Latest & greatest articles for opioid

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Top results for opioid

1. Opioid drugs are no better than standard painkillers for long-term back and joint pain

Opioid drugs are no better than standard painkillers for long-term back and joint pain Opioid drugs are no better than standard painkillers for long-term back and joint pain Dissemination Centre Discover Portal NIHR DC Discover Opioid drugs are no better than standard painkillers for long-term back and joint pain Published on 3 July 2018 doi: People with long-term back pain, or osteoarthritis of their hips or knees, do not get better pain relief from opioid drugs and are more likely to get side (...) effects than those who take paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen. A US study assigned 240 patients to either opioid or non-opioid pain relief drugs and measured their pain over 12 months. Those who were assigned opioid drugs had less relief of their pain and also were more likely to have side-effects related to their medication. The findings may surprise some doctors and patients with long-term pain, because of the widely held belief that opioids

2019 NIHR Dissemination Centre

2. Opioid use disorder

Opioid use disorder Opioid use disorder - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Opioid use disorder Last reviewed: December 2018 Last updated: January 2019 Summary Heroin and prescription opioid misuse is a major health concern. From a diagnostic perspective, it is imperative that the physician understands the criteria for opioid use disorder. Comorbid medical and psychiatric illnesses, as well as other (...) substance use disorders, should be assessed. Physicians should be aware of methods for screening and detection of opioid use in clinical settings. Evidence-based treatments include detoxification, maintenance therapy, and psychosocial and supportive therapies. Treatment requires a multidisciplinary approach, is long term, and involves modifying deeply ingrained behaviours through the use of medications and psychosocial treatments. Definition An opioid is a synthetic or natural agent that stimulates

2019 BMJ Best Practice

3. Opioid overdose

Opioid overdose Opioid overdose - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Opioid overdose Last reviewed: August 2018 Last updated: September 2018 Summary The patient's history from bystanders/friends/family can assist diagnosis. Signs include central nervous system (CNS) and respiratory depression, miosis, and apnoea. Initial treatment consists of ensuring adequate ventilation followed by administration (...) of the opioid antagonist naloxone. Monitor patients for re-sedation and repeat antidote dose if necessary. Definition An opioid is any synthetic or natural agent that stimulates opioid receptors and produces opium-like effects. Opiates are opioids naturally derived from the opium poppy, Papaver somniferum , and include morphine and codeine. Opioids are used in the treatment of pain but are often sold illicitly and abused for their euphoric effects. An overdose occurs when larger quantities than physically

2019 BMJ Best Practice

4. Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study

Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study 30309973 2018 12 07 1399-3003 52 6 2018 Dec The European respiratory journal Eur. Respir. J. Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study. 1801278 10.1183/13993003.01278-2018 Safety concerns are a barrier to prescribing benzodiazepines (BDZs) and opioids in interstitial lung disease (ILD). We therefore examined the association of BDZs and opioids (...) on risk of admission to hospital and death.We conducted a population-based longitudinal cohort study of fibrotic ILD patients starting long-term oxygen therapy in Sweden between October 2005 and December 2014. Effects of BDZs and opioids on rates of admission to hospital and mortality were analysed using Fine-Gray and Cox regression while adjusting for potential confounders.We included 1603 patients (61% females). BDZs were used by 196 (12%) patients and opioids were used by 254 (15%) patients

2019 EvidenceUpdates

5. Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015

Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015 30471102 2019 01 07 1532-5415 67 1 2019 Jan Journal of the American Geriatrics Society J Am Geriatr Soc Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015. 128-132 10.1111/jgs.15659 To examine the effect of age on the likelihood of PIP of opioids and the effect of PIP on adverse outcomes. Retrospective cohort study. Data from multiple state agencies (...) in Massachusetts from 2011 to 2015. Adult Massachusetts residents (N=3,078,163) who received at least one prescription opioid during the study period; approximately half (1,589,365) aged 50 and older. We measured exposure to 5 types of PIP: high-dose opioids, coprescription with benzodiazepines, multiple opioid prescribers, multiple opioid pharmacies, and continuous opioid therapy without a pain diagnosis. We examined 3 adverse outcomes: nonfatal opioid overdose, fatal opioid overdose, and all-cause mortality

