Articles: opioid.
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Preventive medicine · Jun 2018
Public support for safe consumption sites and syringe services programs to combat the opioid epidemic.
We examine Americans' support for two evidence-based harm reduction strategies - safe consumption sites and syringe exchange programs - and their attitudes about individuals who use opioids. We conducted a web-based survey of a nationally representative sample of U. S. adults in July-August 2017 (N = 1004). ⋯ Democrats and Independents were more likely than Republicans to support both strategies. Stigmatizing attitudes toward people who use opioids are a key modifiable barrier to garnering the public support needed to fully implement evidence-based harm reduction strategies to combat the opioid epidemic. Dissemination and evaluation of stigma reduction campaigns are a public health priority.
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We investigated whether written guidelines for surgeons and educational handouts for patients regarding safe and effective opioid use after hand surgery could reduce prescription sizes while achieving high patient satisfaction and a low refill rate. ⋯ Therapeutic II.
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J Pharm Health Serv Res · Jun 2018
Opioids in Georgia Medicaid: Gender and Insurance Disparities in Utilization and Potential Inappropriate Prescribing Practices.
Medicaid populations have been disproportionately affected by the opioid epidemic. In Georgia, opioid deaths have increased at more than twice the rate of the nation at large. It is unknown if certain populations within the Medicaid unduly receive opioid prescriptions or experience inappropriate prescribing of opioids. Thus, this study examines gender and insurance disparities in the use of opioids and the prevalence of indicators for potential inappropriate prescribing of opioids in the Georgia Medicaid population. ⋯ Results indicate statistically significant disparities among male/female patients and FFS/MC patients in the general use of opioids and in potential inappropriate prescribing of opioids. Policies aimed at curbing potential inappropriate prescribing of opioids, especially among male and FFS enrollees are needed to reduce prescription drug abuse within this population.
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To evaluate the effectiveness of opioids and/or pregabalin on patient-reported outcomes among fibromyalgia (FM) patients based on levels of improvement. ⋯ Pregabalin without opioids provided the most favorable outcomes overall based on ≥ 30% and ≥ 50% improvement thresholds and AUC, with support for moderate MED opioids + pregabalin in patients suffering from fatigue. While most patients took less than recommended pregabalin doses, higher doses may lead to improved outcomes.
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Anesthesia and analgesia · Jun 2018
Randomized Controlled Trial Comparative StudyAdductor Canal Block With Continuous Infusion Versus Intermittent Boluses and Morphine Consumption: A Randomized, Blinded, Controlled Clinical Trial.
Based on the assumption that relatively large volumes of local anesthetic optimize an adductor canal block (ACB), we theorized that an ACB administered as repeated boluses would improve analgesia without compromising mobility, compared with a continuous infusion. ⋯ Changing the mode of administration for an ACB from continuous infusion to repeated intermittent boluses did not decrease opioid consumption, pain, nor mobility.