Articles: opioid.
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Drug Alcohol Depend · Nov 2015
Comparative StudyPrescription monitoring programs and emergency department visits involving opioids, 2004-2011.
To determine the association between prescription drug monitoring program (PDMP) implementation and emergency department (ED) visits involving opioid analgesics. ⋯ During 2004-2011, PDMP implementation was not associated with a change in opioid-related morbidity, as measured by emergency department visits involving opioid analgesics. Urgent investigation is needed to determine the optimal PDMP structure and capabilities to improve opioid analgesic safety.
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Preventive medicine · Nov 2015
HIV prevention and treatment strategies can help address the overdose crisis.
Since the 1990s, effective HIV prevention and treatment strategies have been coordinated and implemented in the United States, resulting in substantial reductions in HIV-related death and HIV transmission among people who use injection drugs. During the same period, despite substantial long-term funding of War on Drugs policies, opioid addiction, driven by increased prescription opioid use and heroin accessibility, has made overdose the leading cause of accidental injury death in the United States. This commentary describes how the prevention and treatment successes among people who use drugs in the HIV/AIDS epidemic can be applied to address the opioid overdose crisis.
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Interactions between exogenous and endogenous opioids are not commonly investigated as a basis for sexually dimorphic opioid analgesia. We investigated the influence of spinal endomorphin 2 (EM2), an endogenous mu-opioid receptor (MOR) ligand, on the spinal antinociception produced by intrathecally administered opioids. Activation of spinal MORs facilitated spinal EM2 release. This effect was sexually dimorphic, occurring in males but not in females. Although activational effects of testosterone were required for opioid facilitation of spinal EM2 release in males, the absence of this facilitation in females did not result from either insufficient levels of testosterone or mitigating effects of estrogens. Strikingly, in males, the contribution of spinal EM2 to the analgesia produced by intrathecally applied MOR agonists depended on their analgesic efficacy relative to that of EM2. Spinal EM2 released by the higher efficacy MOR agonist sufentanil diminished sufentanil's analgesic effect, whereas EM2 released by the lower efficacy morphine had the opposite effect on spinal morphine antinociception. Understanding antithetical contributions of endogenous EM2 to intrathecal opioid antinociception not only enlightens the selection of opioid medications for pain management but also helps to explain variable sex dependence of the antinociception produced by different opioids, facilitating the acceptance of sexually dimorphic antinociception as a basic tenet. ⋯ The male-specific MOR-coupled enhancement of spinal EM2 release implies a parallel ability to harness endogenous EM2 antinociception. The inferred diminished ability of females to utilize the spinal EM2 antinociceptive system could contribute to their greater frequency and severity of chronic pain syndromes.
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J Subst Abuse Treat · Nov 2015
The characteristics of a cohort who tamper with prescribed and diverted opioid medications.
To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®. ⋯ Findings highlight the heterogeneity in the patterns and clinical correlates of opioid use among people who tamper with pharmaceutical opioids. Targeted health interventions are essential to reduce the associated harms.
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J Subst Abuse Treat · Nov 2015
Variations in Cannabis Use Level and Correlates in Opiate-Users on Methadone Maintenance Treatment: A French Prospective Study.
Concurrent cannabis use is very frequent among opioid users on methadone maintenance treatment (MMT), which could reflect a coping strategy during MMT. The aims of this study were to describe variations in cannabis use and to explore whether MMT could modify the patterns of cannabis use correlates. ⋯ Cannabis use during MMT more likely reflects pre-existing common liability to substance use or self-medication practices towards health problems than a behavior aimed at managing problems with MMT. With recent research suggesting an interaction between cannabinoid and opioid systems, the benefit of cannabis-based pharmacotherapies during MMT should be further explored in addiction research.