Articles: opioid.
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Addictive behaviors · Nov 2018
Medical, psychosocial, and treatment predictors of opioid overdose among high risk opioid users.
Drug overdoses are the leading cause of accidental death in the United States. It is imperative to explore predictors of opioid overdose in order to facilitate targeted treatment and prevention efforts. The present study was conducted as an exploratory examination of the factors associated with having a past opioid overdose. ⋯ Overall, this study demonstrated certain demographic and drug use factors associated with elevated risk for an overdose. Understanding the risk factors associated with drug overdose can lead to targeted naloxone training and distribution to prevent fatal overdoses.
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This study examined whether a modern total knee arthroplasty (TKA) protocol without a tourniquet results in less patient-reported pain and in-hospital opioid consumption compared to TKA with a tourniquet. ⋯ Avoiding tourniquet use during TKA for females may be a relatively risk-free adjunct to minimize opioid consumption during hospitalization. Further study is warranted to elucidate the factors accounting for different outcomes in females and males.
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Preventive medicine · Nov 2018
Correlations between population-levels of prescription opioid dispensing and related deaths in Ontario (Canada), 2005-2016.
Canada is experiencing an ongoing opioid-related public health crisis, including persistently rising opioid (e.g., poisoning) mortality. Previous research has documented marked correlations between population-levels of opioid dispensing and deaths. We examined possible correlations between annual population-level dispensing of specific opioid formulations and related poisoning deaths in Ontario (Canada), for the period 2005-2016. ⋯ Strong correlations between levels of dispensing and deaths for select opioid formulations were found. For select others, extrinsic factors - e.g., increasing involvement of non-medical opioid products (e.g., fentanyl) in overdose deaths - likely confounded underlying correlation effects. Opioid dispensing levels continue to influence population-level mortality levels, and need to be addressed by prevention strategies.
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ANZ journal of surgery · Nov 2018
Opioid prescribing in orthopaedic and neurosurgical specialties in a tertiary hospital: a retrospective audit of hospital discharge data.
To understand patterns of opioid prescribing on discharge in the orthopaedic and neurosurgical wards of a tertiary metropolitan hospital. ⋯ Orthopaedic and neurosurgical units had high opioid prescribing rates on discharge from hospital. This highlights the need for clear communication of the intended medication management plan post-discharge in order to minimize inappropriate and ongoing use of opioids post-surgery.
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Few studies have evaluated the impact of preoperative opioid use on risk of subsequent revision following primary total knee arthroplasty (TKA). The purpose of this study was to determine whether preoperative opioid use is associated with an increased risk of early revision TKA. ⋯ This study identified preoperative opioid use as being independently associated with a greater risk for an early revision TKA. Younger age, obesity, and smoking were also associated with elevated risk. These findings support efforts to reduce inappropriate opioid prescribing.