Journal of opioid management最新文献

{"title":"Predictors of MOUD referral among persons with involvement in the criminal legal system.","authors":"Andrew P Bontemps, Sofia Mildrum Chana, Elizabeth S Hawes, Yoser Al Rawi, Christina E Cenczyk, Lindsey R Atkins, Li Li, Karen L Cropsey","doi":"10.5055/jom.0831","DOIUrl":"https://doi.org/10.5055/jom.0831","url":null,"abstract":"<p><strong>Introduction: </strong>Opioid use disorder (OUD) is a significant cause of opioid-related fatality, and while medications to treat OUD (MOUD) are effective, disparities remain in the access and uptake of such medications. This study investigated factors that may influence referral to and initiation of MOUD treatment.</p><p><strong>Methods: </strong>Data from electronic medical records of 677 patients with a history of criminal legal system involvement in a recovery program were used to examine the flow of MOUD referral.</p><p><strong>Results: </strong>Among patients identified as potentially eligible for MOUD treatment, about 38.0 percent were referred and 18.8 percent were confirmed to initiate MOUD treatment. Logistic regression analyses highlighted female gender and unemployment due to incarceration as positive and negative predictors of referral, respectively. The Chi-square test revealed that women and uninsured patients were more likely to initiate referred MOUD treatment.</p><p><strong>Conclusions: </strong>Data highlight the need for greater connection between referral agencies and MOUD treatment providers, considering factors that may influence referral.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 2","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859159","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":"Opioid use and disposal at 2 weeks post-surgery: Brief communication regarding excess opioids and disposal habits.","authors":"Henry Kuechly, Sarah Kurkowski, John Bonamer, Brian Newyear, Brian Johnson, Brian Grawe","doi":"10.5055/jom.0854","DOIUrl":"10.5055/jom.0854","url":null,"abstract":"<p><strong>Objective: </strong>To measure the number of unused prescription opioids and disposal habits of patients following orthopedic shoulder surgery.</p><p><strong>Design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Academic orthopedic sports medicine department.</p><p><strong>Patients: </strong>Sixty-seven patients undergoing shoulder surgery.</p><p><strong>Interventions: </strong>Nine-question opioid use questionnaire.</p><p><strong>Main outcome measures: </strong>Responses to an opioid use questionnaire were collected at 2 weeks post-surgery. Outcomes of interest included the amount of initial opioid prescription used and the disposal of excess opioids.</p><p><strong>Results: </strong>Sixty-seven patients completed the opioid use questionnaire. Forty-six (68.7 percent) patients reported having excess opioids at 2 weeks. Of the 46 patients with excess opioids, 57 percent disposed of the excess, and 43 percent planned to keep their opioids.</p><p><strong>Conclusion: </strong>Two-thirds of the patients reported having excess opioids, highlighting the issue of an overabundance of unused prescription opioids in America. Utilization of opioid-free pain management strategies and drug disposal kits should be explored to reduce the number of unused and improperly disposed opioids.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 2","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855322","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":"Opioid prescribing patterns for distal radius fractures in the ambulatory setting: A 10-year retrospective study.","authors":"Brian Pettitt-Schieber, Robert P Lesko, Fei Wang, Jinesh Shah, Joseph A Ricci","doi":"10.5055/jom.0862","DOIUrl":"10.5055/jom.0862","url":null,"abstract":"<p><strong>Objective: </strong>Distal radius fractures (DRFs) are one of the most common orthopedic injuries, with most managed in the nonoperative ambulatory setting. The objectives of this study are to examine National Health Center Statistics (NHCS) data for DRF treated in the nonoperative ambulatory setting to identify opioid and nonopioid analgesic prescribing patterns and to determine demographic risk factors for prescription of these medications. Design, setting, patients, and measures: This study is a retrospective analysis of data collected by the NHCS from 2007 to 2016. Utilizing International Classification of Diseases codes, all visits to emergency departments and doctors' offices for DRFs were identified. Variables of interest included demographic data, expected payment source, and prescription of opioid or nonopioid analgesics.</p><p><strong>Results: </strong>During the study timeframe, 15,572,531 total visits for DRFs were recorded. DRF visits requiring opioid and nonopioid analgesic prescriptions increased over time. Patients aged 45-64 years were significantly more likely to receive an opioid prescription than any other age group (p < 0.05). Opioid prescription was positively correlated with the use of workers' compensation and negatively correlated with patients receiving services under charity care (p < 0.05).</p><p><strong>Conclusions: </strong>Prescriptions of both opioid and nonopioid analgesic medications for DRF have been steadily increasing over time in the nonoperative ambulatory setting, with middle-aged adults most likely to receive an opioid prescription. Opioid prescription rates differ significantly between patients utilizing workers' compensation and patients receiving services under charity care, suggesting that socioeconomic factors play a role in prescribing patterns.