scholarly journals Case Reports on the Failure of Smoking Marijuana to Prevent Relapse to Use of Opiates in Adolescents/Young Adults With Opiate Use Disorder

2021 ◽  
pp. 100011
Author(s):  
Steven L. Jaffe
Keyword(s):  
Young Adults ◽  
Case Reports ◽  
Opiate Use ◽  
Opiate Use Disorder ◽  
Smoking Marijuana

scholarly journals Opioid-Induced Respiratory Depression in Pediatric Palliative Care Patients with Severe Neurological Impairment—A Scoping Literature Review and Case Reports

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 312
Author(s):  
Maximilian David Mauritz ◽  
Carola Hasan ◽  
Larissa Alice Dreier ◽  
Pia Schmidt ◽  
Boris Zernikow
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Young Adults ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Case Reports ◽  
Neurological Impairment ◽  
Opioid Therapy ◽  
Pediatric Palliative Care ◽  
Severe Neurological Impairment

Pediatric Palliative Care (PPC) addresses children, adolescents, and young adults with a broad spectrum of underlying diseases. A substantial proportion of these patients have irreversible conditions accompanied by Severe Neurological Impairment (SNI). For the treatment of pain and dyspnea, strong opioids are widely used in PPC. Nonetheless, there is considerable uncertainty regarding the opioid-related side effects in pediatric patients with SNI, particularly concerning Opioid-Induced Respiratory Depression (OIRD). Research on pain and OIRD in pediatric patients with SNI is limited. Using scoping review methodology, we performed a systematic literature search for OIRD in pediatric patients with SNI. Out of n = 521 identified articles, n = 6 studies were included in the review. Most studies examined the effects of short-term intravenous opioid therapy. The incidence of OIRD varied between 0.13% and 4.6%; besides SNI, comorbidities, and polypharmacy were the most relevant risk factors. Additionally, three clinical cases of OIRD in PPC patients receiving oral or transdermal opioids are presented and discussed. The case reports indicate that the risk factors identified in the scoping review also apply to adolescents and young adults with SNI receiving low-dose oral or transdermal opioid therapy. However, the risk of OIRD should never be a barrier to adequate symptom relief. We recommend careful consideration and systematic observation of opioid therapy in this population of patients.

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

scholarly journals 1239 Mind Blown: Exploding Head Syndrome as a Side Effect of Marijuana

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A472-A473
Author(s):  
Christopher Missak ◽  
Jenie George ◽  
Indira Gurubhagavatula
Keyword(s):  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Epileptiform Activity ◽  
Temporal Correlation ◽  
Marijuana Use ◽  
The United States ◽  
Apnea Hypopnea Index ◽  
Previously Treated ◽  
Work Up ◽  
Smoking Marijuana

Abstract Introduction Marijuana use is increasing the United States and has been associated with increased sensory perception, euphoria, and altered cognition. Exploding head syndrome is a parasomnia characterized by loud explosion-like noises occurring prior to or during sleep. This the first report to link marijuana use with the occurrence of EHS. Report of Case A 45-year-old man with depression, anxiety and multisubstance abuse reported two years of neuropsychiatric symptoms including: “fireworks going off in my brain,” visual hallucinations, and sudden arousals characterized by panic and vertigo. He reported bouts of occupational stress and severe anxiety previously treated with clonazepam for six months, but discontinued it due to poor clinical response. Normal findings were reported on a previous work-up including: MRI, EEG, and head CT Scan. During his visit, he reported that he had been smoking marijuana three times a day for 24 years. One month prior to his visit he discontinued marijuana, stopped clonazepam, and started using mirtazapine with improvement in all aforementioned symptoms. During the same month, he relapsed and smoked marijuana once with a sudden return of all previously described symptoms on the night following its use. These symptoms then resolved and did not recur again until 9 months later, after another episode of weekend marijuana use. An in-lab polysomnogram revealed an apnea-hypopnea index 2.2 per hour, increased alpha intrusion throughout the study, and no epileptiform activity. No parasomnias were observed during rapid-eye-movement (REM) or non-REM sleep. Conclusion The etiology of EHS remains elusive. A review of the research has proposed five major theories and case reports suggest a complex etiology. Given the temporal correlation with marijuana use and symptom resolution with its cessation, we presume that EHS resulted from a complex interplay between neurons susceptible to cannabinoids and their derivatives.

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 Sequential Bilateral Vertebral Artery Dissections with Prompt Resolution of Initial Insult

2020 ◽  
Vol 12 (2) ◽  
pp. 189-198
Author(s):  
Sarkis Morales Vidal ◽  
Carlos Lara ◽  
Ari Gordin
Keyword(s):  
Young Adults ◽  
Vertebral Artery ◽  
Case Reports ◽  
Arterial Dissection ◽  
Stroke In Young Adults ◽  
Potential Trigger ◽  
Sequential Nature ◽  
Stroke In Young

Vertebral arterial dissection is a known cause of stroke in young adults. There has been a multitude of cases of bilateral vertebral dissections, including progression from one vertebral artery to another. This case reports the curious sequential nature of the healing of a previously dissected vertebral artery with subsequent dissection of the collateral vertebral artery. Follow-up neuroimaging evaluation performed several months later showed healed bilateral vertebral artery. The potential trigger was neck cracking.

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 Sudden Cardiac Death in US Young Adults, 1989-1996

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1345-1345
Author(s):  
Zhi-Jie Zheng ◽  
Janet B. Croft ◽  
Wayne H. Giles ◽  
George A. Mensah
Keyword(s):  
Young Adults ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Case Reports ◽  
Mortality Rates ◽  
Adolescents And Young Adults ◽  
Surveillance Report ◽  
Underlying Causes ◽  
Icd Codes ◽  
Death Data

0007 Anecdotal evidence and case reports indicate that sudden cardiac death (SCD) occurs in adolescents and young adults. To investigate the epidemiologic pattern and secular trend of SCD among ages 15-34 years, we analyzed US Multiple Causes of Death data from 1989 to 1996. SCD is defined as death due to cardiac disease (ICD-9 codes: 390-398, 402 and 404-429)that occurred out of hospital or in emergency room. This definition has been used in prior studies with reasonable accuracy. Mortality rates were calculated using mid-year population estimates as the denominators, and standardized to 1970. In 1996, 3,000 sudden cardiac deaths occurred for this specific age group, which reflects a 10% increase from 1989 (n=2,719). The leading underlying causes of SCD were ischemic heart disease (ICD codes 410-414, and 429.2), and arrhythmias or cardiomyopathies (ICD codes 425-427), each accounting for 35% of all SCDs. SCD mortality rates were twice as high in men as in women, and increased with age. From 1989 to 1996, age-standardized SCD mortality rates increased in both men (+10%) and women (+31%) ( Figure). Although SCD is relatively rare in US adolescents and young adults, the increased trend of SCD mortality warrants further investigation. This is the first national surveillance report on SCD in young adults. Figure 1.

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