Journal of opioid management最新文献

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The "Micro"cosm: Magnifying the Nuance of Low Dose Buprenorphine Inductions. 微 "宇宙:放大低剂量丁丙诺啡诱导的细微差别。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/bupe.24.rpj.1050
Tanya Uritsky, Emily Casey
{"title":"The \"Micro\"cosm: Magnifying the Nuance of Low Dose Buprenorphine Inductions.","authors":"Tanya Uritsky, Emily Casey","doi":"10.5055/bupe.24.rpj.1050","DOIUrl":"10.5055/bupe.24.rpj.1050","url":null,"abstract":"<p><strong>Background: </strong>Now that the X-wavier is a thing of the past, patients with Opioid Use Disorder (OUD) who previously lacked access to buprenorphine may have access to lower barrier care and may be looking to make the transition from either methadone or illicit fentanyl to buprenorphine. This can be quite challenging and both fentanyl and methadone are hihghly potent drugs and can result in a difficult transtition to buprenorphine.</p><p><strong>Purpose/hypothesis: </strong>A transition from high potency opioids to buprenorphine is challenging and can cause discomfort or withdrawal in patients. Procedures/data/observations: Patients tend to have a difficult time when undergoing a transition from significant fentanyl use (> 1 bundle/day) or high dose methadone to buprenorphine. Over the last year, we've supported this transition for our hospitalized patients and have learned some tips and tricks to ease the transitions. Through our work we've come up with a strategy to transition patients that includes utilizing full mu agonists while initiating a low dose buprenorphine induction. We have developed an informal protocol for this transition that takes advantage of the flexibility of low dose buprenorphine induction strategies and includes the use of non-opioid adjuvant medications to control symptoms of discomfort and withdrawal.</p><p><strong>Conclusions/applications: </strong>A transition from the use of significant fentanyl or high dose methadone to buprenorphine is possible and can take place over a matter of a few days. Such a transition requires careful attention to patient symptoms, availability of as needed short acting opioids, and the judicious use of non-opioid adjuvants.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"B8"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348585","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}
引用次数: 0
Implementing a text-message-based intervention to increase access to naloxone for patients on chronic opioid therapy. 实施基于短信的干预措施,增加长期阿片类药物治疗患者获得纳洛酮的机会。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/jom.0830
Scott G Weiner, Salah Alrakawi, Morgan Kelley, Amrita Chabria Shahani, Cheryl Silva, Andrew D McCatty, Danielle Lasden, Karthik Sivashanker
{"title":"Implementing a text-message-based intervention to increase access to naloxone for patients on chronic opioid therapy.","authors":"Scott G Weiner, Salah Alrakawi, Morgan Kelley, Amrita Chabria Shahani, Cheryl Silva, Andrew D McCatty, Danielle Lasden, Karthik Sivashanker","doi":"10.5055/jom.0830","DOIUrl":"10.5055/jom.0830","url":null,"abstract":"<p><strong>Objective: </strong>To implement a text-message-based intervention for primary care patients taking chronic opioid therapy to increase access to naloxone.</p><p><strong>Design: </strong>Retrospective analysis of a hospital quality improvement initiative.</p><p><strong>Setting: </strong>This study was conducted with selected primary care practices affiliated with an academic medical center between March and July 2022.</p><p><strong>Participants: </strong>Patients were eligible for receiving the intervention if they had chronic (≥90 days) opioid use of ≥50 morphine milligram equivalents/day and had not previously opted out of receiving text messages.</p><p><strong>Interventions: </strong>Text messages were sent to patients inquiring about interest in obtaining a naloxone kit, which prompted a pharmacist to contact the patient and provide the medication by mail.</p><p><strong>Main outcome measures: </strong>We examined response rates to text messages and numbers of naloxone kits dispensed.</p><p><strong>Results: </strong>There were 243 patients identified who were sent the text message. Of these, 230 (94.7 percent) had a primary language of English, 150 (61.7 percent) were White, and 57 (23.5 percent) were Black/African American. The mean age was 57.3 years. After receiving the text messages, 64 (26.3 percent) of the 243 patients responded with \"unsubscribe.\" Thirty-five (14.4 percent) patients responded to the message, and 18 patients (51.4 percent of those who responded or 7.4 percent of all included patients) wanted the medication and were contacted by a pharmacist who filled and mailed the prescription to them.</p><p><strong>Conclusions: </strong>A text-message-based program to provide naloxone to patients with chronic opioid use was feasible. However, fewer than 15 percent of patients responded to the message, and just half of those wanted the medicine.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"289-296"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348472","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}