2019 EvidenceUpdates

6. Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. (PubMed)

Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. Importance: Harms and benefits of opioids for chronic noncancer pain remain unclear. Objective: To systematically review randomized clinical trials (RCTs) of opioids for chronic noncancer pain. Data Sources and Study Selection: The databases of CENTRAL, CINAHL, EMBASE, MEDLINE, AMED, and PsycINFO were searched from inception to April 2018 for RCTs of opioids for chronic noncancer pain vs any nonopioid control. Data (...) component score [SF-36 PCS]; higher is better and the MID is 5 points), and incidence of vomiting. Results: Ninety-six RCTs including 26 169 participants (61% female; median age, 58 years [interquartile range, 51-61 years]) were included. Of the included studies, there were 25 trials of neuropathic pain, 32 trials of nociceptive pain, 33 trials of central sensitization (pain present in the absence of tissue damage), and 6 trials of mixed types of pain. Compared with placebo, opioid use was associated

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2018 JAMA

7. Cost-Effectiveness of Buprenorphine-Naloxone Versus Extended-Release Naltrexone to Prevent Opioid Relapse. (PubMed)

Cost-Effectiveness of Buprenorphine-Naloxone Versus Extended-Release Naltrexone to Prevent Opioid Relapse. Background: Not enough evidence exists to compare buprenorphine-naloxone with extended-release naltrexone for treating opioid use disorder. Objective: To evaluate the cost-effectiveness of buprenorphine-naloxone versus extended-release naltrexone. Design: Cost-effectiveness analysis alongside a previously reported randomized clinical trial of 570 adults in 8 U.S. inpatient or residential (...) treatment programs. Data Sources: Study instruments. Target Population: Adults with opioid use disorder. Time Horizon: 24-week intervention with an additional 12 weeks of observation. Perspective: Health care sector and societal. Interventions: Buprenorphine-naloxone and extended-release naltrexone. Outcome Measures: Incremental costs combined with incremental quality-adjusted life-years (QALYs) and incremental time abstinent from opioids. Results of Base-Case Analysis: Use of the health care sector

2018 Annals of Internal Medicine

8. Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery. (PubMed)

Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery. BACKGROUND: Postoperative pain is a common consequence of surgery and can have deleterious effects. It has been suggested that the administration of opioid analgesia before a painful stimulus may improve pain control. This can be done in two ways. We defined 'preventive opioids' as opioids administered before incision and continued postoperatively, and 'pre-emptive opioids' as opioids given (...) before incision but not continued postoperatively. Both pre-emptive and preventive analgesia involve the initiation of an analgesic agent prior to surgical incision with the aim of reducing intraoperative nociception and therefore postoperative pain. OBJECTIVES: To assess the efficacy of preventive and pre-emptive opioids for reducing postoperative pain in adults undergoing all types of surgery. SEARCH METHODS: We searched the following electronic databases: CENTRAL, MEDLINE, Embase, AMED, and CINAHL

2018 Cochrane

9. Location, Location, Location: Treating patients with opioid use disorder in primary care

Location, Location, Location: Treating patients with opioid use disorder in primary care Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary (...) care research. www.acfp.ca October 9, 2018 Location, Location, Location: Treating patients with opioid use disorder in primary care Clinical Question: How well is opioid agonist therapy managed in primary care? Bottom Line: For opioid-dependent patients, receiving opioid agonist therapy (OAT) in a primary care setting versus a specialized opioid treatment program results in an additional 1 in 6 patients retained in treatment and abstinent from street opioids at 42 weeks. Additionally, twice as many patients

2018 Tools for Practice

10. Buprenorphine-Naloxone (Suboxone) for Pharmaceutical Opioid Use Disorder

Buprenorphine-Naloxone (Suboxone) for Pharmaceutical Opioid Use Disorder Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca November 5, 2018 Buprenorphine-Naloxone (Suboxone ? ) for Pharmaceutical Opioid Use Disorder Clinical Question: Is buprenorphine (with or without naloxone) effective as maintenance therapy in pharmaceutical opioid use disorder? Bottom Line: Retention in treatment at 15 weeks was seen in 75% taking buprenorphine compared to 26% in detoxification and/or counselling, with 37% reporting ongoing substance use compared to 60% in control. Outcomes between buprenorphine and methadone

