Relevant bibliographies by topics / Opioid consumption

Academic literature on the topic 'Opioid consumption'

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Published: 4 June 2021
Last updated: 13 February 2022

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Journal articles on the topic "Opioid consumption"

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Jarlbaek, Lene. "Opioid prescribing habits differ between Denmark, Sweden and Norway – and they change over time." Scandinavian Journal of Pain 19, no. 3 (July 26, 2019): 491–99. http://dx.doi.org/10.1515/sjpain-2018-0342.

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Abstract Background and aims The medical use of opioids in different countries is often subject to public concern and debate, frequently based on rough figures from prescription databases made for registration of consumption. However, public access to some of these databases allow for further exploration of the prescription data, which can be processed to increase knowledge and insight into national opioid prescribing-behavior. Denmark, Sweden and Norway are considered closely related with regard to health care and culture. So, this study aims to provide a more detailed picture of opioid prescribing and its changes in the three Scandinavian countries during 2006–2014, using public assessable prescription data. Methods Data on dispensed opioid prescriptions (ATC; N02A, and R05DA04) were downloaded from each country’s prescription-databases. The amounts of dispensed opioids were used as proxy for consumption or use of opioids. Potential differences between dispensed prescriptions and actual use cannot be drawn from these databases. Consumption-data were converted from defined daily doses (DDDs) to mg oral morphine equivalents (omeqs). Changes in the choice of opioid-types, consumption and number of users were presented using descriptive statistics and compared. Results Opioid users: during the whole period, Norway had the highest, and Denmark the lowest, number of opioid users/1,000 inhabitants. From 2006 to 2014 the numbers of users/1,000 inhabitants changed from 98 to 105 in Norway, from 66 to 75 in Denmark, and from 79 to 78 in Sweden. Opioid consumption/1,000 inhabitants: The results depended much on the unit of measurement. The differences between the countries in consumption/1,000 inhabitants were small when DDDs was used as unit, while using mg omeqs significant differences between the countries appeared. Denmark had a much higher consumption of omeqs per 1,000 inhabitants compared to Sweden and Norway. Opioid consumption/user: during the whole period, Norway had the lowest, and Denmark the highest consumption/user. In 2006, the annual average consumption/user was 1979, 3615, 6025 mg omeq/user in Norway, Sweden and Denmark, respectively. In 2014 the corresponding consumption was 2426, 3473, 6361 mg omeq/user. The preferred choices of opioid-types changed during the period in all three countries. The balance between use of weak or strong opioids showed more prominent changes in Norway and Sweden compared to Denmark. Conclusions This study has shown how public assessable opioid prescription data can provide insight in the doctors’ prescribing behavior, and how it might change over time. The amounts of dispensed opioids, opioid prescribing habits and changes were compared between the countries, and significant differences appeared. Within each country, the overall picture of opioid consumption appeared rather stable. Implications Studies like this can contribute to qualify the ongoing debates of use of opioids in different nations and to monitor effects of initiatives taken by health-care authorities and health-care policy-makers.
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Bhashyam, Abhiram R., Cornelia Keyser, Christopher P. Miller, Jennifer Jacobs, Eric Bluman, Jeremy T. Smith, and Christopher Chiodo. "Prospective Evaluation of Opioid Use After Adoption of a Prescribing Guideline for Outpatient Foot and Ankle Surgery." Foot & Ankle International 40, no. 11 (July 18, 2019): 1260–66. http://dx.doi.org/10.1177/1071100719863711.

