Latest & greatest articles for opioid

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Top results for opioid

1. New directions in the treatment of opioid withdrawal. (Abstract)

New directions in the treatment of opioid withdrawal. The treatment of opioid withdrawal is an important area of clinical concern when treating patients with chronic, non-cancer pain, patients with active opioid use disorder, and patients receiving medication for opioid use disorder. Current standards of care for medically supervised withdrawal include treatment with μ-opioid receptor agonists, (eg, methadone), partial agonists (eg, buprenorphine), and α2-adrenergic receptor agonists (eg (...) , clonidine and lofexidine). Newer agents likewise exploit these pharmacological mechanisms, including tramadol (μ-opioid receptor agonism) and tizanidine (α2 agonism). Areas for future research include managing withdrawal in the context of stabilising patients with opioid use disorder to extended-release naltrexone, transitioning patients with opioid use disorder from methadone to buprenorphine, and tapering opioids in patients with chronic, non-cancer pain.Copyright © 2020 Elsevier Ltd. All rights

2020 Lancet

2. Effect on Opioids Requirement of Early Administration of Intranasal Ketamine for Acute Traumatic Pain Full Text available with Trip Pro

Effect on Opioids Requirement of Early Administration of Intranasal Ketamine for Acute Traumatic Pain Effect on Opioids Requirement of Early Administration of Intranasal Ketamine for Acute Traumatic Pain - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National Center (...) Link Copy Actions Cite Share Permalink Copy Page navigation Clin J Pain Actions . 2020 Jun;36(6):458-462. doi: 10.1097/AJP.0000000000000821. Effect on Opioids Requirement of Early Administration of Intranasal Ketamine for Acute Traumatic Pain , , , , , , , , , , , Affiliations Expand Affiliations 1 Emergency Department, Fattouma Bourguiba University Hospital. 2 Research Laboratory LR12SP18, University of Monastir. 3 Emergency Department, Farhat Hached University Hospital. 4 Emergency Department

2020 EvidenceUpdates

3. Opioid-induced Euphoria Among Emergency Department Patients With Acute Severe Pain: An Analysis of Data From a Randomized Trial

. Available at: https://www.ashpintersections.org/2016/02/pharm-d-m-d-team-successfully-enacts-opioid-free-ed-shift/. Accessed November 18, 2019. Xi ZX, Stein EA. GABAergic mechanisms of opiate reinforcement. Alcohol Alcohol 2002;37:485-94. Wightman R, Perrone J, Portelli I, Nelson L. Likeability and abuse liability of commonly prescribed opioids. J Med Toxicol 2012;8:335-40. Chinn E, Friedman BW, Naeem F, et al. Randomized trial of intravenous lidocaine versus hydromorphone for acute abdominal pain (...) Opioid-induced Euphoria Among Emergency Department Patients With Acute Severe Pain: An Analysis of Data From a Randomized Trial Opioid-induced Euphoria Among Emergency Department Patients With Acute Severe Pain: An Analysis of Data From a Randomized Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health

2020 EvidenceUpdates

4. Can prescribers avoid contributing to opioid use disorder?

Can prescribers avoid contributing to opioid use disorder? Can prescribers avoid contributing to opioid use disorder? January - February 2020 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: +1-604-822-0700 Fax: +1-604-822-0701 E-mail: info@ti.ubc.ca www.ti.ubc.ca 125 Case vignette: A 21 y/o has surgery for a condition expect- ed to improve. He fills (...) a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Is a re - newal of opioid appropriate, potentially dangerous, or both? A ggressive promotion of opioids for chronic non-cancer pain (CNCP) began in the 1990s, cou- pled with advocacy of “pain as the 5th vital sign” and popularization of numerical scales for patients to self- rate pain. 1 Enthusiasm for this approach waned as clinical experience

