Articles: opioid.
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The Collaborative for REMS (Risk Evaluation and Mitigation Strategy) Education (CO*RE) includes 13 organizations that provide REMS Program Companies (RPC) grant-supported accredited education on extended-release and long-acting (ER/LA) opioid therapy. This report summarizes results of a survey designed to investigate the impact of participant criteria and to better understand the roles and preferences of continuing medical education/continuing education (CME/CE) participants. ⋯ The authors concluded the likelihood of underreporting is small, but there is an opportunity to clarify license and prescribing questions; opioid management responsibilities are distributed among nonprescribing team members who play roles in reducing adverse outcomes from both ER/LA and IR opioids, who would therefore benefit from REMS education; and clinicians favor a test-based learning tool, should future circumstances warrant it. These findings could have implications for planning future ER/LA opioid REMS curriculum and for setting and interpreting training goals for the US Food and Drug Administration's (FDA) ER/LA opioid REMS program.
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J Psychoactive Drugs · Apr 2017
Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014.
Opioid use disorders (OUDs) are receiving significant attention in the U. S. as a public health crisis. Access to treatment for OUDs is essential and was expected to improve following implementation of the federal parity law and the Affordable Care Act. ⋯ Results showed treatment for OUDs was covered by nearly all health plan products in each year of the survey, but the types and patterns varied by year. Prior authorization requirements for OTPs have decreased over time. Despite the promise of expanded access to OUD treatment suggested by parity and the ACA, improved health plan coverage for treatment of OUDs, while essential, is not sufficient to address the opioid crisis.
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Int. J. Drug Policy · Apr 2017
Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.
In 2014 Health Canada replaced the Marihuana for Medical Access Regulations (MMAR) with the Marihuana for Medical Purposes Regulations (MMPR). One of the primary changes in the new program has been to move from a single Licensed Producer (LP) of cannabis to multiple Licensed Producers. This is the first comprehensive survey of patients enrolled in the MMPR. ⋯ The finding that patients report its use as a substitute for prescription drugs supports prior research on medical cannabis users; however, this study is the first to specify the classes of prescription drugs for which cannabis it is used as a substitute, and to match this substitution to specific diagnostic categories. The findings that some authorized patients purchase cannabis from unregulated sources and that a significant percentage of patients were charged for medical cannabis recommendations highlight ongoing policy challenges for this federal program.
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Am Health Drug Benefits · Apr 2017
Comparing Healthcare Utilization and Costs Among Medicaid-Insured Patients with Chronic Noncancer Pain with and without Opioid-Induced Constipation: A Retrospective Analysis.
Constipation is a common adverse effect of opioid use and has been associated with increased healthcare utilization and costs among patients receiving opioids for pain management. ⋯ Among Medicaid enrollees who receive opioids for chronic noncancer pain, constipation is associated with increased all-cause healthcare utilization and costs.
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Androgen deficiency is common among men who use opioids daily for chronic pain. In previous studies, we found that long-acting opioids are associated with greater odds of androgen suppression than equipotent doses of short-acting opioids. Here we examined whether specific commonly prescribed opioids were associated with greater odds of androgen deficiency compared to hydrocodone. ⋯ Our results suggest that certain opioids are associated with increased odds of androgen deficiency compared with hydrocodone. Transdermal fentanyl, methadone and oxycodone were associated with higher odds of androgen deficiency than hydrocodone.