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

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

Benzhydrocodone/Acetaminophen (Apadaz) for Pain
Date: July 15, 2019 Issue #:  1576Summary:  The FDA has approvedApadaz (KemPharm), a short-acting, fixed-dose combination of benzhydrocodone and acetaminophen, for short-term management (≤14 days) of acute pain severe enough to require an opioid and for which alternative treatment options are inadequate. Benzhydrocodone is a prodrug of hydrocodone. Fixed-dose combinations of short-acting hydrocodone and acetaminophen or ibuprofen have been available for years and are the most abused opioid products in the US.Apadaz was developed under the presumption that inclusion of the inactive prodrug wo...
Source: The Medical Letter - July 2, 2019 Category: Drugs & Pharmacology Authors: admin Tags: Acetaminophen Apadaz benzhydrocodone Ibudone Ibuprofen Norco NSAIDs Opioids Pain Tramacet tramadol Ultracet Vicoprofen Xylon Source Type: research

Of Dry Sockets and Preemptive Opioids
Removal of third molars is accompanied by the ever-present reality of patients occasionally developing localized alveolar osteitis —dry socket. Since telephone prescriptions for Schedule II drugs are technically permitted but, for practical purposes, virtually impossible, should hydrocodone be provided to everyone at the time of surgery “just in case” symptoms of dry socket develop? If so, are you convinced hydrocodone ac tually helps dry socket pain better than NSAIDs-acetaminophen? Thirty-plus years of private practice clinical experience have convinced me oral analgesics are largely ineffective for dry...
Source: Journal of Oral and Maxillofacial Surgery - June 29, 2019 Category: ENT & OMF Authors: Brent L. Florine Source Type: research

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System
Background: Hydrocodone-combination analgesics were changed from Schedule III to Schedule II to discourage the prescribing of these analgesics. Our primary aim was to explore the effect of hydrocodone rescheduling on opioid prescribing within an urban safety-net health care system. Methods and Design: Data were extracted from electronic records of ambulatory patients (N = 82,432 patients) prescribed hydrocodone-combination, codeine-combination, or tramadol opioid analgesics (N = 200,675 prescriptions) between October 6, 2013 and October 6, 2015. Data analyses modeled predicted probabilities of hydrocodone-combination pres...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Northrup, T. F., Carroll, K., Suchting, R., Villarreal, Y. R., Zare, M., Stotts, A. L. Tags: Original Research Source Type: research

Genome-Wide Association Study Identifies Genomic Loci Affecting Filet Firmness and Protein Content in Rainbow Trout
The objective of the current study was to explore the genetic architecture in one of the most important muscle quality attributes, filet firmness in relation to protein content, and identify QTL associated with these traits in a rainbow trout population developed by the USDA/NCCCWA selective breeding program. Materials and Methods Ethics Statement Institutional Animal Care and Use Committee of the United States Department of Agriculture, National Center for Cool and Cold Water Aquaculture (Leetown, WV, United States) specifically reviewed and approved all husbandry practices used in this study (IACUC approval #056). Fi...
Source: Frontiers in Genetics - May 3, 2019 Category: Genetics & Stem Cells Source Type: research

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System.
Abstract BACKGROUND: Hydrocodone-combination analgesics were changed from Schedule III to Schedule II to discourage the prescribing of these analgesics. Our primary aim was to explore the effect of hydrocodone rescheduling on opioid prescribing within an urban safety-net health care system. METHODS AND DESIGN: Data were extracted from electronic records of ambulatory patients (N = 82,432 patients) prescribed hydrocodone-combination, codeine-combination, or tramadol opioid analgesics (N = 200,675 prescriptions) between October 6, 2013 and October 6, 2015. Data analyses modeled predicted probabilities of hydroc...
Source: American Family Physician - May 1, 2019 Category: Primary Care Authors: Northrup TF, Carroll K, Suchting R, Villarreal YR, Zare M, Stotts AL Tags: J Am Board Fam Med Source Type: research

Opioids: A Review of Pharmacokinetics and Pharmacodynamics in Neonates, Infants, and Children
AbstractPain management in the pediatric population is complex for many reasons. Mild pain is usually managed quite well with oral acetaminophen or ibuprofen. Situations involving more severe pain often require the use of an opioid, which may be administered by many different routes, depending on clinical necessity. Acute and chronic disease states, as well as the constantly changing maturational process, produce unique challenges at every level of pediatrics in dosing and management of all medications, especially with regard to high-risk opioids. Although there has been significant progress in the understanding of opioid ...
Source: European Journal of Drug Metabolism and Pharmacokinetics - April 22, 2019 Category: Drugs & Pharmacology Source Type: research

