Journal of opioid management最新文献

{"title":"Post-operative opioid consumption in pediatric solid organ transplant recipients: A single-site retrospective evaluation.","authors":"Joseph C Resch, Benjamin Langworthy, Ranad Ghalban, Shelby Graf, Srinath Chinnakotla, Gwenyth Fischer","doi":"10.5055/jom.0980","DOIUrl":"10.5055/jom.0980","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data depicting post-operative opioid consumption in pediatric solid organ transplant (SOT) recipients, limiting ability to perform power analyses in designing prospective trials focusing on analgesia or adjuvant therapies in these populations. There is additionally unclear effect magnitude of various confounders of analgesic and sedative medications encountered in the pediatric intensive care unit (PICU).</p><p><strong>Methods: </strong>Retrospective review of pediatric patients aged 2 months-18 years at a single institution was performed on 137 SOT recipients (cardiac, liver, renal, total pancreatectomy with islet cell autotransplantation [TPIAT]) to evaluate post-operative opioid consumption in the PICU, analgesic confounders, pain scores, and opioid-related adverse effects (constipation, ileus, pruritus, nausea, urinary retention, delirium, respiratory depression, withdrawal). Values for correlative and multiplicative effect magnitude were analyzed for planned variables.</p><p><strong>Results: </strong>Average daily opioid requirement in oral morphine equivalents per kilogram was (cardiac) 12.5 (median 6.98, interquartile range [IQR] 14.3), (liver) 12.6 (median 10.1, IQR 15.3), (renal) 1.47 (median 0.614, IQR 0.95), and (TPIAT) 4.1 (median 3.44, IQR 2.6). Mechanical ventilation dependence, extracorporeal membrane oxygenation use, and open abdomen or chest demonstrated the highest correlation and effect magnitudes with opioid consumption of variables evaluated. No trends were identified for opioid-related adverse effects.</p><p><strong>Conclusion: </strong>Children receiving SOT have high opioid consumption relative to many populations in the PICU. Control for and evaluation of pain confounders such as mechanical ventilation and extracorporeal membrane oxygenation should be utilized in prospective studies analyzing opioid use, adjuvant analgesics, or outcomes in critically ill transplant recipients.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"91-110"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344555","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":"Formulation development and a Phase 1 clinical study of PF614-MPAR, an oxycodone prodrug with oral opioid overdose protection.","authors":"D Lynn Kirkpatrick, Linda A Pestano, Cari Evans, Jeffrey Millard, Jeffrey Levy, Vanessa Zann, Katie Pepper, William K Schmidt","doi":"10.5055/jom.0991","DOIUrl":"10.5055/jom.0991","url":null,"abstract":"<p><strong>Introduction: </strong>Prevention of oral overdose of opioids is a critical unmet need. PF614-Multi-Pill Abuse Resistance (MPAR®) was designed to deliver desired opioid-level analgesia at therapeutic dose levels while providing overdose protection if consumed at higher-than-intended doses, through a unique trypsin-activated prodrug approach. PF614, a prodrug of oxycodone, releases oxycodone only after oral ingestion and exposure to trypsin in the small intestine. PF614-MPAR, a combination of PF614 and a potent trypsin inhibitor, nafamostat, will reduce oxycodone release if taken at higher-than-intended doses. The goal of this Phase 1 study was to determine the optimal PF614-nafamostat formulation to optimize the overdose protection that PF614-MPAR should provide.</p><p><strong>Methods: </strong>Healthy subjects received oral PF614 25 mg alone or in combination with 10 nafamostat formulations (1-10 mg each), which included immediate-release (IR) solutions, slow or fast extended-release (ER) beads, or a combination of IR/ER nafamostat. Plasma oxycodone concentrations were measured to determine PF614 activation and to identify a nafamostat formulation that would reduce the release of oxycodone only when more than two doses were consumed orally. Once an optimal nafamostat formulation was identified, \"PF614-MPAR 25 mg,\" -overdose protection was evaluated by administering one to eight escalating oral doses to naltrexone-blocked subjects.</p><p><strong>Results: </strong>The selected PF614 MPAR 25 mg formulation delivered therapeutic oxycodone concentrations equivalent to PF614 alone when administered as one or two doses. However, oxycodone release was suppressed when PF614-MPAR was delivered at 3×, 5×, or 8× doses simultaneously.</p><p><strong>Conclusion: </strong>PF614-MPAR may be the first opioid with both abuse resistance and oral overdose protection.