Articles: opioid.
-
Palliative medicine · Jun 2021
Randomized Controlled TrialHealthcare professionals' views of the use of oral morphine and transmucosal diamorphine in the management of paediatric breakthrough pain and the feasibility of a randomised controlled trial: A focus group study (DIPPER).
Oral morphine is frequently used for breakthrough pain but the oral route is not always available and absorption is slow. Transmucosal diamorphine is administered by buccal, sublingual or intranasal routes, and rapidly absorbed. ⋯ There were perceived advantages to transmucosal diamorphine, but there is a need for access to a safe preparation. A clinical trial would be feasible provided barriers were overcome.
-
Expert Opin Pharmacother · Jun 2021
Can NSAIDs and Acetaminophen Effectively Replace Opioid Treatment Options for Acute Pain?
Opioid analgesia for acute painful conditions has come under increasing scrutiny with the public health crisis of opioid overdose, leading clinicians to seek nonopioid alternatives, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (paracetamol). ⋯ The short-term use of opioids under close clinical supervision, such as in-hospital use of opioid analgesics for postoperative pain, may be appropriate, but even here, combination therapy or nonopioid therapy may be preferred. The use of opioids even for acute pain of short duration has been questioned. The ideal analgesic has yet to be developed, but effective pain control pharmacological regimens for acute pain are available.
-
Addictive behaviors · Jun 2021
Tobacco use severity in relation to opioid misuse and dependence among adult tobacco users with chronic pain: The moderating role of pain-related anxiety.
The opioid epidemic is a significant public health crisis that is often linked to chronic pain management. One ensuing consequence of long-term opioid use for chronic pain is a high potential for opioid misuse and dependence. Although tobacco is commonly used among individuals with chronic pain, it is associated with an increased risk for opioid-related problems. ⋯ Two hierarchical linear regression analyses were conducted to test main and interactive effects of tobacco use severity and pain-related anxiety for current opioid misuse and severity of opioid dependence. Results indicated a significant moderation effect, such that the relationship between tobacco use severity and opioid misuse and dependence was stronger among individuals with higher (but not lower) pain-related anxiety. These findings build upon the extant literature by demonstrating an interactive effect of tobacco use severity and pain-related anxiety in terms of opioid-related outcomes and suggest that current tobacco users with elevated levels of pain-related anxiety may be at increased risk for opioid misuse and dependence.
-
Observational Study
Postoperative opioid administration characteristics associated with opioid-induced respiratory depression: Results from the PRODIGY trial.
Opioid administration for pain in general care floor patients remains common, and can lead to adverse outcomes, including respiratory compromise. The PRODIGY trial found that among ward patients receiving parenteral opioids, 46% experienced ≥1 respiratory depression episode. The objective of this analysis was to evaluate the geographic differences of opioid administration and examine the association between opioid administration characteristics and the occurrence of respiratory depression. ⋯ Despite varying opioid administration characteristics between Asia, Europe, and the United States, opioid-induced respiratory depression remains a common global problem on general care medical and surgical wards. While the use of post-procedure tramadol or post-procedure epidural opioids may reduce the incidence of respiratory depression, continuous monitoring is also necessary to ensure patient safety when receiving postoperative opioids. REGISTRATION NUMBER: www.clinicaltrials.gov, ID: NCT02811302.