scholarly journals Pictorial Cue Reactivity and Craving Measures in Individuals With Opiate Use Disorder Enrolled in Buprenorphine-Maintenance Program

2021 ◽  
Vol 168 ◽  
pp. S137-S138
Author(s):  
Erik Ortiz ◽  
Ashley Coleman ◽  
Irene Pericot-Valverde ◽  
Kaileigh Byrne ◽  
Alain Litwin ◽  
...  
Keyword(s):  
Cue Reactivity ◽  
Opiate Use ◽  
Maintenance Program ◽  
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

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 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.

Pain management in patients undergoing treatment for head and neck cancer with opiate use disorder on medication-assisted treatment.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 120-120
Author(s):  
Dana Guyer ◽  
Ariel E. Birnbaum ◽  
Kara Lynne Leonard ◽  
Esther Yu
Keyword(s):  
Head And Neck Cancer ◽  
Pain Management ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Pain Medication ◽  
Medication Assisted Treatment ◽  
Opiate Use ◽  
History Of ◽  
Opiate Use Disorder

120 Background: Buprenorphine, a partial agonist at the mu opiate receptor, is an effective pain medication and use has increased for patients with cancer pain, especially those with concurrent opiate use disorder (OUD). Substance use disorder is common in head and neck cancer patients since alcohol and tobacco are predisposing factors. Definitive chemoradiation (chemoRT) for head and neck cancer is a difficult treatment with a high burden of symptoms, including mucositis pain, dysphagia and odynophagia. Patients undergoing concurrent chemoRT routinely require systemic opiates to manage pain and tolerate treatment. This is a review of our institution’s experience using buprenorphine and methadone for pain management in patients with OUD during chemoRT for head and neck cancer. Methods: We reviewed all cases seen in the Lifespan Cancer Institute head and neck cancer multidisciplinary clinic between July 2018 and June 2019. Approximately 40% of patients had a history of opiate use disorder and one-fifth of those were on medication-assisted treatment with buprenorphine or methadone. The charts of patients with OUD were reviewed with respect to history of buprenorphine or methadone use, pain scores during chemoRT, effectiveness of pain medications during chemoRT, and change of pain medication during treatment. Results: 5 patients on buprenorphine and 4 patients on methadone underwent treatment with chemoRT for head and neck cancer. Despite effectiveness for pain with other cancer patients, we did not find that buprenorphine was an effective opiate for patients undergoing chemoRT for head and neck cancer. All patients on buprenorphine had to be rotated off to another opiate (generally methadone) to achieve adequate pain relief. Median time to pain medication change was 3 weeks (range: prior to starting to week 5/7). The patients on methadone generally were able to tolerate treatment with minor adjustments to their methadone. Conclusions: The ceiling effect of buprenorphine that makes it effective for OUD is a barrier to managing the severe pain from chemoRT for head and neck cancer, while methadone is effective for both pain control and maintenance of sobriety during a taxing treatment.

Fear and Loathing in the ED: When Staff Are Afraid to Provide Compassionate Care

2020 ◽  
pp. 135-140
Author(s):  
Thomas E. Robey ◽  
Jay M. Brenner
Keyword(s):  
Mental Health ◽  
Ethical Dilemmas ◽  
Opiate Withdrawal ◽  
Emergency Setting ◽  
Opiate Use ◽  
Wide Range ◽  
Novel Approaches ◽  
Individual Capacity ◽  
Opiate Use Disorder ◽  
Opiate Drug

Opiate use disorder has a wide range of physical and social complications that often present first in the emergency department. Physiological dependence may interfere with a patient’s own attempts to detox from opiate drug use. As a result, emergency providers are faced with difficulty discerning an opiate-dependent patient’s genuine intent, especially when he or she is experiencing withdrawal. Seemingly paternalistic actions may be justified when the patient’s stated goals of “getting clean” conflict with his or her more urgent demands for opiates to end debilitating withdrawal symptoms. Individual capacity may be compromised by drug dependence. Novel approaches adapted to the emergency setting, such as medication-assisted therapy (MAT) with buprenorphine induction can help patients suffering from opiate withdrawal and mitigate conflict that may occur when patients feel undertreated by typical pharmacological approaches to withdrawal. Clinical, mental health, and legal options exist to help treat opiate withdrawal, but their applications are not without ethical dilemmas.

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