2020 Therapeutics Letter

5. Tramadol: an opioid analgesic to be used with caution

Tramadol: an opioid analgesic to be used with caution Prescrire IN ENGLISH - Spotlight ''Tramadol: an opioid analgesic to be used with caution'', 1 June 2020 {1} {1} {1} | | > > > Tramadol: an opioid analgesic to be used with caution Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Tramadol: an opioid analgesic to be used with caution Classified (...) as a weak opioid, tramadol poses risks that require the same vigilance as with morphine. Tramadol is an opioid marketed for the relief of moderate to severe pain. It exposes patients to the adverse effects of opioids (intestinal, neuropsychological, and respiratory disorders, dependence and addiction, etc.), and to specific adverse effects, including hypoglycaemia and cardiac arrhythmia, with a risk of overdose in combination with other medicines or in some patients. Tramadol became the best-selling

2020 Prescrire

6. Opioid Treatments for Chronic Pain

Opioid Treatments for Chronic Pain Opioid Treatments for Chronic Pain Comparative Effectiveness Review Number 229 R Comparative Effectiveness Review Number 229 Opioid Treatments for Chronic Pain Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific Northwest Evidence-based Practice Center Portland, OR Investigators: Roger Chou, M.D. Daniel Hartung (...) , Pharm.D. Judith Turner, Ph.D. Ian Blazina, M.P.H. Brian Chan, M.D. Ximena Levander, M.D. Marian McDonagh, Pharm.D. Shelley Selph, M.D., M.P.H. Rongwei Fu, Ph.D. Miranda Pappas, M.A. AHRQ Publication No. 20-EHC011 April 2020 ii Key Messages Purpose of Review To assess the effectiveness and harms of opioid therapy for chronic noncancer pain, alternative opioid dosing strategies, and risk mitigation strategies Key Messages • Opioids are associated with small improvements versus placebo in pain

2020 Effective Health Care Program (AHRQ)

7. Safety And Efficacy Of The Unique Opioid Buprenorphine For The Treatment Of Chronic Pain Full Text available with Trip Pro

Safety And Efficacy Of The Unique Opioid Buprenorphine For The Treatment Of Chronic Pain Safety And Efficacy Of The Unique Opioid Buprenorphine For The Treatment Of Chronic Pain - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National Center for Biotechnology Information (...) :3299-3317. doi: 10.2147/JPR.S231948. eCollection 2019. Safety And Efficacy Of The Unique Opioid Buprenorphine For The Treatment Of Chronic Pain , Affiliations Expand Affiliations 1 NEMA Research, Inc., Naples, FL, USA. 2 Neumentum, Palo Alto, CA, USA. 3 University of Arizona College of Pharmacy, Tucson, AZ, USA. 4 Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA. PMID: 31997882 PMCID: DOI: Item in Clipboard Review Safety And Efficacy Of The Unique

2020 EvidenceUpdates

8. Naloxone nasal spray (Nyxoid) for opioid overdose

Naloxone nasal spray (Nyxoid) for opioid overdose Naloxone nasal spray (Nyxoid) for opioid overdose - NPS MedicineWise Log In Menu During the COVID-19 pandemic, you need to continue to take your usual medicines and stay as healthy as possible. Here is some important information for everyone to keep in mind. Featured topics 30 Mar 2020 30 Mar 2020 30 Mar 2020 Featured article Information for consumers about medicines and COVID-19 | Updated regularly as the situation changes. Keep a medicines (...) February 2020 19 February 2020 8 January 2020 Featured topic 20 years of helping Australians make better decisions about medicines, medical tests and other health technologies Partner with us Latest projects Search Search Search Search POPULAR Log in Log in All fields are required Email address* Password* Log in Naloxone nasal spray (Nyxoid) for opioid overdose PBS listing of naloxone nasal spray to increase naloxone use as emergency rescue treatment in the community 15 January 2020 Key points Naloxone

2020 National Prescribing Service Limited (Australia)

9. Opioids, chronic pain and the bigger picture

Opioids, chronic pain and the bigger picture OPIOID TAPERING ALGORITHM 1–9 Patient who is taking opioids No meaningful improvement in pain and/or function Cause of pain has resolved Adverse effects are intolerable Risk of harm outweighs potential benefits Signs of aberrant behaviour • Discuss the decision to taper an opioid with the patient • Ask each patient about their treatment goals and their perceived benefits and harms of opioid treatment • Listen to the patient’s beliefs and concerns (...) about, and motivations for, tapering • Discuss the benefits of tapering • Ensure the patient knows that tapering may take several months • Reassure the patient and discuss how you can monitor and support them Does the patient agree to tapering? NO • Revisit the patient’s beliefs and concerns about tapering opioids • Reinforce the rationale for tapering including potential benefits of tapering and harm of continuing long term • Assess for substance use disorder • Discuss the decision to taper

