Articles: narcotic-antagonists.
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Both opioid use disorder and mortality for opioid overdoses are increasing. Family physicians (FPs) can treat opioid use disorder if they are waivered to prescribe buprenorphine. Our objective was to determine personal, practice, and community characteristics associated with FPs prescribing buprenorphine. ⋯ Few FPs prescribed buprenorphine, but those in practice settings with supporting mental health services were more likely to prescribe. With their training in the biopsychosocial model and a more even distribution across the rural continuum, FPs are perfectly situated to meet the increasing need for medication-assisted treatment. However, ensuring they have supporting mental health services will be central to having more FPs provide medication-assisted treatment.
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Background: Research indicates U. S. racial and ethnic minority patients are prescribed opioids for pain less often than non-Hispanic Whites. Racial inequities are strongest for pain conditions with uncertain prognosis (e.g., chronic pain syndrome) compared to acute pain with defined duration (e.g., fractures). ⋯ However, Native American and Hispanic CPS patients prescribed opioids are more likely to get naloxone prescriptions despite being less likely to get opioid prescriptions. And while Native American and Asian/Pacific Islander fracture patients and "other" race/ethnicity CPS patients are less likely to receive an opioid prescription than non-Hispanic Whites, there is no difference from non-Hispanic Whites in their likelihood of receiving a naloxone prescription. Conclusions: Among patients prescribed opioids, naloxone prescriptions vary by patient race/ethnicity and by health condition, indicating the need for efforts to assure equitable diffusion of this harm reduction intervention.
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Using data from 2016 to 2018, we demonstrate a sharp increase in graduating family medicine residents and early-career family physicians who intend to or actually prescribe buprenorphine with no change in mid-to-late-career physicians. Family physicians are responding to the opioid crisis but, growing the family medicine workforce to treat opioid-use disorder will require a larger response from mid-to-late-career physicians.
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Observational Study
Pulmonary Complications of Opioid Overdose Treated With Naloxone.
We aim to determine whether administration of higher doses of naloxone for the treatment of opioid overdose is associated with increased pulmonary complications. ⋯ Higher doses of naloxone in the out-of-hospital treatment of opioid overdose are associated with a higher rate of pulmonary complications. Furthermore, prospective study is needed to determine the causality of this relationship.
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The United States is currently experiencing an opioid epidemic, as drug overdose deaths have become a leading cause of death. According to the Centers for Disease Control, in 2017, opioids were responsible for 47,000 deaths, which involved both illicit and prescription opioids. ⋯ The purpose of this program was to train patients and their families on how to respond to an opioid overdose and administer naloxone spray. The paper describes the implementation of this program.