Articles: opioid.
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Anaesth Intensive Care · Sep 2023
Supply of opioids and information provided to patients after surgery in an Australian hospital: A cross-sectional study.
Opioids are commonly prescribed to manage pain after surgery. However, excessive supply on discharge can increase patients' risk of persistent opioid use and contribute to the reservoir of unused opioids in the community that may be misused. This study aimed to evaluate the use of opioids in Australian surgical patients after discharge and patient satisfaction with the provision of opioid information after discharge. ⋯ However, the majority (51.5%; 34/66) did not recall receiving any information about the signs of opioid toxicity and interactions between opioids and alcohol. In conclusion, around 40% of patients had more than half of their opioid supply remaining after they ceased taking their opioid. Although most patients recalled receiving information about their opioids, more than half did not recall receiving any information about the signs of opioid toxicity or interactions between opioids and alcohol.
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J Pain Palliat Care Pharmacother · Sep 2023
Buprenorphine Inductions via Transdermal Patches for Opioid Use Disorder in the Inpatient Setting.
Buprenorphine inductions traditionally require an opioid-free period due to the risk of precipitated opioid withdrawal. Hospitalized patients with opioid use disorder and concurrent acute pain may be eligible for buprenorphine therapy. However, effective buprenorphine induction strategies in this patient population have not been well established. ⋯ All seven patients completed the induction and were discharged on sublingual buprenorphine. Low dose transdermal buprenorphine provides a reasonable strategy for hospitalized patients on full agonist opioid therapy or those who have failed conventional buprenorphine induction strategies. Reducing barriers such as opioid abstinence is key to combating opioid use disorder.
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J Pain Symptom Manage · Sep 2023
Opioid prescription denials by community pharmacies for cancer-related pain: A case series.
Pain is one of the most common symptoms experienced by patients living with cancer. Guidelines recommend opioids as the mainstay in the management of cancer-related pain. ⋯ Additionally, in the setting of the opioid epidemic, there have been reports of systemic bias within community pharmacies, leading to experiences with embarrassment and shame for patients with cancer-related pain. This case series presents specific examples of community pharmacies declining to fill opioid prescriptions for patients with cancer-related pain and associated patient suffering.
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Experts recommend using the lowest effective dose of naloxone to balance the reversal of opioid-induced respiratory depression and avoid precipitated opioid withdrawal, however, there is no established dosing standards within the emergency department (ED). ⋯ Lower doses of naloxone in the ED may help reduce related adverse events without increasing the need for additional doses. Future studies should evaluate the effectiveness of lower doses of naloxone to reverse opioid-induced respiratory depression without causing precipitated opioid withdrawal.
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Anesthesia and analgesia · Sep 2023
Caring for Our Patients With Opioid Use Disorder in the Perioperative Period: A Guide for the Anesthesiologist.
Opioid use disorder (OUD) is a rising public health crisis, impacting millions of individuals and families worldwide. Anesthesiologists can play a key role in improving morbidity and mortality around the time of surgery by informing perioperative teams and guiding evidence-based care and access to life-saving treatment for patients with active OUD or in recovery. ⋯ The article concludes with a stepwise approach for the anesthesiologist to support OUD treatment and recovery. The anesthesiologist is an important leader of the perioperative team to promote these suggested best practices and help save lives.