the 1970s ushered in what became an accepted standard of care for most of medicine and dentistry, including oral and maxillofacial surgery: Hydrocodone with acetaminophen was introduced as Vicodin (Knoll Pharmaceutical Company, Whippany, NJ) in 1978 and rapidly embraced by providers to treat all types of pain. Curiously, centuries-old concerns about opioid addiction were largely set aside, and hydrocodone-acetaminophen combinations became the most-prescribed drugs in the US by the early 2000s and remain in the top ten. (Source: Journal of Oral and Maxillofacial Surgery)
Source: Journal of Oral and Maxillofacial Surgery - September 18, 2019 Category: ENT & OMF Authors: Brent L. Florine Source Type: research

Opioid-prescribing Practices in a Graduate Endodontic Clinic before and after Implementation of the Federal Schedule II Prescribing Mandate
Opioid prescriptions have the potential for misuse. In October 2014, the federal schedule II prescribing mandate reclassified hydrocodone combination products from schedule III to schedule II drugs that required a written prescription. The aim of this study was to evaluate the opioid-prescribing practices in a graduate endodontic clinic (GEC) before and after the mandate. (Source: Journal of Endodontics)
Source: Journal of Endodontics - September 12, 2019 Category: Dentistry Authors: Andrew M. Broadsword, Christine M. Sedgley, Richie Kohli, Al M. Best, Karan J. Replogle Tags: Clinical Research Source Type: research

The Vicodin Abuse Problem: A Mathematical Approach
Publication date: Available online 9 September 2019Source: Journal of Theoretical BiologyAuthor(s): Wendy K. Caldwell, Benjamin Freedman, Luke Settles, Michael M. Thomas, Erika T. Camacho, Stephen WirkusAbstractThe prescription drug epidemic in the United States has gained attention in recent years. Vicodin, along with its generic version, is the country’s mostly widely prescribed pain reliever, and it contains a narcotic component that can lead to physical and chemical dependency. The majority of Vicodin abusers were first introduced via prescription, unlike other drugs which are often experienced for the first time...
Source: Journal of Theoretical Biology - September 10, 2019 Category: Biology Source Type: research

Effects of Rescheduling Hydrocodone on Opioid Prescribing in Ohio.
CONCLUSIONS: The 2014 federal rescheduling of hydrocodone was associated with declines in hydrocodone prescriptions in Ohio beyond what had already been occurring, and hydrocodone may have been briefly substituted with codeine. These results indicate that rescheduling did have a lasting effect but affected prescribing specialties variably. PMID: 31502638 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - September 10, 2019 Category: Anesthesiology Authors: Liu Y, Baker O, Schuur JD, Weiner SG Tags: Pain Med Source Type: research

Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences.
This study explored how HCP rescheduling and associated administrative barriers may have affected physician treatment of acute (aNCP) and chronic (cNCP) noncancer pain. To this end, physician members of the Texas Medical Association completed a self-administered online questionnaire. Pharmacotherapy treatment plan was measured with two questions asking physicians whether they were more likely to recommend HCPs, acetaminophen/codeine (APAP/codeine), nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, or other agents for the treatment of aNCP and cNCP. Two Likert-scaled items were used to assess administrative burden. I...
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 28, 2019 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

161. Effects of Drug Enforcement Agency (DEA) narcotic restrictions on a multidisciplinary spine practice: analysis of patient discharges from the practice during a 10-year period
In the late 1990s to early 2000s, concern about pain under-treatment resulted in greater numbers of prescriptions for pain medications being written across the United States. After this, according to CDC data, from 1999 to 2017, more than 700,000 people died from a drug overdose with approximately 68% of the more than 70,200 opioid-related overdose deaths in 2017 alone. Government agencies across the country have taken measures to address this alarming trend. An instrumental change occurred on October 6, 2014 when the US Drug Enforcement Agency (DEA) rescheduled hydrocodone combination products from Schedule III to Schedul...
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jennifer J. Shivers, Donna D. Ohnmeiss, Andrew R. Block Source Type: research

Tramadol Prescription over a 4-Year Period in the USA
AbstractPurpose of ReviewDeaths associated to tramadol, a synthetic opioid, are rising globally. Herein, we characterize prescription patterns of tramadol relative to other opioids in the USA from 2012 to 2015, by geographic region and physician specialty.Recent FindingsData on opioid was obtained using Truven Health Analytics MarketScan for the years 2012 –2015. Inclusion criteria included subjects living in the USA with ages from 12 to 64 years. Patterns of prescription of tramadol were contrasted with other prescription opioids including hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl. B...
Source: Current Pain and Headache Reports - August 6, 2019 Category: Neurology Source Type: research

Race and ethnicity: Not factors in the prescribing of hydrocodone and codeine-containing products in two pediatric emergency departments.
CONCLUSIONS: Pediatric patients of all races and ethnicities received fewer HCP prescriptions after the 2014 DEA rescheduling of HCPs. However, Caucasian patients were prescribed HCPs and CCPs for abdominal pain more frequently than African American patients. There were no significant differences in the number of prescriptions of HCPs and CCPs by provider race. PMID: 31343724 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - July 27, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Post-Tonsillectomy Outcomes in Children With and Without Narcotics Prescriptions.
Abstract OBJECTIVE: To examine differences in outcomes after tonsillectomy in children who received outpatient narcotics prescriptions compared to those who did not. METHODS: The MarketScan database was analyzed for claims made for 14 days following tonsillectomy/adenotonsillectomy between 2008 and 2012 for privately insured children 1 to 17 years. Post-op bleeding, dehydration, emergency department (ED) visits, readmissions, and mean total costs for the 14 days after tonsillectomy were compared. RESULTS: Of the 294 795 patients included, 60.9% received a narcotic prescription. Acetaminophen/hydrocodone ...
Source: Ear, Nose and Throat Journal - July 14, 2019 Category: ENT & OMF Authors: Carr MM, Schaefer EW, Schubart JR Tags: Ear Nose Throat J Source Type: research