引用次数: 0
Buprenorphine: The Opioid that Cried 'Partial Agonist'. 丁丙诺啡:呐喊着 "部分激动剂 "的阿片类药物。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/bupe.24.rpj.1040
Jeffrey J Bettinger, Jacqueline Cleary
{"title":"Buprenorphine: The Opioid that Cried 'Partial Agonist'.","authors":"Jeffrey J Bettinger, Jacqueline Cleary","doi":"10.5055/bupe.24.rpj.1040","DOIUrl":"10.5055/bupe.24.rpj.1040","url":null,"abstract":"<p><strong>Background: </strong>Although buprenorphine use has increased dramatically over the past decade, its unique pharmacologic and pharmacokinetic profile often leads to misconceptions about its overall utility and has created a drastic underrepresentation in patients with chronic non-can- cer pain. A common misnomer associated with buprenorphine is because of 'partial agonist' activity, it exhibits a plateauing of typical opioid-related side effects (including respiratory depression, constipation, euphoria, and hypogonadal axis suppression), but additionally it must exhibit a plateauing effect of overall analgesic potential. However, novel downstream molecular and cellular mechanisms offer new insights that help support the clinical potential that buprenorphine's analgesic actions may not have a ceiling, like its side effect profile. This interactive symposium will provide an enhanced review of the evolving research that helps unravel the complexity around buprenorphine's varying pharmacologic effects including actions on various opioid receptors, promiscuity to elicit varying actions on mu-opioid receptors coupled with different isoforms of G~ subunits, role in the intracellular recruitment of beta-arrestin, binding to different splice variants of mu-opioid receptors, and greater spinal versus supraspinal activity. The final half of this symposium will be designed to substantiate evidence with various human clinical trial data to further support buprenorphine's place on the analgesic ladder.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"B9"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348565","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}
引用次数: 0
Overcoming challenges of prescribing long-term opioid therapy in residency clinics. 克服住院医师诊所开具长期阿片类药物治疗处方的挑战。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/jom.0869
Kathryn Brown, Joel Farley, Ezra Golberstein, David Satin, Peter Harper, Chrystian Pereira, Andrew H Slattengren, Kristi Van Riper, Katherine Montag Schafer
{"title":"Overcoming challenges of prescribing long-term opioid therapy in residency clinics.","authors":"Kathryn Brown, Joel Farley, Ezra Golberstein, David Satin, Peter Harper, Chrystian Pereira, Andrew H Slattengren, Kristi Van Riper, Katherine Montag Schafer","doi":"10.5055/jom.0869","DOIUrl":"10.5055/jom.0869","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the impact of a standardized opioid prescribing intervention when implemented in three family medicine (FM) residency training - clinics-environments that face operational challenges including regular resident turnover.</p><p><strong>Design: </strong>We performed a retrospective cohort study to compare patterns of long-term opioid prescribing between residency and nonresidency clinics.</p><p><strong>Setting: </strong>This study took place within a large, academic, health system.</p><p><strong>Patients and participants: </strong>Three FM residency clinics were compared with three nonresidency FM clinics.</p><p><strong>Interventions: </strong>A standardized opioid prescribing process was developed and implemented within the FM residency clinics. Nonresidency clinics used an independent process and were not exposed to the intervention.</p><p><strong>Main outcome measures: </strong>Descriptive comparisons were performed for treatment and control clinics' opioid prescribing from 2015 to 2018. The primary outcome was a patient's annual opioid exposure supplied from these select clinics. We also examine coprescribing with high-risk medications that potentiate the overdose risk of opioid prescriptions. Difference-in-difference modeling was used to control for clinic-level variation in practice.</p><p><strong>Results: </strong>Statistically significant decreases were observed in both residency and nonresidency clinics for the mean number of opioid prescriptions and the mean daily morphine milligram equivalent. These decreases were comparable between the residency and nonresidency clinics.</p><p><strong>Conclusions: </strong>Residency clinics face unique challenges and require innovative solutions to keep up with best practices in opioid prescribing. Our residency clinics' implementation of a standardized intervention, including electronic health record integration, standardized processes, and metric management, suggests steps that may be valuable in achieving outcomes comparable to nonresidency clinics in large health systems.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"297-309"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348475","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}
