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Prescription Opioid

Wei-Hsuan Lo-Ciganic, James L Huang, Hao H Zhang, Jeremy C Weiss, Yonghui Wu, C Kent Kwoh, Julie M Donohue, Gerald Cochran, Adam J Gordon, Daniel C Malone, Courtney C Kuza, Walid F Gellad
Importance: Current approaches to identifying individuals at high risk for opioid overdose target many patients who are not truly at high risk. Objective: To develop and validate a machine-learning algorithm to predict opioid overdose risk among Medicare beneficiaries with at least 1 opioid prescription. Design, Setting, and Participants: A prognostic study was conducted between September 1, 2017, and December 31, 2018. Participants (n = 560 057) included fee-for-service Medicare beneficiaries without cancer who filled 1 or more opioid prescriptions from January 1, 2011, to December 31, 2015...
March 1, 2019: JAMA Network Open
Sean J Haley, Andrew R Maroko, Katarzyna Wyka, Margaret Ryerson Baker
BACKGROUND: Increases in pharmaceutical opioid sales have paralleled the quadrupling of prescription opioid overdose deaths and spikes in emergency department visits for non-medical opioid prescription overdoses. In response, federal and state governments have advanced a myriad of policies to reduce opioid availability and increase treatment access, aimed to ultimately reduce opioid-related mortality. Despite these efforts, including ACA Medicaid expansion and more robust prescription drug monitoring programs, opioid-related mortality has continued to rise in NY and 29 other states...
May 2019: Journal of Substance Abuse Treatment
Camille Dufort-Rouleau, Benjamin Martin, Vincent Barré, Véronique Bédard, Émilie Dufort Rouleau, Marie-France Beauchesne, Julie Quenneville, Mathieu Berteau
BACKGROUND: Respiratory distress protocols (RDPs) are protocolized prescriptions comprised of 3 medications (a benzodiazepine, an opioid, and an anticholinergic) administered simultaneously as an emergency treatment for respiratory distress in palliative care patients in the province of Quebec, Canada. However, data on appropriate use that justifies the combination of all 3 components is scarce and based on individual pharmacodynamic properties along with expert consensus. OBJECTIVES: Our study aimed to evaluate the conformity and the effectiveness of RDPs prescribed and administered to hospitalized adult patients...
March 22, 2019: Journal of Palliative Care
Michael L Kent, Robert W Hurley, Gary M Oderda, Debra B Gordon, Eric Sun, Monty Mythen, Timothy E Miller, Andrew D Shaw, Tong J Gan, Julie K M Thacker, Matthew D McEvoy
Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to measure the incidence of and risk factors for persistent postoperative opioid use. The objective of this systematic review is to (1) determine a clinically relevant definition of persistent postoperative opioid use, and (2) characterize its incidence and risk factors for several common surgeries...
March 14, 2019: Anesthesia and Analgesia
Stephanie Parent, Seonaid Nolan, Nadia Fairbairn, Monica Ye, Anthony Wu, Julio Montaner, Rolando Barrios, Lianping Ti
BACKGROUND: Co-prescribing benzodiazepines and opioids is relatively contraindicated due to the possible overdose risk. However, people living with HIV (PLWH) may have concurrent psychiatric and/or chronic pain diagnoses that may lead to the use of opioids and/or benzodiazepines for symptomatic treatment. Consequently, some PLWH may be at-risk for the health harms associated with the co-prescribing of these medications. Given this, the objectives of this study were to first examine the prevalence of opioids and benzodiazepines co-prescribing, and second, to characterize patient factors associated with the co-prescribing of opioids and benzodiazepines among PLWH in British Columbia (BC), Canada...
March 18, 2019: International Journal on Drug Policy
Tatiane da Silva Dal Pizzol, Andréia Turmina Fontanella, Maria Beatriz Cardoso Ferreira, Andréa Dâmaso Bertoldi, Rogerio Boff Borges, Sotero Serrate Mengue
PURPOSE: To estimate the prevalence of use of analgesics in Brazil; and to characterize this use, according to sociodemographic and health-related characteristics. METHODS: A cross-sectional population-based study (National Survey on Access, Use and Promotion of Rational Use of Medicines, PNAUM) was conducted between September 2013 and February 2014. A total of 41,433 people of all ages in Brazilian urban households were interviewed. Occasional use (within the last 15 days) and continuous use of non-opioid analgesics, opioid analgesics and non-steroidal anti-inflammatory drugs were investigated, regardless of whether this use occurred through prescription or self-medication...
