Emergency department patients' perceptions of the efficacy and safety of opioid analgesics.
Authors: Mazer-Amirshahi M, Sun C, Koroshetz L, Soares RW, Kumar A, Calello DP, Perrone J, Nelson LS Abstract INTRODUCTION: Emergency department (ED) providers are on the forefront of the prescription drug crisis and understand-ing patient's perceptions of opioids may allow physicians to better address misconceptions. The aim was to determine the perceptions of ED patients regarding the efficacy and safety of opioid analgesics. METHODS: Cross-sectional study of a convenience sample of adults at a single urban academic ED. Patients completed a tablet-based survey regarding the efficacy and safety of opioid analg...
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Factors influencing the prescribed dose of opioid analgesics in cancer patients.
Authors: Hashimoto M, Aogaki K, Numata C, Moriwaki K, Matsuda Y, Ishii R, Tanaka I, Okamoto Y Abstract The dose of opioids prescribed for cancer pain does not always correlate with the actual pain severity. However, there is little evidence to explain this observation. In the present study, we sought to determine factors that influence the dose of opioid analgesics. A total of 227 patients who were administered opioids between August 2012 and May 2016 and later expired within the Department of Palliative Care at Ashiya Municipal Hospital were included, and the following variables were examined: age, sex, type of ca...
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Evaluating patients who present with pain complaints to a community hospital emergency department: Opioid prescription tracking software versus provider gestalt.
CONCLUSIONS: Providers are able to accurately estimate Narx score, though there are limiting factors. Older patients, those with dental pain, and those who give specific triggers are more difficult to estimate. Providers did not change their prescribing patterns after viewing the actual Narx score. Overestimation versus underestimation of Narx score was not directly studied. PMID: 32885833 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Adjuvant interventions with opioids for vaso-occlusive crisis in sickle cell disease: A mixed treatment network meta-analysis of randomized controlled clinical trials.
CONCLUSION: We observed that arginine and ibuprofen could produce additional analgesic effects when combined with morphine in vaso-occlusive crisis. PMID: 32885834 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Systematic urine drug testing for detecting and managing opioid misuse among chronic noncancer pain patients in primary care-The HARMS Program: A retrospective chart review of 77 patients.
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 - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Polysubstance abuse associated with more frequent opioid use among patients in rural primary care settings.
CONCLUSIONS: Individuals who are polysubstance users have a higher likelihood of opioid use. Interventions that target opioid use would serve the population stronger by including screenings and potential treatments for polysubstance use additionally. PMID: 32885836 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

A multidimensional Rasch analysis of the screener and opioid assessment for patients with pain-revised.
CONCLUSIONS: The SOAPP-R© showed invariance and support for validity, but with a three-dimensional scale structure. PMID: 32885837 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

IV tramadol: A novel option for US patients with acute pain-A review of its pharmacokinetics, abuse potential and clinical safety record.
Authors: Lu L, Harnett M, Reines SA Abstract Tramadol is a centrally acting dual-mechanism (opioid and monoamine reuptake inhibition) analgesic that has been noted to have a lower risk of abuse compared to conventional opioids such as morphine. Oral tramadol has been ap-proved in the United States since 1995 and intravenous (IV) tramadol has been widely prescribed outside the United States (OUS); nevertheless, IV tramadol has not yet been approved for use in the United States. This paper provides a review of the pharmacokinetics (PK) of the IV tramadol dosing regimen being developed in the United States, its abuse ...
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Transdermal Fentanyl patch: An approach to enhance tolerance of conscious proning in COVID-19 patients.
Authors: Mammen S, Yousuf B, Shamsah M Abstract The COVID-19 ARDS appears to have worse outcomes than ARDS from other causes. It is a predictable serious complication and the key strategy is to maintain oxygenation. Adopting the prone position for conscious COVID-19 patients requiring basic respiratory support, is shown to benefit patients in terms of improving oxygenation, reducing the need for invasive ventilation and potentially even reducing mortality. Cough and myalgia are the common and most distressing symptoms seen in conscious COVID-19 patients which can impair tolerance to awake proning. Modified awake pr...
Source: Journal of Opioid Management - September 5, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Potential pharmacological perspectives for the treatment/prevention of the SARS-COV-2 infection in opioid dependent patients.
Authors: Coppola M, Mondola R PMID: 32421836 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

