Bup Feeds

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Voluntary Running-Wheel Activity, Arterial Blood Gases, and Thermal Antinociception in Rats after 3 Buprenorphine Formulations.

Buprenorphine Research (PubMed) - Sun, 05/15/2016 - 7:00am

Voluntary Running-Wheel Activity, Arterial Blood Gases, and Thermal Antinociception in Rats after 3 Buprenorphine Formulations.

J Am Assoc Lab Anim Sci. 2016;55(3):306-11

Authors: Johnson RA

Abstract
Buprenorphine HCl (BUP) is a μ-opioid agonist used in laboratory rodents. New formulations of buprenorphine (for example, sustained-released buprenorphine [BUP SR], extended-release buprenorphine [BUP ER]) have been developed to extend the analgesic duration. In a crossover design, 8 adult rats were injected subcutaneously with either BUP, BUP SR, BUP ER, or saline, after which voluntary running-wheel activity, arterial blood gases, and thermal withdrawal latency were assessed. Wheel running was decreased at 24 h compared with baseline in all treatment groups but returned to baseline by 48 h. Arterial pH, HCO3(-), and CO2 were not changed between groups or over time. However, arterial oxygen was lower than baseline in the BUP (-8 ± 2 mm Hg), BUP SR (-7 ± 1 mm Hg), and BUP ER (-17 ± 2 mm Hg) groups compared with saline controls (3 ± 2 mm Hg); the BUP ER group showed the greatest decrease when all time points were combined. BUP increased the withdrawal latency at 1 h (15% ± 3%), whereas BUP ER increased latencies at 4, 8, 12, and 48 h (35% ± 11%, 21% ± 7%, 26% ± 7%, and 22% ± 9%, respectively) and BUP SR prolonged latencies at 24, 48, and 72 h (15% ± 6%, 18% ± 5%, and 20% ± 8%, respectively). The duration of thermal analgesia varied between buprenorphine formulations, but all 3 formulations reduced voluntary-running activity at 24 h after injection and might cause hypoxemia in normal adult rats.

PMID: 27177564 [PubMed - in process]

Categories: Bup Feeds

Postoperative Analgesia Due to Sustained-Release Buprenorphine, Sustained-Release Meloxicam, and Carprofen Gel in a Model of Incisional Pain in Rats (Rattus norvegicus).

Buprenorphine Research (PubMed) - Sun, 05/15/2016 - 7:00am

Postoperative Analgesia Due to Sustained-Release Buprenorphine, Sustained-Release Meloxicam, and Carprofen Gel in a Model of Incisional Pain in Rats (Rattus norvegicus).

J Am Assoc Lab Anim Sci. 2016;55(3):300-5

Authors: Seymour TL, Adams SC, Felt SA, Jampachaisri K, Yeomans DC, Pacharinsak C

Abstract
Postoperative analgesia in laboratory rats is complicated by the frequent handling associated with common analgesic dosing requirements. Here, we evaluated sustained-release buprenorphine (Bup-SR), sustained-release meloxicam (Melox-SR), and carprofen gel (CG) as refinements for postoperative analgesia. The aim of this study was to investigate whether postoperative administration of Bup-SR, Melox-SR, or CG effectively controls behavioral mechanical and thermal hypersensitivity in a rat model of incisional pain. Rats were randomly assigned to 1 of 5 treatment groups: saline, 1 mL/kg SC BID; buprenorphine HCl (Bup HCl), 0.05 mg/kg SC BID; Bup-SR, 1.2 mg/kg SC once; Melox-SR, 4 mg/kg SC once; and CG, 2 oz PO daily. Mechanical and thermal hypersensitivity were tested daily from day-1 through 4. Bup HCl and Bup-SR attenuated mechanical and thermal hypersensitivity on days 1 through 4. Melox-SR and CG attenuated mechanical hypersensitivity-but not thermal hypersensitivity-on days 1 through 4. Plasma concentrations, measured by using UPLC with mass spectrometry, were consistent between both buprenorphine formulations. Gross pathologic examination revealed no signs of toxicity in any group. These findings suggest that postoperative administration of Bup HCl and Bup-SR-but not Melox-SR or CG-effectively attenuates mechanical and thermal hypersensitivity in a rat model of incisional pain.

PMID: 27177563 [PubMed - in process]

Categories: Bup Feeds

The Use of Transdermal Buprenorphine in Complex Regional Pain Syndrome: A Report of Two Cases.

