Using the mouse grimace scale and behaviour to assess pain in CBA mice following vasectomy.

Buprenorphine Research (PubMed) - Tue, 08/09/2016 - 7:02am

Using the mouse grimace scale and behaviour to assess pain in CBA mice following vasectomy.

Appl Anim Behav Sci. 2016 Aug;181:160-165

Authors: Miller AL, Kitson GL, Skalkoyannis B, Flecknell PA, Leach MC

Abstract
Mice used in biomedical research should have pain reduced to an absolute minimum through refinement of procedures or by the provision of appropriate analgesia. Vasectomy is a common and potentially painful surgical procedure carried out on male mice to facilitate the production of genetically modified mice. The aim of our study was to determine if 0.05 mg/kg buprenorphine would ameliorate pain associated changes following abdominal vasectomy and to determine if the mouse grimace scale is an appropriate tool for the assessment of pain in this model. Eight male CBA mice underwent abdominal vasectomy as part of a genetically modified mouse-breeding programme. Here we assessed pain using a previously validated behaviour-based method and the mouse grimace scale. All mice received buprenorphine (0.05 mg/kg s.c.) pre-surgery. Behaviour and grimace scores were compared between baseline (pre-surgery), 30 min, 5 h, 24 h and 25 h post surgery. Following 24 h post-op, all mice were administered 5 mg/kg meloxicam (s.c.) as additional analgesia. Significant increases in specific pain behaviours and mouse grimace scale score were found 30 min post surgery. At 5 h post surgery, scores were returning to baseline levels. Frequency of rearing was significantly decreased at both 30 min and 5 h post surgery compared to baseline, demonstrating a longer lasting change in normal exploratory behaviour. Buprenorphine (0.05 mg/kg) was ineffective at ameliorating these pain-associated changes in CBA mice and should be considered inadequate at this dose. By 24 h post surgery, pain associated behaviours, grimace scale and rearing had all returned to baseline levels. There was no change in pain behaviours or MGS following administration of meloxicam indicating that an additional dose of meloxicam does not appear to offer benefit at this point. Using the mouse grimace scale to assess pain in mice, appeared to be effective in the immediate post vasectomy period in CBA mice demonstrating the same duration of increased score as the pain associated behaviours.

PMID: 27499567 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study.

Buprenorphine Research (PubMed) - Tue, 08/09/2016 - 7:02am
Related Articles

Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study.

BMC Pregnancy Childbirth. 2016;16(1):206

Authors: Farr A, Kiss H, Hagmann M, Holzer I, Kueronya V, Husslein PW, Petricevic L

Abstract
BACKGROUND: Vaginal infections are a risk factor for preterm delivery. In this study, we sought to evaluate the vaginal flora of pregnant women receiving opioid maintenance therapy (OMT) in comparison to non-dependent, non-maintained controls.
METHODS: A total of 3763 women with singleton pregnancies who underwent routine screening for asymptomatic vaginal infections between 10 + 0 and 16 + 0 gestational weeks were examined. Vaginal smears were Gram-stained, and microscopically evaluated for bacterial vaginosis, candidiasis, and trichomoniasis. In a retrospective manner, data of 132 women receiving OMT (cases) were matched for age, ethnicity, parity, education, previous preterm delivery, and smoking status to the data of 3631 controls. The vaginal flora at antenatal screening served as the primary outcome measure. Secondary outcome measures were gestational age and birth weight.
RESULTS: In the OMT group, 62/132 (47 %) pregnant women received methadone, 39/132 (29.5 %) buprenorphine, and 31/132 (23.5 %) slow-release oral morphine. Normal or intermediate flora was found in 72/132 OMT women (54.5 %) and 2865/3631 controls [78.9 %; OR 0.49 (95 % CI, 0.33-0.71); p < 0.001]. Candidiasis occurred more frequently in OMT women than in controls [OR 2.11 (95 % CI, 1.26-3.27); p < 0.001]. Findings were inconclusive regarding bacterial vaginosis (± candidiasis) and trichomoniasis. Compared to infants of the control group, those of women with OMT had a lower mean birth weight [MD -165.3 g (95 % CI, -283.6 to -46.9); p = 0.006].
CONCLUSIONS: Pregnant women with OMT are at risk for asymptomatic vaginal infections. As recurrent candidiasis is associated with preterm delivery, the vulnerability of this patient population should lead to consequent antenatal infection screening at early gestation.

