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

form

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

 Please leave this field empty



The post form appeared first on Partnership for Drug-Free Kids.

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

Pages

Subscribe to BupPractice aggregator - Bup Feeds