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Medication assisted treatment for opioid

Carl A Latkin, Lauren Dayton, Melissa A Davey-Rothwell, Karin E Tobin
BACKGROUND: Fentanyl-related mortality has skyrocketed among people who use opioids (PWUO) in North America. The current study of PWUO aims to examine the perceived fentanyl risk and training needs; fatal overdose prevention behaviors; and, feasibility of a peer education approach to reducing fentanyl-related fatal overdoses in Baltimore, Maryland, USA. METHODS: 316 street-recruited PWUO were interviewed about fentanyl in Baltimore, MD. RESULTS: Most participants (56%) reported that "all" or "almost all" heroin in Baltimore was adulterated with fentanyl and were worried (75%) about their drug buddies overdosing on fentanyl...
February 15, 2019: Substance Use & Misuse
Christina E Rodriguez, Kaylin A Klie
Pharmacotherapy, or medication-assisted treatment (MAT), is a critical component of a comprehensive treatment plan for the pregnant woman with opioid use disorder (OUD). Methadone and buprenorphine are two types of opioid-agonist therapy which prevent withdrawal symptoms and control opioid cravings. Methadone is a long-acting mu-opioid receptor agonist that has been shown to increase retention in treatment programs and attendance at prenatal care while decreasing pregnancy complications. However methadone can only be administered by treatment facilities when used for OUD...
January 21, 2019: Seminars in Perinatology
Diana M Higgins, Kathryn M LaChappelle, Kristin L Serowik, Mary A Driscoll, Allison Lee, Alicia A Heapy
Objective: Cognitive behavioral therapy for chronic pain (CBT-CP) has been identified as an evidence-based adjunct or alternative to opioid pain care. However, little is known about which patients participate in CBT-CP. This study examined predictors of enrollment in a noninferiority trial of in-person vs technology-based CBT-CP for patients with chronic back pain. Setting: A single Veterans Health Affairs (VHA) medical center. Subjects: Veterans with chronic back pain...
September 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Pallavi Joshi, Nikita K Shah, Harshal D Kirane
No abstract text is available yet for this article.
December 27, 2018: American Journal of Geriatric Psychiatry
Mohammadali Nikoo, Ehsan Moazen-Zadeh, Nooshin Nikoo, Sanam Javidanbardan, Alireza Kazemi, Fiona Choi, Marc Vogel, Ali Gholami, Saeed Tavakoli, Reza Givaki, Majid Jazani, Fatemeh Mohammadian, Nader Markazi Moghaddam, Nasser Goudarzi, Christian Schutz, Kerry Jang, Shahin Akhondzadeh, Michael Krausz
OBJECTIVES: This is the first study to compare the safety and efficacy of opium tincture (OT) with methadone for treatment of opioid use disorder. METHODS: In this multicenter, double-blind, noninferiority controlled trial, a stratified sample of 204 participants with opioid use disorder were recruited from community outreach, drop-in centers, and triangular clinics. Participants were excluded in case of active participation in another treatment program for opioid use disorder, hypersensitivity to trial medications, pregnancy, and certain serious medical conditions...
February 4, 2019: International Journal of Methods in Psychiatric Research
Kirsten J Langdon, Kathrine Dove, Susan Ramsey
Opioid use disorder and anxiety disorders co-occur at strikingly high rates, and this comorbidity is marked by a more severe clinical presentation and poorer prognosis for treatment. Given the substantial morbidity and mortality associated with these two disorders, it is imperative to understand factors related to the high rates of co-occurrence in order to inform the development of specialized treatments for this population. Several lines of study suggest that simultaneously addressing opioid-related and anxiety-related symptoms and processes, particularly intolerance of distress and pain-related anxiety, may yield improved outcomes for this high risk, vulnerable population...
January 4, 2019: Current Opinion in Psychology
Jayson J Spas, Joanna Buscemi, Ravi Prasad, E Amy Janke, Claudio R Nigg
Opioid use has become an epidemic in the USA. Although there are safe uses for opioids to help manage acute pain, the effects of long-term use and any misuse of opioids can have grave outcomes, including death. To provide an empirically based "ask" for increased funding from the federal government to increase the reimbursement for and the integration of the behavioral component of Medication-Assisted-Treatment (MAT) for opioid use disorders, current policy was reviewed and important gaps in funding and treatment fidelity were identified...
