Articles: opioid.
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Pharmacoepidemiol Drug Saf · Sep 2014
Prescriber response to unsolicited prescription drug monitoring program reports in Massachusetts.
To describe prescriber response to unsolicited patient reports from the Massachusetts prescription drug monitoring program (PDMP). ⋯ Unsolicited reporting of PDMP data has the potential to improve clinical practice by alerting providers about patients with multiple prescribers and potentially medically unnecessary prescriptions.
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Patients with opioid use disorder maintained on methadone report more chronic pain than the general population. The current study characterized chronic pain in patients with opioid use disorder. ⋯ Results suggest there is a large discrepancy in the percent of patients who may need treatment for pain and those receiving treatment for pain and that more efforts should be made to provide standard pain management techniques to patients with opioid use disorder to reduce their overall level of pain and potentially improve their overall treatment outcomes.
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Randomized Controlled Trial
A novel adaptive servoventilation (ASVAuto) for the treatment of central sleep apnea associated with chronic use of opioids.
To compare the efficacy and patient comfort of a new mode of minute ventilation-targeted adaptive servoventilation (ASVAuto) with auto-titrating expiratory positive airway pressure (EPAP) versus bilevel with back-up respiratory rate (bilevel-ST) in patients with central sleep apnea (CSA) associated with chronic use of opioid medications. ⋯ The ASVAuto was significantly more effective than bilevel-ST for the treatment of CSA associated with chronic opioid use.
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The use of opioid medication for chronic pain has been increasing. The main aim of this study was to assess how many patients on opioids for chronic pain had sleep disordered breathing (SDB) and the type of SDB. The impact of these medications on daytime arterial blood gas (ABG) measurements and psychomotor vigilance was also studied. ⋯ A commentary on this article appears in this issue on page 853
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Review
Would legalizing illicit opioids reduce overdose fatalities? Implications from a natural experiment.
Overdose is the leading cause of premature mortality among heroin users. We examine whether the provision of regulated and quality-controlled heroin to users in specified doses would reduce heroin overdose rates. We also address this in the context of the epidemic of prescription opioid use and deaths seen in recent years in the United States and internationally. ⋯ The surge in the use of pharmaceutical opioids provides an example of the legal delivery of opioids of known dosage and free of contaminants, where overdose deaths can be examined to test these assumptions. Rates of fatal opioid overdose have escalated, with increased rates of prescribing of pharmaceutical opioids. On the basis of the experience with prescription opioids, unregulated legal heroin access would not reduce overdose rates.