(405) What is the Effect on Acute Pain when a Patient's Sleep is Disturbed by Opioid-Induced Nausea and Vomiting (OINV)?
Sleep is an important factor in postoperative recovery, especially for patients experiencing moderate-to-severe acute pain. In contrast, sleep  disturbance may have deleterious effects on patient recovery, including increased pain and length-of-stay.1 However, it is unclear if nausea and vomiting interfere with sleep and with what analgesic consequence. Is there evidence of OINV-related sleep disturbance and its effect on acute pain in a randomized controlled trial (RCT)? In a previous RCT,2 it was noted that some patients using hydrocodone 7.5mg/acetaminophen 325mg (HC/APAP) awoke with nausea, retching and/or vo...
Source: The Journal of Pain - March 21, 2019 Category: Materials Science Authors: T. Gan, B. Schachtel Source Type: research

Impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration.
CONCLUSION: HCP dispensing in VHA declined by 19.4% in the quarter after reclassification, which was driven largely by patients receiving long-term therapy. More than 13,000 veterans discontinued receipt of long-term HCP therapy after reclassification and the majority did not receive a replacement analgesic through VHA. PMID: 30873558 [PubMed - as supplied by publisher] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - March 15, 2019 Category: Drugs & Pharmacology Authors: Steckler TJ, Mosher HJ, Desloover-Koch Y, Lund BC Tags: Am J Health Syst Pharm Source Type: research

American Society of Plastic Surgeons Member Post-Operative Opioid Prescribing Patterns
Source: Plastic and Reconstructive Surgery – Global Open - March 1, 2019 Category: Cosmetic Surgery Tags: Special Topic Source Type: research

Opioid Prescribing in the Pediatric Orthopaedic Trauma Population.
Authors: Simril RT, Scannell BP, Wally MK, LeFlore MH, Seymour RB, Hsu JR, Beuhler M, Bosse MJ, Gerkin E, Gibbs M, Griggs C, Jarrett S, Leas D, Runyon M, Saha A, Schiro S, Watling B, Wyatt S Abstract The purpose of this article is to describe opioid prescribing patterns for children with orthopaedic injuries. A retrospective chart review was conducted on pediatric orthopaedic trauma patients (n = 124) who were discharged from the hospital or emergency department or had a clinic visit during a 1-month period. Patient demographics, prescription specifics, injury details, and fracture fixation information were collect...
Source: Journal of surgical orthopaedic advances - February 21, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

The effect of a more strict 2014 DEA schedule designation for hydrocodone products on opioid prescription rates in the United States
. (Source: Clinical Toxicology)
Source: Clinical Toxicology - February 21, 2019 Category: Toxicology Authors: Matthew L. Harrison Thomas L. Walsh Source Type: research

Prescription opioid use by injured workers in Tennessee: a descriptive study using linked statewide databases.
CONCLUSIONS: Injured workers have a high prevalence of opioid use after injury, but prescribing patterns generally tend to follow Tennessee prescribing guidelines. PMID: 30853149 [PubMed - as supplied by publisher] (Source: Annals of Epidemiology)
Source: Annals of Epidemiology - February 14, 2019 Category: Epidemiology Authors: Durand Z, Nechuta S, Krishnaswami S, Hurwitz EL, McPheeters M Tags: Ann Epidemiol Source Type: research

Trends in the medical supply of fentanyl and fentanyl analogues: United States, 2006 to 2017
The objectives of this study were to: 1) characterize the temporal pattern of fentanyl, fentanyl analogue, and other opioid use over the past decade, and 2) determine whether opioid prescribing laws impacted fentanyl use in the US. Drug weights were obtained from the US Automated Reports of Consolidated Orders System (June 2018), a comprehensive publically available resource, from 2006 to 2017 for fentanyl, sufentanil, remifentanil, alfentanil, other prescription opioids, and analyzed by presence of a state opioid prescribing law. Fentanyl, corrected for population, was reduced from 2016 to 2017 (−17.9%) and these de...
Source: Preventive Medicine - February 12, 2019 Category: International Medicine & Public Health Source Type: research

Reduced Opioid Use After Surgeon-Administered Genicular Nerve Block for Anterior Cruciate Ligament Reconstruction in Adults and Adolescents
ConclusionOpioid use was unexpectedly low among patients undergoing ACLR after a surgeon-administered circumferential genicular nerve block and fat pad infiltration. With this protocol, the graft choice and patient age did not correlate with increased opioid use. These results could be useful in guiding post-operative opioid prescribing after ACLR. (Source: HSS Journal)
Source: HSS Journal - January 28, 2019 Category: Orthopaedics Source Type: research