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Background: In 2016, our provider group adopted an initial prescription opioid maximum guideline to reduce overprescription of opioids. The purpose of this study was to prospectively assess opioid consumption patterns following implementation of this guideline in patients undergoing outpatient foot and ankle surgery. Methods: Over a 1-year period, we prospectively analyzed opioid prescription and use patterns of 303 consecutive patients. Opioid consumption was verified by pill counts completed at the 2- and 6-week postoperative visits. The morphine equivalent dose was calculated for each prescription and converted to the equivalent 5-mg oxycodone “pill.” We used the regression coefficients from a regression model of opioid consumption to create a revised guideline for maximum initial opioid prescriptions based on patient age, bony vs nonbony procedure, and anatomic location (forefoot/midfoot/hindfoot/ankle). Results: On average, 37.4 pills were prescribed and 18.9 pills used (47.6% utilization). Only 17.2% of patients used their full prescription quantity. By 2 weeks, 88% of patients no longer used opioids. Only 1.3% of patients used prescription opioids beyond 6 weeks. Independent risk factors for increased opioid consumption were younger age ( P = .003), male sex ( P = .007), recent preoperative opioid use ( P = .019), bony procedures ( P < .001), and ankle/hindfoot procedures ( P = .016 and P < .001). Conclusion: This study showed the amount of opioid consumption for patients undergoing foot and ankle procedures. We present a modified guideline for the maximum initial prescription of opioids following outpatient foot and ankle procedures that can be used as a benchmark for further study in decreasing overprescribing. Level of Evidence: Level II, prospective observational cohort study.
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Wilson, Sylvia H., Bethany J. Wolf, Stefanie M. Robinson, Cecil Nelson, and Latha Hebbar. "Intravenous vs Oral Acetaminophen for Analgesia After Cesarean Delivery: A Randomized Trial." Pain Medicine 20, no. 8 (December 17, 2018): 1584–91. http://dx.doi.org/10.1093/pm/pny253.

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Abstract Objective Examination of postoperative analgesia with intravenous and oral acetaminophen. Design Prospective, three-arm, nonblinded, randomized clinical trial. Setting A single academic medical center. Subjects Parturients scheduled for elective cesarean delivery. Methods This trial randomized 141 parturients to receive intravenous acetaminophen (1 g every eight hours, three doses), oral acetaminophen (1 g every eight hours, three doses), or no acetaminophen. All patients received a standardized neuraxial anesthetic with intrathecal opioids and scheduled postoperative ketorolac. The primary outcome, 24-hour opioid consumption, was evaluated using the Kruskal-Wallace test and Tukey-Kramer adjustment for multiple comparisons. Secondary outcomes included 48-hour opioid consumption, first opioid rescue, pain scores, patient satisfaction, times to ambulation and discharge, and side effects. Results Over 18 months, 141 parturients with similar demographic variables completed the study. Median (interquartile range) opioid consumption in intravenous morphine milligram equivalents at 24 hours was 0 (5), 0 (7), and 5 (7) for the intravenous, oral, and no groups, respectively, and differed between groups (global P = 0.017). Opioid consumption and other secondary outcomes did not differ between the intravenous vs oral or oral vs no groups. Opioid consumption was reduced at 24 hours with intravenous vs no acetaminophen (P = 0.015). Patients receiving no acetaminophen had 5.8 times the odds of consuming opioids (P = 0.036), consumed 40% more opioids controlling for time (P = 0.041), and had higher pain scores with ambulation (P = 0.004) compared with the intravenous group. Conclusions Intravenous acetaminophen did not reduce 24-hour opioid consumption or other outcomes compared with oral acetaminophen. Intravenous acetaminophen did decrease opioid consumption and pain scores compared with no acetaminophen.
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Miller, Andrew, Nayoung Kim, and Asif M. Ilyas. "Prospective Evaluation of Opioid Consumption Following Hand Surgery Performed Wide Awake Versus With Sedation." HAND 12, no. 6 (November 28, 2016): 606–9. http://dx.doi.org/10.1177/1558944716677536.

