Articles: opioid.
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Meta Analysis
Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses.
This systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD). ⋯ Patients with cardiac, respiratory disease and/or obstructive sleep apnoea were at increased risk for OIRD. Patients with postoperative OIRD received higher doses of morphine equivalent daily dose.
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Harm reduction journal · Dec 2018
Multicenter StudyThe complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic.
Opioid agonist therapy (OAT) has been available in a standard regime in the Czech Republic since 2000. Buprenorphine is the leading medication, while methadone is available only in a few specialised centres. There is an important leakage of buprenorphine onto the illicit market, and the majority of Czech opioid users are characterised by the misuse (and injecting) of diverted buprenorphine medications. ⋯ This affordability barrier together with limited accessibility is likely the leading factor of limited coverage of OAT and of recent stagnation in the number of patients in the official treatment programmes in the Czech Republic. It also encourages doctor shopping and the re-selling of parts of their medication at a higher price, which represents the main factor that drives the Czech illicit market for buprenorphine, but at the same time co-finances the medication of clients in official OAT programmes. Improving access to OAT by making it financially affordable is essential to further increase OAT coverage and is one of the factors that can reduce the illicit market with OAT medications.
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More than half of patients hospitalized annually receive an opioid during their inpatient hospitalization, which may serve as a first opioid exposure. Although recent research addresses outpatient opioid prescribing following delivery, little is known regarding the extent to which opioids are used during the postpartum hospitalization following vaginal delivery. ⋯ In a large cohort, nearly one-quarter of women use opioid analgesia during the last 24 hours of inpatient hospitalization following vaginal delivery. Although patient factors account for some of the variation in inpatient opioid use, both use of acetaminophen and having had postpartum orders written by an advanced practitioner were independently associated with lower odds of inpatient opioid use.
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To determine the rate of patients visiting the emergency department who are at risk of opioid overdose. ⋯ The rate of patients visiting the emergency department at risk of opioid overdose increased significantly from 2013 to 2016. Naloxone was not routinely prescribed to this patient cohort.