Journal of opioid management最新文献

{"title":"Re: \"The NOPAIN Act: Implications for Opioid Use Reduction in Orthopedic Surgery\".","authors":"James Priano, Annelise Thomsen, Kevin Warner, Joseph Wagner, Daniel Stevens","doi":"10.5055/jom.1004","DOIUrl":"https://doi.org/10.5055/jom.1004","url":null,"abstract":"","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"343"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining physicians' behaviors regarding buprenorphine prescribing for opioid use disorder.","authors":"Khashayar Eshtiaghi, Poonam Bhatjire, Aryan Shokrollah Shirazi, Marc Fleming","doi":"10.5055/jom.0978","DOIUrl":"https://doi.org/10.5055/jom.0978","url":null,"abstract":"<p><strong>Background: </strong>The opioid overdose crisis affects approximately 2.1 million Americans with opioid use disorder (OUD). Buprenorphine is an effective treatment that reduces mortality and supports recovery, yet physician perceptions and behaviors influence its prescribing. Understanding these factors is crucial for expanding access. This study examines California physicians' prescribing behaviors regarding buprenorphine for OUD.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted via Qualtrics among California physicians. In total, we received 101 completed responses, representing various specialties and practice environments. Descriptive and inferential statistical methods, including independent t-tests, Wilcoxon signed-rank tests, and Kruskal-Wallis tests, were used to analyze the data and examine demographic differences in prescribing behaviors.</p><p><strong>Results: </strong>Most respondents indicated a low demand for buprenorphine treatment and disagreed with the adequacy of naloxone access in overdose situations. Many of the physicians did not view Drug Enforcement Administration (DEA) interference as a major concern and felt that stigma did not hinder their ability to treat OUD. Male physicians reported obtaining buprenorphine training to be more challenging than did their female counterparts. Physicians in suburban settings expressed greater concerns about DEA involvement than those in urban areas. Furthermore, physicians with a Drug Addiction Treatment Act-Waiver felt better supported and trained than those without one.</p><p><strong>Conclusion: </strong>This study sheds light on California physicians' views and behaviors regarding prescribing buprenorphine for OUD. The challenges related to required training for buprenorphine prescribing indicate an area that needs further research. Additionally, concerns about DEA regulations in suburban areas and limited access to naloxone in overdose situations highlight the need for targeted interventions.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"405-414"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medications for opioid use disorder receipt in intensive care patients with opioid use disorder-A statewide cohort study.","authors":"Aurora N Quaye, Leo K Westgard, Janelle M Richard, Alysse G Wurcel","doi":"10.5055/jom.1003","DOIUrl":"10.5055/jom.1003","url":null,"abstract":"<p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Seven intensive care units (ICUs) across the MaineHealth system.</p><p><strong>Patients: </strong>Adults with opioid use disorder (OUD) admitted to the ICU between November 2023 and June 2025.</p><p><strong>Intervention: </strong>None.</p><p><strong>Measures: </strong>Receipt of medications for OUD (M-OUD) assessed preadmission, during hospitalization (ICU and general ward), and at discharge, stratified by prior treatment status and hospital rurality.</p><p><strong>Results: </strong>Among 1,113 patients, 15.6 percent were on M-OUD preadmission. M-OUD exposure increased during ICU care, with no significant difference between urban and rural patients (44 percent vs 39 percent, p = 0.134). On the general ward, M-OUD exposure decreased: 29.8 percent of previously untreated patients received M-OUD, while 57.2 percent of those on preadmission M-OUD did not receive therapy (p < 0.001). At discharge, M-OUD prescribing was significantly lower in rural versus urban patients (8 percent vs 22 percent, p < 0.001).</p><p><strong>Conclusion: </strong>M-OUD remains underutilized across the ICU care continuum, with loss of treatment continuity at discharge for rural and urban patients.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"369-373"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buprenorphine microinductions: Investigating the ideal initial dose based on oral morphine equivalent requirements for stabilizing withdrawal symptoms.","authors":"Temple C Coldren, Jennifer L Costello, Kimberly A Guglielmo, Katlyn C Wood","doi":"10.5055/jom.1002","DOIUrl":"https://doi.org/10.5055/jom.1002","url":null,"abstract":"<p><strong>Objective: </strong>To determine if a relationship exists between oral morphine equivalent (OME) requirements to stabilize acute opioid withdrawal symptoms and the initial buprenorphine dose in patients who successfully complete a buprenorphine microinduction, defined as discharge on buprenorphine.