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A public health outbreak management framework applied to surges in opioid overdoses.
Authors: Moore K, Boulet M, Lew J, Papadomanolakis-Pakis N Abstract Over the past decade, Canada and the United States have been facing an epidemic of harms from prescription opioids. More recently, opioid-naïve individuals have been exposed to illicit opioids through adulterated combination products. This has resulted in sudden surges of opioid-related mortality. A proactive public health solution is needed to prevent further death. We propose examining these surges in opioid overdoses as outbreaks and investigating them in a similar way to an outbreak of an infectious disease. An epidemiologic investigation ...
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Trends in Florida's Prescription Drug Monitoring Program registration and utilization: Implications for increasing voluntary use.
CONCLUSION: PDMP registration among physicians and pharmacists is limited, and the use of the PDMP among registrants is more limited still. Our findings suggest that Florida will not meet national policy goals for registrants by the end of 2017, although new initiatives may alter this trend. Allowing the PDMP to help prescribers meet other professional needs, such as "meaningful use" or similar efforts, may be effective in increasing PDMP use. PMID: 29199394 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Projecting the cost, utilization, and patient care impact of prescribing extended release non-abuse-deterrent opioids to chronic pain patients.
CONCLUSIONS: A physician's decision to prescribe ER ADOs could lead to large reductions in misuse and/or abuse-related events and associated costs across many patient populations. PMID: 29199395 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Educational intervention for physicians to address the risk of opioid abuse.
CONCLUSIONS: Although this intervention did not affect pain-related outcomes, future interventions involving care coordination across primary care and mental health may impact opioid abuse and improve quality of life of patients with pain. PMID: 29199396 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid tolerance and urine drug testing among initiates of extended-release or long-acting opioids in Food and Drug Administration's Sentinel System.
CONCLUSIONS: These results suggest potential areas for improving appropriate ER/LA opioid analgesic prescribing practices. PMID: 29199397 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Tramadol for maintenance in opioid dependence: A retrospective chart review.
CONCLUSION: Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence. PMID: 29199398 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