引用次数: 0
Prescription opioids following herpes zoster: An observational study among insured adults, United States, 2007-2021. 带状疱疹后处方阿片类药物:2007-2021 年美国投保成年人观察研究。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/jom.0845
Kathleen Dooling, Jessica Leung, Michele K Bohm
{"title":"Prescription opioids following herpes zoster: An observational study among insured adults, United States, 2007-2021.","authors":"Kathleen Dooling, Jessica Leung, Michele K Bohm","doi":"10.5055/jom.0845","DOIUrl":"10.5055/jom.0845","url":null,"abstract":"<p><strong>Background: </strong>The opioid overdose epidemic has resulted in hundreds of thousands of overdose deaths in the United States (US). One indication for opioids is herpes zoster (HZ)-a common painful condition with an estimated 1 million cases occurring annually in the US.</p><p><strong>Objective: </strong>We aimed to characterize prescription opioid claims and trends among patients with HZ who were previously opioid naive.</p><p><strong>Design: </strong>We used a cohort study involving three insurance claims databases in the US. We included all beneficiaries 18-64 years (commercial and Medicaid) and beneficiaries 65 years and older (Medicare) who were diagnosed with incident HZ during 2007-2021. We determined the proportion of opioid-naive patients with HZ who filled an opioid prescription within 30 days and 180 days following HZ diagnosis. We also examined trends over the study period, proportion receiving moderate, high dosages (50-89 morphine milligram equivalent [MME], and ≥90 MME per day), and long-term receipt.</p><p><strong>Results: </strong>Among all three insurance databases, 2,595,837 patients had an incident episode of HZ and were opioid naive during the prior 6 months. Within 30 days following HZ, 623,515 (24 percent) filled a prescription for an opioid. The percentage with an opioid claim declined during 2007-2021 for all groups; 65 percent for commercially insured patients, 51 percent for Medicaid-insured patients, and 60 percent for Medicare-insured patients. Approximately 8-15 percent of all beneficiaries received moderate and 2-6 percent received high dosage opioids. Long-term prescription opioid use of at least 6 months was found in 7-12 percent of the patients.</p><p><strong>Conclusions: </strong>Continuing trends in judicious opioid prescribing as well as use of recommended HZ vaccines may decrease opioid prescriptions for HZ.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"319-328"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348584","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}
引用次数: 0
Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data. 滥用/误用羟考酮制剂后与阿片类药物相关的临床结果和相关医疗费用:对真实世界数据的 HEOR 分析。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/jom.0878
Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg
{"title":"Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data.","authors":"Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg","doi":"10.5055/jom.0878","DOIUrl":"10.5055/jom.0878","url":null,"abstract":"<p><strong>Objective: </strong>The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: -exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).</p><p><strong>Study design: </strong>A real-world, observational study.</p><p><strong>Main outcome measures: </strong>Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.</p><p><strong>Results: </strong>Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.</p><p><strong>Conclusions: </strong>This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"281-288"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348473","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}
引用次数: 0
Partial Agonist, Full Barrier: A Case-Based Discussion on Challenges with Buprenorphine in Chronic Pain Management. 部分激动剂,全面障碍:以案例为基础,探讨丁丙诺啡在慢性疼痛治疗中面临的挑战。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/bupe.24.rpj.1030
Tonya S Hershman, Michelle Park