2020 National Prescribing Service Limited (Australia)

10. Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review

Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health (...) Share Permalink Copy Page navigation Pain Physician Actions . 2019 Nov;22(6):E551-E562. Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review , , , , Affiliations Expand Affiliations 1 Pharmacy Department Alfred Health, School of Public Health and Preventative Medicine Monash University, Alfred Hospital, Melbourne, Australia. 2 Pharmacy Department Alfred Health, Anaesthesia and Perioperative Medicine Department Alfred Health, Alfred Hospital, Melbourne

2020 EvidenceUpdates

11. Naldemedine (Rizmoic) - For the treatment of opioid-induced constipation (OIC)

Naldemedine (Rizmoic) - For the treatment of opioid-induced constipation (OIC) Published 13 April 2020 1 SMC2242 naldemedine 200 micrograms film-coated tablets (Rizmoic®) Shionogi BV 06 March 2020 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following a full submission naldemedine (Rizmoic ® ) is accepted (...) for use within NHSScotland. Indication under review: For the treatment of opioid induced constipation (OIC) in adult patients who have previously been treated with a laxative. Naldemedine compared to placebo significantly improved the spontaneous bowel movement response rate in patients with opioid induced constipation and either non-cancer or cancer pain. Chairman Scottish Medicines Consortium www.scottishmedicines.org.uk 2 Indication For the treatment of opioid induced constipation (OIC) in adult

2020 Scottish Medicines Consortium

12. Canadian guidelines on opioid use disorder among older adults

Canadian guidelines on opioid use disorder among older adults 123 CANADIAN GERIATRICS JOURNAL, VOLUME 23, ISSUE 1, MARCH 2020 ABSTRACT Background In Canada, rates of hospital admission from opioid overdose are higher for older adults (= 65) than younger adults, and opioid use disorder (OUD) is a growing concern. In response, Health Canada commissioned the Canadian Coalition of Se- niors’ Mental Health to create guidelines for the prevention, screening, assessment, and treatment of OUD in older (...) adults. Methods A systematic review of English language literature from 2008–2018 regarding OUD in adults was conducted. Previ- ously published guidelines were evaluated using AGREE II, and key guidelines updated using ADAPTE method, by drawing on current literature. Recommendations were created and assessed using the GRADE method. Results Thirty-two recommendations were created. Prevention recom- mendations: it is key to prioritize non-pharmacological and non-opioid strategies to treat acute

2020 CPG Infobase

13. Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression

Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression - GOV.UK Tell us whether you accept cookies We use about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. Accept all cookies You’ve accepted all cookies. You can at any time. Hide Search Stay at home Only go outside for food, health reasons (...) or work (but only if you cannot work from home) If you go out, stay 2 metres (6ft) away from other people at all times Wash your hands as soon as you get home Do not meet others, even friends or family. You can spread the virus even if you don’t have symptoms. Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression Benzodiazepines and opioids can both cause respiratory depression, which can be fatal if not recognised in time. Only prescribe together

2020 MHRA Drug Safety Update

14. Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study. Full Text available with Trip Pro

Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study. To compare the risk of mortality among people with opioid use disorder on and off opioid agonist treatment (OAT) in a setting with a high prevalence of illicitly manufactured fentanyl and other potent synthetic opioids in the illicit drug supply.Population based retrospective cohort study.Individual level linkage of five health administrative datasets (...) capturing drug dispensations, hospital admissions, physician billing records, ambulatory care reports, and deaths in British Columbia, Canada.55 347 people with opioid use disorder who received OAT between 1 January 1996 and 30 September 2018.All cause and cause specific crude mortality rates (per 1000 person years) to determine absolute risk of mortality and all cause age and sex standardised mortality ratios to determine relative risk of mortality compared with the general population. Mortality risk

2020 BMJ

15. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. Full Text available with Trip Pro

Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. To examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration.Observational evaluation.Veterans Health Administration.1 394 102 patients in the Veterans Health Administration with an outpatient prescription for an opioid analgesic from (...) fiscal year 2013 to the end of fiscal year 2014 (1 October 2012 to 30 September 2014).A multivariable Cox non-proportional hazards regression model examined death from overdose or suicide, with the interaction of time varying opioid cessation by length of treatment (≤30, 31-90, 91-400, and >400 days) as the main covariates. Stopping treatment with opioids was measured as the time when a patient was estimated to have no prescription for opioids, up to the end of the next fiscal year (2014

2020 BMJ

16. Impact of Timing of Preprocedural Opioids on Adverse Events in Procedural Sedation (Abstract)

Impact of Timing of Preprocedural Opioids on Adverse Events in Procedural Sedation The risk of respiratory depression is increased when opioids are added to sedative agents. In our recent multicenter emergency department (ED) procedural sedation cohort, we reported a strong association between preprocedural opioids and sedation-related adverse events. We sought to examine the association between timing of opioids and the incidence of adverse sedation outcomes.We conducted a secondary analysis (...) of a prospective cohort of children aged 0 to 18 years who received sedation for a painful procedure in six Canadian pediatric EDs from July 2010 to February 2015. The primary risk factor was timing of opioid administration, adjusted for age, opioid type, preprocedural and sedation medications, and procedure type. Outcomes were 1) oxygen desaturation, 2) vomiting, and 3) positive pressure ventilation (PPV).Of the 6,295 children in the original cohort, 1,806 (29%) received a preprocedural opioid. Patients

2020 EvidenceUpdates

17. Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial (Abstract)

Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial To determine the efficacy of a preoperative fascia iliaca compartment block in decreasing postoperative pain and improving functional recovery after hip fracture surgery.Randomized prospective Level 1 therapeutic.Academic Level 1 trauma center.Geriatric patients with fractures of the proximal femur (neck, intertrochanteric, or subtrochanteric regions) were prospectively (...) postoperative opioid consumption while improving patient satisfaction. We recommend the integration of this safe and efficacious modality into institutional geriatric hip fracture protocols as an adjunctive pain control strategy.Therapeutic Level II See Instructions for Authors for a complete description of levels of evidence.

2020 EvidenceUpdates

18. Does Integrative Medicine Reduce Prescribed Opioid Use for Chronic Pain? A Systematic Literature Review

Does Integrative Medicine Reduce Prescribed Opioid Use for Chronic Pain? A Systematic Literature Review Does Integrative Medicine Reduce Prescribed Opioid Use for Chronic Pain? A Systematic Literature Review - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes (...) to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Pain Med Actions 2019 Nov 22 [Online ahead of print] Does Integrative Medicine Reduce Prescribed Opioid Use for Chronic Pain? A Systematic Literature Review , , , , , Affiliations Expand Affiliations 1 Canadian College of Naturopathic Medicine, North York, Ontario, Canada. 2 Institute of Medical Science, University of Toronto, Toronto

2020 EvidenceUpdates

19. Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain

Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Management Briefs eBrief-no166 -- Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Talk to the Veterans Crisis Line now An official website of the United States government Here's how you know The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're (...) eBrief-no166 -- Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Health Services Research & Development Management eBrief no. 166 » Issue 166 January 2020 The report is a product of the VA/HSR&D Evidence Synthesis Program. Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain In response to the evolving public health crisis related to opioid use, many providers, health systems, and payers

2020 Veterans Affairs - R&D

20. Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study. Full Text available with Trip Pro

Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study. To examine the distribution and patterns of opioid prescribing in the United States.Retrospective, observational study.National private insurer covering all 50 US states and Washington DC.An annual average of 669 495 providers prescribing 8.9 million opioid prescriptions to 3.9 million patients from 2003 through 2017.Standardized doses of opioids in morphine milligram (...) equivalents (MMEs) and number of opioid prescriptions.In 2017, the top 1% of providers accounted for 49% of all opioid doses and 27% of all opioid prescriptions. In absolute terms, the top 1% of providers prescribed an average of 748 000 MMEs-nearly 1000 times more than the middle 1%. At least half of all providers in the top 1% in one year were also in the top 1% in adjacent years. More than two fifths of all prescriptions written by the top 1% of providers were for more than 50 MMEs a day and over four

2020 BMJ