PMID: 27495167 [PubMed - in process]

Categories: Bup Feeds

Anti-inflammatory effect of dual nociceptin and opioid receptor agonist, BU08070, in experimental colitis in mice.

Buprenorphine Research (PubMed) - Tue, 08/09/2016 - 7:02am
Related Articles

Anti-inflammatory effect of dual nociceptin and opioid receptor agonist, BU08070, in experimental colitis in mice.

Eur J Pharmacol. 2015 Oct 15;765:582-90

Authors: Zielińska M, Ben Haddou T, Cami-Kobeci G, Sałaga M, Jarmuż A, Padysz M, Kordek R, Spetea M, Husbands SM, Fichna J

Abstract
Endogenous opioid and nociceptin systems are widely distributed in the gastrointestinal tract where they seem to play a crucial role in maintaining the intestinal homeostasis. The aim of our study was to assess whether activation of nociceptin (NOP) and µ-opioid (MOP) receptors by a mixed NOP/MOP receptor agonist, BU08070, induces anti-inflammatory response in experimental colitis. The anti-inflammatory effect of BU08070 (1 mg/kg i.p.) was characterized in the mouse model of 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis, based on the assessment of the macroscopic and microscopic total damage scores and determination of myeloperoxidase (MPO) activity and TNF-α level in the colon. The effect of BU08070 on cell viability and NF-κB was characterized in THP-1 Blue cell line. The antinociceptive activity of BU08070 was examined in mustard oil-induced mouse model of abdominal pain. A potent anti-inflammatory effect of BU08070 (1 mg/kg i.p.) was observed as indicated by decrease in macroscopic damage score (1.88±0.39 vs. 5.19±0.43 units in TNBS alone treated mice), MPO activity (2.29±0.37 vs. 9.64±2.55 units) and TNF-α level in the colon (35.85±2.45 vs. 49.79±3.81 pg/ml). The anti-inflammatory effect of BU08070 was reversed by selective NOP and MOP receptor antagonists. BU08070 produced concentration-dependent inhibition of TNF-α and LPS-induced NF-κB activation. BU08070 exerted antinociceptive action in mice with experimental colitis. In conclusion, BU08070 significantly reduced the severity of colitis in TNBS-treated mice compared with controls. These results suggest that BU08070 is a potential therapeutic agent for inflammatory bowel diseases therapy.

PMID: 26404500 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

They’re Going to Ask. Be Ready with Answers.

Drug and Alcohol News (JoinTogether.com) - Mon, 08/08/2016 - 4:33pm

Your kids are going to ask you tough questions about drugs and alcohol (see below for examples). Not to worry — we’re here to help you answer them.

But before talking with your teen, keep the following strategies in mind to help you have a positive and productive conversation — no matter what question is thrown at you.

  1. Remain calm. Take a deep breath before responding.
  2. Keep an open mind. If your child feels judged, he’s less likely to be receptive to what you have to say.
  3. Avoid lecturing. Instead, try to come from a place of positivity and curiosity which will help lead to a more open dialogue. Example: Let’s explore your question in more detail, because it’s a good one.
  4. Thank your child for coming to you with questions. This will reassure him that you’re a safe place to get answers. At the end of your conversation, thank him again for talking with you.
  5. Remind your teen that you care deeply about his health and well-being. Example: “I want us to be able to discuss these topics because I love you and I want to help during these years when you’re faced with a lot of difficult choices.”

Get more tips on how to talk with your child about drugs (video) >

YOUR CHILD ASKS: Prescription drugs aren’t as bad as street drugs, right?

Be sure your child understands that simply because prescription drugs are legal it does not mean they are always safe — and that prescription drugs are only legal for the person for whom they’re prescribed.

Abuse of prescription medicines can be just as addictive and dangerous (even fatal) as the abuse of illegal street drugs. In fact, some of those “hardcore,” illegal street drugs are made of the same stuff as prescription pain relievers.

Read More

For instance, heroin and oxycodone are both opioids derived from a common root: poppy. While kids might think that taking a prescription painkiller (like OxyContin, Percocet and Vicodin) gives the full-on euphoria of heroin without the risks, the truth is, if misused or abused, prescription painkillers are very dangerous. Also, if you take someone else’s prescription you may not know what the pill really is or what the strength is. A large, single dose of oxycodone can result in potentially fatal respiratory depression.

