Buprenorphine News Feed

Buprenorphine-Naloxone treatment of prescription opioid abuse: does past performance predict future results?

Pub Med: Keyword Buprenorphine - 5 hours 58 min ago

Buprenorphine-Naloxone treatment of prescription opioid abuse: does past performance predict future results?

J Clin Psychiatry. 2015 Feb;76(2):195-197

Authors: Langleben DD

Abstract
Misuse of prescription opioids is a national public health problem: In the United States, according to the 2012 National Survey on Drug Use and Health, 4.5 million, or 1.7%, of persons aged 12 or older reported current nonmedical use of pain relievers, and 335,000 reported currently using heroin. This is an upward trend, as heroin use has more than doubled since 2002. Transition from ingesting or insufflating (ie, snorting) prescription opioids to snorting or smoking (ie, inhaling the fumes) heroin has become more common and is driven by the increasing purity and lower cost.

PMID: 25742206 [PubMed - as supplied by publisher]

Deep Brain Stimulation for Substance Abuse

MedWorm Addiction Feeds - 10 hours 53 min ago
Abstract Substance abuse represents a significant public health issue, yet current standard treatments are largely ineffective. Deep brain stimulation (DBS) surgery may offer an effective interventional approach to treat substance abuse by enabling direct manipulation of neural circuits. DBS has been successfully used in patients with movement disorders and, more recently, in select psychiatric conditions. The ability of DBS surgery to address addictive behavior, however, critically relies upon fundamental knowledge of reward pathways within the brain. Recent evidence has provided insight into those pathways, and studies using DBS surgery in animal models of addiction and reports describing the successful use of DBS in humans with substance abuse disorders provide encouraging supp...

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A reward-centred model of anorexia nervosa: A focussed narrative review of the neurological and psychophysiological literature

MedWorm Addiction Feeds - March 5, 2015 - 6:00pm
Publication date: Available online 28 February 2015 Source:Neuroscience & Biobehavioral Reviews Author(s): Caitlin B. O’Hara , Ulrike Schmidt , Iain C. Campbell This focussed narrative review examines neurobiological and psychophysiological evidence supporting a role for altered reward processes in the development and maintenance of anorexia nervosa (AN). In AN, there does not appear to be a generalised inability to experience reward. Rather, data suggest that a reluctance to gain weight leads to an aversive appraisal of food- and taste-related stimuli. As a result, cues compatible with this aberrant mode of thinking become rewarding for the individual. Evidence also suggests that attribution of motivational salience to such cues promotes anorectic behaviours. These findings ar...

T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen–ozone discolysis: a randomized, double-blind trial with steroid and O 2 –O 3 discolysis versus steroid only

MedWorm Addiction Feeds - March 5, 2015 - 3:26pm
Conclusions T2 shine-through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen–ozone treatment. (Source: La Radiologia Medica)

The Love of My Life has Bipolar Disorder

MedWorm Addiction Feeds - March 5, 2015 - 12:14pm
Every girl who is looking for her Prince Charming always envisions a tall, dark and handsome man. Few descriptions of this person ever describe his mental condition; however, psychology tells us that if a person is tall, dark and handsome, the halo effect that we ascribe to him will automatically include intelligence, wit and mental stability. (If you are unfamiliar with the halo effect, it simply means that a person with one good quality is seen to have many good qualities.) Few, if any women will ever achieve this perfect vision in their real lives. I have yet to meet the perfect woman on this earth, so we can assume that there is no such thing as a perfect man. Once I got over needing to have a cartoon as my life partner, I found the love of my life in a package much different than the ...

Family interventions reduce smoking rates in children, adolescents

MedWorm Addiction Feeds - March 5, 2015 - 10:06am
A global review into the effectiveness of family-based programs has found these programs can be highly effective in stopping children from taking up smoking. "Preventing children from starting to smoke is important to avoid a lifetime of addiction, poor health, and social and economic consequences," said one expert and investigator. (Source: ScienceDaily Headlines)

Abstracts from the 2014 Addiction Health Services Research (AHSR) Conference.

MedWorm Addiction Feeds - March 5, 2015 - 8:18am
Authors: PMID: 25734816 [PubMed - in process] (Source: Addiction Science and Clinical Practice)

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Functional Magnetic Resonance Imaging in Abstinent MDMA Users: A Review.

MedWorm Addiction Feeds - March 5, 2015 - 7:12am
Authors: Garg A, Kapoor S, Goel M, Chopra S, Chopra M, Kapoor A, Cann UM, Behera C Abstract Ecstasy or 3,4-methylenedioxymethamphetamine (MDMA) is a popular drug of abuse. In the animal studies MDMA has been shown to have deleterious effects on the serotonergic neurotransmitter system. Understanding the adverse effects of MDMA on human brain function is of considerable importance owing to the rising number of MDMA users. Various neuroimaging studies have investigated the structural, chemical and functional differences in the brain integrity of chronic MDMA users. Various neurocognitive domains like working memory, episodic memory, semantic memory, visual stimulation, motor function and impulsivity have been compared between chronic MDMA users and non-users using fMRI. The fMRI stud...

