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Intravenous Drug Abuse

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21. Needle embolism in intravenous drug abuse (PubMed)

Needle embolism in intravenous drug abuse Although intravenous drug users report the breaking of a needle as a relatively common occurrence, central embolism of needle fragments occurs infrequently in the literature. Central needle embolism also poses a conundrum for the radiologist, as the needle may be easily overlooked when the clinical history is nonspecific. We present two cases of needle embolism to the lung, one complicated by inflammatory mass and progressive pleuritic chest pain

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2015 Radiology Case Reports

22. Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use (PubMed)

Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use Spontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened and she developed lower extremity weakness. Magnetic resonance imaging (MRI) revealed an SEA, and cesarean

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2018 Case reports in obstetrics and gynecology

23. Pulmonary hypertension in patients with a history of intravenous drug use. (PubMed)

Pulmonary hypertension in patients with a history of intravenous drug use. Pulmonary hypertension may be a consequence of intrinsic elevation in pulmonary vasculature resistance or complicate numerous other conditions affecting the cardiac and respiratory systems. In this review we sought to explore the relationship between pulmonary hypertension and intravenous drug use.A narrative review was conducted using PubMed MeSH search with further papers were identified using a standard PubMed search (...) with relevant key terms and various synonyms.HIV infection may be associated with pulmonary hypertension due to indirect consequences of viral infection, venous thromboembolism, or its therapies. Anti-retroviral infection may also influence plasma concentrations of commonly used treatments for pulmonary hypertension. Intravenous drug use is acknowledged as an important portal for the acquisition of hepatitis virus C infection, with portopulmonary hypertension a potential complication associated with poor

2018 Current medical research and opinion

24. A mechanistic investigation of thrombotic microangiopathy associated with intravenous abuse of Opana ER. (PubMed)

A mechanistic investigation of thrombotic microangiopathy associated with intravenous abuse of Opana ER. Since 2012, a number of case reports have described the occurrence of thrombotic microangiopathy (TMA) following IV abuse of extended-release oxymorphone hydrochloride (Opana ER), an oral opioid for long-term treatment of chronic pain. Here, we present unique clinical features of 3 patients and investigate IV exposure to the tablet's inert ingredients as a possible causal mechanism. Guinea (...) inquisitive of IV drug abuse when presented with cases of TMA.

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2016 Blood

25. Intravenous melatonin abuse leading to recurrent aortic valve endocarditis: a case report and discussion. (PubMed)

Intravenous melatonin abuse leading to recurrent aortic valve endocarditis: a case report and discussion. Reports of inappropriate medication use are widespread. There is a growing literature detailing abuse of drugs not typically thought to have high abuse liability. Melatonin is considered to be generally safe and is categorized by the Food and Drug Administration as a nutritional supplement. There are no known reports of intravenous melatonin abuse in the medical literature.The authors (...) report a case of a patient injecting melatonin with euphoric and then sedative effects leading to two episodes of infective endocarditis culminating in aortic valve replacement.Infective endocarditis continues to be a major potential complication of intravenous drug abuse. The proliferation of novel street drugs, resurgence in the use of older drugs and ongoing abuse of medications warrant continued research and vigilance in treating substance use disorders and attendant medical complications.

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2016 BMC Psychiatry

26. Intravenous abuse potential study of oxycodone alone or in combination with naltrexone in nondependent recreational opioid users. (PubMed)

participants experienced adverse events after intravenous oxycodone (n = 27 [90%]) versus intravenous simulated crushed ALO-02 (n = 4 [12.5%]) or placebo (n = 2 [6.5%]).Intravenous administration of simulated crushed ALO-02 resulted in significantly lower abuse potential, as assessed by subjective ratings of drug liking and high, than intravenous oxycodone in nondependent, recreational opioid users. This suggests that injection of ALO-02 may not be as desirable to recreational opioid users compared (...) Intravenous abuse potential study of oxycodone alone or in combination with naltrexone in nondependent recreational opioid users. ALO-02, comprising pellets of extended-release oxycodone surrounding sequestered naltrexone, is intended to deter abuse.Determine the abuse potential of intravenous oxycodone combined with naltrexone, which represents simulated crushed ALO-02 in solution, compared with intravenous oxycodone in nondependent, recreational opioid users.A randomized, double-blind