It’s also important to point out that combining prescription drugs with other substances — particularly alcohol — can result in life-threatening respiratory distress and death.

Learn how to safeguard and dispose of unused or expired medicine >
Learn about our action campaign, The Medicine Abuse Project >
Watch our new film exploring teen stress and pressure and the unhealthy ways many cope, including abusing Rx stimulants, BREAKING POINTS >

Get the news and updates you need to stay informed. Sign up now >

YOUR CHILD ASKS: Weed’s legal, isn’t it?

Marijuana remains illegal under federal law, but marijuana for medical purpose is now legal in 25 states, of which four (plus Washington, DC) have legalized it for recreational purposes.

In those four states (Alaska, Colorado, Oregon, Washington, plus DC), you must be 21 years old to purchase, possess or use retail marijuana or marijuana products. And it is illegal to give or sell retail marijuana to minors.

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The people in these states hope that by 21, they’ve given young adults enough time to make their own decision around it.

But why would states make something legal that could be harmful?

Let’s look at alcohol. It’s legal, but causes damage, including DUIs, car accidents and other behavior that leads to jail time. Alcohol can also cause major health problems, including liver problems. Cigarettes are also legal, even though they are highly addictive and proven to cause birth defects and cancer. Just because something is legal and regulated doesn’t make it safe or mean it isn’t harmful.

Mind-altering substances — including marijuana — are harmful for the still-developing teen brain. During the adolescent years, your teen is especially susceptible to the negative effects of any and all drug use, including marijuana.

Scientific evidence shows that marijuana use during the teen years could potentially lower a person’s IQ and interferes with other aspects of functioning and well-being. Even occasional use of pot can cause teens to engage in risky behavior, be taken advantage of, find themselves in vulnerable situations and make bad choices while under the influence — like combining weed and alcohol, driving while high or engaging in unsafe sex.

Note: it’s important that your child inherently understands that you don’t approve of his use of marijuana, in the same way that you don’t want him to smoke cigarettes, drink alcohol or use other drugs. Teenagers say that parents are the most important influence when it comes to drugs and alcohol. (They are listening to you, even though they may not show it.) That’s why it’s important to be clear about your expectations.

Learn how to talk to your kids about marijuana with our free Marijuana Talk Kit >

 

YOUR CHILD ASKS: Drinking is worse than smoking weed, isn’t it?

While some teens may argue that weed is safer than alcohol, research shows that teens don’t typically use alcohol OR weed; they use both, often at the same time — a dangerous combination. The biggest impact of mixing marijuana and alcohol is the significant increase in impairment in judgment. The level of intoxication and secondary effects experienced can be unpredictable. Some people may be more prone to episodes of lightheadedness and fatigue.

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Also, because marijuana is an anti-emetic (used to treat nausea and vomiting in medical situations), it may be easier to drink alcohol until dangerously high blood alcohol levels are reached, as the normal body defense of vomiting when drunk may be muted by the marijuana.

Tell your teen that you don’t want her to be doing anything that can harm her — whether that’s smoking pot, cigarettes, drinking or other reckless behavior.

Remain curious and ask your teen why she thinks weed is safer than alcohol.

Learn how to talk to your kids about marijuana with our free Marijuana Talk Kit >
Watch this video: Marijuana vs. Alcohol: What to Say to Your Teen >
Learn more about Underage Drinking >

Get the news and updates you need to stay informed. Sign up now >

YOUR CHILD ASKS: Why is heroin so addictive?

Heroin is a highly-addictive drug derived from morphine, which is obtained from opium poppy plants.

Heroin use impacts the brain more severely than other substances and can create brain changes that lead to addiction.

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After an injection of heroin, the user reports feeling a surge of euphoria or “rush.” With regular heroin use, tolerance develops. This means the person must use more heroin to achieve the same intensity or effect.

At higher doses used over time, addiction develops and the person has an overpowering physical urge for the drug. This is called craving. The person also experiences a loss of control, making it more difficult to refuse the drug, even when use becomes harmful. Most people who are addicted to opioids cannot taper off (use less of the drug over time) without help.

With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (“cold turkey”), kicking movements and other symptoms.