Buprenorphine Research (PubMed) - Sat, 05/14/2016 - 2:00pm

The Use of Transdermal Buprenorphine in Complex Regional Pain Syndrome: A Report of Two Cases.

J Pain Palliat Care Pharmacother. 2016 May 12;:1-4

Authors: Onofrio S, Vartan CM, Nazario M, DiScala S, Cuevas-Trisan R, Melendez-Benabe J

Abstract
Management of complex regional pain syndrome (CRPS) can be challenging. Various pharmacological approaches have produced mixed results. Buprenorphine activates mu-opioid receptors and antagonizes kappa and delta receptors, acts at N-methyl-d-aspartate (NMDA) receptor, and is an orphan-related ligand-1 receptor agonist. It is available in transdermal patches that last for up to 7 days. This report describes two patients with refractory CRPS who were treated with transdermal buprenorphine. The patients experienced approximately 50% reduction in pain intensity scores. Application site rash that occurred was managed with topical steroid spray used before applying the patch.

PMID: 27172230 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Opioid addiction treatment argued as 'essential' insurance benefit.

Buprenorphine Research (PubMed) - Sat, 05/14/2016 - 2:00pm
Related Articles

Opioid addiction treatment argued as 'essential' insurance benefit.

Mod Healthc. 2016 Jan 4;46(1):10

Authors: Herman B

PMID: 27086374 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

[Opiate substitution records success stories].

Buprenorphine Research (PubMed) - Sat, 05/14/2016 - 2:00pm

[Opiate substitution records success stories].

MMW Fortschr Med. 2015 Dec 14;157(21-22):29

Authors: Heinlein H

PMID: 26960851 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

You Can Help End the Heroin Epidemic. Find Out How

Drug and Alcohol News (JoinTogether.com) - Wed, 05/11/2016 - 4:25pm

We are facing an epidemic in our country. Heroin and other opioids are ravaging our communities. Deaths from heroin increased 248% between 2010 and 2014. More Americans die from drug overdoses than in car crashes, and this increasing trend is driven by Rx painkillers.

Too many families are struggling and don’t know where to turn. Enough is enough. It’s time to raise awareness about what is happening around us every day, and to help prevent and treat opioid abuse and addiction.

With funding and support from the High Intensity Drug Trafficking Areas (HIDTAs) in the eastern United States, we launched a comprehensive resource to help families and communities address the country’s growing heroin and prescription drug abuse crisis.

This new resource Heroin and Other Opioids: From Understanding to Action provides parents with information, support for their family and treatment resources for their loved one.

It can be hard to understand how someone can go from prescription pain medicine abuse to heroin. The resources’ short, powerful, animated film explains this progression while illustrating the epidemic’s devastation to communities.

The mobile-friendly resource also includes:
• Facts about heroin’s risks and effects
• A guide on what medications can be abused
• An interactive infographic that shows one teen’s path from painkiller abuse to heroin
• Information on safeguarding and disposal of unused, expired medications
• Help for a loved one struggling with an opioid addiction treatment locators
• A medication-assisted treatment e-Book explaining the medications that can help with an opioid addiction: Methadone, Buprenorphine and Naltrexone
• Help for communities creating a plan for safe drug disposal
• A community education presentation titled “Heroin and Other Opioids: From Understanding to Action” that can be delivered by local law enforcement and their community partners.
• A directory of state substance abuse agencies and initiatives to address heroin and other opioids

Families concerned about a loved one who is using heroin, other opioids or any other drug of abuse can contact our toll-free Helpline at 1-855-DRUGFREE (1-855-378-4373) where they will speak with a caring and trained specialist who will listen, help develop a plan of action and identify community resources.

Help us end the heroin epidemic in our country. Please visit this online resource at drugfree.org/heroin to gain an understanding of this vital issue and how you and others in your community can take action to affect change. ‪#‎endmedicineabuse‬‬

The post You Can Help End the Heroin Epidemic. Find Out How appeared first on Partnership for Drug-Free Kids.

Categories: Bup Feeds

Doubling Cap on Patients Physicians Can Treat With Buprenorphine.

Buprenorphine Research (PubMed) - Wed, 05/11/2016 - 7:30am

Doubling Cap on Patients Physicians Can Treat With Buprenorphine.

JAMA. 2016 May 10;315(18):1938

Authors: Rubin R

PMID: 27163974 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Monitoring Neonatal Abstinence Syndrome in buprenorphine-exposed IVF twins: A case study.

