Research on opioids, addiction, and treatment. Covers traditional care practices, opioid treatment in pregnancy, illicit fentanyl, and treatment disparities.
A recent NIH report warns of dose-dependent risks of long-term opioid therapy, while an ACP policy paper tackles clinical documentation in electronic health records. These guidelines aim to improve care and documentation practices among healthcare professionals.
Researchers have discovered that individuals in opioid recovery exhibit signs of re-regulation of their brain's reward system within several weeks of medical-assisted opioid withdrawal. This finding suggests that the natural reward system may return to normal, making it easier for patients to remain drug-free outside treatment.
A survey of primary care physicians suggests a decrease in opioid prescriptions, with 58% reporting reduced prescribing habits. The study highlights the growing concern among doctors about the risks of prescription opioid use, including addiction and death by overdose.
Researchers found that tramadol use was associated with an increased risk of hospitalization for hypoglycemia, especially in the first 30 days. The study analyzed data from over 334,000 patients and found that tramadol was linked to a higher risk of severe hypoglycemia compared to codeine.
Researchers at McGill University found that tramadol use is associated with a two-fold increased risk of hospitalization for severe hypoglycemia. The study also suggests that this risk is particularly high in the first 30 days of tramadol use.
Most primary care physicians believe prescription drug abuse is a significant problem in their communities and that opioids are often overused to treat pain. As a result, many have decreased their prescribing of these products over the past year.
A new study published in the Journal of Behavioral Medicine found that Mindfulness-Oriented Recovery Enhancement (MORE) increases brain activation to natural healthy pleasures, reducing opioid cravings. Participants who received eight weeks of MORE instruction exhibited increased brain activity in response to enjoyable experiences.
Young adults who don't attend college are at high risk for non-medical prescription opioid use and disorder, while college-educated peers are more likely to misuse stimulants. The study analyzed data from 36,781 young adults aged 18-22, revealing a significant gap in substance abuse patterns between college graduates and non-graduates.
A new study published in PAIN found that chronic pain patients without opioid treatment have an increased risk of death compared to those with pain but without opioid use. Long-term opioid users had a higher risk of death due to causes other than cardiovascular and cancer mortality, as well as a four times higher risk of toxicity poiso...
A new study in the European Journal of Neuroscience found that oxycodone increases dopamine levels more significantly than morphine, potentially making it more addictive. The study aims to better understand addiction and inform treatment for pain relief.
The NIH/NCCAM initiative aims to enhance options for managing pain and associated problems in US military personnel, veterans, and their families. The research will focus on nondrug approaches to address chronic pain, PTSD, drug abuse, and sleep issues.
The study aims to test a collaborative care intervention to improve chronic opioid therapy management and reduce prescription opioid misuse among HIV-infected patients. Researchers at Boston University School of Medicine hope to develop an effective model that can be adopted nationwide.
A new study by Indiana University researchers found that combining an epilepsy medication with morphine can effectively treat neuropathic pain. The combination of the two drugs resulted in improved pain management and reduced need for opioids, offering a potential solution to the difficult-to-treat condition.
Rates of high-dose opioid dispensing increased across provinces, with Ontario having the highest rates and Quebec the lowest. Provincial differences may be attributed to varying coverage, training, and marketing strategies.
A new study found that states allowing medical marijuana have lower rates of opioid overdose deaths, with a 24.8% lower annual mortality rate after laws were enacted. The alternative treatment may provide relief for some individuals and reduce the risk of overdose.
A new drug, naloxegol, has shown promising results in relieving constipation caused by opioid painkillers. The once-a-day pill maintains opioids' pain-killing effect and blocks their effects in the bowels without diminishing pain relief, offering relief to millions of patients experiencing chronic severe pain.
A telephone-delivered telecare intervention improved chronic musculoskeletal pain compared to usual care, with nearly twice as many patients experiencing a 30% reduction in pain score. The intervention was associated with clinically meaningful improvements in pain and treatment satisfaction.
A study found that nearly half of deployed soldiers reported combat injuries, with 44% experiencing chronic pain and 15.1% using opioids in the past month. The researchers emphasized the urgent need to address chronic pain and opioid misuse among military personnel.
A new study links opioid pain relievers to less improvement and higher levels of dissatisfaction following spine surgery. Patients who used opioids before surgery had worse health outcomes at 3 and 12 months post-op, according to a study published in the Journal of Bone and Joint Surgery.
Saint Louis University researcher Jeffrey Scherrer is investigating the link between chronic opioid use and depression risk. He will analyze medical records of 1 million patients, including those with VA and private sector prescriptions, to understand the impact of opioid exposure on mental health.