Heroin abuse is associated with a number of serious health conditions, including fatal overdose, infectious diseases like hepatitis and HIV (because these diseases are transmitted through contact with blood or other bodily fluids, which can occur when sharing needles or other injection drug use equipment.)

Some teenagers and young adults are at greater risk of becoming addicted because of their temperament or personal situation, such as having a mental health disorder or experiencing trauma in childhood.

In addition, if there is a history of addiction – cocaine, alcohol, nicotine, etc. – in your family, then your child has a much greater risk of developing a drug or alcohol problem. Explain to your teen that while he may be tempted to try drugs, the odds are really against him. His genes make him more vulnerable and he could easily develop a dependence or addiction. Use this family history as a way to talk with your child and regularly remind him of this elevated risk, as you would with any disease.

Learn what you can do about the heroin epidemic >
If your child is addicted to heroin or prescription pain medicine, medication-assisted treatment may help >

 

YOUR CHILD ASKS: Molly just makes you feel happy. What’s wrong with that?

“Molly,” is the powder or crystal form of MDMA, which is the chemical used in Ecstasy. Some claim that Molly is less dangerous than other illegal drugs because it’s not physically addictive, more pure than other forms of ecstasy and will not cause cognitive impairment as it doesn’t kill brain cells. The reality, however, is that the use of Molly — a stimulant drug — comes with serious health risks. The DEA notes that it can cause confusion, anxiety, depression, paranoia, sleep problems and drug craving.

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Health risks can include anything from involuntary teeth clenching, a loss of inhibitions, transfixion on sights and sounds, nausea, blurred vision and chills and/or sweating. More serious risks can even include increased heart rate and blood pressure and seizures.

The news media reported several stories about Molly’s popularity at music festivals. This is perhaps the most hazardous of settings, because when combined with the hot crowded conditions, intake of MDMA can lead to severe dehydration and dramatic increases in body temperature. This, in turn, can lead to muscle breakdown and kidney, liver and cardiovascular failure.

An additional risk of taking Molly is the potential of it being “cut” or mixed with other harmful substances by someone else, despite claims of it being pure.

Learn more about Molly >
Learn more about Ecstasy >

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YOUR CHILD ASKS: Dad, Mom, did you ever try drugs?

Here’s what you can say if you did smoke weed when you were younger:

“I’m not going to pretend like I didn’t, and that’s why I’m talking to you about this. I will tell you that when I did smoke, my judgment was compromised and the only thing that prevented me from getting into some horrible circumstances was luck.”

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You may want to point out some of the negative things that happened to you (or your friends) that you wish didn’t.

“And you may be thinking: Well, you did it, and nothing horrendous happened to you. I just want you to understand that these are chances you may take, and they are just that, chances. A lot of harmful things don’t happen to you because of your ability to make clear decisions. When you are stoned that ability is very much compromised.”

Here, you’re not only being informative but reminding her that marijuana can impact her judgment.

Here’s what you can say if you didn’t smoke weed when you were younger:

“You may or may not believe this, but I never smoked weed when I was a kid. It didn’t have a place in my life, and would have interfered with the activities I enjoyed.”

Here, you’re explaining why marijuana didn’t interest you. Your reasoning may have been that you didn’t want it to interfere with the activities you enjoyed; that you didn’t feel you needed to use weed to fit in; that you were turned off by the smell; or any other honest reason that kept you from trying marijuana yourself.

Learn more: How to Talk to Your Kids About Drugs If You Did Drugs (pdf) >
Watch this video: “But YOU smoked when you were younger” >

 

If you are worried about your teen’s drinking or drug use, please call our Parent Toll-Free Helpline at 1-855-DRUGFREE (1-855-378-4373) to speak with a trained and caring specialist. Or visit Get Help to learn more.

What questions are your kids asking you? Share with us in the comment section below and we’ll help you answer them.

The post They’re Going to Ask. Be Ready with Answers. appeared first on Partnership for Drug-Free Kids.

Categories: Bup Feeds

Treatment of Opioid-Use Disorders.

Buprenorphine Research (PubMed) - Sun, 08/07/2016 - 12:54pm
Related Articles

Treatment of Opioid-Use Disorders.

N Engl J Med. 2016 Jul 28;375(4):357-68

Authors: Schuckit MA

PMID: 27464203 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Shifting blame: Buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America.

Buprenorphine Research (PubMed) - Fri, 08/05/2016 - 6:46am

Shifting blame: Buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America.