Buprenorphine Research (PubMed) - Wed, 05/11/2016 - 7:30am

Monitoring Neonatal Abstinence Syndrome in buprenorphine-exposed IVF twins: A case study.

Subst Abus. 2016 May 10;:0

Authors: Brandt L, Swoboda P, Fischer G, Unger A

Abstract
BACKGROUND: Prior studies have reported on the pregnancies and outcomes of in vitro fertilization (IVF) in special subpopulations; however, there is a lack of studies on opioid exposed IVF-conceived neonates.
CASE PRESENTATION: A young adult IVF-pregnant woman was maintained on buprenorphine throughout pregnancy, and received follow-up from the Addiction Clinic from estimated gestational week 32. She delivered healthy dichorionic twins via caesarian section at 38 weeks gestational age (buprenorphine dose at time of delivery: 16 mg). All maternal supervised urinalysis taken as of gestational week 32 were negative for concomitant substances (prior to treatment initiation at the Addiction Clinic, only self-reports of abstinence from concomitant substances were available). Both healthy children (male birth weight: 3140 g, female birth weight: 2650 g) developed an unusual course of Neonatal Abstinence Syndrome (NAS) requiring extensive treatment (total morphine dose male: 22 mg, and female: 26.75 mg; length of treatment: 33 days and 34 days, respectively; duration of hospitalisation: 40 days).
DISCUSSION: The highly severe and long lasting NAS in both neonates represents a very unusual course following an uneventful pregnancy, and influencing iatrogenic factors cannot be ruled out. Given the multiple variables influencing infant outcomes, this highlights the importance of high-quality, evidence-based standard operating procedures, which (1) are initiated as early as possible during pregnancy to minimize risk factors for adverse infant outcomes, such as concomitant substance use during pregnancy, (2) support the substance-dependent woman throughout the postpartum period, especially in cases of multiple and/or IVF-conceived pregnancies, where additional challenges may arise, and (3) consider the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

PMID: 27163782 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Longitudinal association between pain severity and subsequent opioid use in prescription opioid dependent patients with chronic pain.

Buprenorphine Research (PubMed) - Wed, 05/11/2016 - 7:30am

Longitudinal association between pain severity and subsequent opioid use in prescription opioid dependent patients with chronic pain.

Drug Alcohol Depend. 2016 Apr 25;

Authors: Griffin ML, McDermott KA, McHugh RK, Fitzmaurice GM, Jamison RN, Weiss RD

Abstract
BACKGROUND: Patients with prescription opioid use disorder commonly report relief of chronic pain as the chief reason for first opioid use; indeed, the prevalence of chronic pain is high in this population. Understanding the association between pain severity and subsequent opioid use is crucial for understanding how to manage these conditions simultaneously and has not been examined in this population. The aim of this analysis was to examine the proximal effect of pain severity on opioid use during 12 weeks of buprenorphine-naloxone therapy for patients with chronic pain and prescription opioid use disorder.
METHODS: This study is a secondary analysis of a national, randomized, controlled trial of buprenorphine-naloxone plus counseling for prescription opioid dependent patients. The association between past-week pain severity and opioid use in the subsequent week was examined in 148 patients presenting with chronic pain at baseline.
RESULTS: Results from a multivariable logistic regression model showed that greater pain severity in a given week was significantly associated with increased odds of opioid use in the following week over the 12-week treatment, even after adjusting for covariates associated with opioid use (aOR=1.15, p<0.001).
CONCLUSIONS: Despite previous reports of no association between baseline pain and subsequent opioid use, our findings suggest that patients who experience flare-ups of pain during treatment are prone to relapse to opioid use. Future studies may identify those who are at risk to use opioids by carefully monitoring patterns of their pain intensity over time.

PMID: 27161860 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Prince and Opioid Overdose? Enough is Enough.

Drug and Alcohol News (JoinTogether.com) - Tue, 05/10/2016 - 2:27pm

“Wait, what? No. No, no, no, no, no.” That was the gut-punch reaction I felt when I heard the devastating news that Prince – THE Prince – had died. I didn’t want to believe it. I still can’t believe it, actually. Prince is this ethereal legend that I think most of us strangely assumed would live forever.