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"37-A26"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344543","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":"Systematic review of real-world data associated with opioid scheduling and nonmedical use.","authors":"Suzanne K Vosburg, Taryn Dailey-Govoni, Jody L Green","doi":"10.5055/jom.0967","DOIUrl":"10.5055/jom.0967","url":null,"abstract":"<p><strong>Objective: </strong>In the context of increased use of buprenorphine for pain management, comparison of real-world data (RWD) on prescription opioid nonmedical use (NMU) based on their controlled substance schedule may assist providers in providing effective pain management therapy while mitigating the risk of opioid NMU.</p><p><strong>Design: </strong>A systematic literature review of articles reporting RWD on prescription opioid NMU involving Schedule II (CII), Schedule III (CIII), and Schedule IV (CIV) opioid medications was conducted using PubMed®.</p><p><strong>Patients/participants: </strong>Human RWD collected in the United States from January 2010 to December 2023.</p><p><strong>Main outcome measure(s): </strong>Articles reporting RWD of prescription opioid NMU. Exclusions included buprenorphine/methadone medications for opioid use disorder, chronic use, or overdose without clearly established NMU (could not rule out legitimate medical use).</p><p><strong>Results: </strong>There were 2,585 articles screened for inclusion, 102 articles were assessed with a validated data extraction form, and 16 articles were reviewed that compared NMU and/or secondary NMU-related outcomes. Of these, only five articles contained RWD on NMU; all showed more NMU associated with CII than CIII or CIV opioids. Two articles evaluated buprenorphine (CIII) for analgesia and found lower rates of CIII NMU than comparator CII opioids.</p><p><strong>Conclusions: </strong>Results of this systematic review support the differentiation in scheduling between CII and CIII/CIV opioid medications with RWD. This study also reveals a research gap in comparing CIII opioid medications for analgesia to CII and CIV opioids, an area of current and future interest, considering the growing use of buprenorphine for pain management, along with initiatives to curb opioid NMU.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"77-89"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344520","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":"Oral gabapentin versus metoclopramide for prevention of intrathecal opioid-induced pruritus.","authors":"Douaa Galal Mohammad Mohammad Ibrahim, Marina Edwar Aziz Abd El-Shahid, Manal Mohammad Kamal Shams, Heba Mahmoud Abd El-Rahman Ali","doi":"10.5055/jom.0928","DOIUrl":"10.5055/jom.0928","url":null,"abstract":"<p><strong>Background: </strong>Spinal opioids are frequently coadministered with local anesthetics for analgesia, allowing the use of a lower dose of each agent, thus minimizing side effects. Most opioid-induced side effects, such as nausea, vomiting, and respiratory depression, are usually encountered with systemic use, while pruritus is more common with intrathecal or epidural administration.</p><p><strong>Objectives: </strong>To compare the action of gabapentin versus metoclopramide in prevention of intrathecal opioid-induced pruritus.</p><p><strong>Study design: </strong>After ethical committee approval and informed patient' consent, this prospective randomized comparative clinical trial was conducted at Ain Shams University Hospitals on 62 adult patients undergoing elective operations under spinal anesthesia. The subjects were randomly divided into two groups: Group G (received 300 mg of oral gabapentin) and group M (received 10 mg of oral metoclopramide) 2 hours before spinal anesthesia.</p><p><strong>Results: </strong>The overall incidence of pruritus in both groups was 31.5 percent (48.8 percent in group G and 45.2 percent in group M). There was no statistically significant difference between the two groups. As for the severity, both drugs showed low visual analog scale scores from the first hour after intrathecal fentanyl administration. Gabapentin showed more potency in decreasing the severity of pruritus as only two patients in group G needed rescue treatment compared to five patients in group M (but the difference was of no statistical significance).The overall incidence of nausea was 17.7 percent (22.58 percent in group G and 12.9 percent in group M), while the incidence of vomiting was 11.29 percent (16.13 percent in group G and 6.45 percent in group M). There was no statistically significant difference between the two groups.</p><p><strong>Conclusion: </strong>Gabapentin is as effective as metoclopramide in prevention of intrathecal opioid-induced pruritus. Moreover, gabapentin proved to be slightly more effective in reducing the severity of pruritus than metoclopramide.