The impact of an innovative pharmacist-led inpatient opioid de-escalation intervention in post-operative orthopedic patients.
CONCLUSION: Pharmacist-led inpatient opioid de-escalation is effective, does not increase pain intensity, and reduces constipation. Hospitals should explore the viability of extending pharmacist-led opioid de-escalation to other surgical patients and following hospital discharge, aiming for opioid cessation. PMID: 32421837 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Factors associated with participation and nonparticipation in a VA Whole Health Primary Care Pain Education and Opioid Monitoring Program (PC-POP).
CONCLUSIONS: Given that primary care is the dominant healthcare setting in which opioids are prescribed for chronic noncancer pain, programs are needed to assist primary care providers to meet the rigorous requirements of guideline concordant care. The current study examined participation factors in such a program and found that certain veterans were less likely to participate than others. Identifying such veterans at the outset, in combination with intentional recruitment efforts and individualized interventions, may promote entry into PC-POP. PMID: 32421838 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Evaluation and analysis of the Modified Finnegan Scoring System for assessment of neonatal abstinence syndrome.
CONCLUSIONS: Of the various signs of NAS used to score the MF, few are frequently observed. Our study reinforces literature that proposes a shortened MF assessment tool. Experimental research will be needed to determine the efficacy of a shortened MF tool for diagnosing NAS. PMID: 32421839 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

National gender differences in the prescribing of opioid medications from 2006 to 2015.
Authors: Marie Preciado S, Tomaszewski D, Cheetham TC, Gregorian T, Xavioer S, Fawaz S Abstract OBJECTIVE: To identify gender differences in opioid prescribing from ambulatory care settings and identify factors associated with prescribing of opioids for men and women. DESIGN AND PARTICIPANTS: Retrospective analysis of data from The National Ambulatory Medical Care Survey from January 1, 2006 to December 31, 2015. Eligible patients were at least 18 years old on the date of the physician office visit. Data were collected on patient demographics and clinical factors. Data were analyzed using bivariate and multivar...
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

An open-label, randomized, single-dose, two-period, two-treatment crossover bioavailability study comparing 5 mg/0.5 mL of intramuscular naloxone hydrochloride to 2 mg/0.4 mL intramuscular naloxone hydrochloride autoinjector in healthy subjects.
We examined the bioavailability of an investigational 5 mg intramuscular naloxone in a prefilled syringe (PFS) compared to 2 mg intramuscular naloxone in an autoinjector (AI) at the current approved dose in a crossover design which included 14 healthy subjects. Overall, both doses were well tol-erated with no adverse events noted during the trial. The pharmacokinetic results showed that a higher dose of intra-muscular naloxone hydrochloride increases Cmax, AUC, and t1/2; however, Tmax was similar for both treatments. Statistical analysis indicated that there were statistical differences between the test and reference treat...
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Cannabidiol (CBD) as a treatment of acute and chronic back pain: A case series and literature review.
Conclusion: Hemp-derived CBD in a transdermal cream provided significant symptom and pain relief for the patients described in this case series. Based on these results, we believe further investigation is warranted to see if CBD-containing products should have a more prominent role in the treatment of acute and chronic pain. PMID: 32421842 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Managing breakthrough pain for advanced malignancy in elderly patients: A real challenge.
We report a case morphine toxicity in an elderly patient of lung cancer with concomitant presence of chronic obstructive pulmonary disease (COPD) and recent onset renal impairment. Opioid analgesic overdose is a lethal but at the same time, a preventable and treatable condition. We managed the case using naloxone infusion. However, we emphasize early anticipation and recognition of predisposing factors followed by timely intervention to manage this life-threatening condition. PMID: 32421843 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Incidence and correlates of opioid-related psychiatric emergency care: A retrospective, multiyear cohort study.
CONCLUSION: EDs are serving increasing numbers of patients in psychiatric crisis related to opioid-use. A decision support tool could be developed and validated in the future to provide reliable, clinically relevant information to providers and case managers relevant to opioid-related ED presentations. PMID: 32421844 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Patient and pediatric caregiver experiences and expectations about opioid risk education and counselling.
CONCLUSION: This unique study points out the need for more research, training, and resources for aligning opioid risk counselling and education with patient expectations as a patient centered effort. PMID: 32421845 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - May 20, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Can opioid vigilance and patient-centered care coexist? A qualitative study of communicative tensions encountered by surgical trainees.
CONCLUSION: Surgical training programs must supply trainees with post-surgical prescribing guidelines and communication skills training. Training should emphasize how PCC directives may work in tandem with-not in opposition to-opioid vigilance. PMID: 32329884 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Comorbidities in an Australian sample of chronic and new opioid users.
CONCLUSIONS: Mental health morbidities commonly associated with chronic opioid use increase in prevalence as chronic use continues. PMID: 32329885 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Successful use of buprenorphine-naloxone medication-assisted program to treat concurrent pain and opioid addiction after cancer therapy.
Authors: Moryl N, Filkins A, Griffo Y, Malhotra V, Jain RH, Frierson E, Inturrisi C Abstract Cancer pain is often treated with opioids, a therapeutic regimen that can become a challenge in patients with an opioid use disorder (OUD). While use of the buprenorphine-naloxone combination is an effective medication-assisted treatment (MAT) for OUD, its use in pain patients with OUD has been controversial due to concerns that co-administration of buprenorphine can reduce or block analge-sia and precipitate opioid withdrawal in those patients requiring full opioid agonists. Data on its use in cancer pain patients are lack...
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Aromatherapy as an adjunctive therapy for neonatal abstinence syndrome: A pilot study.
CONCLUSIONS: The use of aromatherapy appears to help mitigate symptoms of NAS and offers to be a viable treatment modality when used with conventional therapy. PMID: 32329887 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Effect of physical manipulation on the oral pharmacokinetic profile of Xtampza ® ER (oxycodone DETERx® formulation): A review of published studies.
Effect of physical manipulation on the oral pharmacokinetic profile of Xtampza® ER (oxycodone DETERx® formulation): A review of published studies. J Opioid Manag. 2020 Mar/Apr;16(2):127-139 Authors: Gudin J Abstract Opioids can be an effective treatment option for appropriate patients with chronic pain for whom nonpharmacological or nonopioid treatment does not provide adequate pain relief. However, extended-release (ER) opioid formulations, because of their high drug content, are attractive options for nonmedical use and abuse. Xtampza® ER (oxycodone DETERx®) capsules, an ER abuse-dete...
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