Prince was my go-to, know-every-lyric, sing-at-the-top-of-my-lungs favorite artist growing up, as was his “posse”:  The Time, Sheila E, Vanity 6. Hearing “Controversy” on the radio when I was 10, being at a slumber party the first time I saw Purple Rain, playing Darling Nikki backwards to hear his secret message at the end and, Diamonds and Pearls in college. I was lucky enough to see him twice in concert – his tiny frame, high heels and palpable energy jumping (literally) from instrument to instrument is really other-worldly.

And as each story comes out, pointing to a possible opioid overdose as the cause of his sudden death, my heart sinks further and further that another life could have possibly been taken by this devastating epidemic. Not again. It is taking far too many lives of beautiful, creative and beloved individuals – in fact, 78 Americans die every day from an opioid overdose.

We need to make everyone – our families, our kids, our communities – aware of this dangerous, addictive behavior. And not just that, we need to move awareness into action.

For me, that’s two-fold, both as a parent and as an executive at the Partnership. While we wait for the results of the toxicology report for definite answers, that doesn’t stop the questions coming from families who look to us for how to talk with their kids about the headlines surrounding his death. And that doesn’t stop questions from my own kids.

While my 10-year-old son didn’t have a connection to Prince like I did, he was curious and sad about his death. He asked me about how he died, and I took a breath and said, “We don’t know yet.” But I took the opportunity to talk about the reports that it could be from abusing prescription pills. I said, “Remember how we talked about how some medicine is good, but some medicine can be harmful, especially if you take too much, or if it’s not yours? Well, there’s a chance that’s what happened to Prince.” We then talked about how sad it is to lose someone so talented to drugs. “So buddy, that’s why you shouldn’t even take a chance. Drugs, including pills, can be really, really dangerous even if your friends may think they are no big deal.”

Honestly, I wish I didn’t have to have this conversation. Whether it’s our favorite music icon or our neighbor or relative – when will these overdoses stop?

Enough is enough. Please, safeguard your medications. Learn more about these drugs and their risks. Talk to your kids. Talk to each other – as parents – about what we can all do to keep our families safe from this devastating epidemic. And if you or someone you know needs help, please call our toll-free helpline 1-855-DRUGFREE to speak with one of our trained and caring specialists.

The post Prince and Opioid Overdose? Enough is Enough. appeared first on Partnership for Drug-Free Kids.

Categories: Bup Feeds

Opioid agonist treatment for pharmaceutical opioid dependent people.

Buprenorphine Research (PubMed) - Tue, 05/10/2016 - 7:30am

Opioid agonist treatment for pharmaceutical opioid dependent people.

Cochrane Database Syst Rev. 2016 May 9;5:CD011117

Authors: Nielsen S, Larance B, Degenhardt L, Gowing L, Kehler C, Lintzeris N

Abstract
BACKGROUND: There are increasing concerns regarding pharmaceutical opioid harms including overdose and dependence, with an associated increase in treatment demand. People dependent on pharmaceutical opioids appear to differ in important ways from people who use heroin, yet most opioid agonist treatment research has been conducted in people who use heroin.
OBJECTIVES: To assess the effects of maintenance agonist pharmacotherapy for the treatment of pharmaceutical opioid dependence.
SEARCH METHODS: The search included the Cochrane Drugs and Alcohol Group's Specialised Register of Trials; the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 5); PubMed (January 1966 to May 2015); EMBASE (Ovid) (January 1974 to May 2015); CINAHL (EBSCOhost) (1982 to May 2015); ISI Web of Science (to May 2014); and PsycINFO (Ovid) (1806 to May 2014).
SELECTION CRITERIA: We included randomised controlled trials examining maintenance opioid agonist treatments that made the following two comparisons:1. full opioid agonists (methadone, morphine, oxycodone, levo-alpha-acetylmethadol (LAAM), or codeine) versus different full opioid agonists or partial opioid agonists (buprenorphine) for maintenance treatment and2. full or partial opioid agonist maintenance versus placebo, detoxification only, or psychological treatment (without opioid agonist treatment).
DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures.
MAIN RESULTS: We identified six randomised controlled trials that met inclusion criteria (607 participants).We found moderate quality evidence from two studies of no difference between methadone and buprenorphine in self reported opioid use (risk ratio (RR) 0.37, 95% confidence interval (CI) 0.08 to 1.63) or opioid positive urine drug tests (RR 0.81, 95% CI 0.56 to 1.18). There was low quality evidence from three studies of no difference in retention between buprenorphine and methadone maintenance treatment (RR 0.69, 95% CI 0.39 to 1.22). There was moderate quality evidence from two studies of no difference between methadone and buprenorphine on adverse events (RR 1.10, 95% CI 0.64 to 1.91).We found low quality evidence from three studies favouring maintenance buprenorphine treatment over detoxification or psychological treatment in terms of fewer opioid positive urine drug tests (RR 0.63, 95% CI 0.43 to 0.91) and self reported opioid use in the past 30 days (RR 0.54, 95% CI 0.31 to 0.93). There was no difference on days of unsanctioned opioid use (standardised mean difference (SMD) -0.31, 95% CI -0.66 to 0.04). There was moderate quality evidence favouring buprenorphine maintenance over detoxification or psychological treatment on retention in treatment (RR 0.33, 95% CI 0.23 to 0.47). There was moderate quality evidence favouring buprenorphine maintenance over detoxification or psychological treatment on adverse events (RR 0.19, 95% CI 0.06 to 0.57).The main weaknesses in the quality of the data was the use of open-label study designs.
AUTHORS' CONCLUSIONS: There was low to moderate quality evidence supporting the use of maintenance agonist pharmacotherapy for pharmaceutical opioid dependence. Methadone or buprenorphine appeared equally effective. Maintenance treatment with buprenorphine appeared more effective than detoxification or psychological treatments.Due to the overall low to moderate quality of the evidence and small sample sizes, there is the possibility that the further research may change these findings.