2019: PloS One
Maribeth C Lovegrove, Deborah Dowell, Andrew I Geller, Sandra K Goring, Kathleen O Rose, Nina J Weidle, Daniel S Budnitz
OBJECTIVES: To estimate the number of US emergency department visits for prescription opioid harms by patient characteristics, intent, clinical manifestations, and active ingredient. METHODS: We used data from medical record-based surveillance from a nationally representative 60-hospital sample. RESULTS: Based on 7769 cases, there were 267 020 estimated emergency department visits annually (95% confidence interval [CI] = 209 833, 324 206) for prescription opioid harms from 2016 to 2017...
March 21, 2019: American Journal of Public Health
Andrew H Rogers, Brooke Y Kauffman, Jafar Bakhshaie, R Kathryn McHugh, Joseph W Ditre, Michael J Zvolensky
BACKGROUND: The opioid epidemic is a significant public health crisis, and this problem is particularly prevalent among individuals with chronic pain. Accordingly, there is an urgent need for interventions to mitigate the risk for opioid misuse and opioid use disorder among people with pain. Given that mental health problems, specifically anxiety, are common among people who misuse opioids, it is important to examine factors that link mental health problems with opioid misuse to ultimately inform the development of novel interventions...
March 21, 2019: American Journal of Drug and Alcohol Abuse
Ali Haider, Yu Qian, Zhanni Lu, Syed Naqvi, Amy Zhuang, Akhila Reddy, Shalini Dalal, Joseph Arthur, Kimberson Tanco, Rony Dev, Janet Williams, Jimin Wu, Diane Liu, Eduardo Bruera
Importance: The recent parenteral opioid shortage (POS) has potential implications for cancer-related pain management in hospitalized patients. Objective: This study compared changes in opioid prescriptions and clinically improved pain (CIP) among patients treated by an inpatient palliative care (PC) team before and after our institution first reported the POS. Design, Setting, and Participants: A cohort study of 386 eligible patients with cancer treated at a comprehensive cancer center 1 month before and after the announcement of the POS...
March 21, 2019: JAMA Oncology
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April 2019: American Journal of Nursing
Jane Nikles, Subaat Khan, John Leou, Gerben Keijzers, Joanna Ng, Catherine Bond, Gota Nakamura, Rhonda Le, Michele Sterling
OBJECTIVE: To describe clinical presentation and management of neck soft tissue injury in an Australian ED. METHODS: This is a retrospective cohort study conducted in a tertiary hospital ED in Queensland, Australia. This study included all patients aged 18-65 years presenting with neck sprain/strain in 2016. Main outcome measures are patient demographics, comorbidities, presentation, acute management and follow up. RESULTS: Of 339 patients, 176 (52%) had cervical computed tomography (CT) scans and 3% plain radiographs...
March 20, 2019: Emergency Medicine Australasia: EMA
Amy M Yule, Rachael M Lyons, Timothy E Wilens
Purpose of review: To review information specific to adolescents regarding trends in opioid use, risk factors for opioid misuse, medical co-morbidity, and treatment updates. Recent findings: Although opioid misuse in adolescents is uncommon, it is associated with morbidity and mortality such as hepatitis C and overdose. Adolescents commonly start with prescription opioid misuse before transitioning to heroin use. The existing literature supports the use of buprenorphine/naloxone for the treatment of adolescent opioid use disorders...
June 2018: Current Pediatrics Reports
Aishwarya Vijay, Taeho Greg Rhee, Joseph S Ross
The United States is currently facing an epidemic of opioid-related deaths, increasingly associated with fentanyl use. Our objective was to characterize rates of fentanyl, general opioid and non-opioid pain medication prescription at a national level in both outpatient and emergency department settings. We used a retrospective cross-sectional research design using data from the 2006-2015 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys. Between 2006-2015, 66,987 (17...