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Single-center community teaching hospital in Lancaster, Pennsylvania.</p><p><strong>Patients and participants: </strong>Included adult patients admitted to Penn Medicine Lancaster General Hospital from February 1, 2022, to February 1, 2025, with opioid use disorder, who attempted a buprenorphine microinduction. A microinduction was defined as an initial sublingual buprenorphine dose less than 2 mg or a buccal dose less than 900 mcg. Patients were excluded if they were on buprenorphine prior to admission. Thirty patients met criteria for inclusion.</p><p><strong>Main outcome measure: </strong>To determine if the 24-hour OME received on the day of buprenorphine initiation (stabilizing OME) is predictive of the starting buprenorphine dose among patients who had a successful microinduction.</p><p><strong>Results: </strong>Of the 30 patients, 25 (83.3 percent) successfully completed a microinduction. Among these 25 patients, there was no statistically significant association found between the initial buprenorphine dose and either the stabilizing OME or the self-reported quantity of illicit opioid use. Similarly, microinduction length was not significantly associated with either variable.</p><p><strong>Conclusions: </strong>Findings support an individualized approach to buprenorphine microinductions, as no statistically significant associations were found between the initial buprenorphine dose and stabilizing OME requirements.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"361-367"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-titrating opioid agonists with buprenorphine for chronic pain in sickle cell disease.","authors":"Jason S Silver, Jared S Eng, Margaret Hsu","doi":"10.5055/jom.1006","DOIUrl":"10.5055/jom.1006","url":null,"abstract":"<p><p>Chronic opioid therapy for pain in sickle cell disease (SCD) carries risks of tolerance, hyperalgesia, and morbidity. Buprenorphine offers a safer alternative, yet optimal induction strategies for SCD patients dependent on full agonists remain unclear and traditionally require mild withdrawal prior to initiation. Three adult SCD patients transitioned from full opioid agonists (morphine equivalent daily dose 90-410 mg) to buprenorphine using a cross-titration strategy stratified by baseline opioid use to avoid withdrawal and maintain analgesia. These cases support an individualized buprenorphine induction approach that continues full agonists, expanding strategies to improve tolerability and transition success for adults with SCD.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"425-431"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of sublingual sufentanil on post-operative pain control in spine surgery.","authors":"Linda S Aglio, Laura Mendez-Pino, Leah A Baez, Samuel Justice, Kara G Fields, Marina Sá Teixeira, Ali Oran, Reem Abbaker, Robert R Edwards, Richard D Urman","doi":"10.5055/jom.0981","DOIUrl":"https://doi.org/10.5055/jom.0981","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing spinal fusion surgery often experience moderate to severe pain during the first three post-operative days. Few data are currently available regarding the use of specific opioid analgesics for the spine surgery population, which routinely experiences significant acute pain. This study aims to examine the perioperative use of sublingual sufentanil tablet (SST) as part of the analgesic regimen for spine surgery.</p><p><strong>Methods: </strong>This study was a prospective cohort (n = 30) with a two-arm (n = 80 each) historical control cohort. Both the prospective arm and the two retrospective control groups received a standard general anesthetic. The prospective arm received intraoperative sufentanil infusion and SST right after extubation and SST q1h in the post-anesthesia care unit (PACU) for Numerical Rating Scale (NRS) > 3, with intravenous hydromorphone used for breakthrough pain. The control groups received intraoperative sufentanil infusion alone or intraoperative remifentanil infusion alone, both with subsequent intravenous hydromorphone used for breakthrough pain (similar to the prospective SST arm). Multivariable linear regression models with inverse probability of treatment weighting were used to measure the effectiveness of SST in reducing the primary outcome of post-operative pain intensity scores in the PACU.</p><p><strong>Results: </strong>A total of 190 patients were analyzed. The study group that received SST experienced lower average pain intensity scores in the PACU compared with the two historical control groups, with NRS scores of 3.22 in the SST group, 5.66 in the remifentanil group, and 5.05 in the sufentanil group. In the multivariable regression models, the SST group had an average PACU pain score that was 1.86 points lower (95 percent confidence interval [CI]: [-2.61, -1.10], p < 0.001) than the remifentanil group, and that was 1.10 points lower (95 percent CI: [-1.87, -0.34], p = 0.005) than the sufentanil group.