PMID: 27157143 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Effectiveness of opioid analgesics in chronic noncancer pain.

Buprenorphine Research (PubMed) - Fri, 05/06/2016 - 6:30am
Related Articles

Effectiveness of opioid analgesics in chronic noncancer pain.

Pain Pract. 2015 Mar;15(3):272-8

Authors: Ferrari R, Zanolin ME, Duse G, Visentin M

Abstract
BACKGROUND: There is general agreement about the need to perform a screening test to assess the risk of opioid misuse prior to starting a long-term opioid treatment for chronic noncancer pain. The evidence supporting the effectiveness of opioid long-term treatment is weak, and no predictors of its usefulness have been assessed.
OBJECTIVE: The aim of this study was to assess the effect on pain and quality of life of chronic opioid treatment, and detect the possible predictors of its effectiveness.
METHODS: This observational, prospective study was conducted in 2 Italian Pain Relief Units on 77 patients affected by intractable chronic pain. Patients were submitted to psycho-logical tests, investigating the individual pain experience, risk of opioid misuse, mood states, quality of life, and personality characteristics prior to starting treatment and at 2,4, and 6-month follow-up.
RESULTS: Both maximum and habitual pain, as measured with VAS, underwent a statistically significant reduction at 2, 4, and 6-month follow-up. In multivariate analysis, lower scores in the Pain Medication Questionnaire (PMQ) were predictive of a major reduction in maximum VAS (P = 0.005). Both low PMQ and MMPI-cynicism scores were predictive of habitual VAS decrease (P = 0.012 and P = 0.028, respectively).
CONCLUSION: The results indicate that pain relief significantly improved over a 6-month period of opioid treatment, together with quality of life. The outcome was better in patients with a pretreatment low risk of opioid misuse, low scores in the Cynicism scale of MMPI-2, and no aberrant drug behaviors at follow-up. Therefore, a psychological screening and support is crucial for a good outcome of opioid therapy for chronic noncancer pain patients.

PMID: 25914912 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose: A Cohort Study.

Buprenorphine Research (PubMed) - Thu, 05/05/2016 - 8:00am
Related Articles

Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose: A Cohort Study.