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Background: We prospectively evaluated opioid consumption postoperatively following trigger finger release (TFR) and open carpal tunnel release (CTR), and hypothesized that cases performed wide awake with local anesthesia and no tourniquet (WALANT) would result in increased opioid consumption compared with cases performed under monitored anesthesia care (MAC). Methods: Postoperative opioid consumption following CTR and TFR was prospectively collected over 6 months. The primary end points of the study were: (1) total opioid consumption; and (2) the number of days an opioid was used for both groups. Results: Mean opioid use and number of days the opioid was used for all MAC cases were 3.95 pills and 1.8 days, respectively. The results for WALANT were 3.85 pills and 1.6 days. Conclusions: These results suggest that effective pain control postoperatively may be independent of anesthesia type for soft tissue procedures of the hand. Specifically, average opioid consumption and days of utilization were similar in both the MAC and WALANT groups. Average postoperative opioid consumption was approximately only 4 opioid pills. Consideration should be given to prescribing fewer opioids for surgeries such as CTR and TFR.
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Kvarda, Peter, Noortje Catharina Hagemeijer, Gregory Waryasz, Daniel Guss, Christopher W. DiGiovanni, and Anne H. Johnson. "Opioid Consumption Rate Following Foot and Ankle Surgery." Foot & Ankle International 40, no. 8 (May 21, 2019): 905–13. http://dx.doi.org/10.1177/1071100719848354.

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Background: The rapid increase in the consumption of prescription opioids has become one of the leading medical, economic, and sociological burdens in North America. In the United States, orthopedic surgery is the fourth leading specialty in the number of opioids prescribed, and the largest among all operative specialties. There is insufficient evidence to guide surgeons about appropriate opioid prescription amounts after orthopedic foot and ankle (F&A) procedures. The aim of this study was to determine the opioid consumption rate after foot and ankle procedures and identify risk factors associated with higher use. Methods: A total of 535 patients who underwent foot and/or ankle surgery between August 2016 and March 2018 were included in the study. Each patient received a preoperative discussion about postoperative pain and expectations alongside a standardized handout. At the 2-week postoperative visit, the patients self-reported the amount of consumed opioids. Prescription details, number of opioid pills consumed, refill requests, pain-issue-related telephone calls, and additional physician/emergency department visits were documented. Patient demographics, comorbidities, use of regional anesthesia, hospitalization, surgery type/severity, and preoperative opioid use were collected. A total of 244 patients had a sufficiently complete data set for inclusion in the final cohort. Subjects had a mean age of 50 years (±16.3) and a body mass index (BMI) of 29 (±6.1). Sixty-six (27%) patients underwent a soft tissue procedure alone and 178 (73%) underwent a bony procedure. Results: On average, patients consumed 46.6% of the prescribed pills following a bony procedure and 42.4% after a soft tissue procedure, which resulted in a total of 4496 leftover pills. BMI, procedure type (bony vs soft tissue)/severity, and number of opioids prescribed were positively correlated with elevated consumption rates ( P = .008, P < .001, P < .001, P < .001, respectively). Conclusion: BMI, procedure type, and higher initial pill dispensation correlated with a larger number of consumed pills during the postoperative period. On average, patients took 42.4% of the prescribed opioid after soft tissue procedures and 46.6% after bony procedures, resulting in a significant number of unused pills. Future guidelines are necessary to improve postoperative pain management to prevent narcotic overprescription and minimize the downstream potential for unprescribed community opioid access. Level of Evidence: Level III, retrospective case series, analytic.
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Merrill, Haley M., Daniel M. Dean, Jay L. Mottla, Steven K. Neufeld, Daniel J. Cuttica, and Matthew M. Buchanan. "Opioid Consumption Following Foot and Ankle Surgery." Foot & Ankle International 39, no. 6 (March 5, 2018): 649–56. http://dx.doi.org/10.1177/1071100718757527.