An overview on medication-assisted treatment (MAT) for opioid dependence.
Authors: Maiti T, Das S, Ramasamy A, Stanley Xavier A, Kumar Behera S, Selvarajan S Abstract In this article, a broad overview of medication-assisted treatment (MAT) for opioid dependence has been provided. Significant benefits of commonly used drugs (buprenorphine, methadone, and naltrexone-based regimens) along with the therapeutic aspects of other available options are highlighted. Salient points on each or individual drug therapy, comparison of pharmacological profiles of dif-ferent drugs, effective clinical practice in different scenarios, relevant drug interactions, and safety issues in various populations ha...
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid overdoses: Emerging clinical challenges.
CONCLUSION: There is an alarming number of visits to the ED due to opioid overdoses with differences in age and gender. Clinicians are facing diagnostic, treatment and follow-up challenges for the management of these cases. PMID: 32329890 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Caregiver-fabricated illness in a child prescribed long-term opioids and benzodiazepines.
We present a case in which CFIC was associated with long-term prescribing of opioids, benzodiazepines, and other central nervous system depressants. PMID: 32329891 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - April 25, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Perceived patient benefits from using prescription opioids and other therapies to manage persistent pain.
CONCLUSION: Overall, PP patients felt the benefits of opioid use outweighed the risks, and using opioid medication sig-nificantly improved their quality of life. This may be partly due to the poor efficacy of other nonprescription medications and complementary therapies in managing PP beyond short-term relief. PMID: 32091612 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Effect of intrathecal morphine before and after laminectomy on intra-operative surgical stress response and post-operative pain: A prospective randomized study.
CONCLUSION: Pre-emptive intrathecal morphine analgesia is an effective technique for controlling surgical stress re-sponse and post-lumbar laminectomy pain. PMID: 32091613 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid dispensation among systemic lupus erythematosus patients who persistently frequent the emergency department.
CONCLUSION: Opioids are commonly dispensed in the ED for SLE patients. This is true even for patients utilizing the ED for SLE-related disease activity/complications. PMID: 32091614 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Staff time requirements for postoperative pain management: Comparison of sufentanil sublingual tablet system and intravenous patient-controlled analgesia.
Authors: Meuser T, Nardi-Hiebl S, Eberhart L, Paul M, Böttger R, Reutershan J Abstract OBJECTIVE: Assessment and allocation of required staff time for postoperative pain management for two different pa-tient-controlled technologies, sufentanil sublingual tablet system (SSTS) and intravenous analgesia (PCiA). DESIGN: Activity-based evaluation. SETTING: The study was conducted at four German hospitals based on the availability of the two technologies studied and their respective bed capacity broadly reflecting the German hospital landscape. PATIENTS AND PARTICIPANTS: Staff activities were recorded fo...
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