2016 The American journal of drug and alcohol abuse Controlled trial quality: predicted high

27. Septic Arthritis in Intravenous Drug Abusers: A Historical Comparison of Habits and Pathogens. (PubMed)

Septic Arthritis in Intravenous Drug Abusers: A Historical Comparison of Habits and Pathogens. Intravenous drug abuse (IVDA) is a common problem; there were more than 16 million users worldwide in 2008. Numerous reports highlight the infectious skeletal complication associated with IVDA.To determine septic arthritis pathogens in IVDA in a U.S. hospital and compare the current causative organisms to a cohort from the 1980s at the same institution.An institutional review board-approved

2014 Journal of Emergency Medicine

28. Infected pseudoaneurysms in intravenous drug abusers: Ligation or reconstruction? (PubMed)

Infected pseudoaneurysms in intravenous drug abusers: Ligation or reconstruction? Infected pseudoaneurysm in intravenous (IV) drug abusers is a serious clinical problem, with difficult and controversial management. With existing controversies regarding their optimal management, we present the results of simple ligation and local debridement for treatment of infected pseudoaneurysms.Records of 72 consecutive patients with pseudoaneurysms in IV drug abusers over the last 20 years were reviewed

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2014 International Journal of Applied and Basic Medical Research

29. Abuse Potential of Intravenous Oxycodone/Naloxone Solution in Nondependent Recreational Drug Users. (PubMed)

Abuse Potential of Intravenous Oxycodone/Naloxone Solution in Nondependent Recreational Drug Users. Abuse of opioid analgesics has become a public health issue. Some opioid abusers use intravenous administration to increase the magnitude of positive reinforcing effects. Intravenous co-administration of oxycodone with naloxone, an opioid antagonist, may reduce these rewarding effects and discourage abuse. A 2:1 oxycodone:naloxone (OXN) tablet formulation has been studied in the USA (...) compared among treatments.Pharmacokinetics were similar between OXY and sOXN. Subjects reported significantly fewer rewarding effects with sOXN compared with OXY; differences between sOXN and placebo were generally not significant. sOXN was well tolerated.Significant reductions in drug liking and other subjective effects following administration of sOXN compared with OXY indicate that naloxone concentrations were sufficient to antagonize the effects of oxycodone when abused by the intravenous route

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2014 Clinical drug investigation Controlled trial quality: uncertain

30. A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user (PubMed)

C Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland. eng Case Reports 2016 04 22 United States JAAD Case Rep 101665210 2352-5126 desomorphine intravenous drug abuse krokodil substance abuse ulceration wound healing 2016 5 26 6 0 2016 5 26 6 0 2016 5 26 6 1 epublish 27222881 10.1016/j.jdcr.2016.02.007 S2352-5126(16)00023-0 PMC4864092 Foot (Edinb). 2015 Jun;25(2):114-9 26001995 J Addict Dis. 2012;31(4):407-12 23244560 JAMA Dermatol. 2015 Jan;151(1):32 25587682 (...) A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user 27222881 2016 05 25 2019 02 26 2352-5126 2 2 2016 Mar JAAD case reports JAAD Case Rep A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user. 174-6 10.1016/j.jdcr.2016.02.007 Haskin Alessandra A Howard University College of Medicine, Washington, DC. Kim Noori N Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland. Aguh Crystal