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 2","pages":"109-117"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866551","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":"Conversion ratios: Why is it so challenging to construct opioid conversion tables?","authors":"Mellar P Davis, Mary Lynn McPherson, Akhila Reddy, Amy A Case","doi":"10.5055/jom.0853","DOIUrl":"10.5055/jom.0853","url":null,"abstract":"<p><p>Standardizing opioid management is challenging due to the absence of a ceiling dose, the unknown ideal therapeutic plasma level, and the lack of an clear relationship between dose and therapeutic response. Opioid rotation or conversion, which is switching from one opioid, route of administration, or both, to another, to improve therapeutic response and reduce toxicities, occurs in 20-40 percent of patients treated with opioids. Opioid conversion is often needed when there are adverse effects, toxicities, or inability to tolerate a certain opioid formulation. A majority of patients benefit from opioid conversion, leading to improved analgesia and less adverse effects. There are different published ways of converting opioids in the literature. This review of 20 years of literature is centered on opioid conversions and aims to discuss the complexity of converting opioids. We discuss study designs, outcomes and measures, pain phenotypes, patient characteristics, comparisons of equivalent doses between opioids, reconciling conversion ratios between opioids, routes, directional differences, half-lives and metabolites, interindividual variability, and comparison to package insert information. Palliative care specialists have not yet come to a consensus on the ideal opioid equianalgesic table; however, we discuss a recently updated table, based on retrospective evidence, that may serve as a gold standard for practical use in the palliative care population. More robust, well-designed studies are needed to validate and guide future opioid conversion data.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 2","pages":"169-179"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865274","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":"United States marijuana legalization and opioid mortality trends before and during the first year of the COVID-19 pandemic.","authors":"Archie Bleyer, Brian Barnes, Kenneth Finn","doi":"10.5055/jom.0829","DOIUrl":"https://doi.org/10.5055/jom.0829","url":null,"abstract":"<p><strong>Background: </strong>To determine if marijuana legalization was associated with reduced opioid mortality.</p><p><strong>Study design: </strong>The United States (US) opioid mortality trend during the 2010-2019 decade was compared in states and District of Columbia (jurisdictions) that had implemented marijuana legalization with states that had not. Acceleration of opioid mortality during 2020, the first year of the coronavirus disease 2019 (COVID-19) pandemic, was also compared in recreational and medicinal-only legalizing jurisdictions.</p><p><strong>Methods: </strong>Joinpoint methodology was applied to the Centers for Disease Control and Prevention WONDER data. Trends in legalizing jurisdictions were cumulative aggregates.</p><p><strong>Results: </strong>The overall opioid and fentanyl death rates and the percentage of opioid deaths due to fentanyl increased more during 2010-2019 in jurisdictions that legalized marijuana than in those that did not (pairwise comparison p = 0.007, 0.05, and 0.006, respectively). By 2019, the all-opioid and fentanyl death rates were 44 and 50 percent greater in the legalizing than in the nonlegalizing jurisdictions, respectively. When the COVID-19 pandemic hit in 2020, jurisdictions that implemented recreational marijuana legalization before 2019 had significantly greater increases in both overall opioid and fentanyl death rates than jurisdictions with medicinal-only legalization. For all-opioids, the mean (95 percent confidence interval) 2019-to-2020 increases were 46.5 percent (36.6, 56.3 percent) and 29.1 percent (20.2, 37.9 percent), respectively (p = 0.02). For fentanyl, they were 115.6 percent (80.2, 151.6 percent) and 55.4 percent (31.6, 79.2 percent), respectively (p = 0.01).</p><p><strong>Conclusions: </strong>During the past decade, marijuana legalization in the US was associated at the jurisdiction level with a greater acceleration in opioid death rate. An even greater increase in opioid mortality occurred in recreational-legalizing jurisdictions with the onset of the COVID-19 pandemic. Marijuana legalization is correlated with worsening of the US opioid epidemic.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 2","pages":"119-132"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858237","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":"Chronic opioid pain treatment converted to buprenorphine: A case series using a 3-step low-dose incremental dosing guideline","authors":"Gregory Acampora, Yi Zhang","doi":"10.5055/jom.0822","DOIUrl":"https://doi.org/10.5055/jom.0822","url":null,"abstract":"We report a 30-case series from the Pain Management Center at the Massachusetts General Hospital where we have applied a guideline to convert chronic treatment for pain from full agonist opioids (FAO) to buprenorphine (BUP). Of the patients, 24 (80 percent) elected to continue BUP over FAO. Five conversions were stopped for side effects (fatigue) and/or lack of sufficient pain reduction. One patient elected not to participate on the day that the conversion was to begin. There were no major adverse events. We conclude that conversion to BUP should be considered as an alternative to treat patients on chronic opioids for pain.","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":" 86","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792967","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":"Monitoring