Articles: opioid.
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Drug Alcohol Depend · Jul 2021
Shorter outpatient wait-times for buprenorphine are associated with linkage to care post-hospital discharge.
Inpatient addiction consult services (ACS) lower barriers to accessing medications for opioid use disorder (MOUD), however not every patient recommended for MOUD links to outpatient care. We hypothesized that fewer days between discharge date and outpatient appointment date was associated with improved linkage to buprenorphine treatment among patients evaluated by an ACS. ⋯ For hospitalized patients with OUD evaluated for initiating MOUD, same- and next-day appointments are associated with increased odds of linkage to outpatient MOUD care post-discharge compared to waiting two or more days.
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The Z-drugs (zolpidem, zopiclone, zaleplon) are widely used to treat insomnia in patients receiving prescription opioids, and the risk of overdose resulting from this coprescription has not been explored. The authors compared the rates of overdose among patients using opioids plus Z-drugs and patients using opioids alone. ⋯ Among patients receiving prescription opioids, after controlling for all confounding factors, concomitant treatment with Z-drugs was associated with a substantial relative increase in the risk of overdose. The potential implications are significant given the large number of opioid-treated patients receiving Z-drugs.
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J. Thorac. Cardiovasc. Surg. · Jul 2021
Postoperative opioid use after lobectomy for primary lung cancer: A propensity-matched analysis of premier hospital data.
To evaluate opioid administration after robotic lobectomy (RL) compared with video-assisted thoracic surgery (VATS) and open lobectomy in patients with lung cancer. ⋯ Patients undergoing RL for primary lung cancer received opioids less frequently, and with lower total and average daily doses, compared with those undergoing VATS and open lobectomy. Studies are needed to determine whether early opioid dosage reductions translate into less chronic opioid use.
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In response to the opioid epidemic, many states have enacted policies limiting opioid prescriptions. There is a paucity of evidence of the impact of opioid prescribing interventions in primary care populations, including whether unintended consequences arise from limiting the availability of prescribed opioids. ⋯ Limiting prescription opioids did not change the opioid overdose rate among primary care patients, but it reduced the rate of opioid-related adverse effects in the year following the state-level policy change, particularly among patients with chronic opioid prescription history and opioid-naïve patients. Limiting the quantity and duration of opioid prescriptions may have beneficial effects among primary care patients.
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Cancer pain is highly prevalent and often managed in primary care or by oncology providers in combination with primary care providers. ⋯ Our findings highlight how real-time negotiation about roles in opioid pain management is needed between interdisciplinary clinicians. Lack of cross-disciplinary role agreement may result in delays in clinically appropriate cancer pain management.