The effect of toothpicks containing flavoring and flavoring plus jambu extract (spilanthol) to promote salivation in patients -diagnosed with opioid-induced dry mouth (xerostomia).
CONCLUSIONS: Toothpicks infused with either flavoring or flavoring plus spilanthol are likely to be an effective remedy for opioid-induced dry mouth. Addition of spilanthol may improve effectiveness over flavoring alone and may be better ac-cepted because spilanthol appears to improve mouthfeel. PMID: 29199399 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - December 6, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid receptor antagonists in the treatment of pathological gambling.
Authors: Coppola M, Mondola R PMID: 28983886 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - October 7, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Characteristics and treatment patterns of US commercially insured and Medicaid patients with opioid dependence or abuse.
CONCLUSIONS: The results suggest that there are opportunities to improve care through comprehensive and coordinated treatment for opioid dependence/abuse. Policies aimed at improving treatment access may be warranted. PMID: 28953313 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Postoperative pain scores and opioid consumption in opioid-dependent patients with cancer after intraoperative remifentanil analgesia: A prospective case-controlled study.
Authors: Motamed C, Audibert J, Albi-Feldzer A, Bouroche G, Jayr C Abstract BACKGROUND: Opioid dependency is becoming increasingly common among surgical patients with cancer, and can lead to inadequate pain relief during the initial postoperative period. No guidelines are currently available for the management of perioperative and postoperative morphine administration in these patients. As a first approach, the authors assessed the opioid requirements of these patients during the early postoperative period. METHODS: A group of 35 consecutive surgical patients with cancer on opioid therapy (opioid-dependent grou...
Source: Journal of Opioid Management - September 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Implications of prescription drug monitoring and medical cannabis legislation on opioid overdose mortality.
Authors: Phillips E, Gazmararian J Abstract OBJECTIVES: To determine whether specific state legislation has an effect on opioid overdose mortality rates compared to states without those types of legislation. DESIGN: Ecological study estimating opioid-related mortality in states with and without a prescription drug monitoring program (PDMP) and/or medical cannabis legislation. SETTING AND PARTICIPANTS: Opioid-related mortality rates for 50 states and Washington DC from 2011 to 2014 were obtained from CDC WONDER. PDMP data were obtained from the National Alliance for Model State Drug Laws, and data on medical...
Source: Journal of Opioid Management - September 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Impact of opioids on oxidative status and related signaling pathways: An integrated view.
CONCLUSION: Opioids modulate the redox homeostasis; therefore, understanding the profile of oxidative changes in individuals with opioid use disorder could be of significant benefits in the clinical setting, to help with selection of an efficient antioxidant therapy and diminishing oxidative damage. PMID: 28953316 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Comparing methods of naloxone administration: A narrative review.
Authors: Fellows SE, Coppola AJ, Gandhi MA Abstract The effectiveness and safety of naloxone for the reversal of opioid toxicity are reviewed. A literature search was performed using PubMed, the Cochrane Library, CINAHL, and Medline. Clinical trials comparing either the clinical efficacy or pharmacokinetic/pharmacodynamic properties displayed by intravenous, intramuscular, intranasal, subcutaneous, and nebulized naloxone were included; however, trials with primary endpoints evaluating oral or endotracheal naloxone were excluded. Naloxone was shown to be clinically effective via all routes of administration, when co...
Source: Journal of Opioid Management - September 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Oxycodone-induced neurotoxicity secondary to concurrent voriconazole use in a patient with cancer.
Authors: Alghothani L, Gustin J Abstract Chronic pain is common in patients with underlying malignancy with prevalence of up to 70 percent in those with advanced disease. Opioids are often used for those with both active disease and chronic cancer-related pain. In high-risk patients with hematologic malignancies and pneumonia, the Infectious Diseases Society of America recommends empiric antifungal therapy, often with voriconazole or another similar azole agent. Thus, patients with cancer are commonly on medications, such as antifungals, that have the potential to interact with opioids, causing adverse effects. Our...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid management strategy decreases admissions in high-utilizing adults with sickle cell disease.
CONCLUSION: An opioid management strategy, as part of a larger effort to improve care for high-utilizing adults with SCD, decreased rate of admissions and opioid use. PMID: 28829516 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Assessing the impact of the extended-release/long-acting opioid an-algesics risk evaluation and mitigation strategies on opioid prescrip-tion volume.
Authors: Divino V, Cepeda S, Coplan P, Maziere JY, Yuan Y, Wade RL Abstract OBJECTIVE: The Food and Drug Administration approved the extended-release/long-acting (ER/LA) opioid analgesics risk evaluation and mitigation strategies (REMS) in July 2012 to educate healthcare providers and patients about safe and appropriate opioid analgesic use. The authors evaluated the impact of the REMS on ER/LA opioid analgesic utilization, overall and stratified by patient characteristics and prescriber type associated with greater expected need for analgesia. DESIGN: Retrospective repeated cross-sectional study. QuintilesIMS'...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Cost of opioid-treated chronic low back pain: Findings from a pilot randomized controlled trial of mindfulness meditation-based intervention.
Authors: Zgierska AE, Ircink J, Burzinski CA, Mundt MP Abstract OBJECTIVE: Opioid-treated chronic low back pain (CLBP) is debilitating, costly, and often refractory to existing treatments. This secondary analysis aims to pilot-test the hypothesis that mindfulness meditation (MM) can reduce economic burden related to opioid-treated CLBP. DESIGN: Twenty-six-week unblinded pilot randomized controlled trial, comparing MM, adjunctive to usual-care, to usual care alone. SETTING: Outpatient. PARTICIPANTS: Thirty-five adults with opioid-treated CLBP (≥30 morphine-equivalent mg/day) for 3 + months enrolled; n...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Looking both ways before crossing the street: Assessing the benefits and risk of opioids in treating patients at risk of sleep -disordered breathing for pain and dyspnea.
Authors: Davis MP, Behm B, Balachandran D Abstract Opioids adversely influence respiration in five distinct ways. Opioids reduce the respiratory rate, tidal volume, amplitude, reflex responses to hypercapnia and hypoxia, and arousability related necessary for respiratory adaptive responses. Opioids cause impairment of upper pharyngeal dilator muscles leading to obstructive apnea. Opioids cause complex sleep disordered breathing (SDB) consisting of central sleep apnea and obstructive sleep apnea. Clinically opioids worsen pre-existing SDB. Recent studies have shown increased morbidity and mortality in patients recei...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Tramadol-associated mania: A case report.
This report describes an unusual case of tramadol-associated mania in a patient without a charted diagnosis of bipolar disorder. However, she had a history of two prior episodes of mania following administration of tramadol that were also believed to be related to medication-induced mood disorder rather than underlying bipolar disorder. We hypothesize that tramadol-associated mania may have an underlying mechanism involving monoamine neurotransmission and increased oxidative stress. PMID: 28829520 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