Hot Topic: Global Trends in the Use of Opioid Analgesics
This study aimed to contribute to the debate on the availability of opioids for pain management by comparing regional and global trends for controlled strong opioids most commonly used for pain over the past 21  years. We conducted a series of analyses on the use of 12 opioids, with a focus on fentanyl, hydrocodone, hydromorphone, morphine, and oxycodone over the 21-year period of 1995–2015, at a regional and global level with country-level data, using random intercept mixed models to assess for change over time and interactions, and controlling for country economic development.Recent FindingsDespite the suffici...
Source: Current Addiction Reports - January 25, 2019 Category: Addiction Source Type: research

42: Non-opioid versus opioid analgesia after hospital discharge from a cesarean delivery: a randomized clinical trial
Our objective was to compare postoperative pain scores between women who underwent cesarean delivery (CD) and were discharged home on a regimen of either ibuprofen/acetaminophen (non-opioid group) or ibuprofen/acetaminophen plus hydrocodone (opioid group). (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - December 25, 2018 Category: OBGYN Authors: Jenifer Dinis, Eleazar Soto, Suneet P. Chauhan, Baha Sibai Tags: Oral Plenary 2 Source Type: research

Think twice before prescribing certain drugs to children
Publication date: Available online 19 December 2018Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): Nicholas P. SaggeseAbstractCodeine, tramadol, and hydrocodone have been associated with morbidity and death in children, secondary to respiratory depression. The aim of this paper is to increase awareness of this issue and to encourage clinicians to prescribe safer alternatives such as morphine, ibuprofen, or paracetamol. (Source: British Journal of Oral and Maxillofacial Surgery)
Source: British Journal of Oral and Maxillofacial Surgery - December 20, 2018 Category: ENT & OMF Source Type: research

Think twice before prescribing certain drugs to children
Codeine, tramadol, and hydrocodone have been associated with morbidity and death in children, secondary to respiratory depression. The aim of this paper is to increase awareness of this issue and to encourage clinicians to prescribe safer alternatives such as morphine, ibuprofen, or paracetamol. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 19, 2018 Category: ENT & OMF Authors: Nicholas P. Saggese Tags: Short communication Source Type: research

Trends in Opioid Prescribing Among Hemodialysis Patients, 2007 –2014
Conclusion: Opioid prescribing among HD patients declined between 2012 and 2014. However, HD patients continue receiving substantially more opioids than the general US population.Am J Nephrol 2019;49:20 –31 (Source: American Journal of Nephrology)
Source: American Journal of Nephrology - December 13, 2018 Category: Neurology Source Type: research

Trends in Opioid Prescribing Among Hemodialysis Patients, 2007-2014.
CONCLUSION: Opioid prescribing among HD patients declined between 2012 and 2014. However, HD patients continue receiving substantially more opioids than the general US population. PMID: 30544114 [PubMed - as supplied by publisher] (Source: American Journal of Nephrology)
Source: American Journal of Nephrology - December 13, 2018 Category: Urology & Nephrology Authors: Daubresse M, Alexander GC, Crews DC, Segev DL, McAdams-DeMarco MA Tags: Am J Nephrol Source Type: research

Error in Figure 2
This article was corrected online. (Source: JAMA Surgery)
Source: JAMA Surgery - December 1, 2018 Category: Surgery Source Type: research

Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011-2016.
This report identifies the specific drugs involved most frequently in drug overdose deaths in the United States from 2011 through 2016. Methods-Record-level data from the 2011-2016 National Vital Statistics System-Mortality files were linked to electronic files containing literal text information from death certificates. Drug overdose deaths were identified using the International Classification of Diseases, Tenth Revision underlying causeof- death codes X40-X44, X60-X64, X85, and Y10-Y14. Drug mentions were identified by searching the literal text in three fields of the death certificate: the causes of death from Part I, ...
Source: Natl Vital Stat Rep - December 1, 2018 Category: Statistics Authors: Hedegaard H, Bastian BA, Trinidad JP, Spencer M, Warner M Tags: Natl Vital Stat Rep Source Type: research

A  Prospective, Randomized, Double-Blinded Controlled Trial Comparing Ibuprofen and Acetaminophen Versus Hydrocodone and Acetaminophen for Soft Tissue Hand Procedures
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. (Source: The Journal of Hand Surgery)
Source: The Journal of Hand Surgery - November 27, 2018 Category: Surgery Authors: Kent Weinheimer, Brett Michelotti, Jeremy Silver, Kenneth Taylor, Alexander Payatakes Tags: Scientific article Source Type: research