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2016 JAAD Case Reports

31. Abuse-Deterrent Formulations of Opioids: Effectiveness and Value

into a syringe. Yes Vantrela™ ER Hydrocodone 2017 Incorporates abuse-deterrent technology designed to resist drug extraction through the most common routes: oral, intranasal, and intravenous. No **RoxyBond® Oxycodone 2017 Includes inactive ingredients that make the tablets harder to misuse by physical manipulation, chemical extraction, or both; in vitro data suggest physicochemical properties that are expected to make abuse through injection difficult. No *Modified from Becker, 2017. 14 **Only ADF approved (...) not been very well studied. It is generally believed that chewing an ER opioid is an important step towards addiction, followed by intranasal and intravenous routes of abuse. 21 However, even among patients entering drug rehabilitation programs, oral abuse of the IR formulation or the manipulated ER formulation remains the major route, with the exception of morphine, abused through the intravenous route in 66% of patients entering drug rehabilitation. 23 Understanding the characteristics and pathways

2017 California Technology Assessment Forum

32. Drug and Alcohol Abuse amongst Anaesthetists - Guidance on Identification and Management 2

in trainees. The most immediate risk is of harm to patients. A report of drug or alcohol abuse in an anaesthetist should be taken seriously and investigated without delay. Physical or behavioural symptoms at work indicate advanced addiction. Anaesthetists are more likely than other doctors to abuse narcotics as a drug of choice, to abuse drugs intravenously and to be addicted to more than one drug. Concerns should be reported to the clinical director in the first instance. A one-to-one confrontation (...) to access specialist treatment facilities for substance abuse disorders than other speciality groups [6, 8, 14, 15]. Anaesthetists are more likely to abuse opioids as a drug of choice, to abuse drugs intravenously and to be addicted to more than one drug [6, 16]. Some of those in treatment actually cited drug availability or access as a reason for choosing anaesthesia as a career [14]. In 2007, 66% of the General Medical Council (GMC) annual caseload involved health problems – 43% involved alcohol abuse

2011 Association of Anaesthetists of GB and Ireland

33. Mitigation of IV Abuse Through the Use of Abuse-Deterrent Opioid Formulations: An Overview of Current Technologies. (PubMed)

Mitigation of IV Abuse Through the Use of Abuse-Deterrent Opioid Formulations: An Overview of Current Technologies. Providers who treat patients with chronic pain face a dual challenge: providing adequate access to opioid therapies for appropriate pain management while adopting strategies to minimize the risk for abuse. Commonly prescribed opioids have substantial abuse potential when administered intravenously, and extended-release (ER)/long-acting (LA) opioids may be targeted for IV abuse (...) because of the higher per-dose medication level. The consequences of IV opioid abuse are severe and increase the risks for adverse outcomes, including mortality due to acute health events, serious infections, and deep vein thrombosis, to name a few. To reduce the potential for abuse of prescription opioids by both recreational and experienced drug abusers, abuse-deterrent formulations (ADFs) of opioid medications employ either physical/chemical barriers or agonist-antagonist combinations. Here we

2018 Pain Practice

34. A tale of 2 ADFs: differences in the effectiveness of abuse-deterrent formulations of oxymorphone and oxycodone extended-release drugs. (PubMed)

with insufflation (78%-28.8%) and intravenous injection of the active drug (42.7%-21.4%). However, although the Opana ER ADF was effective in reducing insufflation (80%-37.1%), injection (60.0%-51.4%), and overall nonoral abuse (94.3%-77.1%), it showed no significant decrease over time. Bearing in mind that the Opana ER sample was smaller in size than that for OxyContin, our results nonetheless suggest disparate outcomes resulting from the introduction of the ADFs, which could indicate that an ADF's (...) A tale of 2 ADFs: differences in the effectiveness of abuse-deterrent formulations of oxymorphone and oxycodone extended-release drugs. The introduction of extended-release opioid analgesics helped initiate an epidemic of prescription opioid abuse in the United States. To make access to the drug by crushing or dissolution more difficult, abuse-deterrent formulations (ADFs) of OxyContin (Purdue Pharma, Stamford, CT) and Opana ER (Endo Pharmaceuticals Inc., Malvern, PA), which use the same