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344547","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":"Timing and opioid dosage considerations before changing analgesic strategy.","authors":"Pietro Buonavolontà, Maria Alfieri, Angela Cangiano, Marco Cascella, Antonio Frangiosa","doi":"10.5055/jom.0975","DOIUrl":"https://doi.org/10.5055/jom.0975","url":null,"abstract":"","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344523","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":"Development, optimization, and in vitro assessment of abuse-deterrent formulation.","authors":"Jaydip Bhola, Chetan Borkhataria","doi":"10.5055/jom.0973","DOIUrl":"10.5055/jom.0973","url":null,"abstract":"<p><p>Drug abuse and misuse have been a public health issue for many years. To curb this problem, abuse-deterrent formulations (ADFs) have been developed. The present research aimed to develop an ADF using a simple yet effective, scalable, and cost-effective technique. The combination of hydrophobic and hydrophilic materials was used to develop the ADF. The hydrophilic drug molecule was coated with a hydrophobic wax material (hydrogenated castor oil-HCO). This hydrophobic coating retards drug extraction and release from the crushed formulation. A hydrophilic polymer, polyethylene oxide (PEO), was included in ADF. It provides mechanical strength to the formulation and deters from physical manipulation. It can also form a gel-like structure by rapid uptake of solvent, which deters -intravenous abuse. In this research, HCO was explored as a hydrophobic material. A 32 full factorial design was utilized to optimize the formulation, in which the quantity of HCO and PEO has a significant impact on the abuse-deterrent features of the formulation. The optimized formulation was tested using a range of real-life conditions. Stability study proves that the prepared formulation is stable at accelerated and long-term conditions for 6 months.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"51-67"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344561","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":"Pain neuroscience education intervention for patients who experience chronic musculoskeletal pain with concurrent opioid dependence: A pilot study.","authors":"Nicole D Windsor, Barbara S Smith","doi":"10.5055/jom.0974","DOIUrl":"10.5055/jom.0974","url":null,"abstract":"<p><strong>Objective: </strong>The objectives were to examine changes in kinesiophobia, pain self-efficacy, and knowledge of the neurophysiology of pain. We hypothesized that implementing an adapted-pain neuroscience education (a-PNE) curriculum, as a single intervention, for patients who experience chronic musculoskeletal pain and concurrent opioid dependence, would demonstrate positive change in kinesiophobia and self-efficacy regarding pain management, which may translate to improvements in functional ability.</p><p><strong>Design: </strong>This study used a pretest-post-test, quasi-experimental design.</p><p><strong>Setting: </strong>A formal opioid management program (OMP) within a clinic associated with the University of Kentucky.</p><p><strong>Participants: </strong>Patients actively participating in the OMP.</p><p><strong>Interventions: </strong>Pain neuroscience education.</p><p><strong>Main outcome measures: </strong>The Tampa Scale for Kinesiophobia-11, the Pain Self-Efficacy Questionnaire (PSEQ), and the Neurophysiology of Pain Questionnaire (NPQ) were utilized during this study. Subjects completed each questionnaire at three time points: preintervention, post-intervention, and 90 days post-intervention.</p><p><strong>Results: </strong>No significant interactions between groups and the three time points were found. The a-PNE group significantly improved their knowledge between pre- and post-intervention on the NPQ and PSEQ according to paired-samples t-tests. The a-PNE group scored significantly higher at post-intervention and 90-day post-intervention than the general health education control group on the NPQ according to independent-samples t-tests.</p><p><strong>Conclusion: </strong>An a-PNE curriculum may be beneficial in assisting patients to understand the neurophysiology behind their pain experience. Furthermore, positive changes were noted in pain self-efficacy. The results also indicate that an a-PNE curriculum intervention was acceptable in terms of approach and understandability for the participating patients.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"111-121"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344536","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 past is prologue: Reconceptualizing methadone and buprenorphine for post-operative pain.","authors":"Thomas R Hickey, Yi Zhang, Gregory Acampora","doi":"10.5055/jom.0968","DOIUrl":"10.5055/jom.0968","url":null,"abstract":"<p><p>Opioids remain a central element of perioperative pain management despite increased utilization of multimodal adjuvant strategies intended to reduce their use. Contemporary use of methadone and buprenorphine, both conceived as opioid analgesics, is dominated by their essential roles in the treatment of opioid use disorder. Compared to usual care opioids, however, they provide improved post-operative pain control while reducing analgesic requirements. These findings argue for their expanded role within perioperative multimodal analgesia strategies.