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Background Orthopedic surgeons frequently prescribe pain medications during the postoperative period. The efficacy of these medications at alleviating pain after foot/ankle surgery and the quantity of medication required (and conversely, leftover) are unknown. Methods: Patients undergoing foot/ankle surgery during a 3-month period who met inclusion criteria were surveyed at their first postoperative visit. Information collected included gender, number of prescribed pills remaining, satisfaction with pain control, and willingness to surrender leftover opioids to a Drug Enforcement Administration (DEA) disposal center. Additional data, including utilization of a perioperative nerve block and type (bony versus nonbony) and anatomic region of procedure, were collected through review of the medical record. All data were analyzed in a retrospective fashion. A total of 171 patients with a mean age of 53.1 ± 15.5 years (range, 18-81 years) were included in the study. Results: The mean number of opioids taken was 27.2 ± 17.5 pills (range, 0-70). The mean number of short-acting opioids and long-acting opioids taken was 21.4 ± 14.8 and 9.2 ± 5.0 pills, respectively. Most (73.5%) patients were satisfied with their pain control. Patients who underwent ankle/hindfoot surgery took more long-acting opioids on average than others ( P = .047). There was not a significant difference in opioid usage between bony and nonbony procedures. Of those with leftover opioids, 63% were willing to surrender them to a DEA disposal center. Patients willing to surrender leftover medications had both more short-acting ( P < .001) and long-acting ( P = .015) opioids leftover than those not willing to surrender them. Conclusion: Most patients undergoing foot/ankle surgery had opioids leftover at the first postoperative visit, and most were willing to surrender them. We can adequately treat patients’ pain and decrease the number of opioid pills available in the community by decreasing the number of pills prescribed and encouraging disposal of leftovers. Level of Evidence: Level IV, retrospective case series.
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Chapman, Talia, Nayoung Kim, Mitchell Maltenfort, and Asif M. Ilyas. "Prospective Evaluation of Opioid Consumption Following Carpal Tunnel Release Surgery." HAND 12, no. 1 (July 7, 2016): 39–42. http://dx.doi.org/10.1177/1558944716646765.

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Background: Postoperative pain management and opioid consumption following carpal tunnel release (CTR) surgery may be influenced by many variables. To understand factors affecting opioid consumption, a prospective study was undertaken with the hypothesis that CTR performed under local anesthesia (wide awake local anesthesia with no tourniquet [WALANT]) would result in increased opioid consumption postoperatively compared with cases performed under sedation. Methods: All patients undergoing open CTR surgery were consecutively enrolled over a 6-month period. Information collected included patient demographics, surgical technique, amount and type of narcotic prescribed, number of pills taken, and type of anesthesia. Results: 277 patients were enrolled (56% women, 44% men). On average, 21 pills were prescribed, and 4.3 pills (median = 2) were consumed. There was no difference in consumption between patients who received WALANT (78 cases) versus (198 cases) sedation (4.9 vs 3.9 pills, respectively) ( P = .22). There was no difference in opioid consumption based on insurance type ( P = .47) or type of narcotic ( P = .85). However, more men consumed no opioids (47%) compared with women (36%) ( P < .05) and older patients consumed less than younger patients ( P < .05). Conclusions: Opioid consumption following CTR is more influenced by age and gender, and less influenced by anesthesia type, insurance type, or the type of opioid prescribed. Many more opioids were prescribed than needed, on an average of 5:1. Many patients, particularly older patients, do not require any opioid analgesia after CTR.
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CLAUSEN, T. G. "International opioid consumption." Acta Anaesthesiologica Scandinavica 41, no. 1 (January 1997): 162–65. http://dx.doi.org/10.1111/j.1399-6576.1997.tb04632.x.

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McKissack, Haley, Jun Kit He, Robert D. Stibolt, Aaradhana J. Jha, Perry Washburn, Sameer M. Naranje, Gerald McGwin, and Michael D. Johnson. "Effect of Postoperative Gabapentin Administration on Opioid Consumption." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0030. http://dx.doi.org/10.1177/2473011419s00301.