2016 Pain

35. Arteriovenous fistula of the groin in a drug abuser with endocarditis (PubMed)

Arteriovenous fistula of the groin in a drug abuser with endocarditis Intravenous drug abusers commonly develop endocarditis due to injection of particulate matter that can cause endothelial damage to the valves. The frequent need to access the venous system can result in vascular traumas with potential complications including arteriovenous (AV) fistulas. Here, we present the case of an intravenous drug abuser with endocarditis and an unusually large AV fistula in the groin. The patient

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2016 Journal of surgical case reports

36. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain Consensus Guidelines on the Use of Intravenous Ketamine Infu... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account Registered (...) Articles & Issues Collections For Authors Journal Info > > Consensus Guidelines on the Use of Intravenous Ketamine Infu... Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Regional Anesthesia and Pain Medicine. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request

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2018 American Society of Regional Anesthesia and Pain Medicine

37. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management

differ from those for ketamine used to treat chronic conditions, with the exception of the use of ketamine in active substance abusers (Grade C relative contraindication for chronic pain, not a contraindication for acute pain) and poorly controlled cardiovascular disease (Grade B relative contraindication for chronic pain, Grade C for acute pain). These differences were attributed to the more urgent nature of treating acute pain, and for substance abuse, the fact that in most cases the drug of abuse (...) Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management Consensus Guidelines on the Use of Intravenous Ketamine Infu... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account

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2018 American Society of Regional Anesthesia and Pain Medicine

38. Intravenous drug use is associated with alloimmunization in pregnancy. (PubMed)

Intravenous drug use is associated with alloimmunization in pregnancy. Anecdotal evidence has suggested an association of intravenous drug abuse with alloimmunization; however, published data are limited to case reports.The purpose of this study was to determine whether women with a history of intravenous drug abuse have an increased risk of alloimmunization.A retrospective cohort study was performed with the use of data from a single-center blood bank and perinatal database from 2008-2014 (...) . Blood bank data were used to identify women with alloimmunization, which was defined as a positive antibody screen in pregnancy not due to naturally occurring antibodies, agglutinins, autoantibodies, or Rh immunoglobulin administration. Intravenous drug abuse was ascertained from a comprehensive database that has captured all drug abuse in pregnancy since 2008. For women who contributed >1 pregnancy to the database, only the most recent pregnancy was included. The rates of alloimmunization among

2016 American Journal of Obstetrics and Gynecology

39. Polyvinylpyrrolidone induced artefactual prolongation of activated partial thromboplastin times in intravenous drug users with renal failure. (PubMed)

as underlying cause in patients with renal failure.Unexpectedly prolonged activated partial thromboplastin times (APTTs) were noted in several patients with chronic renal insufficiency and a history of intravenous drug abuse. Deposits of polyvinylpyrrolidone (PVP), an excipient in one oral methadone solution used in opioid maintenance programs, were found in renal biopsies. One case is described in detail, and this is followed by a summary of findings in 11 other patients and the results of an in vitro (...) in patients with chronic renal failure and a history of intravenous drug abuse.© 2016 International Society on Thrombosis and Haemostasis.

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2016 Journal of Thrombosis and Haemostasis

40. Hemolytic Disease of the Fetus and Newborn due to Intravenous Drug Use (PubMed)

Hemolytic Disease of the Fetus and Newborn due to Intravenous Drug Use Objectives The objective is to present a pregnancy complication associated with intravenous drug use, namely, that of red blood cell alloimmunization and hemolytic disease of the fetus and newborn. Methods An observational case series is presented including women with red blood cell alloimmunization most likely secondary to intravenous drug abuse Results Five pregnancies were identified that were complicated by red blood (...) cell alloimmunization and significant hemolytic disease of the fetus and newborn, necessitating intrauterine transfusion, an indicated preterm birth, or neonatal therapy. Conclusions As opioid abuse continues to increase in the United States, clinicians should be aware of the potential for alloimmunization to red blood cell antibodies as yet another negative outcome from intravenous drug abuse.

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2016 AJP Reports

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