Researchers found a dramatic rise in opioid analgesic prescriptions during US emergency department visits from 2001 to 2010, with some opioids increasing by 668.2 percent. Despite modest increases in painful conditions, the findings suggest a concerning trend that may lead to misuse and addiction.
Research examining opioid painkiller use reveals that individuals initially obtain medications from friends and relatives, but as usage increases, prescriptions from physicians become a common source. The study emphasizes the importance of judicious prescribing practices to curb serious health issues.
A new approach to breast reconstruction surgery, known as an enhanced recovery pathway, has been shown to reduce opioid painkiller use in patients by 50% and decrease hospital stays by a day on average. The method includes preoperative analgesics, nonsteroidal anti-inflammatories, and resuming food and walking soon after surgery.
New research reveals that opioid use changes the activity of a specific protein needed for normal brain function, affecting both pain relief and tolerance. The study found that blocking this protein can reduce addiction-related behaviors, but increasing its activity lowers pain relief response and leads to faster morphine tolerance.
Researchers at University of Utah developed Mindfulness-Oriented Recovery Enhancement, reducing opioid misuse and pain-related impairment in chronic pain patients. The new treatment combines mindfulness training, reappraisal, and savoring to address underlying processes involved in chronic pain and opioid misuse.
Studies in animal models reveal that mTOR activation contributes to morphine tolerance and hyperalgesia, while mitochondrial iron accumulation promotes doxorubicin-associated cardiotoxicity. These findings suggest potential therapeutic targets for improving pain management and limiting cardiotoxicity.
Research finds mTOR activation in neurons of dorsal horn contributes to morphine tolerance and hyperalgesia; rapamycin treatment improves opioid tolerance and hyperalgesia in rats. Targeting the mTOR pathway may enhance pain management.
The proportion of opioid treatment programs offering on-site testing for human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) decreased substantially between 2000 and 2011, despite guidelines recommending routine opt-out HIV testing. For-profit opioid treatment programs were more likely to experience this decline.
A study examining incidence and trend of substance use disorder among medical residents found that 0.86% had a confirmed SUD during training, with increasing rates over the study period.
Researchers found that oxycodone is the most popular drug due to its high quality, while hydrocodone remains a favorite despite lower euphoric qualities. Hydrocodone's popularity stems from its affordability, ease of access, and perceived safety, making it an attractive option for risk-averse users.
A study analyzing over 1 million hospital admissions found that over 50% of nonsurgical patients were prescribed opioids, with high doses and late discharge increasing the risk of adverse events. Regional variation in prescribing rates was also observed, with a 37% difference between the highest and lowest regions.
A systematic review found multivitamin supplements lack effectiveness in preventing cardiovascular disease, cancer, and mortality. Guidelines for opioid prescribing also need improvement to mitigate overdose deaths among patients with chronic pain.
A new study by Indiana University researchers found that access to healthcare in counties with more dentists and pharmacists is associated with higher rates of opioid abuse. The study concludes that the structure of local healthcare systems plays a key role in determining community-level access to opioids.
A recent study published in Annals of Internal Medicine found that women who adhered to a Mediterranean-type diet in midlife had greater physical and mental function in old age. Researchers also developed a scoring system to identify low-risk patients for strep throat, which could potentially save hundreds of thousands of doctor visits...
A study published in Journal of General Internal Medicine found that long-term opioid use is linked to a higher risk of developing major depression. Patients who used opioids for 180 days or longer were at a 53% increased risk, while those using them for 90-180 days had a 25% increased risk.
Researchers analyzed conversations between chronic pain patients and their physicians about opioid treatment, revealing three patterns of physician responses: reassurance, avoidance, and gathering information. The study emphasizes the crucial role of a strong therapeutic alliance in discussing risks and benefits of opioid treatment.
A University of Michigan study found that the brain's natural painkiller system responds to social rejection, releasing chemicals called opioids to ease social pain. Individuals with high resilience scores exhibited greater opioid release during social rejection, suggesting a protective or adaptive response.
A new Kaiser Permanente study found that 77% of obese patients who used opioids before bariatric surgery continued to use them chronically after surgery. Chronic opioid use increased by 13% in the first year after surgery.
A study found that bariatric surgery led to greater chronic opioid use in patients with chronic pain, regardless of pre-surgery depression or chronic pain diagnoses. Weight loss after surgery did not reduce opioid use for these patients.