{"title":"Partial Agonist, Full Barrier: A Case-Based Discussion on Challenges with Buprenorphine in Chronic Pain Management.","authors":"Tonya S Hershman, Michelle Park","doi":"10.5055/bupe.24.rpj.1030","DOIUrl":"10.5055/bupe.24.rpj.1030","url":null,"abstract":"<p><strong>Background: </strong>More patients are on chronic opioids, as patients who were initially started on full agonist opioids for cancer-related pain are living longer. Despite doing well from the cancer stand- point, some patients have difficulty tapering off their opioids because they have been taking them for years. Given the potential complications of chronic full agonist opioids, it is important to manage these patients in a safer way. However, there are various challenges including lack of education for patients and healthcare professionals and lack of product availability. Many healthcare providers do not have much formal training on initiating, maintaining, and tapering the various buprenorphine products. These providers may not be able to effectively educate patients given the lack of education. Also, patients research these products on their own and are hesitant to try them because of misinformation. Even if patients are informed thoroughly about buprenorphine, there are barriers to obtaining them including insurance denial and lack of product availability at pharmacies. Given the above challenges, easily accessible best practices as well as avenues for healthcare professionals to educate and guide each other are needed.</p><p><strong>Purpose/hypothesis: </strong>Given the potential complications of chronic full agonist opioids, it is important to manage these patients in a safer way. However, there are various challenges including lack of education for patients and healthcare professionals and lack of product availability.</p><p><strong>Conclusions/applications: </strong>Given the above challenges, easily accessible best practices as well as avenues for healthcare professionals to educate and guide each other are needed.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"B5"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348476","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}
引用次数: 0
Buprenorphine: Opioid Agonist-Antagonist for Refractory Pain of Sickle Cell Disease Patients During Hematopoietic Stem Cell Transplant, Uncontrolled By Full-Agonist Opioids. 丁丙诺啡:丁丙诺啡:阿片类药物激动剂-拮抗剂,用于治疗镰状细胞疾病患者在造血干细胞移植过程中出现的、无法用全阿片类药物控制的难治性疼痛。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/bupe.24.rpj.1065
Mayuko Sakae
{"title":"Buprenorphine: Opioid Agonist-Antagonist for Refractory Pain of Sickle Cell Disease Patients During Hematopoietic Stem Cell Transplant, Uncontrolled By Full-Agonist Opioids.","authors":"Mayuko Sakae","doi":"10.5055/bupe.24.rpj.1065","DOIUrl":"10.5055/bupe.24.rpj.1065","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow transplant (BMT) offers potential cure for cancer and a spectrum of otherwise incur- able diseases. The BMT process can cause multi-systemic pain in patients with sickle cell disease (SCD) refractory to high-dose opioid analgesics during BMT because of their pre-existing opioid-tolerance. Because of frequent pain resulting in hyperalgesia and chronic opioid use, SCD patients undergoing BMT often experience excruciating pain uncontrolled by exceedingly high-dose opioids with severe and intolerable adverse effects.</p><p><strong>Purpose/hypothesis: </strong>There is a small but growing body of literature about the successful buprenorphine effect for SCD's chronic pain management that had failed sufficient pain relief by the traditional full-agonist opioids in the outpatient setting. However, the buprenorphine use for acute inpatient pain management has not been previously researched. Pilot prospective clinical trial with buprenorphine-based pain management for acute BMT-related pain was initiated for SCD patients' pain uncontrolled by full-agonist opioids. Procedures/data/observations: Buprenorphine was started as scheduled and as-needed analgesics, supplemented by full-agonist opioids upon consultation for uncontrolled BMT-related pain of SCD patients. Patients' 24-hour opioid requirement by morphine equivalent daily doses (MEDD) were assessed at 3 time points: 1)immediately before pain escalation; 2)consultation; 3)discharge. MEDDs were compared to those of patients treated with full-agonist opioids only. Cases treated by full-agonist opioids (morphine/hydromorphone/fentanyl/methadone/oxycodone) had MEDD escalation by 1230-16300% by discharge compared to immediately before BMT-related pain escalation. Buprenorphine-supported cases had significantly smaller MEDD increase by 220-317%.</p><p><strong>Conclusions/applications: </strong>Our case series suggests superior pain control by adding Buprenorphine prior to opioid dose escalation during BMT for SCD. Buprenorphine may provide the advantageous effect for other patients with complex pain background and experiencing difficult pain management during BMT due to pre-existing hyperalgesia and high opioid-tolerance. The evidence for buprenorphine's analgesic effect is moderate but growing, and more randomized controlled trials comparing the buprenorphine and other standard opioids are needed.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"B14"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348564","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}
引用次数: 0
Fentanyl dose-sparing in polyarthritic rats requires full agonism at 5-HT1A receptors: Comparison between NLX-112, (±)8-OH-DPAT, and buspirone. 多关节炎大鼠的芬太尼剂量节省需要 5-HT1A 受体的完全激动:NLX-112、(±)8-OH-DPAT 和丁螺环酮之间的比较。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/jom.0874
