Drug and alcohol dependence
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Substance use during pregnancy is a major medical and public health concern. Determination of the most appropriate screening protocol remains a clinical conundrum. Interviews and/or laboratory drug screens may be costly, inaccurate, and are frequently inadequate to identify patterns of substance use for a given population or geographic area. We compared commercially available urine "dip cup" toxicology screens obtained in the clinic to university hospital drug toxicology results. ⋯ Commercially available urine dip cups are cost-effective, equally comparable to hospital based screening, and provide 'real time' results germane to clinical care and treatment planning.
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Drug Alcohol Depend · Nov 2019
Pain severity and prescription opioid misuse among individuals with chronic pain: The moderating role of alcohol use severity.
Chronic pain is a public health problem associated with opioid misuse. Yet, it is important to understand factors underlying opioid misuse in the context of pain. Alcohol use is one factor to consider given past work documenting use of alcohol to manage pain. However, it is unknown whether alcohol use severity exacerbates the relation between pain and opioid misuse. This study sought to examine relations between pain and prescription opioid misuse and the moderating role of alcohol use severity in two online survey studies of individuals with chronic pain. ⋯ In two online samples, there was evidence of a novel interaction of pain severity and alcohol use severity in relation to opioid misuse. Although cross-sectional, results replicated in two studies. Pain severity was related to opioid misuse among those with higher but not lower alcohol use. Those who use alcohol, even below suggested cut-offs, may be more likely to misuse opioids when in pain.
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In Korea, the sale of the first heated tobacco product (HTP), IQOS®, commenced in June 2017. This study evaluates the rates of HTP use and examines HTP users' smoking patterns of various tobacco products. ⋯ Given the smoking pattern of HTP users in terms of mutual use with cigarettes, HTPs might not be an alternative to cigarettes as tobacco companies claim.
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Drug Alcohol Depend · Nov 2019
Correlation between interleukin-6 levels and methadone maintenance therapy outcomes.
The outcome of methadone maintenance therapy (MMT) varies in each patient with opioid use disorder (OUD). Opioid abuse activates proinflammatory processes by increasing cytokine production and impairing neurotrophic factor expression, and possibly leads to a vicious cycle that hinders recovery. Therefore, we investigated whether markers of inflammation and neurotrophic expression correlate with the MMT outcomes in OUD patients. ⋯ Higher IL-6 levels were associated with poor MMT outcomes. Additional studies on regulating IL-6 expression to improve treatment outcomes in OUD patients might be warranted.
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Drug Alcohol Depend · Nov 2019
Predictors of availability of long-acting medication for opioid use disorder.
The U.S. Food and Drug Administration has approved three long-acting medications for opioid use disorder (MOUD): extended-release naltrexone (XR-NTX) in 2010, a subdermal buprenorphine implant in 2016, and a depot buprenorphine injection in 2017. Long-acting MOUD options may improve adherence while reducing diversion, but their availability compared to daily-dosing MOUD has not been well-characterized. The objective of this analysis was to characterize the availability of long-acting MOUD in substance use disorder treatment settings in the United States. ⋯ In 2017, XR-NTX was available at most of the minority of facilities offering MOUD, but the buprenorphine implant was not. Increasing the availability of MOUD, including long-acting options, is necessary to address unmet need for opioid use disorder treatment.