Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers.

Pub Med: Keyword Buprenorphine - 9 hours 51 min ago
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Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers.

J Subst Abuse Treat. 2015 Jun 26;

Authors: LaBelle CT, Han SC, Bergeron A, Samet JH

Abstract
We describe a Massachusetts Bureau of Substance Abuse Services' (BSAS) initiative to disseminate the office-based opioid treatment with buprenorphine (OBOT-B) Massachusetts Model from its development at Boston Medical Center (BMC) to its implementation at fourteen community health centers (CHCs) beginning in 2007. The Massachusetts Collaborative Care Model for the delivery of opioid agonist therapy with buprenorphine, in which nurses working with physicians play a central role in the evaluation and monitoring of patients, holds promise for the effective expansion of treatment for opioid use disorders. The training of and technical assistance for the OBOT nurses as well as a limited program assessment are described. Data spanning 6years (2007-2013) report patient demographics, prior treatment for opioid use disorders, history of overdose, housing, and employment. The expansion of OBOT to the fourteen CHCs increased the number of physicians who were "waivered" (i.e., enabling their prescribing of buprenorphine) by 375%, from 24 to 114, within 3years. During this period the annual admissions of OBOT patients to CHCs markedly increased. Dissemination of the Massachusetts Model of the Office-Based Opioid Treatment with Buprenorphine employing a collaborative care model with a central role for nursing enabled implementation of effective treatment for patients with an opioid use disorder at community health centers throughout Massachusetts while effectively engaging primary care physicians in this endeavor.

PMID: 26233698 [PubMed - as supplied by publisher]

Psychiatric aspects of organ transplantation and donation

MedWorm Addiction Feeds - 14 hours 19 min ago
Purpose of review: Psychiatrists and other mental health professionals typically assist with evaluating and treating psychiatric and behavioral issues in transplant candidates, recipients, and living organ donors. In this review recent findings on specific psychiatric issues in adult solid organ transplant candidates and recipients, as well as living donors are discussed as well as their relevance to clinical practice. Recent findings: Patients with complex mental health and addiction histories can have outcomes similar to patients without these disorders but may require specialized pretransplant preparation or posttransplant interventions to optimize their outcomes. Specific attention to the preparation and wellbeing of living donors is needed. Summary: As transplant programmes increasing...

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Drug Needle Exchanges Gain Ground after Indiana HIV Outbreak

MedWorm Addiction Feeds - August 3, 2015 - 2:42pm
Needle exchanges, which exist in 34 states, are gaining wider acceptance as health officials nationwide have expressed alarm at the surge in opiate abuse -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)

Eminem: Why I used to run 17 miles a day

MedWorm Addiction Feeds - August 3, 2015 - 9:32am
The rapper has revealed how he used exercise to overcome his drug addiction (Source: Telegraph Health)

If you're using drugs, scientists want to help you avoid addiction

MedWorm Addiction Feeds - August 3, 2015 - 7:33am
Abstinence is the best way to avoid drug addiction. But in many societies, drug use is the norm, not the exception, especially by youth. What keeps the majority of users from becoming addicted? How drugs are taken has something to do with it, according to pharmacology researchers. (Source: ScienceDaily Headlines)

The top reasons to avoid MSG: An industry secret ingredient for food addiction

MedWorm Addiction Feeds - August 3, 2015 - 1:00am
(NaturalNews) Most people have seen signs in Chinese and other restaurants proclaiming that their food is "MSG free" or a note on the menu letting diners know that is it possible to have their food prepared without monosodium glutamate. One of the big reasons that consumers became... (Source: NaturalNews.com)

Interventions for waterpipe smoking cessation.

MedWorm Addiction Feeds - August 2, 2015 - 11:50pm
CONCLUSIONS: Although the literature on waterpipe cessation interventions remains sparse, the reviewed studies provide a basis for developing interventions in this area. The lack of statistically significant effects in one of the three studies is not unexpected, given the small and pilot nature of the studies. The studies highlight important design and content issues that need to be considered for future cessation trials in waterpipe smokers. These include building on the vast experience developed in the study of smoking cessation interventions in cigarette smokers, whilst including components and assessment tools that address the specific aspects of waterpipe smoking, such as its social dimension, unique experiences, and cues. PMID: 26228266 [PubMed - as supplied by publisher] (Source...

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Effect of acupuncture on expression of ΔFosB and CREB in hippocampal heroin-relapse rats

MedWorm Addiction Feeds - August 2, 2015 - 7:00pm
Conclusion Acupuncture can downregulate Δ FosB and CREB expression in rats' hippocampal area and inhibit the addiction memory. (Source: World Journal of Acupuncture Moxibustion)

Discriminative stimulus effects of morphine and oxycodone in the absence and presence of acetic acid in male and female C57Bl/6 mice.

