85 Physician-perceived Barriers to Treating Opiate Use Disorder in the Emergency Department

2020 ◽  
Vol 76 (4) ◽  
pp. S33-S34
Author(s):  
G. Logan ◽  
A. Craen ◽  
E. Drone ◽  
J. Houck ◽  
F. Rivera Alvarez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Perceived Barriers ◽  
Opiate Use ◽  
Opiate Use Disorder

Mu Opioid Receptor Gene (OPRM1) in Patients With Opiate Use Disorder

2020 ◽  
Vol 19 (1) ◽  
pp. 16-21
Author(s):  
Nehal Mostafa ◽  
Maha W. Mobasher ◽  
Heba N. El Baz ◽  
Mohamed A. Khalil
Keyword(s):  
Opioid Receptor ◽  
Receptor Gene ◽  
Mu Opioid Receptor ◽  
Mu Opioid ◽  
Opiate Use ◽  
Opiate Use Disorder

HIV Testing in the Emergency Department: Provider Attitudes and Perceived Barriers Towards Testing

2013 ◽  
Vol 62 (4) ◽  
pp. S152
Author(s):  
B.M. Lo ◽  
L.B. Gadkowsi ◽  
J. Knips ◽  
A.L. Teel ◽  
A. Laing ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Perceived Barriers ◽  
Provider Attitudes

Levomethadyl Acetate versus Buprenorphine versus Methadone for Opioid Dependence

2018 ◽  
Author(s):  
Robert Ross ◽  
Brian Fuehrlein
Keyword(s):  
Substance Use ◽  
Opioid Dependence ◽  
Clinical Case ◽  
Low Dose ◽  
High Dose ◽  
Opiate Use ◽  
Opiate Use Disorder ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on substance use disorders. Which of the following is most effective for treatment of opioid dependence: levomethadyl acetate, buprenorphine, high-dose methadone, or low-dose methadone? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study demonstrates that buprenorphine, high-dose methadone, and levomethadyl acetate are equally effective in the treatment of opiate use disorder. All three treatments are significantly more effective than low-dose methadone.

scholarly journals Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

CJEM ◽  
2012 ◽  
Vol 14 (01) ◽  
pp. 14-19 ◽  
Author(s):  
Robin Cardamore ◽  
Joe Nemeth ◽  
Christine Meyers
Keyword(s):  
Emergency Department ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Positive Impact ◽  
Pediatric Trauma ◽  
Great Majority ◽  
Pediatric Emergency ◽  
Perceived Barriers ◽  
Emergency Physicians ◽  
The Future

ABSTRACT Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

scholarly journals Buprenorphine/naloxone maintenance therapy in patients with meperidine use disorder

2017 ◽  
Vol 6 (9) ◽  
pp. 2292
Author(s):  
Ahmet Bulent Yazici ◽  
Alime Burcin Saykan ◽  
Esra Yazici ◽  
Atila Erol
Keyword(s):  
Maintenance Therapy ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Partial Agonist ◽  
Treatment Options ◽  
Full Remission ◽  
Opiate Use ◽  
Care Workers ◽  
Opiate Use Disorder ◽  
Long Acting

Meperidine hydrochloride is a synthetic opioid and a weak µ receptor agonist. Meperidine use disorder is mostly iatrogenic and is common in health care workers. In addition, it is prescribed in acute and chronic pain complaints, and has a high potential for creating addiction. Treatment of meperidine use disorder is a challenging issue and there is no standardised treatment for meperidine addiction. Buprenorphine is a μ receptor partial agonist, a long-acting synthetic opioid for the treatment of opioid dependence and has a buprenorphine/naloxone (BN) form combined with naloxone. Buprenorphine maintenance therapy is one of the treatment options performed in opiate use disorder. But there is a paucity of data about treatment of meperidine use disorder. Here, a full remission case report is presented with BN maintenance treatment for a patient with meperidine use disorder diagnosis.

scholarly journals Acute pain management in patients with opiate maintenance treatment in primary care: a qualitative study

2020 ◽  
Author(s):  
morgane guillou landreat ◽  
Melia Baillot ◽  
Le Goff Delphine ◽  
Le Reste Jean Yves
Keyword(s):  
General Practice ◽  
Data Collection ◽  
Thematic Analysis ◽  
Acute Pain ◽  
Maintenance Treatment ◽  
Structured Interviews ◽  
Opiate Use ◽  
Number Of Patients ◽  
Data Collection Technique ◽  
Opiate Use Disorder

Abstract Background: Opiate use disorders are a worldwide disease. In the last 30 years, opiate maintenance treatment prescription changed patients’ and also changed physicians’ practice. General practitioners (GPs) have to deal with patients on OMT who are in acute pain. Both clinically and pharmacologically, the treatment of acute pain in patients with an opiate use disorder and an OMT(opiate maintenance treatment) differs from that given to patients with other conditions. As this situation is complex, it was important to explore whether GPs recognised this problem and whether they managed it effectively.Objective: To investigate how GPs identify and manage situations of acute pain in patients with opiate use disorders and OMT. Methods: semi-structured interviews were used as a data collection technique with a purposive sample of practising GPs. Data collection continued until saturation was reached. Analysis was undertaken using a thematic analysis method. Two independent researchers, working blind and pooling data, carried out the analysis. Results: The maximal variation of the sample and saturation of data were reached with 11 GPs. The thematic analysis resulted in 4 main themes: (1) the importance and difficulties of professional links , (2) the specific clinical reasoning , (3) the importance of the doctor-patient relationship and (4) the particular characteristics of OMT patients. Conclusion: The complexity of pain and opioid dependence represents significant challenges for GPs. It is hard to achieve a balance between pain relief and opiate use disorder treatment. These questions are particularly important in general practice, where the practitioner may feel insufficiently trained, and isolated. Existing protocols do not seem to be in line with general practice. The number of patients on OMT has increased since it was first marketed; GPs will increasingly have to deal with these situations and will have to issue their own recommendations.

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