The prevalence of nasal obstruction as a consideration in the treatment of opioid overdose.
CONCLUSIONS: Obstructive nasal pathology is relatively common in patients who experience serious OIRD, and in itself is associated with a higher risk of having OIRD. PMID: 28829521 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioid pain medication prescriptions obtained through emergency medical visits in the Veterans Health Administration.
CONCLUSIONS: The writing of OPM prescriptions after an ED visit is on the decline in the VA. Compliance with prescribing guidelines is increasing, but is not yet at goal. PMID: 28829522 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Sex differences in the daily rhythmicity of morphine consumption after major abdominal surgery.
Authors: Cattaneo S, Ingelmo P, Scudeller L, Gregori M, Bugada D, Baciarello M, Marchesini M, Alberio G, Normanno M, Jotti GS, Meschi T, Fanelli G, Massimo A Abstract OBJECTIVE: The sex of the patients has been shown to affect postoperative pain and morphine consumption; still a clear understanding able to explain the reasons behind this difference struggles to emerge. Our research aimed to investigate one specific aspect of the variability in morphine consumption between sexes. Previous studies have shown that circadian rhythm can influence opioid consumption. Furthermore, circadian rhythm is different between fem...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

A comprehensive clinical review of opioid-induced allodynia: Discussion of the current evidence and clinical implications.
This article outlines how research on opioid-induced hyperalgesia has led to the discovery of allodynia. Next, this article provides a detailed review of the current literature on allodynia, which includes animal studies, case reports, case series, and randomized controlled trials. Finally, the authors provide some potential clinical implications and applications for clinicians in regards to prescribing practices of opioids in the presence of allodynia. PMID: 28829524 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

State survey of medical boards regarding abrupt loss of a prescriber of controlled substances.
CONCLUSIONS: Most states do not have operational plans in place. However, a few have key strategies that may be useful in addressing potential problems following abrupt loss of a CS prescriber. State medical boards can play a significant role in the development of comprehensive preparedness plans to mitigate damage from the loss of CS prescribers in the community. PMID: 28829525 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Clinical relevance of the pharmacokinetic characteristics of an abuse-deterrent, extended-release, injection-molded morphine tablet.
CONCLUSIONS: Morphine-ADER-IMT, an ER morphine formulation with robust AD features, has a clinical PK profile that is well suited for patients with chronic pain. PMID: 28829526 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Does caffeine improve respiratory rate during remifentanil target controlled infusion sedation? A case report in endoscopic sedation.
Authors: Sbaraglia F, De Riso M, Riccioni ME, Costamagna G, Sammartino M Abstract Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthin...
Source: Journal of Opioid Management - August 24, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

A qualitative exploration of chronic pain and opioid treatment among HIV patients with drug use disorders.
CONCLUSIONS: Participant struggles with receiving and managing prescribed opioid analgesics suggest a need for: therapies beyond these medications; guidelines for providers specific to this population; and harm reduction trainings for providers. PMID: 28345742 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Opioids and nonopioids for postoperative pain control in patients with chronic kidney disease.
CONCLUSIONS: There is considerable variability in POPM practices for patients with all stages of CKD. Morphine is favored even in end-stage renal disease. Departments of anesthesiology are insufficiently involved in drafting standard operating procedures. PMID: 28345743 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Eleven years of children methadone poisoning in a referral center: A review of 453 cases.
This study aimed to evaluate the possible risk factors of death and/or intubation in methadone-poisoned children of 12 years or younger. DESIGN: Retrospective routine database study. SETTING: The only tertiary hospital for children poisoning in Tehran. PATIENTS: Four hundred fifty-three methadone-poisoned patients aged 12 or younger were studied between 2001 and 2012. MAIN OUTCOME MEASURES: In-hospital mortality and intubation/mechanical ventilation. RESULTS: Of a total of 475 children included, 22 were excluded due to coingestion of other drugs. Three (0.66 percent) expired and 12 (2.65 percent) were i...
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