January 25, 2019: Translational Behavioral Medicine
Joanne Csete
Expanding access to treatment of opioid use disorder (OUD) is central to addressing the US overdose mortality crisis. Numerous barriers to OUD treatment are encountered in criminal justice institutions and processes, with which people with OUD are disproportionately involved. OUD treatment access is severely limited in US corrections facilities, with few exceptions. Drug treatment courts, which in principle provide court-supervised treatment as an alternative to prison, have also unduly limited treatment options, particularly medication-assisted treatment...
January 24, 2019: American Journal of Public Health
Kelley W Collier, Lauren K MacAfee, Bronwyn M Kenny, Marjorie C Meyer
INTRODUCTION: Women with opioid use disorder have higher rates of unplanned pregnancies, shorter interpregnancy intervals and lower rates of contraceptive use compared to women without substance use disorders. This contributes to worse perinatal and reproductive health outcomes for this population. It has been suggested that co-location of medication assisted treatment (MAT) and reproductive health services could allow for improved outcomes among women with substance use disorders. The aim of this study was to determine if location where women received MAT influenced their pregnancy planning, interpregnancy interval or uptake of postpartum contraception between subsequent pregnancies...
March 2019: Journal of Substance Abuse Treatment
Apostolos A Alexandridis, Nabarun Dasgupta, Agnieszka D McCort, Christopher L Ringwalt, Wayne D Rosamond, Paul R Chelminski, Stephen W Marshall
BACKGROUND: Project Lazarus (PL) is a seven-strategy, community-coalition-based intervention designed to reduce opioid overdose and dependence. The seven strategies include: community education, provider education, hospital emergency department policy change, diversion control, support programs for patients with pain, naloxone policies, and addiction treatment expansion. PL was originally developed in Wilkes County, NC. It was made available to all counties in North Carolina starting in March 2013 with funding of up to $34,400 per county per year...
January 21, 2019: Injury Epidemiology
Matthew Chinman, Walid F Gellad, Sharon McCarthy, Adam J Gordon, Shari Rogal, Maria K Mor, Leslie R M Hausmann
BACKGROUND: Mitigating the risks of adverse outcomes from opioids is critical. Thus, the Veterans Affairs (VA) Healthcare System developed the Stratification Tool for Opioid Risk Management (STORM), a dashboard to assist clinicians with opioid risk evaluation and mitigation. Updated daily, STORM calculates a "risk score" of adverse outcomes (e.g., suicide-related events, overdoses, overdose death) from variables in the VA medical record for all patients with an opioid prescription and displays this information along with documentation of recommended risk mitigation strategies and non-opioid pain treatments...
January 18, 2019: Implementation Science: IS
Joseph Guydish, Deborah Yip, Thao Le, Noah R Gubner, Denise D Williams, Kevin L Delucchi
OBJECTIVE: Specialty addiction programs treat people who are addicted to alcohol, opioids, stimulants, and other drugs. This study identified the proportion of addiction program clients who received tobacco-related services and factors associated with receipt of such services. METHODS: In 2015 and 2016, clients (N=2,119) in 24 programs were surveyed for receipt of services aligning with three of the five As of tobacco cessation: ask, advise, assist. Multivariate analyses examined factors associated with receipt of each service...
January 11, 2019: Psychiatric Services: a Journal of the American Psychiatric Association
Rebecca B Naumann, Andrew W Roberts, Stephen W Marshall, Asheley C Skinner
BACKGROUND: "Lock-in" programs (LIPs) identify beneficiaries demonstrating potential overutilization of opioids, and other controlled substances, and restrict their access to these medications. LIPs are expanding to address the opioid crisis and could be an effective tool for connecting people to opioid use disorder treatment. We examined the immediate and sustained effects of a Medicaid LIP on overdose risk and use of medication-assisted treatment (MAT) for opioid use disorder...