2018 Tools for Practice

11. Does this patient taking prescription opioids have opioid use disorder?

Does this patient taking prescription opioids have opioid use disorder? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca October 22, 2018 Does this patient taking prescription opioids have opioid use disorder? Clinical Question: What is the best tool to help identify patients with prescription opioid use disorder? Bottom Line: Despite over 50 studies in the literature, only two have compared case-finding tools to the Diagnostic and Screening Manual for Mental Disorders (DSM), the most commonly used diagnostic criteria for patients with opioid use disorder (OUD). A single, small study demonstrates

2018 Tools for Practice

12. Nerve-ous About Opioids? Treatment of neuropathic pain with opioids

Nerve-ous About Opioids? Treatment of neuropathic pain with opioids Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca (...) June 18, 2018 Nerve-ous About Opioids? Treatment of neuropathic pain with opioids Clinical Question: What are the risks and benefits of opioids for neuropathic pain? Bottom Line: Compared to placebo, high-dose opioids moderately (at least 30%) reduce pain for an additional 1 in every 5-8 people over 4-12 weeks. Opioid-related adverse events lead to discontinuation for 1 in every 11-12 people over placebo. Other medications (like tricyclic antidepressants, gabapentin/pregabalin, and duloxetine

2018 Tools for Practice

13. Opioid overdose: an antidote to be administered promptly

Opioid overdose: an antidote to be administered promptly Prescrire IN ENGLISH - Spotlight ''Opioid overdose: an antidote to be administered promptly'', 1 December 2018 {1} {1} {1} | | > > > Opioid overdose: an antidote to be administered promptly Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Opioid overdose: an antidote to be administered (...) promptly Naloxone nasal spray (Nalscue°) is easy to use, and can save the lives of people who have overdosed on opioids. Opioid overdoses are sometimes fatal due to respiratory and then cardiac arrest. Overdoses can occur with all opioids, whether illicit or prescribed: heroin, morphine, oxycodone, methadone, codeine, tramadol, etc. Naloxone, an opioid antidote, is effective in reducing mortality from opioid overdose, provided it is administered promptly. Often, opioid overdoses occur in the presence

2018 Prescrire

14. A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder

A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder 30336703 2018 10 19 1535-7228 2018 Oct 19 The American journal of psychiatry Am J Psychiatry A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder. appiajp201817070732 10.1176/appi.ajp.2018.17070732 The oral (...) formulation of the opioid antagonist naltrexone has shown limited effectiveness for treatment of opioid use disorder due to poor adherence. Long-acting injection naltrexone (XR-naltrexone), administered monthly, circumvents the need for daily pill taking, potentially improving adherence, and has been shown to be superior to placebo in reducing opioid use over 6 months of treatment. This open-label trial compared the outcomes of patients with opioid use disorder treated with XR-naltrexone or oral

2018 EvidenceUpdates

15. Opioid-Sparing Analgesia and Enhanced Recovery After Total Knee Arthroplasty Using Combined Triple Nerve Blocks With Local Infiltration Analgesia

Opioid-Sparing Analgesia and Enhanced Recovery After Total Knee Arthroplasty Using Combined Triple Nerve Blocks With Local Infiltration Analgesia 30401559 2018 11 07 1532-8406 2018 Oct 13 The Journal of arthroplasty J Arthroplasty Opioid-Sparing Analgesia and Enhanced Recovery After Total Knee Arthroplasty Using Combined Triple Nerve Blocks With Local Infiltration Analgesia. S0883-5403(18)30897-0 10.1016/j.arth.2018.10.009 Peripheral nerve block and local infiltration analgesia (LIA) have (...) an increasing role as part of multimodal analgesia for enhanced recovery after total knee arthroplasty (TKA). We hypothesized that the combination of obturator nerve block (ONB) and tibial nerve block (TNB) would reduce pain and opioid consumption more than ONB or TNB alone when combined with continuous adductor canal block and LIA. Ninety patients were recruited into the study and received spinal anesthesia, LIA, and continuous adductor canal block. They were further randomized to receive either an ONB