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Category: Foot & Ankle Surgery Introduction/Purpose: Prescription opioids are commonly used to control postoperative pain in foot and ankle surgery, but present potentially detrimental side effects including sedation, respiratory depression, and addiction. In foot and ankle surgery, pain is a common cause of delayed hospital discharge and decreased willingness to move, thereby slowing recovery. Gabapentin acts by decreasing lesion-induced hyperexcitability of posterior horn neurons and central sensitization, and has been explored as a potential addition to patients’ pain regimen. Although studies have previously assessed the effect of gabapentin on pain relief, to our knowledge none have evaluated whether gabapentin is effective in opioid consumption reduction beyond the immediate postoperative period. This study aims to assess whether gabapentin acts synergistically to improve postoperative pain among patients undergoing foot and ankle surgery. Methods: Patients from a single institution who underwent elective foot and ankle surgery were identified using CPT codes 27700, 27702, 27870, 28705, 28715, 28725, 28730, and 28740. Those prescribed opioids postoperatively were included. A retrospective chart review was conducted for each patient to identify prescription dose, number of pills, date in which prescription was filled, and dates of refills for oxycodone, hydrocodone, oxycodone-acetaminophen, hydrocodone-acetaminophen, tramadol, and gabapentin. Medication information was collected only for prescriptions by the operating surgeon, nurse practitioner, physician assistant, resident, or fellow which were pertinent to the foot/ankle surgery performed; prescriptions from other services or providers were not included in order to ensure that the medications prescribed were specific to postoperative pain. Opioid quantities were converted to morphine equivalents and compared at various time intervals between patients who were prescribed only opioids, and patients who were prescribed opioids and gabapentin. Results: Among patients prescribed gabapentin plus opioids, total opioids prescribed (in morphine equivalents, OME) was 68.33, 221.25, 87.50, and 400.83 at weeks 1-2, 3-6, 7-12, and greater than 12, respectively. Although not statistically significantly different, patients prescribed only opioids had greater average amounts of opioids prescribed at all time intervals, equaling 98.34 OME, 553.52 OME, 540.53 OME, and 766.25 OME at weeks 1-2, 3-6, 7-12, and greater than 12, respectively. When excluding patients taking opioids preoperatively, total morphine equivalents prescribed was significantly less among patients prescribed gabapentin (196.94 OME) in comparison to those prescribed only opioids (457.41 OME) (p=0.0255). Conclusion: The findings of this study suggest that gabapentin may be effective in reducing postoperative opioid consumption beyond the immediate postoperative period among elective foot and ankle surgery patients. Gabapentin may be particularly beneficial within the three to six week postoperative period. Prospective clinical trials are warranted to further validate these results.
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Balsamo, Duilio, Paolo Bajardi, Alberto Salomone, and Rossano Schifanella. "Patterns of Routes of Administration and Drug Tampering for Nonmedical Opioid Consumption: Data Mining and Content Analysis of Reddit Discussions." Journal of Medical Internet Research 23, no. 1 (January 4, 2021): e21212. http://dx.doi.org/10.2196/21212.

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Background The complex unfolding of the US opioid epidemic in the last 20 years has been the subject of a large body of medical and pharmacological research, and it has sparked a multidisciplinary discussion on how to implement interventions and policies to effectively control its impact on public health. Objective This study leverages Reddit, a social media platform, as the primary data source to investigate the opioid crisis. We aimed to find a large cohort of Reddit users interested in discussing the use of opioids, trace the temporal evolution of their interest, and extensively characterize patterns of the nonmedical consumption of opioids, with a focus on routes of administration and drug tampering. Methods We used a semiautomatic information retrieval algorithm to identify subreddits discussing nonmedical opioid consumption and developed a methodology based on word embedding to find alternative colloquial and nonmedical terms referring to opioid substances, routes of administration, and drug-tampering methods. We modeled the preferences of adoption of substances and routes of administration, estimating their prevalence and temporal unfolding. Ultimately, through the evaluation of odds ratios based on co-mentions, we measured the strength of association between opioid substances, routes of administration, and drug tampering. Results We identified 32 subreddits discussing nonmedical opioid usage from 2014 to 2018 and observed the evolution of interest among over 86,000 Reddit users potentially involved in firsthand opioid usage. We learned the language model of opioid consumption and provided alternative vocabularies for opioid substances, routes of administration, and drug tampering. A data-driven taxonomy of nonmedical routes of administration was proposed. We modeled the temporal evolution of interest in opioid consumption by ranking the popularity of the adoption of opioid substances and routes of administration, observing relevant trends, such as the surge in synthetic opioids like fentanyl and an increasing interest in rectal administration. In addition, we measured the strength of association between drug tampering, routes of administration, and substance consumption, finding evidence of understudied abusive behaviors, like chewing fentanyl patches and dissolving buprenorphine sublingually. Conclusions This work investigated some important consumption-related aspects of the opioid epidemic using Reddit data. We believe that our approach may provide a novel perspective for a more comprehensive understanding of nonmedical abuse of opioids substances and inform the prevention, treatment, and control of the public health effects.
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Dissertations / Theses on the topic "Opioid consumption"