buprenorphine in patients on medication-assisted treatment","authors":"Amadeo Pesce, Katie Bollman, Kevin Krock, A. Cua, Keith Tran, Richard Thomas","doi":"10.5055/jom.0844","DOIUrl":"https://doi.org/10.5055/jom.0844","url":null,"abstract":"Background: Buprenorphine is used for medication-assisted treatment of opioid dependence. \u0000Purpose: Monitoring of medication adherence involves testing of urine or oral fluid for the drug or its metabolite. \u0000Methods: Quantitative results using liquid chromatography tandem mass spectrometer testing defined the excretion pattern of the drug and its metabolites. \u0000Results: Frequency distribution curves of buprenorphine and norbuprenorphine describe the expected drug concentrations of patients on this medication. \u0000Conclusion: Urine and oral fluid drug testing can be used to monitor adherence in this population.","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"347 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139852413","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":"Monitoring buprenorphine in patients on medication-assisted treatment","authors":"Amadeo Pesce, Katie Bollman, Kevin Krock, A. Cua, Keith Tran, Richard Thomas","doi":"10.5055/jom.0844","DOIUrl":"https://doi.org/10.5055/jom.0844","url":null,"abstract":"Background: Buprenorphine is used for medication-assisted treatment of opioid dependence. \u0000Purpose: Monitoring of medication adherence involves testing of urine or oral fluid for the drug or its metabolite. \u0000Methods: Quantitative results using liquid chromatography tandem mass spectrometer testing defined the excretion pattern of the drug and its metabolites. \u0000Results: Frequency distribution curves of buprenorphine and norbuprenorphine describe the expected drug concentrations of patients on this medication. \u0000Conclusion: Urine and oral fluid drug testing can be used to monitor adherence in this population.","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792356","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":"Cancer pain patients do not successfully handle opioids","authors":"Liel Kosev, Ofir Morag, Michelle Levitan, Itay Goor-Aryeh","doi":"10.5055/jom.0849","DOIUrl":"https://doi.org/10.5055/jom.0849","url":null,"abstract":"Objective: To evaluate patterns of opioid handling as well as their associated variables. \u0000Design: A transversal study. \u0000Setting: Institutional care. \u0000Participants: One hundred cancer pain patients aged 18 and above at diagnosis. \u0000Interventions: Open and dichotomous questions related to opioid handling and a depression-anxiety scale. \u0000Main outcome measure(s): The percentage of patients who properly handled opioids. \u0000Results: Of those surveyed, 42.1 percent of patients reported receiving opioid storage instructions, 73 percent did not receive any instructions related to proper opioid return/disposal, and 39 percent wrongly discarded them. The mean of patients with anxiety symptoms was 6.95 and of depression symptoms was 8.19. The Hebrew Version of the Hospital and Anxiety Scale total mean was 15.1. A significant relationship among patients with poor disposal habits was also found. \u0000Conclusions: Despite being aware of opioid's danger, patients' attitudes evidenced a poor safety responsibility. We believe that this might be due to the high percentage of disinformation and the influence of psychological symptoms on patients' decision-making.","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":" 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792670","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 the relationship between head trauma and opioid use disorder: A systematic review","authors":"Ali Abid, Mariam Paracha, Iva Çepele, Awais Paracha, Joseph Rueve, Akbar Fidahussain, Humza Rehman, Mckimmon Engelhardt, Noor Alyasiry, Zohair Siddiqui, Satvik Vasireddy, Bishal Kadariya, Nikitha B. Rao, Rohan Das, Wilson Rodriguez, Dixie Meyer","doi":"10.5055/jom.0846","DOIUrl":"https://doi.org/10.5055/jom.0846","url":null,"abstract":"Objective: To examine recent literature and determine common clinical risk factors between antecedent traumatic brain injury (TBI) and the following development of opioid misuse and provide a framework for clinical identification of at-risk subjects and evaluate potential treatment implications within this association. \u0000Design: A comprehensive systematic literature search of PubMed was conducted for articles between 2000 and December 2022. Studies were included if the human participant had any head trauma exposure and any chronic opioid use or dependence. After eligibility criteria were applied, 16 studies were assessed for thematic trends. \u0000Results: Opioid use disorder (OUD) risks are heightened in cohorts with head trauma exposed to opioids while in the hospital, specifically with tramadol and oxycodone. Chronic pain was the most common predictor of long-term OUD, and continuous somatic symptoms associated with the TBI can lead to long-term opioid usage. Individuals who present with coexisting psychiatric conditions pose significantly more risk associated with a higher risk of long-term opioid use. \u0000Conclusion: Findings indicate that therapists and clinicians must consider a risk profile for persons with TBI and follow an integrated care approach to account for mental health, prior substance misuse, presenting somatic symptoms, and current medication regimen during evaluation.","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":" 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792984","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}