Journal of opioid management
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Randomized Controlled Trial Comparative Study
Comparison of efficacy between buprenorphine and tramadol in the detoxification of opioid (heroin)-dependent subjects.
Tramadol is a synthetic opiate and a centrally acting weak m-opioid receptor agonist. The potential advantages of tramadol include ease of administration, low abuse potential, and being nonscheduled. This study compared tramadol and buprenorphine for controlling withdrawal symptoms in patients with opioid dependence syndrome. ⋯ Tramadol was found to have limited detoxification efficacy in moderate to severe opioid withdrawal and substantial risk of seizures as compared to buprenorphine. Further studies are warranted to examine its efficacy in mild opioid withdrawal symptoms and its potential use in outpatient settings where its administration advantages may be valuable.
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To evaluate a composite measure for chronic pain that balances pain relief with tolerability. ⋯ Tapentadol ER was associated with significantly better composite outcomes than oxycodone CR. Because both pain relief and gastrointestinal tolerability appeared to be related to outcomes, the composite measure may represent a useful tool for comparing opioids that merits further evaluation.
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Hydrocodone/acetaminophen is not only the most commonly prescribed opioid in the United States but also the most common prescription medication written in America. Although original and early trials confirmed its ability to manage acute pain from surgery and musculoskeletal injury, it is perhaps more widely used today in the management of chronic pain. However, the opioid product was introduced for the management of moderate to moderately severe pain. ⋯ This review summarizes the current knowledge of the pharmacokinetics, pharmacodynamics, and metabolism of hydrocodone. Recent information regarding the possibility of hydrocodone as a prodrug for hydromorphone is discussed. The available clinical trials for the use of hydrocodone in the management of acute, chronic, and cancer pain are presented.
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Clinical Trial
Open-label study to evaluate the efficacy and safety of extended-release hydromorphone in patients with chronic neuropathic pain.
To assess the efficacy and safety of once-daily hydromorphone extended-release tablets (OROS [Alza Corporation, Mountain View, CA] hydromorphone ER) in patients with chronic neuropathic pain. ⋯ Patients with chronic neuropathic pain were safely and effectively converted to and maintained on OROS hydromorphone ER.
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To determine what, if any, public health and societal impacts are associated specifically with injection of prescription opioids. ⋯ This study demonstrates an approach to measure the potential impact of injecting prescription opioids on public health indicators. Findings indicate a positive association between injection of prescription opioids and public health indicators suggesting a need for prescription opioid formulations that may inhibit injection of these medications.