Articles: opioid.
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Anesthesia and analgesia · Dec 2024
Associations Between Social Determinants of Health and Opioid-Use Disorder Among Chronic Pain Patients From a Multi-Institutional Dataset.
This study examined the association between opioid-use disorder (OUD)-related diagnoses (eg, opioid dependence) and social determinants of health (SDoH) among patients with chronic pain. ⋯ The study revealed a significantly greater social disadvantage metric in chronic pain individuals with OUD.
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In the United States, on average, every 15 s, someone visits a hospital emergency department (ED) for a dental condition. This commentary summarizes the recommendations from a 2024 clinical practice guideline for the pharmacological management of acute dental pain associated with tooth extractions and toothache applicable to ED settings, hospitals, and urgent care clinics where definitive dental treatment is not immediately available. ⋯ NSAIDs with or without acetaminophen are first-line therapy for managing acute dental pain following tooth extraction(s) and temporarily managing toothache. Opioids should be reserved for clinical situations when first-line therapy is insufficient or contraindications to NSAIDs exist.
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Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive. ⋯ Tramadol was identified in a subset of patients presenting to the Emergency Department with opioid overdoses suggesting adulteration of illicitly manufactured fentanyl with tramadol. Its presence was not associated with a lack of treatment response, difference in severity of overdose, or increased risk of complications.
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Reg Anesth Pain Med · Dec 2024
Opioid consumption in the first 30 days after surgery was independently associated with new persistent opioid use.
Previous studies suggest that new persistent opioid use (NPOU) after surgery was associated with larger perioperative opioid prescriptions, but the association between NPOU and postoperative opioid consumption is unknown. ⋯ Demonstrating that opioid consumption in the first 30 days after surgery was independently associated with NPOU underscores the importance of perioperative opioid prescribing on long-term outcomes.