Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Sep 2010
Emergency department visits involving nonmedical use of selected prescription drugs in the United States, 2004-2008.
This report, adapted from the lead article in the June 10, 2010, issue of Morbidity and Mortality Weekly Reports, describes the alarming increase in overdose deaths involving prescription drugs. Oxycodone, hydrocodone, and methadone were the drugs most highly implicated. Data were derived from the federal Drug Abuse Warning Network (Dawn). Other drugs commonly used in managing pain patients, including benzodiazepines and muscle relaxants, also were implicated.
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J Pain Palliat Care Pharmacother · Sep 2010
Meta AnalysisEfficacy of the sustained-release hydromorphone in neuropathic pain management: pooled analysis of three open-label studies.
This pooled analysis was designed to determine whether the analgesic response to treatment with OROS hydromorphone, as measured by the "pain on average" scale of the Brief Pain Inventory (BPI), was different in patients with neuropathic pain compared to those with nociceptive pain, after adjusting for differences in baseline characteristics. Three open-label studies on patients with neuropathic and nociceptive malignant and nonmalignant chronic pain were analyzed. A mixed model for repeated measures linear regression analysis was used to compare the effect of OROS hydromorphone on patients with neuropathic and nociceptive pain, adjusting for potentially confounding factors. ⋯ For some outcome variables, treatment was more effective for patients with neuropathic pain. The treatment was generally well tolerated. This pooled analysis shows that treatment with OROS hydromorphone had similar efficacy for neuropathic and nociceptive pain.
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J Pain Palliat Care Pharmacother · Sep 2010
Practice GuidelineUtah clinical guidelines on prescribing opioids for treatment of pain.
Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain were produced and made available to medical providers in March 2009. These guidelines were developed by a multidisciplinary consensus panel after a review of existing evidence-based guidelines. Common recommendations were compiled and presented to the panel for review. ⋯ A second panel reviewed existing tools for providers and determined the need for any new tools. The final guidelines include 20 tools for providers to use in their practice. The complete version of the guidelines and the accompanying tools are available at: www.useonlyasdirected.org or www.health.utah.gov/prescription.
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J Pain Palliat Care Pharmacother · Sep 2010
Comparative StudyCost and comorbidities associated with opioid abuse in managed care and Medicaid patients in the United Stated: a comparison of two recently published studies.
Opioid abuse places a large burden on the U. S. society. Two similarly designed studies recently identified the economic and health impact of opioid abuse in patients with private or Medicaid insurance. ⋯ Costs for nonabuser Medicaid beneficiaries were $7008 versus $1830 for those with private insurance, which likely reflects the lower health status of the overall Medicaid population. In both studies, the prevalence of comorbidities associated with substance abuse or chronic pain were significantly higher in abusers than nonabusers. These studies confirm that opioid abuse is associated with comorbidities that increase direct medical costs for patients with private insurance and for Medicaid beneficiaries, increasing the societal burden of opioid abuse.