Transcult Psychiatry. 2016 Aug 3;

Authors: Mendoza S, Rivera-Cabrero AS, Hansen H

Abstract
Growing nonmedical prescription opioid analgesic use among suburban and rural Whites has changed the public's perception of the nature of opioid addiction, and of appropriate interventions. Opioid addiction has been recast as a biological disorder in which patients are victims of their neurotransmitters and opioid prescribers are irresponsible purveyors of dangerous substances requiring controls. This framing has led to a different set of policy responses than the "War on Drugs" that has focused on heroin trade in poor urban communities; in response to prescription opioid addiction, prescription drug monitoring programs and tamper-resistant opioid formulations have arisen as primary interventions in place of law enforcement. Through the analysis of preliminary findings from interviews with physicians who are certified to manage opioid addiction with the opioid pharmaceutical buprenorphine, we argue that an increase in prescriber monitoring has shifted the focus from addicted people to prescribers as a threat, paradoxically driving users to illicit markets and constricting their access to pharmaceutical treatment for opioid addiction. Prescriber monitoring is also altering clinical cultures of care, as general physicians respond to heightened surveillance and the psychosocial complexities of treating addiction with either rejection of opioid dependent patients, or with resourceful attempts to create support systems for their treatment where none exists.

PMID: 27488225 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Relative Contribution of Adjuvants to Local Anesthetic for Prolonging the Duration of Peripheral Nerve Blocks in Rats.

Buprenorphine Research (PubMed) - Wed, 08/03/2016 - 3:41pm
Related Articles

Relative Contribution of Adjuvants to Local Anesthetic for Prolonging the Duration of Peripheral Nerve Blocks in Rats.

Reg Anesth Pain Med. 2016 Aug 1;

Authors: Buvanendran A, Kroin JS, Li J, Moric M, Tuman KJ

Abstract
BACKGROUND AND OBJECTIVES: A chemically compatible, safe 4-drug multimodal formulation of bupivacaine combined with 3 adjuvants (clonidine, buprenorphine, and dexamethasone) has been proposed for long-lasting single-injection peripheral nerve blocks in patients. However, the relative importance of each of the adjuvants of the 4-drug formulation in producing long-lasting nerve blocks has not been determined. The aim of this study in rats was to determine which adjuvants (clonidine, buprenorphine, or dexamethasone) are essential for producing a long-lasting nerve block.
METHODS: After baseline sensory and motor responses were recorded, 0.1 mL of drug solution was injected into the sciatic notch of rats. Animals were reevaluated at 10-minute intervals after injection for the absence or presence of sensory and motor response in the sciatic nerve. The 4-drug formulation of 0.25% bupivacaine plus all 3 adjuvants (clonidine, buprenorphine, and dexamethasone), 0.25% bupivacaine with 1 or 2 of the adjuvants added separately, and 0.25% bupivacaine alone were compared for duration of nerve block.
RESULTS: The 4-drug multimodal solution produced a longer duration of sensory and motor nerve block than 0.25% bupivacaine alone (P < 0.0001). Bupivacaine plus clonidine also produced a longer duration of nerve block than 0.25% bupivacaine alone (P = 0.0157), but bupivacaine plus buprenorphine or bupivacaine plus dexamethasone did not prolong nerve block compared to bupivacaine alone. There was no difference (P = 0.1414) in the duration of nerve block between the 4-drug multimodal solution versus bupivacaine plus clonidine.
CONCLUSIONS: This animal study confirmed that the 4-drug multimodal formulation proposed for clinical nerve block produces superior duration of action compared to local anesthetic alone. This rat sciatic nerve model also indicated that one of the 3 adjuvants, clonidine, could by itself account for the extended duration of nerve block of bupivacaine.

PMID: 27483415 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Reply: Buprenorphine Versus Methadone for Opioid Dependence in Pregnancy.

Buprenorphine Research (PubMed) - Wed, 08/03/2016 - 3:41pm
Related Articles

Reply: Buprenorphine Versus Methadone for Opioid Dependence in Pregnancy.

Ann Pharmacother. 2016 Aug 1;

Authors: Noormohammadi A

PMID: 27481840 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Comment: Buprenorphine Versus Methadone for Opioid Dependence in Pregnancy.