</p><p><strong>Conclusion: </strong>SST appears to be a potentially beneficial adjunctive analgesic therapy in spine surgery patients who experience moderate to severe post-operative pain, resulting in improved pain intensity scores in the post-operative recovery period. Further analysis should examine the impact on longer-term post-operative opioid consumption and post-discharge pain-related outcomes.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"375-384"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial of mobile-based contingency management to promote self-monitoring among individuals with chronic pain.","authors":"Kathryn M Polak, Robert N Jamison, Wally Smith, Dace S Svikis","doi":"10.5055/jom.0990","DOIUrl":"10.5055/jom.0990","url":null,"abstract":"<p><strong>Objective: </strong>Strategies are needed to sustain daily monitoring of pain symptoms and related behaviors. However, low adherence rates have impeded the use of self-monitoring among chronic pain patients. This pilot study tested a novel mobile-based contingency management (CM) intervention promoting self-monitoring of pain symptom severity, related variables, and prescription opioid use among individuals with chronic pain.</p><p><strong>Design: </strong>A parallel-arm randomized controlled trial (RCT).</p><p><strong>Setting: </strong>Online recruitment via ResearchMatch.org.</p><p><strong>Participants: </strong>Adults (N = 81) with noncancer chronic pain (≥3 months) and lifetime opioid prescription(s) for pain management were randomized to either the CM group (n = 46) or the control group (n = 35). Of those randomized, n = 72 completed follow-up.</p><p><strong>Interventions: </strong>A fully automated CM app (DynamiCare Rewards) delivered incentives on an escalating variable-ratio reinforcement schedule over 28 days.</p><p><strong>Main outcome measures: </strong>The number of completed daily surveys and the longest period of continuous daily survey completion were compared using independent t-tests. Feasibility and acceptability measures were also examined.</p><p><strong>Results: </strong>CM participants completed significantly more daily surveys (26.09 vs 23.06; p = .03) and had significantly longer sustained periods of daily survey completion (22.07 vs 17.11; p = .01) than the control participants. Acceptability ratings were high and similar for the two groups (all p > .05).</p><p><strong>Conclusions: </strong>This study is the first to test an app-based escalating variable-ratio CM schedule for promoting sustained daily pain self-monitoring. Findings indicate a large-scale RCT may be warranted. Establishing a valid method for improving self-monitoring adherence has broad research implications. Future studies will explore other target behaviors and examine relationships between pain symptom severity and related variables, eg, sleep.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"345-360"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative attitudes about post-operative pain and opioids among patients on long-term opioid therapy undergoing total joint arthroplasty.","authors":"Kevin R Riggs, Burel R Goodin, Inder Kaur, Stefan G Kertesz, Shakristal Williams, Jasvinder A Singh, Jennifer M Hah, Scott Mabry, Cherry Jackson, Andrea L Cherrington","doi":"10.5055/jom.0998","DOIUrl":"10.5055/jom.0998","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to understand the attitudes of patients on long-term opioid therapy (LTOT) about how upcoming total joint arthroplasty (TJA) would affect their future pain and opioid use.</p><p><strong>Design: </strong>Semistructured, in-depth interviews were conducted.</p><p><strong>Setting: </strong>A single academic medical center in the southern United States.</p><p><strong>Participants: </strong>Fifteen patients who were receiving LTOT and were scheduled to undergo total knee or hip arthroplasty.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measure: </strong>We used the Theory of Planned Behavior to inform our semistructured interview questions, exploring behavioral, normative, and control beliefs related to participants' current opioid use and how TJA might affect their intentions regarding their continued opioid requirements. We analyzed interview transcripts using thematic content analysis.</p><p><strong>Results: </strong>Most participants had multisite pain, with some reporting their worst pain at the affected knee or hip. Participants perceived that their current opioid use improved their pain and functioning. They expected that they would be able to decrease or stop chronic opioid therapy at some point after surgery but saw future reductions as largely contingent on improved pain. Despite the expressed desire to take less opioids, participants were uncertain about the specifics of how those reductions would occur, and very few had discussed post-operative plans with their prescribers.