MedWorm Addiction Feeds - August 2, 2015 - 7:00pm
The use of prescription opioids for clinical management of pain remains problematic because of concerns about addiction associated with opioid use. Another difficulty in pain management is the increasing evidence for sex differences in pain behavior and opioid-induced behavioral effects. However, few studies have documented the abuse potential of prescription opioids as a function of pain in rodents, with significant gaps in the literature pertaining to sex differences in the interaction between pain and opioid effects. The present study evaluated the effects of an experimentally induced acute pain state (acetic acid injections) on the potency of morphine and oxycodone to produce discriminative stimulus effects in male and female C57Bl/6 mice trained to discriminate 3.2 mg/kg morphine from...

Against the mainstream: The membrane‐associated type I toxin BsrG from Bacillus subtilis interferes with cell envelope biosynthesis without increasing membrane permeability

MedWorm Addiction Feeds - August 2, 2015 - 7:00pm
Summary Toxin‐antitoxin loci, which encode a toxic protein alongside with either RNA or a protein able to counteract the toxicity, are widespread among Archaea and Bacteria. These loci are implicated in persistence, and as addiction modules to ensure stable inheritance of plasmids and phages. In type I toxin‐antitoxin systems, a small RNA acts as an antitoxin which prevents the synthesis of the toxin. Most type I toxin are small hydrophobic membrane proteins generally assumed to induce pores, or otherwise permeabilize the cytoplasmic membrane and, as a result, induce cell death by energy starvation. Here we show that this mode of action is not a conserved property of type I toxins. The analysis of the cellular toxicity caused by Bacillus subtilis prophage SPβ‐encoded toxin BsrG reve...

The chemistry behind “krokodil”: street-like synthesis and product analysis

MedWorm Addiction Feeds - August 2, 2015 - 7:00pm
“Krokodil” is the street name for an injectable mixture that has been used as a cheap substitute for heroin and is attracting media and researchers attention due to its spreading and extreme toxicity [1–5]. “Krokodil” first appeared around 2002/3 in Russia and Ukraine [1–4]. It is obtained from codeine tablets after a homemade process aimed to synthesize desomorphine, as a low cost option for heroin addicts. Data about the homemade synthesis of “krokodil” are related to a Nagai and “Moscow” methods, both commonly used for methamphetamine [1,6–8]. (Source: Forensic Science International)

Which Character Strengths Are Most Predictive of Well-Being?

MedWorm Addiction Feeds - August 2, 2015 - 6:17pm
If you seek high well-being, your best bets are gratitude and love of learning -- Read more on ScientificAmerican.com (Source: Scientific American - Official RSS Feed)

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Innovative community‐based educational face‐to‐face intervention to reduce HIV, HCV and other blood‐borne infectious risks in difficult‐to‐reach people who inject drugs: results from the ANRS‐AERLI intervention study

MedWorm Addiction Feeds - August 2, 2015 - 3:02am
ConclusionsAn inexpensive and easily implemented educational intervention on risks associated with drug injection significantly reduces unsafe HIV‐HCV transmission practices and injection‐related complications. This article is protected by copyright. All rights reserved. (Source: Addiction)

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Psychiatrists admitted to a physicians' health programme

MedWorm Addiction Feeds - August 1, 2015 - 7:00pm
Conclusions Psychiatrists with mental disorders may be more reluctant to ask for help from a PHP voluntarily than other physicians. Members of this professional group should be encouraged to seek help when affected by mental distress or addiction problems. (Source: Occupational Medicine)

α6-Containing nicotinic acetylcholine receptors in midbrain dopamine neurons are poised to govern dopamine-mediated behaviors and synaptic plasticity

MedWorm Addiction Feeds - August 1, 2015 - 7:00pm
Publication date: 24 September 2015 Source:Neuroscience, Volume 304 Author(s): J.N. Berry, S.E. Engle, J.M. McIntosh, R.M. Drenan Acetylcholine (ACh) acts through nicotinic and muscarinic ACh receptors in the ventral midbrain and striatal areas to influence dopamine (DA) transmission. This cholinergic control of DA transmission is important for processes such as attention and motivated behavior, and is manipulated by nicotine in tobacco products. Identifying and characterizing the key ACh receptors involved in cholinergic control of DA transmission could lead to small molecule therapeutics for treating disorders involving attention, addiction, Parkinson’s disease, and schizophrenia. α6-Containing nicotinic acetylcholine receptors (nAChRs) are highly and specifically expressed in m...