Understanding multi ‐pill ingestion of prescription opioids: Prevalence, characteristics, and motivation
ConclusionsThese results indicate that the ingestion of multiple opioid pills/tablets is extremely common among treatment ‐seeking opioid users. This, and other forms of non‐medical oral use of prescription opioids, should be taken under consideration when developing prevention and intervention efforts targeting the opioid epidemic. (Source: Pharmacoepidemiology and Drug Safety)
Source: Pharmacoepidemiology and Drug Safety - November 9, 2018 Category: Drugs & Pharmacology Authors: Matthew S. Ellis, Theodore J. Cicero, Richard C. Dart, Jody L. Green Tags: BRIEF REPORT Source Type: research

Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study.
CONCLUSIONS: The majority of physicians felt rescheduling negatively impacted both practical and ethical aspects of patient care related to pain management after discharge. Rescheduling has changed physicians) hydrocodone prescribing patterns, leading to more caution when prescribing hydrocodone and greater use of the PMP. Future studies should assess geriatric patients) satisfaction and quality of life regarding pain management since hydrocodone was rescheduled. PMID: 30387855 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 4, 2018 Category: Addiction Tags: J Opioid Manag Source Type: research

The opioid epidemic and patient satisfaction: a review of one institution’s experience
Background: The opioid crisis caused the Drug Enforcement Administration (DEA) to reschedule hydrocodone to schedule II from III. Other narcotics (i.e. codeine) were not reclassified, becoming the narcotic medications for many surgeons. We wanted to review how this rescheduling of hydrocodone influenced prescribing practices and Press Ganey scores. Methods: A retrospective review from April 6, 2014, to April 5, 2015, was conducted on all orthopaedic trauma patients at a level I trauma center. Patient charts were abstracted for the type and amount of narcotic prescribed. Press Ganey scores for the surgeons were collect...
Source: Current Orthopaedic Practice - October 22, 2018 Category: Orthopaedics Tags: SPECIAL FOCUS: Trauma Source Type: research

Opioid Prescribing Practices of Orthopaedic Surgeons: Results of a National Survey.
Authors: Raneses E, Secrist ES, Freedman KB, Sohn DH, Fleeter TB, Aland CM Abstract INTRODUCTION: Opioids are widely used after orthopaedic procedures. Nonmedical opioid use is a growing public health issue. METHODS: An anonymous online survey was distributed by e-mail to the orthopaedic societies of all 50 states and several large private practices to assess practicing orthopaedic surgeons' opioid prescribing practices. RESULTS: A total of 555 orthopaedic surgeons practicing in 37 states responded. The most commonly prescribed opioid for both teenagers and adults was hydrocodone/acetaminophen. Of note, 42....
Source: The Journal of the American Academy of Orthopaedic Surgeons - October 10, 2018 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Prescription Opioid Type and the Likelihood of Prolonged Opioid Use After Orthopaedic Surgery.
Authors: Basilico M, Bhashyam AR, Harris MB, Heng M Abstract INTRODUCTION: A common belief is that some narcotic medications have a higher association with prolonged use. We assessed whether the initial opiate type prescribed to postoperative, opiate-naive orthopaedic trauma patients was associated with prolonged opioid use. METHODS: We studied 17,961 adult, opiate-naive patients treated for a surgical musculoskeletal injury. Discharge prescription in morphine milligram equivalents (MMEs, a standardized dosing unit that allows for comparison across opioid types) was calculated. Opioid prescribing beyond 90 days...
Source: The Journal of the American Academy of Orthopaedic Surgeons - October 7, 2018 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Preclinical and Clinical Pharmacology of Hydrocodone for Chronic Pain: A Mini Review
Luigi Cardia, Gioacchino Calapai, Domenico Quattrone, Cristina Mondello, Vincenzo Arcoraci, Fabrizio Calapai, Carmen Mannucci, Epifanio Mondello (Source: Frontiers in Pharmacology)
Source: Frontiers in Pharmacology - October 7, 2018 Category: Drugs & Pharmacology Source Type: research

Opioid Prescribing Protocol Effect on Oral Surgery Clinic Prescribing Patterns
Opioid abuse in the United States continues in epidemic proportions. In 2016, an average of 175 deaths per day were attributed to an opioid overdose. Forty deaths per day (22.5%) were from semi-synthetic opioid such as hydrocodone and oxycodone. Dentists and oral surgeons are leading prescribers of these analgesics in adolescent patients and frequently are first-time prescribers to opioid-naive patients. In the first quarter of 2016, the University of Minnesota School of Dentistry Department of Oral and Maxillofacial Surgery implemented a mandatory opioid prescribing protocol. (Source: Journal of Oral and Maxillofacial Surgery)
Source: Journal of Oral and Maxillofacial Surgery - October 1, 2018 Category: ENT & OMF Authors: R.A. Nadeau, C.L. Wagner, A.B. Sunstrum, K. Hasstedt, H.K. Tu Tags: Anesthesia Abstract Session Source Type: research