A departmental policy can reduce opioid prescribing after orthopedic surgery.
Authors: Mears SC, Shnaekel A, Wilkinson J, Chen C, Barnes CL Abstract OBJECTIVE: The authors hypothesized that implementation of a department-wide opioid prescribing program would reduce opioid tablets and morphine milligram equivalents (MMEs) prescribed as well as prescription refills. DESIGN: A retrospective study was conducted to determine the effects of a department wide opioid prescribing policy. SETTING: A university teaching hospital Orthopaedic Surgery Department. PATIENTS, PARTICIPANTS: All prescriptions written by members of our department were reviewed for 3 months before and 3 months after ...
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Patterns of heroin use following index prescription opioid exposure.
CONCLUSIONS: This study further supports the role that prescription opioids play in the transition to heroin use. It suggests that oxycodone is the most common prescription opioid used prior to heroin initiation. Additionally, it reports descriptive information as to how and where prescription opioids are obtained. PMID: 32091617 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Risk of chronic opioid use in older persons with pre-existing anxiety.
CONCLUSIONS: A significant proportion of older people will have a chronic episode of opioid use. This risk is increased where a history of anxiety is present. PMID: 32091618 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Harnessing endogenous opioids for pain relief: Fantasy vs reality.
CONCLUSIONS: Utilization of drugs that harness endogenous opioid antinociception in accordance with varying physiological states represents a novel approach for effective pain management while mitigating the present epidemic of death by synthetic opioid overdose. PMID: 32091619 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

A model for an institutional response to the opioid crisis.
Authors: Hanna MN, Chambers C, Punyala A, Iqbal A, Singh B, Oruc C, Prakash P, Prajapati Y, Wang Y, Amery Ai Z, Shechter R, Speed TJ, Koch CG, Williams K Abstract The use of opioid analgesics for pain management has increased dramatically over the past decade, with corresponding increases in negative sequelae including overdose and death. Physicians, policymakers, and researchers are focused on finding ways to decrease opioid use and overdose. This crisis calls for a coordinated response that includes the entire healthcare sector. In this work, the authors lay out a blueprint for such a response at the level of the...
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Holistic approach to opioid use disorder: Think nitric oxide!
Authors: Sackner MA, Lopez JR, Banderas V, Adams JA Abstract This review deals with opioid addiction, chronic pain, and an innovative, noninvasive technology with simultaneous, beneficial applications for both conditions. This technology, called passive simulated jogging device (GENTLE JOGGER, JD) targets addiction and pain by increasing endothelial nitric oxide (NO) bioavailability. It can be self-administered while sitting or lying without resorting to multitasking thereby allowing watching television or operating a computer while effortless, physical activity is produced from motorized foot pedals repetitively s...
Source: Journal of Opioid Management - December 26, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Storage, security, and disposal.
Authors: Hutchison RW PMID: 31849024 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

"Blister packs" rather than "ashes to ashes, dust to dust" for medications.
"Blister packs" rather than "ashes to ashes, dust to dust" for medications. J Opioid Manag. 2019 Sep/Oct;15(5):355-356 Authors: Gupta D, Chakrabortty S PMID: 31849025 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Current practices in naloxone prescribing upon hospital discharge.
CONCLUSIONS: Providers agree with the Centers for Disease Control and Prevention recommendations to prescribe naloxone to high-risk patients. Certain barriers affect the rate of naloxone prescribing at discharge, including lack of time, patient education, provider training, and concern for increasing riskier behaviors. PMID: 31849026 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