2018 EvidenceUpdates

16. Should Buprenorphine Be Administered to Patients With Opioid Withdrawal in the Emergency Department?

Should Buprenorphine Be Administered to Patients With Opioid Withdrawal in the Emergency Department? Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Copyright © 2018 Inc. All rights reserved. | | | | | | The content on this site is intended for health professionals. We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the . Advertisements on this site do not constitute

2018 Annals of Emergency Medicine Systematic Review Snapshots

17. The Next Stage of Buprenorphine Care for Opioid Use Disorder. (PubMed)

The Next Stage of Buprenorphine Care for Opioid Use Disorder. Buprenorphine has been used internationally for the treatment of opioid use disorder (OUD) since the 1990s and has been available in the United States for more than a decade. Initial practice recommendations were intentionally conservative, were based on expert opinion, and were influenced by methadone regulations. Since 2003, the American crisis of OUD has dramatically worsened, and much related empirical research has been

2018 Annals of Internal Medicine

18. Naloxone for opioid-exposed newborn infants. (PubMed)

Naloxone for opioid-exposed newborn infants. BACKGROUND: Naloxone, a specific opioid antagonist, is available for the treatment of newborn infants with cardiorespiratory or neurological depression that may be due to intrauterine exposure to opioid. It is unclear whether newborn infants may benefit from this therapy and whether naloxone has any harmful effects. OBJECTIVES: To determine the effect of naloxone on the need for and duration of neonatal unit stay in infants of mothers who received (...) opioid analgesia prior to delivery or of mothers who have used a prescribed or non-prescribed opioid during pregnancy. SEARCH METHODS: We searched the following databases in February 2018: the Cochrane Central Register of Controlled Trials (the Cochrane Library 2018, Issue 1), MEDLINE (OvidSP), MEDLINE In process & Other Non-Indexed Citations (OvidSP), Embase (OvidSP), CINAHL (EBSCO), Maternity and Infant Care (OvidSP), and PubMed. We searched for ongoing and completed trials in the WHO

2018 Cochrane

19. Receipt of Overlapping Opioid and Benzodiazepine Prescriptions Among Veterans Dually Enrolled in Medicare Part D and the Department of Veterans Affairs: A Cross-sectional Study. (PubMed)

Receipt of Overlapping Opioid and Benzodiazepine Prescriptions Among Veterans Dually Enrolled in Medicare Part D and the Department of Veterans Affairs: A Cross-sectional Study. Background: Overlapping use of opioids and benzodiazepines is associated with increased risk for overdose. Veterans receiving medications concurrently from the U.S. Department of Veterans Affairs (VA) and Medicare may be at higher risk for such overlap. Objective: To assess the association between dual use of VA (...) and Medicare drug benefits and receipt of overlapping opioid and benzodiazepine prescriptions. Design: Cross-sectional. Setting: VA and Medicare. Participants: All veterans enrolled in VA and Medicare Part D who filled at least 2 opioid prescriptions in 2013 (n = 368 891). Measurements: Outcomes were the proportion of patients with a Pharmacy Quality Alliance (PQA) measure of opioid-benzodiazepine overlap (≥2 filled prescriptions for benzodiazepines with ≥30 days of overlap with opioids) and the proportion

2018 Annals of Internal Medicine

20. Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime

Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime 30068260 2018 10 05 1535-7228 175 10 2018 Oct 01 The American journal of psychiatry Am J Psychiatry Medications for Alcohol and Opioid Use Disorders and Risk of Suicidal Behavior, Accidental Overdoses, and Crime. 970-978 10.1176/appi.ajp.2018.17101112 The authors examined associations between medications for alcohol and opioid use disorders (acamprosate, naltrexone, methadone (...) ., violent, nonviolent, and substance-related) as well as reduction in accidental overdoses (hazard ratio=0.75, 95% CI=0.60, 0.93). For methadone, there were significant reductions in the rate of suicidal behaviors (hazard ratio=0.60, 95% CI=0.40-0.88) as well as reductions in all crime categories. However, there was an increased risk for accidental overdoses among individuals taking methadone (hazard ratio=1.25, 95% CI=1.13, 1.38). Medications currently used to treat alcohol and opioid use disorders

2018 EvidenceUpdates