Implementation of Smoking Cessation Treatment in VHA Substance Use Disorder Residential Treatment Programs.

MedWorm Addiction Feeds - March 5, 2015 - 6:52am
CONCLUSIONS: The results identified critical gaps in the provision of SC treatment in VHA SRTPs. These findings suggest actionable opportunities to improve SC treatment in SRTPs, including providing training opportunities, developing or enforcing policies that support SC, implementing systems to track and report tobacco-related diagnoses and treatment, and obtaining leadership support for building a culture that encourages SC. PMID: 25727118 [PubMed - in process] (Source: Psychiatric Services)

A Tale of Two States: Do Consumers See Mental Health Insurance Parity When Shopping on State Exchanges?

MedWorm Addiction Feeds - March 5, 2015 - 6:52am
Authors: Berry KN, Huskamp HA, Goldman HH, Barry CL Abstract All insurance products sold on the health insurance exchanges established by the Affordable Care Act are required to offer mental health and substance use disorder benefits in compliance with requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). This column identifies two dimensions of parity compliance that consumers observe while shopping for insurance products offered on two state-run exchanges. The authors discuss a number of apparent discrepancies with the requirements of MHPAEA in these observable dimensions, emphasizing the potential impact of these factors on consumers' decisions about plan enrollment. The analysis reveals a nuanced picture of how insu...

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VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association.

MedWorm Addiction Feeds - March 5, 2015 - 6:52am
Conclusions: A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances. PMID: 25726979 [PubMed - as supplied by publisher] (Source: Psychiatric Services)

Buprenorphine-naloxone treatment in physicians and nurses with opioid dependence.

Pub Med: Keyword Buprenorphine - March 5, 2015 - 6:30am

Buprenorphine-naloxone treatment in physicians and nurses with opioid dependence.

Subst Abus. 2015 Mar 4;:0

Authors: Braquehais MD, Fadeuilhe C, Håkansson A, Bel MJ, Navarro MC, Roncero C, Bruguera E, Casas M

PMID: 25738533 [PubMed - as supplied by publisher]

Feasibility of implementing share medical appointments (SMAs) for office-based opioid treatment with buprenorphine: A pilot study.

Pub Med: Keyword Buprenorphine - March 5, 2015 - 6:30am

Feasibility of implementing share medical appointments (SMAs) for office-based opioid treatment with buprenorphine: A pilot study.

Subst Abus. 2015 Mar 4;:0

Authors: Suzuki J, Zinser J, Klaiber B, Hannon M, Grassi H, Spinosa M, Ramirez A, Issa M, Chin Feman SP

Abstract
Background: Shared medical appointments (SMAs) are designed to improve patient satisfaction and increase access to treatment. In a typical SMA, 6-12 patients with similar diagnoses attend a group appointment with their health care providers, often lasting 60-120 minutes. All components of an individual visit are completed, and additional time is spent providing education and facilitating peer support. Our aim was to report on patient and program outcomes after implementation of a SMA-based office-based opioid treatment with buprenorphine. Methods: The study was conducted at a hospital-based outpatient psychiatric clinic that previously did not offer any office-based opioid treatment with buprenorphine. Demographic and clinical data (treatment retention, depression, anxiety, craving scores and urine toxicology results) were extracted from the medical records. Patients were recruited to complete a survey assessing their experience. Results: Ninety-three patients enrolled in the program, and 52.7% remained in treatment at 6 months. The proportion of aberrant opioid urine results, depression, anxiety and craving decreased significantly from baseline to 6 months. Twenty two patients completed the survey, who generally agreed that the SMA format allowed for more time with physicians, more support from peers, better coordination of care, and more predictable times for visits. Conclusions: Implementation of a SMA-based buprenorphine program was feasible, with treatment outcomes comparable to traditional models of care. More research is needed to explore the impact of SMA on buprenorphine treatment.

PMID: 25738320 [PubMed - as supplied by publisher]

Comparative trial to study the effectiveness of clonidine hydrochloride and buprenorphine-naloxone in opioid withdrawal - a hospital based study.

Pub Med: Keyword Buprenorphine - March 5, 2015 - 6:30am

Comparative trial to study the effectiveness of clonidine hydrochloride and buprenorphine-naloxone in opioid withdrawal - a hospital based study.