March 17, 2019: Preventive Medicine
Katreena C Merrill, Valynn Christina Haslam, Karlen E Beth Luthy, Craig Nuttall
PURPOSE: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication. DESIGN: Mixed methods design with a chart review and structured phone interview. METHODS: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them...
March 17, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Katherine Gridley, Kirsten Strudwick, Edward Pink, Mark Nelson
OBJECTIVE: The scope of selected emergency physiotherapy practitioners (EPP) in this Australian non-tertiary ED has recently extended to include the prescription of a limited drug formulary, including paracetamol, some NSAIDs and opioids, an anti-emetic, a benzodiazepine and nitrous oxide. Although there are large-scale studies investigating prescription errors made by doctors, there is a lack of data on prescribing practices of physiotherapists in the ED setting. The aim of present study is to compare the prescribing practices of EPP to their medical and nursing colleagues within the setting of treating musculoskeletal injuries in the ED...
March 19, 2019: Emergency Medicine Australasia: EMA
Andrew J Holte, Christopher N Carender, Nicolas O Noiseux, Jesse E Otero, Timothy S Brown
BACKGROUND: Orthopedic surgeons may overprescribe opioids postoperatively. Literature examining opioid prescribing guidelines following total joint arthroplasty (TJA) is limited. METHODS: Retrospective review was conducted of primary TJAs from June 2017 to February 2018, with 3-month follow-up. Patients were divided into those who underwent surgery before (historical cohort) and after (restrictive cohort) implementation of a strict postoperative opioid prescribing protocol...
February 20, 2019: Journal of Arthroplasty
Teresa M Bell, Jodi Raymond, Ashley Vetor, Alejandro Mongalo, Zachary Adams, Thomas Rouse, Aaron Carroll
BACKGROUND: Injured adolescents have a 56% increased risk of developing a substance use disorder (SUD) within 3 years of their injury. The transition from medical prescription opioid use to nonmedical use in adolescent trauma patients has not been longitudinally studied long-term. The aim of this study is to describe 5-year patterns of opioid use in a cohort of injured adolescents as well as the proportion of patients experiencing overdose and SUD diagnoses. METHODS: Our retrospective cohort study consisted of 736 patients 12-18 years old who were admitted for trauma from 2011-2013...
March 15, 2019: Journal of Trauma and Acute Care Surgery
Karen MacKinnon, Bernie Pauly, Sana Shahram, Bruce Wallace, Karen Urbanoski, Carol Gordon, Rebecca Raworth, Marjorie MacDonald, Lenora Marcellus, Diane Sawchuck, Flora Pagan, Heather Strosher, Dakota Inglis, Celeste Macevicius, Nathan Strayed
The purpose of this scoping review is to systematically identify and describe literature that uses a health equity-oriented (HEO) approach for preventing and reducing the harms of stigma or overdose for people who use illicit drugs or misuse prescription opioids.The question of the review is: What is currently known about the use of a HEO approach for preventing the harms of stigma or overdose when people use illicit or street drugs, or use prescription opioids for other than their intended purposes?The review objectives include...
March 14, 2019: JBI Database of Systematic Reviews and Implementation Reports
Dan L Hunt, Ryan D Artuso, Nimisha Kalia, Nina Leung, Edward J Bernacki, Xuguang Grant Tao
BACKGROUND: Antidepressants, benzodiazapines and opioid medications are used to manage the pain, anxiety or depression associated with workplace injuries. OBJECTIVE: To evaluate the impact of these medications on workers' compensation costs and time lost from work. METHODS: A cohort of 22,383 indemnity claims from 2008-2013 were evaluated for the association of prescribed medications on claim cost and delayed claim closure controlling for confounders...
March 13, 2019: Journal of Occupational and Environmental Medicine
Bumsup Lee, Nipun Sodhi, Hiba K Anis, Joseph O Ehiorobo, Michael A Mont
INTRODUCTION: There has been a rapid increase in opioid-related morbidity and mortality worldwide, and the dangers of excessive opioid use have been observed in patients with chronic musculoskeletal pain, including those diagnosed with knee osteoarthritis. Pain management is an important component of nonoperative treatment in knee osteoarthritis and frequently entails the use of opioids. However, this management technique is not without risks, such as addiction, morbidity, and mortality...
March 19, 2019: Surgical Technology International
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