Articles: opioid.
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Otolaryngol Head Neck Surg · Nov 2018
Pain in Head and Neck Cancer Survivors: Prevalence, Predictors, and Quality-of-Life Impact.
Pain is common among patients with cancer, stemming from both malignancy and side effects of treatment. The extent to which pain persists after treatment has received little attention. We examined the prevalence, predictors, and impact on quality of life (QOL) caused by pain among survivors of head and neck cancer. ⋯ Years after head and neck cancer treatment, pain remains a significant problem and is associated with worse QOL. Future efforts should focus on preventing pain from treatment and comprehensive management.
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Drug Alcohol Depend · Nov 2018
Comparative StudyThe G-protein biased mu-opioid agonist, TRV130, produces reinforcing and antinociceptive effects that are comparable to oxycodone in rats.
Mu-opioid agonists (e.g., oxycodone) are highly effective therapeutics for pain. However, they also produce reinforcing effects that increase their likelihood of abuse. Recent strategies in drug development have focused on opioids with biased receptor-signaling profiles that favor activation of specific intracellular pathways over others with the aim of increasing therapeutic selectivity. ⋯ For the Hot-Plate test, male rats (n = 7) received subcutaneous injections of TRV130 (0.1-3.2 mg/kg/inj) or oxycodone (0.1-5.6 mg/kg/inj), and nociceptive response latencies were measured. TRV130 and oxycodone were equi-potent and equi-effective in self-administration and thermal antinociception. This study demonstrates that TRV130 produces reinforcing and antinociceptive effects that are quantitatively similar to oxycodone, and that a biased-signaling profile does not necessarily reduce abuse potential.
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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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Addictive behaviors · Nov 2018
Mixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management.
Opioid prescribing and subsequent rates of serious harms have dramatically increased in the past two decades, yet there are still significant barriers to reduction of risky opioid regimens. This formative evaluation utilized a mixed-methods approach to identify barriers and factors that may facilitate the successful implementation of Primary Care-Integrated Pain Support (PIPS), a clinical program designed to support the reduction of risky opioid regimens while increasing the uptake of non-pharmacologic treatment modalities. ⋯ While organizational readiness for implementing PIPS appears high, modifications to our implementation facilitation strategy (e.g., establishing clinical pharmacists as champions; marketing PIPS to leadership as a way to improve VA opioid safety metrics) may improve capacity of the sites to implement PIPS successfully.