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Svendsen, Kristian. "Methodological Challenges in Pharmacoepidemiological Studies of Opioid Consumption." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for samfunnsmedisin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-17244.

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Everett, Bronwyn L., University of Western Sydney, and of Nursing Family and Community Health School. "The impact of linguistic diversity on postoperative opioid consumption." THESIS_CSHS_NFC_Everett_B.xml, 2000. http://handle.uws.edu.au:8081/1959.7/465.

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Pain management is a critical part of the care of the surgical patient. This study sought to investigate the impact of cultural and linguistic diversity on analgesic administration practices and opioid consumption during postoperative period. A retrospective medical record audit of 278 English-speaking and non-English speaking surgical patients was carried out at four hospitals in Sydney's South West. No differences were found in the type of analgesia prescribed, the mode of analgesia, or the commencement of oral analgesia between the two groups. However, non-English speaking patients consumed less analgesia during the initial postoperative period than their English speaking counterparts. The importance of this difference was further examined within the context of a range of factors known to influence analgesia consumption. A model including sociodemographic and clinical factors - mode of administration of analgesia, gender, and language spoken -predicted 37% of total opioid consumption. Although mode of administration was the most important factor, being of non-English speaking background also contributed substantially. Pain assessment, inclusive of gender and cultural nuances is recommended. The need for further research into pain interpretation in specific linguistic and cultural groups is highlighted
Master of Science (Hons) (Health)
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Everett, Bronwyn L. "The impact of linguistic diversity on postoperative opioid consumption /." View thesis, 2000. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031118.123321/index.html.

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Thesis (MSc (Hons.)Health) -- University of Western Sydney, Macarthur, 2000.
"March 2000" "A thesis presented to the University of Western Sydney Macarthur in partial fulfilment of the requirements for the Degree of Master of Science (Hons) Health" Bibliography: leaves 90-101.
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Yu, Justin M. Eng (Justin K. )Massachusetts Institute of Technology. "Predicting post-surgical opioid consumption using perioperative surgical data." Thesis, Massachusetts Institute of Technology, 2020. https://hdl.handle.net/1721.1/130199.

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Thesis: M. Eng., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, May, 2020
"May 2020." Date of graduation confirmed by MIT Registrar Office. Cataloged from student-submitted PDF of thesis.
Includes bibliographical references (pages 49-50).
Improper consumption of prescription opioids is a massive public health issue in the United States currently. Here, we propose one approach of tackling this issue through using machine learning techniques to predict opioid consumption post discharge for surgical patients. Through the data collected from surgical patients at BIDMC, relevant features will be identified and used to predict if patients high, outlier consumption. Using logistic regression and gradient boosted decision trees, model performance were evaluated at AUCs of 0.7270 and 0.7289 respectively.
by Justin Yu.
M. Eng.
M.Eng. Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science
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Ploj, Karolina. "Involvement of the Opioid System in High Alcohol Consumption : Environmental and Genetic Influences." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5217-5/.

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Guo, Run Xiang, and jessica_guo2000@yahoo com. "The effect of electro-acupuncture on reducing opioid consumption in patients with chronic pain: a randomised controlled clinical trial." RMIT University. Health Sciences, 2007. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080703.161141.

