Journal of addictive diseases
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Randomized Controlled Trial Comparative Study
Tramadol versus methadone for treatment of opiate withdrawal: a double-blind, randomized, clinical trial.
The aim of this study was to compare the efficacy and safety of tramadol versus methadone for treatment of opiate withdrawal. Seventy patients randomly were assigned in two groups to receive either prescribed methadone (60 mg/day) or tramadol (600 mg/day). The withdrawal syndrome of patients was evaluated before and after rapid opiate detoxification using the Objective Opioid Withdrawal Scale (OOWS). ⋯ Dropout rates were similar in both groups. Side effects in the tramadol group were as or less common than in the methadone group, with the exception of perspiration. Tramadol may be as effective as methadone in the control of withdrawal and could be considered as a potential substitute for methadone to manage opioids withdrawal.
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Route of administration is an important contributor to the adverse health consequences of prescription medication abuse. The current study examines characteristics associated with non-oral routes of administration among a large sample of prescription opioid abusers and explores needle-related human immunodeficiency virus (HIV) risk behaviors as well. ⋯ The youngest prescription opioid abusers, ages 18-24, displayed significantly higher odds of using alternate routes of administration and of reusing nonsterile needles for injection. HIV prevention programming should be developed for young prescription opioid injectors.
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Synthetic cannabinoid abuse is increasing in the United States. Synthetic cannabinoid exposures reported to Texas poison centers in 2010 were identified, and the distribution of exposures by selected factors was determined. There were 464 total cases. ⋯ The patients were 73.9% male and 57.3% were 20 years or older. Moderate or major effects or potentially toxic outcome occurred in 59.9% of the exposures. The most frequently reported clinical effects were tachycardia (37.3%), agitation (18.5%), drowsiness (18.5%), vomiting (15.7%), hallucinations (10.8%), and nausea (9.9%).
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A national sample of addiction treatment Program Directors (N = 296) were assessed regarding their attitudes about pharmacological treatment for addiction disorders. Multivariable analyses indicate that directors who worked in organizations affiliated with research institutions and who had more professional experience had significantly more positive attitudes about a range of pharmacological therapies. Also, directors in organizations serving higher percentage homeless clients and clients with severe and persistent mental illness had more negative attitudes toward use of buprenorphine. Community-based organizations providing addiction treatment to specific vulnerable client groups exhibit more negative attitudes about pharmacological evidence-based practices and may underutilize those practices.