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"22 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344516","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 role of opioid analgesics in the development of post-operative delirium: A systematic review and meta-analysis.","authors":"Will S Roberts, Brendan P Chernicki, Justin Reidy, William Delladio, Jean-Pierre P Ouanes, Tsun Yee Law","doi":"10.5055/jom.0959","DOIUrl":"10.5055/jom.0959","url":null,"abstract":"<p><strong>Objective: </strong>To determine the influence of various opioid analgesics on the incidence of post-operative delirium (POD) by analyzing all available, relevant -literature.</p><p><strong>Design: </strong>A database search containing keywords assessing opioids and POD was performed in Embase, Web of Science, and MEDLINE-PubMed. Retrieved studies were screened via Rayyan, and adjusted odds ratios (ORs) for associations between opioid analgesia and POD were extracted, with two-sided p-values < 0.05 being deemed significant.</p><p><strong>Results: </strong>A total of 7,700 patients were analyzed, of which 1,703 developed POD, indicating an incidence of 22.1 percent. Random effects meta-analysis based on 95 percent confidence intervals reveals that opioid use (OR 1.15, 1.09-1.22, p < 0.001), specifically with meperidine (OR 3.36, 1.36-8.32, p < 0.009) or morphine (OR 1.42, 1.29-1.57, p < 0.001), is associated with increased incidence of POD. Furthermore, both perioperative (OR 1.10, 1.04-1.16, p < 0.001) and post-operative opioid administration (OR 1.92, 1.25-2.95, p < 0.003) were also associated with increased risk of POD.</p><p><strong>Conclusion: </strong>Opioid analgesics were associated with higher incidences of POD. Not all opioids increased the incidence of delirium. Elderly and renally impaired patient populations were at higher risk for developing opioid-related POD. Careful selection and judicious utilization of opioid analgesics may reduce the incidence of POD and ultimately the burden on the healthcare system.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"21 6","pages":"551-561"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933780","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":"Treatment characteristics of chronic low back pain patients prescribed Belbuca® and buprenorphine transdermal patches: A retrospective US Medicare claims analysis.","authors":"Filip Stanicic, Vladimir Zah, Dimitrije Grbic, Djurdja Vukicevic","doi":"10.5055/jom.0929","DOIUrl":"10.5055/jom.0929","url":null,"abstract":"<p><strong>Objective: </strong>To explore buprenorphine treatment characteristics and rescue medication utilization in Medicare-insured chronic low back pain (cLBP) patients prescribed buprenorphine buccal film (Belbuca®) or buprenorphine patch.</p><p><strong>Design: </strong>A retrospective real-world analysis using Merative MarketScan® Medicare Supplemental and Coordination of Benefits claims database (from January 1, 2018, to December 31, 2021). The first Belbuca or transdermal patch prescription was considered the index date. Patients were observed 6 months pre- and post-index. Exclusion criteria were gap in insurance coverage, opioid use disorder, or cancer during the observation.</p><p><strong>Setting: </strong>All levels of clinical care.</p><p><strong>Patients: </strong>Patients with cLBP (at least two preindex claims with low back pain diagnosis). Propensity-score matching was performed to balance cohorts for covariates.</p><p><strong>Interventions: </strong>Belbuca and buprenorphine transdermal patches.</p><p><strong>Main outcome measures: </strong>Buprenorphine treatment characteristics and rescue medication utilization.</p><p><strong>Results: </strong>There were 97 matched patients (36 Belbuca, 61 patch). Buprenorphine daily dose was higher in Belbuca (450 mcg vs 260 mcg, p = 0.001), with a wider dosing range (75-1,213 mcg vs 120-716 mcg). Comparing preindex to post-index, initiating Belbuca decreased Schedule II opioid (5.1 vs 3.6, p = 0.038) and long-acting opioid prescription counts (0.8 vs 0.1, p = 0.031), Schedule II opioid treatment duration (103 vs 77 days, p = 0.012), and daily morphine milligram equivalents (42.8 vs 30.4, p = 0.048). In the patch cohort, starting buprenorphine only decreased Schedule II opioid (2.9 vs 4.0, p = 0.014) and short-acting opioid prescription counts (3.7 vs 2.9, p = 0.044).</p><p><strong>Conclusion: </strong>The real-world evidence suggests that elderly cLBP patients may have greater benefits from Belbuca compared to the patch by achieving higher buprenorphine daily doses and decreasing opioid rescue medication use.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"21 6","pages":"509-541"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933806","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}