scholarly journals Failure to identify or effectively manage prescription opioid dependence acted as a gateway to heroin use--buprenorphine/naloxone treatment and recovery in a surgical patient

2014 ◽  
Vol 2014 (dec17 1) ◽  
pp. bcr2014207458-bcr2014207458 ◽  
Author(s):  
S. Conroy ◽  
D. Hill
2013 ◽  
Vol 131 (1-2) ◽  
pp. 112-118 ◽  
Author(s):  
Jessica A. Dreifuss ◽  
Margaret L. Griffin ◽  
Katherine Frost ◽  
Garrett M. Fitzmaurice ◽  
Jennifer Sharpe Potter ◽  
...  

2017 ◽  
Vol 13 (5) ◽  
pp. 329 ◽  
Author(s):  
Siddharth Sarkar, MD, DNB ◽  
Rakesh Lal, MD ◽  
Mohit Varshney, MD ◽  
Yatan Pal Singh Balhara, MD, DNB, MNAMS

Background and aims: Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of individuals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months.Methods: Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened. One hundred consecutive patients who received tramadol for more than 6 months were included.Results: The sample comprised exclusively of males and had a mean age of 40.9 years. The median dose of tramadol at initiation and continuation was 300 mg/ day. Sixty-two patients achieved complete abstinence during the course of treatment. Greater age, longer duration of opioid use, and better follow-up adherence were associated with abstinent status. The rates of abstinence were higher among those presenting with natural opioid use as compared to others (prescription opioid use or heroin use).Conclusion: Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence.


2020 ◽  
Vol 48 (2) ◽  
pp. 249-258 ◽  
Author(s):  
Brandi C. Fink ◽  
Olivier Uyttebrouck ◽  
Richard S. Larson

Overdose deaths involving prescription opioids killed more than 17,000 Americans in 2017, marking a five-fold increase since 1999. High prescribing rates of opioid analgesics have been a substantial contributor to prescription opioid misuse, dependence, overdose and heroin use. There was recognition approximately ten years ago that opioid prescribing patterns were contributing to this startling increase in negative opioid-related outcomes, and federal actions, including Medicare reimbursement reform and regulatory actions, were initiated to restrict opioid prescribing. The current manuscript is a description of those actions, the effect of those actions on opioid prescribing and related patient outcomes. We also describe our proposal of methods of expanding these efforts as an important piece to further reduce opioid-related misuse, dependence, and overdose death.


2009 ◽  
Vol 34 (3) ◽  
pp. 304-311 ◽  
Author(s):  
Stacey C. Sigmon ◽  
Kelly E. Dunn ◽  
Gary J. Badger ◽  
Sarah H. Heil ◽  
Stephen T. Higgins

2016 ◽  
Vol 12 (4) ◽  
pp. 289 ◽  
Author(s):  
Nalini Vadivelu, MD ◽  
Sukanya Mitra, MD, MAMS ◽  
Alice M. Kai, BA ◽  
Gopal Kodumudi, MS ◽  
Karina Gritsenko, MD

Opioid dependence can occur due to prescription opioid use, recreational opioid use, or as a result of opioid use for the treatment of drug addiction. Pain control in these patients is truly a challenge. It is important to understand the patient's condition such as the phenomenon of drug dependence, drug addiction, and pseudo-addiction to provide effective analgesia. This may be accomplished using appropriate multimodal therapies and by treatment of coexisting diseases such as anxiety. The goal is to provide effective analgesia, prevent cognitive and emotional problems, and produce a positive postoperative rehabilitation process. Multimodal options include pharmacological and nonpharmacological approaches, psychological support, and interventional pain procedures, all focused toward providing optimal pain control while preventing undertreatment, withdrawal symptoms, and other complications.


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