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Objectives: Electro-acupuncture (EA) has been demonstrated to be effective in reducing post-operative acute consumption of opioid-like medications (OLM) by previous studies. This effect has not been examined in patients with chronic pain. In this thesis, a randomised, double-blind, sham acupuncture-controlled study was reported. The trial aimed to evaluate the effect of EA in reducing OLM consumption in patients with chronic non-malignant pain. Methods: Thirty-five patients were recruited from a multidisciplinary pain management clinic in Melbourne. After a two-week baseline assessment, participants were randomly assigned to one of the two groups by a computer generated randomisation sequence: real EA (REA, n = 17) or sham EA (SEA, n = 18). The REA group received 2/100 Hz EA stimulation on two pairs of acupoints (Zusanli ST36 and Fenglong ST40 on one leg and Hegu LI4 and Quchi LI11 on one arm) and manual acupuncture on an additional five chosen acupoints for 30 minutes. The SEA group received superficial needling on non-acupoints without Deqi sensation or electrical stimulation. Both groups received treatment twice a week for six weeks. Participants were followed up for 12 weeks at intervals of four weeks. During the trial, participants were given clear instructions on how to reduce their OLM usage. A researcher telephoned the participants three times during the trial to encourage them to reduce OLM intake. The assessor, researcher and participants were blinded to treatment allocation. Outcome measures: The primary outcome measures included OLM consumption, related side effects, dosage of non-opioid analgesics and the intensity and unpleasantness of pain. These measures were recorded daily for two weeks before the intervention, six weeks during the treatment period and three times during the follow up period. Secondary outcome measures were depression and quality of life as assessed by the Beck Depression Inventory-II (BDI-II) and the Medical Outcome Study 36-Item Short Form (SF-36), respectively. Data were analysed with independent t-tests or analysis of variance (ANOVA) where appropriate and per protocol analysis was employed. Results: Nine participants withdrew from the study. At baseline, the two groups were comparable on all demographic characteristics and major outcome variables except for the average intensity of pain. During the treatment period, the reduction of OLM consumption was more rapid in the REA group (64%) than in the SEA (46%) (ANOVA, p less than 0.05). The effect was maintained for four weeks in the REA group. There were no differences in the improvement of all other measures between the two groups. The incidence of EA-related adverse events (AEs) per treatment was 21% and 10% in the REA and SEA groups, respectively. All AEs were minor. Over 90% of the participants were satisfied with the treatments given and would recommend EA to others. The blinding was successful. Conclusions: EA could be an effective and safe treatment for reducing OLM consumption for patients with chronic pain, and may be used as an adjunct therapy in chronic pain management. Further studies with larger sample sizes are warranted.
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Beane, Amber. "Health and Academic Achievement in College and University Students." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3702.

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The purpose of this non-experimental quantitative correlational study was to investigate the relationship between academic achievement and health in a national sample of college students using quantitative data analysis. Specifically, the researcher analyzed the relationship between three health-promoting behaviors (physical activity, strength training, and fruit and vegetable consumption), three negative health behaviors (cigarette, e-cigarette, and opioid use) and obesity with GPA. Cross-sectional data on student health collected from the American College Health Association’s National College Health Assessment II (ACHA-NCHA-II) and completed by 426,650 college students from 650 U.S. colleges during the semesters between 2015 and 2019 formed the foundation for this research. Nine research questions were addressed using a series of chi square tests. Results showed there was a significant positive relationship between health behaviors and grade average. Students who met the recommendations for fruit and vegetable consumption, moderate activity and vigorous physical activity were more likely to have GPAs than those who did not. Students who used cigarettes, opioids, or were obese were more likely to have GPAs.
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Silva, Caroline Cristina. "Participação dos receptores opióides mu e kappa da substância cinzenta periaquedutal na febre induzida por estresse de contenção." Universidade Federal de São Carlos, 2016. https://repositorio.ufscar.br/handle/ufscar/7705.