Ann Intern Med. 2016 Jan 5;164(1):1-9

Authors: Larochelle MR, Liebschutz JM, Zhang F, Ross-Degnan D, Wharam JF

Abstract
BACKGROUND: Nonfatal opioid overdose is an opportunity to identify and treat substance use disorders, but treatment patterns after the overdose are unknown.
OBJECTIVE: To determine prescribed opioid dosage after an opioid overdose and its association with repeated overdose.
DESIGN: Retrospective cohort study.
SETTING: A large U.S. health insurer.
PARTICIPANTS: 2848 commercially insured patients aged 18 to 64 years who had a nonfatal opioid overdose during long-term opioid therapy for noncancer pain between May 2000 and December 2012.
MEASUREMENTS: Nonfatal opioid overdose was identified using International Classification of Diseases, Ninth Revision, Clinical Modification, codes from emergency department or inpatient claims. The primary outcome was daily morphine-equivalent dosage (MED) of opioids dispensed from 60 days before to up to 730 days after the index overdose. We categorized dosages as large (≥100 mg MED), moderate (50 to <100 mg MED), low (<50 mg MED), or none (0 mg MED). Secondary outcomes included time to repeated overdose stratified by daily dosage as a time-varying covariate.
RESULTS: Over a median follow-up of 299 days, opioids were dispensed to 91% of patients after an overdose. Seven percent of patients (n = 212) had a repeated opioid overdose. At 2 years, the cumulative incidence of repeated overdose was 17% (95% CI, 14% to 20%) for patients receiving high dosages of opioids after the index overdose, 15% (CI, 10% to 21%) for those receiving moderate dosages, 9% (CI, 6% to 14%) for those receiving low dosages, and 8% (CI, 6% to 11%) for those receiving no opioids.
LIMITATION: The cohort was limited to commercially insured adults.
CONCLUSION: Almost all patients continue to receive prescription opioids after an overdose. Opioid discontinuation after overdose is associated with lower risk for repeated overdose.
PRIMARY FUNDING SOURCE: Health Resources and Services Administration.

PMID: 26720742 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Drug interactions between buprenorphine, methadone and hepatitis C therapeutics.

Buprenorphine Research (PubMed) - Wed, 05/04/2016 - 9:00am
Related Articles

Drug interactions between buprenorphine, methadone and hepatitis C therapeutics.

Expert Opin Drug Metab Toxicol. 2016 May 3;

Authors: Ogbuagu O, Friedland G, Bruce RD

Abstract
INTRODUCTION: People who inject drugs (PWID) and other individuals with opioid use disorders have a dramatically higher prevalence of hepatitis C virus (HCV) infection than the general population. The availability of novel direct acting antivirals (DAAs) for the treatment of HCV infection with very high efficacy, improved tolerability and shortened treatment durations have led to global efforts to ramp up treatment for all HCV-infected individuals to prevent or delay complications of the disease. Individuals with opioid use disorders, including those on medication-assisted therapy such as methadone or buprenorphine, are a key demographic group that can benefit from HCV treatment given their high HCV prevalence; however, pharmacokinetic and pharmacodynamic drug interactions could blunt their utility. Areas covered: We performed a comprehensive literature review of published and unpublished data from PubMed database, relevant conference abstracts/proceedings and FDA approved drug package inserts, to review the pharmacokinetic (PK) profile and drug interactions between currently approved HCV DAAs and methadone and buprenorphine. Expert opinion: The paper highlights specific drug combinations which result in altered opioid drug levels including telaprevir/methadone, daclatasvir/buprenorphine, and Abbvie 3D combination regimen (paritaprevir, ritonavir, ombitasvir and dasabuvir)/buprenorphine. However, concurrent pharmacodynamics assessments did not reveal significant signs and symptoms of opioid withdrawal or toxicity that would preclude concurrent administration.

PMID: 27140427 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Buprenorphine for the treatment of depression?

Buprenorphine Research (PubMed) - Wed, 05/04/2016 - 9:00am
Related Articles

Buprenorphine for the treatment of depression?

Acta Psychiatr Scand. 2016 May 2;

Authors: Balon R

PMID: 27138058 [PubMed - as supplied by publisher]

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Evaluation of Dexmedetomidine as an Adjuvant to Intrathecal Bupivacaine in Infraumbilical Surgeries.

Buprenorphine Research (PubMed) - Tue, 05/03/2016 - 6:30am

Evaluation of Dexmedetomidine as an Adjuvant to Intrathecal Bupivacaine in Infraumbilical Surgeries.