J Clin Diagn Res. 2015 Jan;9(1):FC01-4

Authors: Hussain SS, Farhat S, Rather YH, Abbas Z

Abstract
OBJECTIVES: Prevalence of opioid addiction has alarmingly increased over the recent years. In South Asian region alone there are more than 10 million opioid abusers amounting to 2% of world population. Detoxification remains to be the first step for the successful treatment of opioid addiction. The present study was carried out to compare the relative efficacy and safety of buprenorphine -naloxone and clonidine hydrochloride in the detoxification of opioid-dependents.
MATERIALS AND METHODS: Present trial was conducted at De- addiction centre of Institute of Mental and Neurosciences (IMNS), GMC Srinagar. Fifty four (54) treatment seeking subjects, 15-50 years of age, fulfilling DSM-1V TR (American Psychiatric association`s Mental Disorders-1V text revision) criteria for opioid dependence were included and randomized into two groups. The groups received either clonidine hydrochloride (Group A) or buprenorphine- naloxone (Bup-Nax) (Group B) for the duration of 10 days. The efficacy of the two drugs in controlling the opioid withdrawal was evaluated by Clinical Opioid Withdrawal Scale (COWS) and their effect on the desire for the abused substance was measured by Visual Analogue Scale (VAS). The safety of the two drugs was measured by taking the side effect profile of the two compared drugs into consideration.
RESULTS: There was significant difference of COWS-score between the two groups which was evident from day 3 (14.85 ± 3.43 vs. 11.67 ± 2.40, p<0.005) and continued till day 6 (2.56 ± 1.40 vs. 0.30 ± 0.61, p<0.005), for Group A and group B respectively. The effect of two drugs in controlling the craving for the abused substance also showed significant difference from day 2 (66.30 ± 10.80 vs. 47.40 ± 12.90, p<0.005) till day 5 (7.78 ± 6.41 vs. 1.85 ± 6.22, p<0.005), for Group A and Group B respectively.
CONCLUSION: Administration of buprenorphine-naloxone was more efficient in reducing the signs and symptoms of opioid withdrawal and in controlling the craving for the abused substance during the first few days of detoxification.

PMID: 25738001 [PubMed]

Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder.

Pub Med: Keyword Buprenorphine - March 5, 2015 - 6:30am

Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder.

Drug Alcohol Depend. 2015 Feb 19;

Authors: Wilder C, Lewis D, Winhusen T

Abstract
BACKGROUND: Increasing use of opioids has led to an increase in the number of pregnant and postpartum women in medication assisted treatment (MAT) for opioid use disorder.
METHODS: We (1) conducted a systematic review of published literature on MAT discontinuation (methadone and buprenorphine) in pregnant and postpartum women and (2) determined methadone discontinuation rates in a retrospective cohort (2006-2013) of pregnant and postpartum women in a university affiliated methadone clinic.
RESULTS: We found limited generalizable literature reports of discontinuation rates, with a range of prenatal discontinuation rates from 0 to 33% and rates which spanned various prenatal and postnatal periods from 26 to 64%. In our cohort of 229 women, 251 pregnancies were reported, with a prenatal methadone discontinuation rate of 11.0%. Based on a Cox proportional hazards model controlling for age, pregnancy outcome, and duration of treatment prior to delivery, the probability of methadone discontinuation at or before 6 months postpartum was 56.0%. Duration of methadone treatment prior to delivery was inversely associated with risk for postpartum discontinuation of treatment (HR=0.98, 95% CI (0.96, 0.99)).
CONCLUSIONS: We conclude that the postpartum period is a time of increased risk for discontinuation of MAT. More accurate assessment of rates of pre- and postpartum MAT discontinuation, as well as further investigation of factors affecting these rates, is warranted. Development and testing of interventions to encourage early prenatal enrollment in MAT and improve postnatal retention in MAT would benefit pregnant women and new mothers with opioid use disorder.

PMID: 25735465 [PubMed - as supplied by publisher]

Mental Health and Online, Land-Based and Mixed Gamblers

MedWorm Addiction Feeds - March 5, 2015 - 5:57am
Abstract Although high rates of problem gambling have been identified among Internet gamblers, most studies have failed to identify the relative contribution of multiple forms of gambling as opposed to the exclusive participation in online forms. The aim of this study was to investigate differences in mental health status in exclusive online, exclusive land-based, and mixed Internet and land-based samples of gamblers drawn from the general population. A sample of 4594 respondents completing an online survey were categorised as exclusive online, land-based and mixed form gamblers. Participants completed a questionnaire eliciting demographic details, participation on all forms of gambling, use of alcohol, tobacco and drugs, help-seeking, and personal problems experienced due to gamb...

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Psychedelic drugs like LSD could be used to treat depression, study suggests

MedWorm Addiction Feeds - March 4, 2015 - 6:52pm
Researchers warn that patients are missing out on potential benefits due to prohibitive regulations on research into recreational drugsPsychedelic drugs could prove to be highly effective treatments for depression and alcoholism, according to scientists who have obtained the first brain scans of people under the influence of LSD.Early results from the trial, involving 20 people, are said to be “very promising” and add to existing evidence that psychoactive drugs could help reverse entrenched patterns of addictive or negative thinking. Continue reading... (Source: Guardian Unlimited Science)

Preventability of adverse effects of analgesics: analysis of spontaneous reports

MedWorm Addiction Feeds - March 4, 2015 - 6:00pm
Conclusions A significant number of analgesic ADRs could be prevented, and being aware of their contributing factors promotes efficient analgesia with minimum risks to the patients. (Source: European Journal of Clinical Pharmacology)

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Effects of morphine on brain plasticity

MedWorm Addiction Feeds - March 4, 2015 - 6:00pm
Conclusions The actions of morphine on both developing and adult brains produce alterations in the plasticity of excitatory postsynaptic sites of the brain areas involved in limbic system functions (reward and learning). Doctors need further studies on plasticity in dendrites and spines and on signalling molecules, such as calcium, in order to improve treatments for addiction. (Source: Neurologia)

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