Brain DNA damage and behavioral changes after repeated intermittent acute ethanol withdrawal by young rats

MedWorm Addiction Feeds - August 1, 2015 - 7:00pm
Conclusions The animal model of repeated intermittent ethanol access induced behavioral changes in rats, and this ethanol exposure model induced an increase in DNA single-strand breaks and ROS production in all brain areas. Our results suggest that these brain damages may influence future behaviors. (Source: Psychopharmacology)

Video Lottery is the Most Harmful Form of Gambling in Canada

MedWorm Addiction Feeds - August 1, 2015 - 7:00pm
Abstract This paper summarizes the degree to which different forms of legal gambling contribute to Problem and Pathological Gambling (PPG) in Canada. Legal gambling activities were compared using meta-analysis of publicly available data concerning Canada’s legal gambling industry. The majority of revenues in the decade spanning 2002–2012 were drawn from Video Lottery Terminals and casino slot machines. Population surveys indicated that three quarters of Canadians reported some form of past-year gambling participation, but most did not play Electronic Gambling Machines. Annual revenues divided by estimated numbers of participants in various gambling activities showed that Video Lottery players spent more money on average than did participants in other forms of gambling. The rel...

8 Weird Things That Happen When You Send a Text

MedWorm Addiction Feeds - August 1, 2015 - 10:26am
This article '8 Weird Things That Happen When You Send A Text' originally ran on Prevention.com. More from Prevention.com: 7 Things To Never Do Before Or After Sex 9 Proven Ways To Lose Stubborn Belly Fat This Haircut Will Make You Look 10 Years Younger Shrink A Size In Just 14 Days 6 Simple Moves To Ease Sciatica Also on HuffPost: -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. (Source: Healthy Living - The Huffington Post)

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Metabolism and Disposition of Prescription Opioids: A Review.

Pub Med: Keyword Buprenorphine - August 1, 2015 - 6:30am
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Metabolism and Disposition of Prescription Opioids: A Review.

Forensic Sci Rev. 2015 Jul;27(2):115-145

Authors: DePriest AZ, Puet BL, Holt AC, Roberts A, Cone EJ

Abstract
Opioid analgesics are commonly prescribed for acute and chronic pain, but are subject to abuse. Consequently, toxicology testing programs are frequently implemented for both forensic and clinical applications. Understanding opioid metabolism and disposition is essential for assessing risk of toxicity and, in some cases, providing additional information regarding risk of therapeutic failure. Opioids significantly metabolized by the cytochrome P450 (CYP450) enzyme system may be subject to drug-drug interactions, including codeine, hydrocodone, oxycodone, fentanyl, meperidine, methadone, buprenorphine, and tramadol. CYP2D6 metabolism is polymorphic, and pharmacogenetic testing has been investigated for codeine, tramadol, oxycodone, and hydrocodone. CYP2B6 pharmacogenetic testing of methadone may reduce the risk of cardiac toxicity associated with the S-enantiomer. Opioids metabolized primarily by uridine 5'-diphosphoglucuronsyltransferase (UGT) enzymes include morphine, hydromorphone, dihydrocodeine, oxymorphone, levorphanol, and tapentadol. Parent and metabolite disposition is described for blood, oral fluid, and urine. Parent drug is most commonly detected in blood and oral fluid, whereas metabolites typically predominate in urine. Oral fluid/blood ratios exceed 1 for most opioids, making this an excellent alternative matrix for testing of this drug class. Metabolites of codeine, hydrocodone, and oxycodone are commercially available, and knowledge of metabolism is necessary for correct interpretation.

PMID: 26227254 [PubMed - as supplied by publisher]

Rural substance use treatment centers in the United States: an assessment of treatment quality by location.

Pub Med: Keyword Buprenorphine - August 1, 2015 - 6:30am
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Rural substance use treatment centers in the United States: an assessment of treatment quality by location.

Am J Drug Alcohol Abuse. 2015 Jul 30;:1-9

Authors: Edmond MB, Aletraris L, Roman PM

Abstract
BACKGROUND: While previous research has added to the understanding of rural residents' unique health challenges, much remains to be learned about the provision of substance use disorder (SUD) treatment in rural areas. A key question is difference in structural resources and quality of care between rural and urban treatment centers.
OBJECTIVE: To examine differences in treatment quality in rural and urban centers and to determine if differences in treatment quality are contextualized by centers' structural resources.
METHODS: Utilizing combined data from two representative samples of SUD treatment centers (n = 591), we used a series of multivariate regressions to analyze the association between center rurality and various indicators of structural characteristics and treatment quality. Interaction effects were further examined between structural characteristics and treatment quality indicators.
RESULTS: We found that structural and quality differences between rural and urban treatment centers were present. Rural centers had reduced access to highly educated counselors, were more likely to be non-profit and dependent on public funding, offered fewer wraparound services, and had less diverse specialized treatment options. Our results also indicated that rural centers were less likely to prescribe buprenorphine as part of their treatment but were more likely to employ nursing staff and offer specialized treatment for adolescents. Rural center access to a physician contextualized the association between center rurality and the more limited provision of wraparound services.
CONCLUSION: Our findings suggest that treatment quality differs between urban and rural centers in complex ways that are subject to resource availability.

PMID: 26225814 [PubMed - as supplied by publisher]

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