J Clin Diagn Res. 2016 Mar;10(3):UC13-6

Authors: Patro SS, Deshmukh H, Ramani YR, Das G

Abstract
INTRODUCTION: Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on. Currently Dexmedetomidine, a highly selective α2-adrenoreceptor agonist is being studied for its adjuvant action in spinal anaesthesia.
AIM: The present study aims to evaluate the efficacy of intrathecal Dexmedetomidine as an adjuvant to Bupivacaine in spinal anaesthesia in patients undergoing infra-umbilical surgeries.
MATERIALS AND METHODS: It was a prospective, double blind study among 60 patients undergoing infraumbilical surgeries under spinal anaesthesia. The patients were randomly allocated to 2 groups (Group I and Group II) of 30 each. Group I received hyperbaric bupivacaine (15 mg) alone and Group II received hyperbaric bupivacaine (15 mg) with Dexmedetomidine (5mcg). The onset time of sensory and motor block, regression time of sensory and motor block, duration of analgesia, haemodynamic parameters were recorded both intra and postoperatively. The primary efficacy parameters were to determine the onset and duration of sensory block, motor block and duration of postoperative analgesia. Secondarily any associated haemodynamic changes and adverse effects of Dexmedetomidine were also recorded.
STATISTICAL ANALYSIS: Continuous data were analysed using the Student's t-test and categorical variables by two-tailed Fisher-exact test or Chi-square test.
RESULTS: Onset of sensory block was 129.33±14.8 seconds in Group II as compared to 208.33±19.18 seconds in Group I with total duration of sensory block as 317.70±16.16 minutes in Group II and 188±11.86 minutes in Group I. Similarly, onset of motor block was 226.33±31.86 minutes and 320.33±29.81 minutes, with total duration of motor block as 286.33±15.15 minutes and 166.5±12.11 minutes in Group II and in Group I respectively. Duration of analgesia was 333.6±20.67 minutes with Dexmedetomidine but 193.67±7.06 minutes in bupivacaine alone group.
CONCLUSION: Dexmedetomidine as an adjuvant had shown early onset of sensory and motor block with longer duration of analgesia and haemodynamic stability in the present study as compared to bupivacaine alone.

PMID: 27134975 [PubMed]

Categories: Bup Feeds

Urine Spiking in a Pain Medicine Clinic: An Attempt to Simulate Adherence.

Buprenorphine Research (PubMed) - Tue, 05/03/2016 - 6:30am
Related Articles

Urine Spiking in a Pain Medicine Clinic: An Attempt to Simulate Adherence.

Pain Med. 2015 Jul;16(7):1449-51

Authors: Lee D, Bazydlo LA, Reisfield GM, Goldberger BA

PMID: 25522892 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Neurocognitive, psychiatric, and substance use characteristics in opioid dependent adults.

Buprenorphine Research (PubMed) - Mon, 05/02/2016 - 7:30am

Neurocognitive, psychiatric, and substance use characteristics in opioid dependent adults.

Addict Behav. 2016 Mar 31;60:137-143

Authors: Arias F, Arnsten JH, Cunningham CO, Coulehan K, Batchelder A, Brisbane M, Segal K, Rivera-Mindt M

Abstract
AIMS: To describe neurocognitive function among opioid-dependent adults seeking buprenorphine treatment and to explore the impact of lifetime psychiatric conditions on neurocognitive function. To explore the additive interaction of patient-based characteristics that may help to inform treatment.
DESIGN: Cross-sectional assessment of neurocognitive function, substance use, and psychiatric characteristics of adults seeking buprenorphine treatment within substance use treatment centers in New York City.
PARTICIPANTS: Thirty-eight opioid-dependent adults seeking buprenorphine treatment.
MEASUREMENTS: A comprehensive battery, which included measures of executive functioning, learning, memory, verbal fluency, attention, processing speed, and motor functioning were administered. The Wide Range Achievement Test-Third Edition, the Composite International Diagnostic Interview, and an audio computer assisted structured interview were also completed. Correlations and independent sample t-tests were used to ascertain group differences.
FINDINGS: Thirty-nine percent of participants were impaired in global neurocognitive function (n=15). Over one third were impaired in either: learning (n=28), memory (n=26), executive functioning (n=17), motor functioning (n=17), attention/working memory (n=14) or verbal fluency (n=12). Lifetime history of alcohol dependence was associated with impairment in global neurocognitive, executive functioning, and motor functioning. Lifetime history of cocaine dependence was associated with impairment in executive functioning and motor functioning (all p's<0.05). Major depressive disorder history was not associated with neurocognitive impairment.
CONCLUSIONS: Among this sample of opioid-dependent adults, there were high rates of global and domain-specific neurocognitive impairment, with severe impairment in learning and memory. Lifetime alcohol and cocaine dependence were associated with greater neurocognitive impairment, particularly in executive functioning. Because executive functioning is critical for decision-making and learning/memory dysfunction may interfere with information encoding, these findings suggest that opioid-dependent adults may require enhanced support for medical decision-making.

PMID: 27131800 [PubMed - as supplied by publisher]

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