Articles: opioid.
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Drug Alcohol Depend · Jan 2014
Discrepancies in prevalence estimates in two national surveys for nonmedical use of a specific opioid product versus any prescription pain reliever.
There is a growing need to understand trends in nonmedical use of prescription pain relievers as a class, as well as specific opioid products. Surveys such as monitoring the future (MTF) and the National Survey on Drug Use and Health (NSDUH) are important tools for understanding trends in abuse of prescription and illegal drugs. This report compares discrepancies in prevalence between these surveys for a specific opioid product (oxycodone) relative to other drugs. ⋯ The discrepancy between surveys in prevalence estimates for nonmedical use of oxycodone exceed those for other drugs, pointing to the importance of visual aids and items used to measure the nonmedical use of specific products.
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Journal of pain research · Jan 2014
ReviewDosing considerations with transdermal formulations of fentanyl and buprenorphine for the treatment of cancer pain.
Opioids continue to be first-line pharmacotherapy for patients suffering from cancer pain. Unfortunately, subtherapeutic dosage prescribing of pain medications remains common, and many cancer patients continue to suffer and experience diminished quality of life. A large variety of therapeutic options are available for cancer pain patients. ⋯ Based on the limited data available, there is significant interpatient variability with transdermal buprenorphine and equipotency recommendations from oral morphine of 75:1-110:1 have been suggested. Cancer patients may require larger transdermal buprenorphine doses to control their pain and may respond better to a more aggressive 75-100:1 potency ratio. This review outlines the prescribing of transdermal fentanyl and transdermal buprenorphine including how to safely and effectively convert to and use them for those with cancer pain.
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Journal of pain research · Jan 2014
A long-term, open-label safety study of single-entity hydrocodone bitartrate extended release for the treatment of moderate to severe chronic pain.
To evaluate the long-term safety, tolerability, and effectiveness of single-entity extended-release hydrocodone in opioid-experienced subjects with moderate to severe chronic pain not receiving adequate pain relief or experiencing intolerable side effects from their current opioid. ⋯ This single-entity, extended-release formulation of hydrocodone was generally safe, well tolerated, and effective in reducing chronic pain for 48 weeks. This formulation provides a new option for patients experiencing chronic pain, especially those who are taking immediate-release hydrocodone and have concerns about liver toxicity due to acetaminophen.
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Practice Guideline
Recognition and management of iatrogenically induced opioid dependence and withdrawal in children.
Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. ⋯ Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.
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Two different patterns of breathlessness have been identified: chronic or continuous breathlessness and breathlessness crisis (acute, incident, episodic, breakthrough breathlessness). Meta-analysis and systematic reviews prove that opioids are beneficial in either opioid-naïve or -tolerant patients. However, data from two recent randomised controlled trials were not able to show the effectiveness of fentanyl for the relief of exertion-induced dyspnoea.