Latest & greatest articles for opioid

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on opioid or other clinical topics then use Trip today.

This page lists the very latest high quality evidence on opioid and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

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

NIHR Dissemination Centre2018

2. Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis.

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

JAMA2018

3. Cost-Effectiveness of Buprenorphine-Naloxone Versus Extended-Release Naltrexone to Prevent Opioid Relapse.

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

Annals of Internal Medicine2018

4. Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery.

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

Cochrane2018

5. 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

Prescrire2018

6. 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

EvidenceUpdates2018

7. 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

Tools for Practice2018

8. 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

Tools for Practice2018

9. 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

Tools for Practice2018

10. 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

Tools for Practice2018

11. 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

EvidenceUpdates2018

12. 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

Annals of Emergency Medicine Systematic Review Snapshots2018

13. The Next Stage of Buprenorphine Care for Opioid Use Disorder.

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

Annals of Internal Medicine2018

14. Naloxone for opioid-exposed newborn infants.

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

Cochrane2018

15. 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.

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

Annals of Internal Medicine2018

16. Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children

Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children - GOV.UK GOV.UK uses cookies to make the site simpler. Search Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children Provide clear information to patients and caregivers about how (...) to minimise the risk of accidental exposure and the importance of appropriate disposal of patches. We continue to receive reports of unintentional opioid toxicity and overdose of fentanyl due to accidental exposure to patches. Published 11 October 2018 From: Therapeutic area: , , , Contents Advice for healthcare professionals: always fully inform patients and their caregivers about directions for safe use for fentanyl patches, including the importance of: not exceeding the prescribed dose following

MHRA Drug Safety Update2018

17. 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

EvidenceUpdates2018

18. 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

BMJ Best Practice2018

19. Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis

Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis 30221175 2018 11 14 2321-3868 6 2018 Burns & trauma Burns Trauma Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis. 25 10.1186/s41038-018-0128-x The USA is currently going through an opioid crisis, associated with tremendous economic and societal impacts. In response to this crisis, healthcare (...) professionals are looking for alternative pain management methods, and non-steroidal anti-inflammatory drugs (NSAIDs) are a sensible choice because of their effectiveness after surgical procedures. However, before surgeons start prescribing NSAIDs in place of opioids, it is crucial to first understand their potential post-surgical complications. The goal of this review is to summarize the data obtained through both animal and human studies, which suggest how a dramatic increase in NSAID use may affect

Burns & trauma2018 Full Text: Link to full Text with Trip Pro

20. Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder

Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder www.ccsa.ca • www.ccdus.ca Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder August 2018 Sheena Taha, PhD Knowledge Broker Best Practices across the Continuum of Care for the Treatment of Opioid Use Disorder This document was published by the Canadian Centre on Substance Use and Addiction (CCSA). Suggested citation: Taha, S. (2018). Best Practices across the Continuum of Care (...) for Treatment of Opioid Use Disorder. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. © Canadian Centre on Substance Use and Addiction, 2018. CCSA, 500–75 Albert Street Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: info@ccsa.ca Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. This document can be downloaded as a PDF at www.ccsa.ca. Ce document est également

Canadian Centre on Substance Abuse2018