Commonly Initiated Opioids and Risk of Fracture Hospitalizations in United States Nursing Homes
ConclusionsThe lower rate of fractures that we documented among tramadol initiators compared with hydrocodone initiators is consistent, albeit attenuated compared with prior studies among community-dwelling older adults. However, overall fracture rates were lower than in community settings, potentially due to the limited risk of falling in this population with limited mobility. (Source: Drugs and Aging)
Source: Drugs and Aging - October 1, 2018 Category: Geriatrics Source Type: research

Impact of rescheduling hydrocodone-combination products in an urban Texas county healthcare system.
CONCLUSION: The scheduling change of HCPs is associated with an immediate decrease in hydrocodone-acetaminophen use at our institution while a simultaneous rise in acetaminophen-codeine products was observed. PMID: 30234922 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 22, 2018 Category: Addiction Tags: J Opioid Manag Source Type: research

Intravenous morphine titration vs. oral hydrocodone/acetaminophen for adults with lower extremity displaced fracture in an emergency department setting: A randomized controlled trial.
The objective of the present study was to test the hypothesis that intravenous morphine titration provides superior analgesia to oral hydrocodone/acetaminophen for patients with lower extremity displaced fracture in an emergency department (ED) setting. A prospective, randomized clinical trial of ED patients suffering acute lower extremity displaced fracture pain was performed with a total of 206 participants included. After application of exclusion criteria, the cohort comprised 166 patients, 85 of which were randomly allocated to the oral hydrocodone/acetaminophen (5 mg/500 mg) group and 81 to the intravenous morphine ti...
Source: Experimental and Therapeutic Medicine - September 21, 2018 Category: General Medicine Tags: Exp Ther Med Source Type: research

Geographic Variation in the Initiation of Commonly Used Opioids and Dosage Strength in United States Nursing Homes
Conclusions: We documented extensive geographic variation in the opioid and dose initiated for nursing home residents, with state explaining the largest proportion of the observed variation. Further work is needed to understand potential drivers of opioid prescribing patterns at the state level. (Source: Medical Care)
Source: Medical Care - September 15, 2018 Category: Health Management Tags: Original Articles Source Type: research

Using trajectory models to assess the effect of hydrocodone upscheduling among chronic hydrocodone users
Pharmacoepidemiology and Drug Safety, EarlyView. (Source: Pharmacoepidemiology and Drug Safety)
Source: Pharmacoepidemiology and Drug Safety - September 6, 2018 Category: Drugs & Pharmacology Authors: Irene B.Murimi , Hsien ‐YenChang , MarkBicket , Christopher M.Jones , G. CalebAlexander Source Type: research

Commonly Initiated Opioids and Risk of Fracture Hospitalizations in United States Nursing Homes
ConclusionsThe lower rate of fractures that we documented among tramadol initiators compared with hydrocodone initiators is consistent, albeit attenuated compared with prior studies among community-dwelling older adults. However, overall fracture rates were lower than in community settings, potentially due to the limited risk of falling in this population with limited mobility. (Source: Drugs and Aging)
Source: Drugs and Aging - September 6, 2018 Category: Geriatrics Source Type: research

Opportunities to Prevent Overdose Deaths Involving Prescription and Illicit Opioids, 11 States, July 2016-June 2017.
This report describes opioid overdose deaths (referred to as opioid deaths) for decedents testing positive for prescription opioids (e.g., oxycodone and hydrocodone), illicit opioids (e.g., heroin, illicitly manufactured fentanyl, and fentanyl analogs), or both prescription and illicit opioids, and describes circumstances surrounding the overdoses, in 11 states participating in CDC's Enhanced State Opioid Overdose Surveillance (ESOOS) program.* During July 2016-June 2017, among 11,884 opioid overdose deaths, 17.4% of decedents tested positive for prescription opioids only, 58.7% for illicit opioids only, and 18.5% for both...
Source: MMWR Morb Mortal Wkl... - August 31, 2018 Category: Epidemiology Authors: Mattson CL, O'Donnell J, Kariisa M, Seth P, Scholl L, Gladden RM Tags: MMWR Morb Mortal Wkly Rep Source Type: research