Researchers uncover a surprisingly long-lasting opioid mechanism for chronic pain control, which also leads to physical and physiological dependence. The study suggests that stress may be a key factor in relapse in chronic pain patients and raises questions about the long-term consequences of this mechanism.
A maternal junk food diet during pregnancy changes the development of the opioid signalling pathway in the baby's brain, making them more likely to overconsume high-fat, high-sugar foods. This alteration can lead to negative metabolic outcomes and a lifelong risk of obesity.
A study found that patients from lower socioeconomic backgrounds are less likely to receive opioid pain medications, regardless of racial or ethnic background. The results highlight the need for increased awareness and consistent treatment practices to address these disparities.
A Kaiser Permanente study found that long-term use of prescription painkillers is associated with a higher risk of erectile dysfunction (ED) in men. Men taking high-dose opioids for at least four months were 50% more likely to receive ED prescriptions than those who did not take opioids.
Researchers found diverse consequences of opioid use in patients with sickle cell disease, including biological, psychological, social, and spiritual effects. The study used a grounded theory approach to gather data from 21 African-American adults with SCD, revealing divergent effects on relationships, productivity, mood, and outlook.
A study of 40 patients on high-dose opioid therapy found improved pain control and mental outlook, but also significant hormonal disturbances and signs of inflammation. Despite these complications, the majority of patients reported improvements in at least one physiologic function.
The American College of Physicians (ACP) releases new recommendations for prostate cancer screening, focusing on shared decision-making and clear patient preference. Men between 50-69 years old should discuss the benefits and harms of PSA testing with their doctor before undergoing screening. The ACP also recommends against screening f...
The Boston University School of Medicine has launched a safe opioid prescribing education program, funded by the first of its kind $1.8 million grant from manufacturers of extended release/long-acting opioid analgesics. The program is designed to train healthcare providers on how to safely manage patients with chronic pain using opioids.
Clinical guidelines suggest monitoring patients closely for harm using urine drug testing, pill counts, and prescription data. Careful management balances pain relief with the risk of addiction and overdose.
A study reveals racial differences in chronic pain management, with black patients experiencing less frequent pain level documentation and more urine drug tests. This may impact the effectiveness of pain management for black patients who overcome barriers to opioid prescriptions.
A training program for potential bystanders has been shown to significantly reduce opioid-related overdose deaths, with a dose-related impact on death rates. However, no significant differences were found in emergency department and acute hospital use.
A new study from Kaiser Permanente found that men on long-acting opioids are 5 times more likely to have low testosterone levels than those on short-acting opioids. The study compared 81 men with chronic pain and found that long-acting opioids significantly increased the risk of low testosterone.
Researchers found that a protein called BDNF is inhibited in opioid addiction, unlike cocaine where it's enhanced. The study identified two genes, sox11 and gadd45g, which mediated the brain's response to morphine, preventing reward and addiction.
Researchers at Boston Medical Center are implementing a new model of care in primary care settings to decrease opioid misuse and addiction among patients with chronic pain. The study aims to evaluate the effectiveness of standardized practice guidelines and tools to improve provider monitoring and patient care.
The US Food and Drug Administration has introduced a new Risk Evaluation and Mitigation Strategy (REMS) to manage the risks of misuse and addiction associated with long-acting and extended-release opioids. The plan includes requirements for prescriber continuing education and patient counseling, aiming to reduce opioid abuse in the US.
Chronic pain patients with depression are more likely to misuse opioids, and primary care physicians should take a leading role in setting opioid prescribing standards. Safer alternatives like physical therapy and cognitive behavioral therapy can be effective treatments for chronic pain.
A longitudinal study found that adolescents and young adults with mental health disorders are 2.4 times more likely to become long-term opioid users than those without a mental health disorder. Long-term opioid use is common among males, older youth, and those from poorer communities.
Researchers found that mental distractions, especially those requiring cognitive effort, reduce pain perception by inhibiting early spinal cord responses to painful stimuli. This effect is mediated by endogenous opioids, naturally produced by the brain.
A Canadian study found opioids significantly improved the quality of life and relief from shortness of breath for advanced COPD patients. However, physicians were hesitant due to lack of guidance, fear of respiratory suppression, and concerns about censure. Innovative educational initiatives may help bridge this gap in care.
Two studies suggest that opioids can stimulate tumor growth and spread in cancer patients, with laboratory research indicating the mu opioid receptor plays a key role. Medications blocking this receptor may reduce cancer growth and metastasis.
The study found that primary care physicians need training on monitoring opioids and assessing risk factors, whereas specialists emphasize the importance of formulating treatment plans and teaching medication safety. The findings highlight the need for targeted education programs to improve public health.