Pharmaceutical Overdose Deaths, United States, 2010

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 02/2013; 309(7):657-9. DOI: 10.1001/jama.2013.272
Source: PubMed
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Available from: Christopher Jones, Dec 02, 2014
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    • "Opioid misuse and dependence are reaching epidemic proportions in the United States (US), resulting in overdoses, premature death, infectious disease and economic costs of $56 billion annually (Becker, Sullivan, Tetrault, Desai, & Fiellin, 2008; Birnbaum et al., 2011; Clausen, Waal, Thoresen, & Gossop, 2009; Hser, Hoffman, Grella, & Anglin, 2001; Jones, Mack, & Paulozzi, 2013; Paulozzi, 2012; SAMHSA, 2010; Shah, Lathrop, Reichard, & Landen, 2008; Wisniewski, Purdy, & Blondell, 2008). The problem is increasingly urgent in rural areas which often struggle with high rates of opioid misuse and a lack of available treatment options (Fortney & Booth, 2001; Lenardson & Gale, 2007; Rosenblum et al., 2011; Rounsaville & Kosten, 2000; Sigmon, 2014). "
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    ABSTRACT: Despite the effectiveness of agonist maintenance for opioid dependence, individuals can remain on waitlists for months, during which they are at significant risk for morbidity and mortality. Interim dosing, consisting of daily medication without counseling, can reduce these risks. In this pilot study, we examined the initial feasibility of a novel technology-assisted interim buprenorphine treatment for waitlisted opioid-dependent adults. Following buprenorphine induction during Week 1, participants (n=10) visited the clinic at Weeks 2, 4, 6, 8, 10 and 12 to ingest their medication under staff observation, provide a urine specimen and receive their remaining doses via a computerized Med-O-Wheel Secure device. They also received daily monitoring via an Interactive Voice Response (IVR) platform, as well as random call-backs for urinalysis and medication adherence checks. The primary outcome was percent of participants negative for illicit opioids at each 2-week visit, with secondary outcomes of past-month drug use, adherence and acceptability. Participants achieved high levels of illicit opioid abstinence, with 90% abstinent at the Week 2 and 4 visits and 60% at Week 12. Significant reductions were observed in self-reported past-month illicit opioid use (p<.001), opioid withdrawal (p<.001), opioid craving (p<.001) and ASI Drug composite score (p=.008). Finally, adherence with buprenorphine administration (99%), daily IVR calls (97%) and random call-backs (82%) was high. Interim buprenorphine treatment shows promise for reducing patient and societal risks during delays to conventional treatment. A larger-scale, randomized clinical trial is underway to more rigorously examine the efficacy of this treatment approach. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Addictive behaviors 07/2015; 51:136-142. DOI:10.1016/j.addbeh.2015.07.030 · 2.76 Impact Factor
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    • "With greater access to opioids there has been a parallel rise in reported cases of misuse and abuse of opioid analgesics (Crum, 2006; Compton and Volkow, 2006) and opioid-related overdose fatalities (Jones et al., 2010). In 2012 it was estimated that 4.9 million individuals 12 years or older were current nonmedical users of pain relievers (SAMHSA, NSDUH, 2013), there were 488,004 emergency department visits related to nonmedical use of opioids in 2011 (SAMHSA, DAWN, 2013) and there were l86,986 admissions to treatment facilities for opioid use disorders (SAMHSA, TEDS, 2013). "
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    ABSTRACT: Opioid therapy is one component of an effective pain management regimen for patients with chronic pain and the majority of these patients use their medications responsibly. However, there are a growing number of these patients who develop an opioid use disorder and in some cases require opioid replacement therapy. Managing these patients is complex and the underlying mechanisms of pain and addiction are not well understood. Developing an effective interdisciplinary treatment program for the individual with pain and an opioid use disorder will depend on enhancing our knowledge of the psychophysiology of pain and addiction. Authors gathered key empirical and theoretical papers examining the psychophysiology of comorbid pain and opioid misuse disorders. This article reviews the current theory of the effect of pain on patients with pain and concomitant addiction, the psychophysiology of pain, opioid use and addiction, and future research in this area. Individuals with a history of opioid misuse have greater levels of hyperalgesia which may be due to alterations in psychophysiological pathways. More research is needed into the psychophysiological biomarkers among individuals with comorbid pain and addiction in order to develop better treatment approaches and improve outcomes among this difficult to treat population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Drug and Alcohol Dependence 11/2014; 146(1). DOI:10.1016/j.drugalcdep.2014.10.023 · 3.42 Impact Factor
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    • "Unfortunately, there is no panacea when it comes to managing pain because patients do not respond similarly to a given medication and may fail to realize the benefits of several formulations due to adverse effects, lack of efficacy due to single nucleotide polymorphism variants [9] [10] [11], or the development of tolerance [12]. In spite of the consensus that patients with valid complaints of pain should receive treatment for their pain, there is an equally valid consensus that there is a real and urgent need to decrease the unintended and undesirable consequences that opioid diversion has on society [13] [14]. Proponents of the new extended-release formulation of hydrocodone argue that there is a real and unmet need for alternate safe and effective options for the management of pain. "
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    ABSTRACT: Recently, the U.S. Food and Drug Administration (FDA) approved Zohydro®, an extended release formulation of the opioid analgesic hydrocodone that contains no acetaminophen. This approval was against the recommendation of the FDA's Expert Panel. Subsequently, both chronic pain advocates and anti-drug abuse advocates have steadfastly expressed their support of, or astonishment at this decision. Here, we review the pharmacokinetics, pharmacodynamics, safety and abuse liability of this hydrocodone formulation and how it relates to Expert Panel's opinion and the FDA decision. We discuss the important issues, risk mitigation, potential use of abuse deterrents, and how the different viewpoints of the Expert Panel and FDA decision makers resulted in the approval and subsequent controversy.
    Pharmacological Research 10/2014; 91. DOI:10.1016/j.phrs.2014.09.006 · 4.41 Impact Factor
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