In vitro and in vivo assessment of the abuse potential of PF614, a novel BIO-MD ™ prodrug of oxycodone.
CONCLUSIONS: The Bio-Activated Molecular Delivery prodrug design limits the use of PF614 to the intended oral route of delivery with reduced potential for IV or nasal abuse, as it cannot be activated intravenously or nasally to provide an active opioid. Unlike existing opioid formulations, the extended-release profile of PF614 cannot be accelerated by chewing or ex vivo extraction to pharmacologically active substances. PMID: 28345745 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

An analysis of errors, discrepancies, and variation in opioid prescriptions for adult outpatients at a teaching hospital.
CONCLUSIONS: Inconsistencies in opioid prescribing remain common. Handwritten prescriptions continue to demonstrate higher associations of errors, discrepancies, and variation from ideal practice and government regulations. All computer-generated prescriptions adhered to best practice guidelines and contained two patient identifiers, and all EHR prescriptions were fully compliant with DEA rules. PMID: 28345746 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Survey of opioid tapering practices of pediatric healthcare providers: A national perspective.
CONCLUSIONS: This study provided a baseline assessment of pediatric opioid tapering practices by pediatric healthcare providers. Results revealed a marked variation in practice patterns that may indicate deficits in the assessment and management of opioid withdrawal in children. The need for the development of assessment-based opioid tapering guidelines for the pediatric population is long overdue. PMID: 28345747 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - March 29, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Attitudes toward the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain: A qualitative study.
CONCLUSIONS: Despite its merits, the Canadian Opioids Guideline suffers from information gaps and from limited uptake, at least in part due to suboptimal format and suboptimal dissemination. PMID: 28059430 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - January 10, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Evaluation of treatment changes following electronic consultation to a pharmacist-run urine drug testing service in a veterans healthcare system.
Authors: Stammet MM, Spradley SS Abstract In 2013, the North Florida/South Georgia Veterans Healthcare System established a pharmacist-run urine drug testing (UDT) electronic consultation (e-consult) service to assist providers with interpretation of this useful yet complex clinical tool. This pilot study aimed to classify clinical treatment changes implemented following e-consult to a pharmacist-run UDT service and analyze factors limiting pharmacist intervention postconsultation. One hundred forty-three e-consults were completed in the 2-year study period including interpretation of 190 UDT results classified as ...
Source: Journal of Opioid Management - January 10, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Primary care providers' prescribing practices of opioid controlled substances.
CONCLUSIONS: Further scrutiny is warranted to more closely analyze provider opioid prescribing habits and ensure that the providers at our Institution are prescribing Schedule II controlled substances in compliance with HB1. PMID: 28059432 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - January 10, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

A 12-week extension study to assess the safety and tolerability of naloxegol in patients with noncancer pain and opioid-induced constipation.
CONCLUSION: Naloxegol was generally safe and well tolerated in this 12-week extension study in patients with noncancer pain and OIC. PMID: 28059433 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - January 10, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Assessment of abuse liability of Tramadol among experienced drug users: Double-blind crossover randomized controlled trial.
CONCLUSION: Tramadol has abuse potential (even in therapeutic doses) more than Placebo but less than or comparable to Buprenorphine. PMID: 28059434 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - January 10, 2017 Category: Addiction Tags: J Opioid Manag Source Type: research

