Articles: opioid.
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In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state. ⋯ This symposium is one of the first steps that a consortium of healthcare institutions, including AMS, will take to address the opioid crisis in Rhode Island. Feedback from the event was elicited to identify gaps in healthcare provider knowledge and will be used to design and implement further interventions. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].
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Prescription opioid-associated abuse and overdose is a significant cause of morbidity and mortality in the United States. Opioid prescriptions generated from emergency departments (EDs) nationwide have increased dramatically over the past 20 years, and opioid-related overdose deaths have become an epidemic, according to the Centers for Disease Control and Prevention. ⋯ Implementation of an ED prescription opioid policy was associated with a significant reduction in total opioid prescriptions and in the number of pills per prescription.
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Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. ⋯ Findings demonstrate that some providers believe they lack knowledge of opioid overdose prevention techniques and hold concerns about OEND implementation. More training of medical providers outside substance use treatment settings is needed, with particular attention to concerns about harmful consequences resulting from the receipt of naloxone.
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J Anaesthesiol Clin Pharmacol · Apr 2017
The effect of esmolol compared to opioids on postoperative nausea and vomiting, postanesthesia care unit discharge time, and analgesia in noncardiac surgery: A meta-analysis.
Perioperative esmolol as an opioid alternative has been shown to reduce postoperative nausea vomiting using opioid sparing. The aim of this meta-analysis was to compare esmolol and opioids on postoperative nausea and vomiting (PONV), time spent in recovery, and analgesia in noncardiac surgeries. ⋯ Compared with opioids, perioperative esmolol may reduce the incidence of postoperative nausea vomiting and increase the volatile anesthetic requirement. Esmolol administration may not improve the early postoperaive pain intensity. Nonetheless, these findings are limited by the absence of high-quality RCTs and the heterogeneity among studies. Further, large-scale studies are needed to explore these results.