A double blind randomized clinical trial of buprenorphine augmentation for treatment of psychotic symptoms in opioid addicted bipolar patients.
CONCLUSIONS: Buprenorphine did not add any efficacy to usual treatment of psychotic episodes of bipolar, although did not aggravate psychiatric symptoms. PMID: 31849027 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Increases in body mass index and cardiovascular risk factors during methadone maintenance treatment.
CONCLUSIONS: These data indicate that methadone maintenance treatment is associated with clinically meaningful weight gain and increases in cardiovascular risk factors. Given the importance of methadone maintenance for treatment of opioid use disorder, future research should examine additional predictors and potential mechanisms of weight gain among methadone patients and develop tailored interventions including nutritional knowledge and lifestyle recommendations. PMID: 31849028 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid-induced constipation in mixed chronic pain patients: Prevalence and predictors analysis.
CONCLUSIONS: OIC was found in almost all evaluations of weak or strong opioidusers (97 percent); moderate to severe OIC was found in 72 percent of the evaluations. Cancer patients were associated with severe constipation. Macrogol was superior to other laxatives. In our experience, macrogol relieved constipation in those on the combination of oxycodone and naloxone and in those on fentanyl patches. Lactulose and glycerol suppositories were associated with severe constipation. PMID: 31849029 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Intraoperative opioid and non-opioid administration patterns and early postoperative pain: A single-center retrospective longitudinal study.
CONCLUSION: This study confirms that intraoperative opioid use has decreased over time with increased utilization of non-opioid analgesic adjuncts and a commensurate decrease in immediate postoperative pain. PMID: 31849030 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Birth outcomes with prescribed chronic and acute opioid exposure during pregnancy.
CONCLUSIONS: While a dose response of opioid exposure was not identified, these results add to existing evidence that opioid exposure during pregnancy is correlated with negative outcomes. Practitioners may better serve pregnant women and their fetuses by encouraging alternate pain relief treatments. PMID: 31849031 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Effects of naltrexone exposure observed in two phase three studies with ALO-02, an extended-release oxycodone surrounding sequestered naltrexone.
CONCLUSIONS: Naltrexone plasma concentrations were low, not correlated with COWS or BPI-sf scores, and considered clinically insignificant. PMID: 31849032 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Fentanyl analogue overdose: Key lessons in management in the synthetic opioid age.
Authors: Raheemullah A, Andruska N Abstract Fentanyl overdoses are growing at an alarming rate. Fentanyl is often mixed into heroin and counterfeit prescription opioid pills without the customer's knowledge and only detected upon laboratory analysis. This is problematic because fentanyl analogues like carfentanil are 10,000 times more potent than morphine and pose new challenges to opioid overdose management. A 62-year-old male with an overdose from a rare fentanyl analogue, acrylfentanyl, was given two doses of intranasal 2 mg naloxone with improvements in respiratory rate. In lieu of more naloxone, his trachea wa...
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

A multicomponent intervention to improve adherence to opioid prescribing and monitoring guidelines in primary care.
Authors: Huang KTL, Blazey-Martin D, Chandler D, Wurcel A, Gillis J, Tishler J Abstract OBJECTIVE: Guidelines for appropriate management of chronic opioid therapy are underutilized by primary care physicians (PCPs). The authors hypothesized that developing a multicomponent, team-based opioid management system with electronic health record (EHR) support would allow our clinicians to improve adherence to chronic opioid prescribing and monitoring guidelines. DESIGN: This was a retrospective pre-post study. SETTING: The authors performed this intervention at our large, urban, academic primary care practice. ...
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Knowledge gaps and practice patterns of clinicians treating patients with opioid use disorder.
CONCLUSIONS: There are multiple educational intervention strategies that can support the clinicians; including reducing restrictions to access treatment for OUD, care coordination programs for patients to improve early access to treatment and education, and frequent chart audit and feedback programs to support clinician decision making and education. PMID: 31850507 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid prescription patterns among patients with fibromyalgia.
Authors: Sarmento CVM, Maz M, Pfeifer T, Pessoa M, Liu W Abstract OBJECTIVES: To investigate opioid prescribing patterns among patients with fibromyalgia (FM) in terms of age, gender, race, type of opioids, and to examine changes in opioid prescription over the past 8 years compared to the US Food and Drug Administration (FDA)-approved FM medications. DESIGN: Retrospective review of data using the Healthcare Enterprise Repository for Ontological Narration database. The collected data were analyzed descriptively and a chi-square test for trend was used to analyze a possible linear relationship between the propor...
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research