Transient low testosterone levels after oral hydrocodone may contribute to misdiagnosis of hypogonadism.
CONCLUSIONS: Five milligrams of hydrocodone did not significantly alter postingestion testosterone levels, but 10 mg ingestion lowered them at 2, 4, and 6 hours postingestion. PMID: 27844470 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Clinically relevant concentrations of opioids for in vitro studies.
CONCLUSIONS: Concentrations of opioids used in vitro should include those that are present in the relevant clinical setting if the effects of opioids detected in vitro are to be of potential relevance to the clinical setting. Therefore, it is essential that these concentrations in the relevant clinical context(s) are known. PMID: 27844471 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Patient-relevant outcomes and health-related quality of life in patients with chronic, severe, noncancer pain treated with tapentadol prolonged release-Using criteria of health technology assessment.
CONCLUSIONS: Added benefit of tapentadol in all endpoint categories suggests that it may be beneficial to initiate treatment of chronic severe nonmalignant pain with tapentadol rather than oxycodone. PMID: 27844472 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Adherence to chronic opioid therapy prescribing guidelines in a primary care clinic.
CONCLUSIONS: Aside from race, most patient characteristics were not predictive of pain agreement implementation. However, controlled medication of higher schedules and the use of certain guideline-recommended practices were associated with an agreement. Studies are needed to examine whether pain agreement or guideline-adherence influence clinical outcomes. PMID: 27844473 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Assessment of acute pain in trauma-A retrospective prehospital evaluation.
CONCLUSIONS: Effect was only documented in one patient after administering opioids in a patient with trauma population, where approximately 17 percent of patients experienced severe pain. Severe pain was correlated to male gender, respiratory intervention, opioid administration, and the diagnosis unspecified multiple injuries. PMID: 27844474 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Rhode Island Board of Medical Licensure and Discipline: Illustration of the disciplinary process as it pertains to cases involving opioid prescribing.
Authors: McDonald JV Abstract Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline. PMID: 27844475 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Coprescribing naloxone for patients on chronic opioid therapy: Les-sons learned from a patient-safety initiative in primary care training sites.
CONCLUSIONS: Primary care practices, particularly primary care training sites, looking to implement a coprescription initiative should take several important factors into consideration during the planning stages, including naloxone availability and availability of the patient for naloxone education. More extensive research on best practices is needed. PMID: 27844476 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Reducing the Community-Prescribed Opioid Load: A Public Health Approach to the Opioid Epidemic.
Authors: Lew J, Moore K PMID: 27575823 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Physician conviction for prescription related deaths: How will this affect the opioid debate?
Authors: Rana H, Braithwaite B PMID: 27575824 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

What's in a number? Recommending practicality in the DATA 2000 patient limits.
This article analyzes the US Department of Health and Human Services' final rule (Final Rule) on MAT, common barriers to treatment, and the cost-benefit of treatment in light of the current opioid abuse epidemic. The article finds that while the Final Rule was a step in the right direction, it does not go far enough to adequately address the epidemic. Finally, the article proposes practical recommendations for increasing patient access to treatment for OUDs, including increasing the patient limit for highly qualified addiction treatment providers so that they can practice addiction medicine on a full-time basis and exempti...
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Clinical analgesia correlates with decline in temporal summation in response to remifentanil infusion in patients with chronic neuropathic (radicular) pain.
Authors: Suzan E, Midbari A, Pud D, Hadad S, Eisenberg E Abstract BACKGROUND: Animal studies have shown that in addition to their antinociceptive effects, opioids have attenuated the electrophysiological "wind-up" phenomenon. Although effects of opioids on clinical pain and on temporal summation (TS), the human correlatives of this phenomenon, have been tested repeatedly, correlations between these two parameters have not been reported so far. OBJECTIVES: To search for possible correlations between the effects of remifentanil on clinical pain intensity and on the magnitude of TS in patients with chron...
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer.
CONCLUSIONS: VHA patients with metastatic cancer and extensive prescription opioid use who are prescribed anxiolytics are likely to have a Food and Drug Administration-approved indication for psychotropics, and anxiolytics in particular, but represent a clinically vulnerable group which merits careful monitoring. PMID: 27575827 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research

Novel peer review method for improving controlled substance prescribing in primary care.
CONCLUSIONS: Use of a CRT in an urban primary care clinic provided helpful insight on prescribing practices and has promise to improve quality of opioid prescribing. PMID: 27575828 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - September 1, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research