January 8, 2019: Medical Care
Sarah A Pendergrass, Richard C Crist, Laney K Jones, Jason R Hoch, Wade H Berrettini
With the urgency to treat patients more effectively for opioid use disorder in the midst of the opioid epidemic, a key area for precision medicine is to improve individualized medication-assisted treatment for opioid use disorder. The expansion of medication-assisted treatment is a key to reducing illicit opioid use, preventing opioid overdose deaths, and reducing the comorbidities and societal impacts of opioid use disorder. The most common medication for opioid use disorder will soon be buprenorphine. Research to date shows the successful impact of buprenorphine treatment, including the pharmacogenomics of buprenorphine response and treatment efficacy...
January 7, 2019: Molecular Psychiatry
Mary Peeler, Kevin Fiscella, Mishka Terplan, Carolyn Sufrin
Pregnant women represent a unique population for correctional facilities to care for. The incarcerated pregnant population is at an increased risk of concurrent opioid use disorder (OUD) that requires specialized care. The evidence-based best practice and standard of care for pregnant women with OUD is medication-assisted treatment (MAT) with methadone or buprenorphine pharmacotherapy. Correctional facilities that house women must be prepared to provide this care in a timely manner upon intake in order to address the serious medical needs of the pregnant woman and her fetus...
January 7, 2019: Journal of Correctional Health Care
Louise Kaplan
No abstract text is available yet for this article.
December 24, 2018: Nurse Practitioner
Bayla Ostrach, Catherine Leiner
OBJECTIVES: The objectives of this article are to present findings from recent qualitative research with patients in a combined perinatal substance use treatment program in Central Appalachia, and to describe and analyze participants' ambivalence about medication-assisted treatment for opioid use disorder (OUD), in the context of widespread societal stigma and judgement. METHODS: We conducted research in a comprehensive outpatient perinatal substance use treatment program housed in a larger obstetric practice serving a large rural, Central Appalachian region...
December 17, 2018: Journal of Addiction Medicine
Peter J Davidson, Karla D Wagner, Paula L Tokar, Shoshanna Scholar
BACKGROUND: The Los Angeles County Jail system is the largest jail system in the United States, with an average daily inmate population of 17,024 in 2017. Existing literature shows the weeks following release from incarceration are associated with increased risk of overdose death among individuals who previously used opioids. One response is to train inmates in overdose prevention and response (OPR) and to provide the opioid antagonist naloxone on release. However, in large jail systems training all inmates can be logistically and financially difficult, leading to interest identifying individuals most likely to benefit from such programs...
December 12, 2018: Addictive Behaviors
Megan L Lawlor, Lori Shook, Kristen McQuerry, Aarthi Srinivasan, Quinetta B Johnson, Niraj R Chavan, Agatha S Critchfield
OBJECTIVE: To determine if a structured care-by-parent (CBP) protocol is associated with a reduction in diagnosis of treatment-requiring Neonatal Opioid Withdrawal Syndrome (NOWS). STUDY DESIGN: We performed a pilot retrospective, case control study of pregnant women enrolled in a comprehensive prenatal care program for opioid-dependent patients during which they received buprenorphine for Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD). Patients who participated in the care-by-parent (CBP) program actively roomed-in with their infants even after maternal hospital discharge while infants continued to be monitored for development of treatment-requiring Neonatal Opioid Withdrawal Syndrome (NOWS)...
December 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
Janice Blanchard, Audrey J Weiss, Marguerite L Barrett, Kimberly W McDermott, Kevin C Heslin
BACKGROUND: State policy approaches designed to provide opioid treatment options have received significant attention in addressing the opioid epidemic in the United States. In particular, expanded availability of naloxone to reverse overdose, Good Samaritan laws intended to protect individuals who attempt to provide or obtain emergency services for someone experiencing an opioid overdose, and expanded coverage of medication-assisted treatment (MAT) for individuals with opioid abuse or dependence may help curtail hospital readmissions from opioids...
December 17, 2018: BMC Health Services Research
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