Ronan Depoortere, Laurent Bardin, Adrian Newman-Tancredi
{"title":"Fentanyl dose-sparing in polyarthritic rats requires full agonism at 5-HT<sub>1A</sub> receptors: Comparison between NLX-112, (±)8-OH-DPAT, and buspirone.","authors":"Ronan Depoortere, Laurent Bardin, Adrian Newman-Tancredi","doi":"10.5055/jom.0874","DOIUrl":"10.5055/jom.0874","url":null,"abstract":"<p><strong>Background: </strong>NLX-112 (a.k.a. F13640, befiradol) is a highly selective and fully efficacious agonist at 5-hydroxytryptamine (5-HT<sub>1A</sub>) receptors. It has been shown to be robustly and potently active in nociceptive, neuropathic and traumatic pain models in rats and mice. In particular, NLX-112 decreases oral fentanyl self-administration (FSA) in polyarthritic rats, ie, it has opioid dose-sparing effects.</p><p><strong>Objective: </strong>To examine if the dose-sparing effects of NLX-112 in polyarthritic rats are shared by other 5-HT<sub>1A</sub> ligands: the prototypical 5-HT<sub>1A</sub> receptor agonist 8-HYDROXY-2-(DI-n-PROPYLAMINO)TETRALIN ((±)8-OH-DPAT), and the 5-HT<sub>1A</sub> receptor partial agonist and weak dopamine D2 receptor blocker, -buspirone.</p><p><strong>Design: </strong>Polyarthritis was induced by inoculating rats with heat-killed Mycobacterium butyricum. They then had access to either a fentanyl (0.008 mg/mL) or a sweetened solution in their home cage. NLX-112, (±)8-OH-DPAT, or buspirone was administered via an osmotic minipump (5 µL/h) during a 2-week infusion period from day 14 to day 28 post-inoculation with Mycobacterium butyricum. Control infusions consisted of sterile 0.9 percent NaCl.</p><p><strong>Results: </strong>NLX-112 (0.63 mg/day) significantly decreased FSA by 47 percent and increased total fluid consumption (TFC) by 7 percent (vehicle-loaded minipumps as controls). Both (±)8-OH-DPAT and buspirone (0.63 and 2.5 mg/day, respectively) failed to reduce FSA; (±)8-OH-DPAT did not modify TFC, while buspirone significantly decreased it by 17 percent.</p><p><strong>Conclusions: </strong>These results suggest that oral FSA dose-sparing effect, in this rat polyarthritis pain model, requires high efficacy activation of 5-HT<sub>1A</sub> receptors, such as that afforded by NLX-112. By contrast, the agonist efficacy of (±)8-OH-DPAT and buspirone seems insufficient for FSA dose-sparing.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"269-274"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348570","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}
引用次数: 0
Impact of an Education Module on the Knowledge and Attitudes of EM Physicians Towards Prescribing Buprenorphine/Naloxone for Opioid Use Disorder. 教育模块对急诊科医生开具丁丙诺啡/纳洛酮治疗阿片类药物使用障碍的知识和态度的影响。
Journal of opioid management Pub Date : 2024-07-01 DOI: 10.5055/bupe.24.rpj.1095
Amy Zosel, Jennifer Hernandez-Meier, Julie Owen
{"title":"Impact of an Education Module on the Knowledge and Attitudes of EM Physicians Towards Prescribing Buprenorphine/Naloxone for Opioid Use Disorder.","authors":"Amy Zosel, Jennifer Hernandez-Meier, Julie Owen","doi":"10.5055/bupe.24.rpj.1095","DOIUrl":"10.5055/bupe.24.rpj.1095","url":null,"abstract":"<p><strong>Background: </strong>Opioid overdose continues to be a major cause of morbidity and mortality. Buprenorphine is an important treatment for patients with opioid-use disorder (OUD) and initiation in the emergency department (ED) has been shown to improve outcomes for these patients.</p><p><strong>Purpose/hypothesis: </strong>Our objective was to assess the impact of a three-pronged education package on the knowledge and attitudes of emergency physicians towards using buprenorphine for treatment of OUD. Procedures/data/observations: We developed a three-pronged educational package including back- ground rationale for OUD treatment with buprenorphine, an evidence-based ED buprenorphine induction pathway and electronic medical record tools. This package was deployed to providers in an urban academic ED. A voluntary confidential pre-post survey was administered. Using a 6-point Likert Scale, participants were asked about their understanding, experience, and confidence with prescribing.</p><p><strong>Conclusions/applications: </strong>A one-hour, three-pronged educational package changed the attitudes of emergency physicians towards buprenorphine treatment and demonstrated an increase in willingness and confidence to prescribe it for patients with OUD. Our findings suggest that healthcare entities that wish to boost buprenorphine prescribing can impact willingness and confidence to prescribe with a short education package.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"B13"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348571","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}
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