</p><p><strong>Conclusions: </strong>Patients may be open to decreasing opioid doses after TJA, but the lack of preoperative planning may be a missed opportunity. Individualized conversations that take patients' own aspirations into account could help clinicians and patients achieve opioid reductions.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"385-393"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Medicaid expansion on naloxone dispensing: A narrative review.","authors":"Suhanee Mitragotri, David T Zhu, Grace Marley, Delesha Carpenter","doi":"10.5055/jom.1011","DOIUrl":"https://doi.org/10.5055/jom.1011","url":null,"abstract":"<p><strong>Objective: </strong>This narrative review aims to describe changes in naloxone dispensing and availability rates between states that have implemented Medicaid expansion compared to those that have not.</p><p><strong>Design: </strong>The review searched four databases (January 2014-March 2025), using predefined inclusion and exclusion criteria and dual independent screening with consensus resolution; data extraction included study design, population, data sources, metrics of naloxone access, main findings, and limitations.</p><p><strong>Results: </strong>Four articles met the inclusion criteria. Two studies found that Medicaid expansion was associated with an increase in naloxone prescriptions by 38-78 per state per quarter and Medicaid-paid prescriptions by 14.21-140.8 per 100,000 individuals per quarter. A third secret shopper study found that naloxone nasal spray availability was higher at pharmacies in states that implemented Medicaid expansion compared to those that did not. In contrast, one study found that Medicaid expansion was not significantly associated with an increase in naloxone prescriptions.</p><p><strong>Conclusions: </strong>Few studies have explored the association between Medicaid expansion and improved access to naloxone. Three of four studies found that expansion was associated with increased naloxone prescriptions and pharmacy availability. Future studies should incorporate standardized measures to assess the impact of Medicaid expansion on naloxone dispensing across a greater number of states and utilize longitudinal data to evaluate its impact over time.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"415-424"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of continuing medical education on opioid prescribing practices.","authors":"Melissa B Weimer, Kaicheng Wang, David A Fiellin, Mary L Warner","doi":"10.5055/jom.0997","DOIUrl":"https://doi.org/10.5055/jom.0997","url":null,"abstract":"<p><strong>Objective: </strong>Clinician adherence to clinical guidelines after engaging in continuing medical education (CME) is often limited to self-report. We sought to determine the impact of a CME course addressing safer opioid prescribing on clinician opioid-related prescribing practices for patients prescribed opioids for pain.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Single health system, Northeast United States.</p><p><strong>Subjects: </strong>Clinician prescribers of opioids (Medical Doctor/Doctor of Osteopathy, Doctor of Podiatric Medicine, Nurse Practitioner, Physician Assistant) who did and did not complete a CME program.</p><p><strong>Methods: </strong>Practice adherence to the Food and Drug Administration Opioid Analgesia Risk Evaluation and Management Strategies (REMS) Education Blueprint was assessed by comparing electronic health record data from clinicians who participated in a CME course (REMS-OA+) with data from matched clinicians who did not (REMS-OA-). We compared prescribing practices, including opioid dose and patient-level outcomes, including visit type, naloxone prescription, and urine drug testing, before and after CME participation. A difference-in-differences (DiD) approach estimated the absolute change in prescribing practices and patient-level outcomes.</p><p><strong>Results: </strong>A total of 49 clinicians completed a portion of the REMS-OA CME and prescribed opioids during the study period. After adjustment, the absolute DiD for prescribing practices and patient-level outcomes was not significantly different between REMS-OA+ prescribers and REMS-OA- prescribers. The only significant difference was that REMS-OA+ prescribers completed more in-person visits compared with telemedicine visits than REMS-OA- prescribers.</p><p><strong>Conclusions: </strong>We did not detect significant differences in clinician adherence to clinical guidance between the REMS-OA CME groups. Improved adherence to guidelines for opioid prescribing likely requires both CME and additional interventions.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 4","pages":"395-404"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}