Buprenorphine Research (PubMed) - Wed, 08/03/2016 - 3:41pm
Related Articles

Comment: Buprenorphine Versus Methadone for Opioid Dependence in Pregnancy.

Ann Pharmacother. 2016 Aug 1;

Authors: Ruan X, Bordelon G, Kaye AD

PMID: 27481839 [PubMed - as supplied by publisher]

Categories: Bup Feeds

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Drug and Alcohol News (JoinTogether.com) - Mon, 08/01/2016 - 3:00pm

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Categories: Bup Feeds

Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting.

Buprenorphine Research (PubMed) - Sun, 07/31/2016 - 6:22am

Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting.

Res Vet Sci. 2016 Aug;107:123-31

Authors: Hedenqvist P, Trbakovic A, Thor A, Ley C, Ekman S, Jensen-Waern M

Abstract
In connection with bilateral maxillary sinus augmentation, the acute effects of the nonsteroidal anti-inflammatory drug carprofen on facial expressions and long-term effects on bone formation were evaluated in 18 male New Zealand White rabbits. A 10×10mm bone window was drilled in the maxilla, the sinus membrane elevated and a titanium mini-implant inserted. One of two test materials was randomly inserted unilaterally and bovine bone chips (control) on the contralateral side in the created space. Rabbits were randomly allocated to receive buprenorphine plus carprofen (n=9) or buprenorphine plus saline (n=9) postoperatively. Buprenorphine was administered subcutaneously every 6h for 3days in a tapered dose (0.05-0.01mg/kg) and carprofen (5mg/kg) or saline administered subcutaneously 1h before, and daily for 4days postoperatively. To assess pain, clinical examination, body weight recording and scoring of facial expressions from photos taken before, and 6-13h after surgery were performed. Twelve weeks after surgery the rabbits were euthanized and sections of maxillary bones and sinuses were analysed with histomorphometry and by qualitative histology. Carprofen had no effect on mean facial expression scores, which increased from 0.0 to 3.6 (carprofen) and 4.3 (saline), of a maximum of 8.0. Neither did carprofen have an effect on bone formation or implant incorporation, whereas the test materials had. In conclusion, treatment with 5mg/kg carprofen once daily for 5days did not reduce facial expression scores after maxillary sinus augmentation in buprenorphine treated rabbits and did not affect long term bone formation.

PMID: 27473985 [PubMed - in process]

Categories: Bup Feeds

Spillover effects of HIV testing policies: changes in HIV testing guidelines and HCV testing practices in drug treatment programs in the United States.

Buprenorphine Research (PubMed) - Sun, 07/31/2016 - 6:22am

Spillover effects of HIV testing policies: changes in HIV testing guidelines and HCV testing practices in drug treatment programs in the United States.

BMC Public Health. 2016;16(1):666

Authors: Frimpong JA, D'Aunno T, Helleringer S, Metsch LR

Abstract
BACKGROUND: To examine the extent to which state adoption of the Centers for Disease Control and Prevention (CDC) 2006 revisions to adult and adolescent HIV testing guidelines is associated with availability of other important prevention and medical services. We hypothesized that in states where the pretest counseling requirement for HIV testing was dropped from state legislation, substance use disorder treatment programs would have higher availability of HCV testing services than in states that had maintained this requirement.
METHODS: We analyzed a nationally representative sample of 383 opioid treatment programs from the 2005 and 2011 National Drug Abuse Treatment System Survey (NDATSS). Data were collected from program directors and clinical supervisors through telephone surveys. Multivariate logistic regression models were used to measure associations between state adoption of CDC recommended guidelines for HIV pretest counseling and availability of HCV testing services.
RESULTS: The effects of HIV testing legislative changes on HCV testing practices varied by type of opioid treatment program. In states that had removed the requirement for HIV pretest counseling, buprenorphine-only programs were more likely to offer HCV testing to their patients. The positive spillover effect of HIV pretest counseling policies, however, did not extend to methadone programs and did not translate into increased availability of on-site HCV testing in either program type.
CONCLUSIONS: Our findings highlight potential positive spillover effects of HIV testing policies on HCV testing practices. They also suggest that maximizing the benefits of HIV policies may require other initiatives, including resources and programmatic efforts that support systematic integration with other services and effective implementation.

PMID: 27473519 [PubMed - as supplied by publisher]

Categories: Bup Feeds

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