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The endogenous opioids are involved in analgesia, thermoregulation and physiological responses to various stressful stimuli such as infection, psychological stress and hypoxia. The mu and kappa receptors in the hypothalamus play a role in endotoxin-induced fever and hypoxia-induced anapyrexia (opposite response to fever), respectively. In addition, periaqueductal gray (PAG), which express both mu and kappa receptors, is involved in defence and thermoregulatory responses. Thus, our hypothesis is that mu and kappa opioid receptors in the PAG modulate the restraint-induced fever in rats by activating and inhibiting this response, respectively. To this end, body temperature (Tb) and heat loss index (HLI; inference for heat conservation/loss) and oxygen consumption (VO ; inference for thermogenesis) of unanesthetized Wistar rats submitted or not to restraint stress, was monitored before and after intra-PAG microinjection of the selective mu opioid receptor antagonist (CTAP; 1 and 10 μg/ 100 nL/ animal), the selective kappa-opioid receptor antagonist (nor-BNI; 1 and 4 μg/ 100 nL/ animal), or vehicle (saline; 100nL/ animal). CTAP and nor-BNI did not change the Tb or the HLI of the animals in euthermia. During the restraint stress, Tb increased in all groups of animals. However, this effect was significantly lower in animals treated with CTAP, and significantly higher in animals treated with nor-BNI. No treatment affected HLI, but CTAP decreased thermogenesis and nor-BNI increased thermogenesis. The results indicate that the mu and kappa opioid receptors in the PAG of rats play a pyrogenic and antipyretic role, respectively, during fever induced by restraint stress and these receptors in PAG may not be essential for the maintenance of Tb during euthermia.
Os opióides endógenos estão envolvidos na analgesia, termorregulação e respostas fisiológicas a vários estímulos estressantes, como infecção, estresse psicológico e hipóxia. Os receptores mu e kappa no hipotálamo desempenham um papel na febre induzida por endotoxina e anapirexia induzida por hipoxia (resposta oposta à febre), respectivamente. Além disso, a substância cinzenta periaquedutal (PAG), que expressa ambos os receptores mu e kappa, está envolvida na defesa e respostas de termorregulação. Assim, nossa hipótese é que os receptores opióides mu e kappa na PAG modulam a febre induzida por contenção em ratos, ativando e inibindo esta resposta, respectivamente. Para este fim, a temperatura corporal (Tc) e o índice de perda de calor (IPC; inferência para a conservação/perda de calor) e o consumo de oxigênio (VO ; inferência para a termogênese) de ratos Wistar não anestesiados submetidos ou não ao estresse contenção, foi monitorado antes e depois microinjeção intra-PAG do antagonista seletivo do receptor opióide mu (CTAP; 1 e 10 μg/ 100 nL/ animal), antagonista seletivo do receptor opióide kappa (nor-BNI; 1 e 4 μg/ 100 nL/ animal) ou veículo (solução salina; 100 nL / animal). A microinjeção de CTAP ou nor-BNI não alterou a Tc ou IPC dos animais em eutermia. Durante o estresse de contenção, a Tc aumentou em todos os grupos de animais. No entanto, este efeito foi significativamente menor no grupo de animais tratados com CTAP, e significativamente maior em animais tratados com nor-BNI. Nenhum tratamento afetou o IPC, mas o CTAP diminuiu a termogênese e o nor-BNI aumentou a termogênese. Os resultados indicam que os receptores opióides mu e kappa na PAG de ratos desempenham um papel pirogênico e antipirético, respectivamente, durante a febre induzida pelo estresse de contenção e estes receptores na PAG podem não ser essenciais para a manutenção de Tc durante eutermia.
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Daoura, Loudin. "Early Environment and Adolescent Ethanol Consumption : Effects on Endogenous Opioids and Behaviour in Rats." Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-198670.

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Excessive and compulsive ethanol drinking is one of the most serious public health issues. Therefore, it is vital to increase the knowledge about risks and protection for alcohol use disorders (AUD) to optimize prevention and treatment strategies. Ethanol consumption commonly initiates during adolescence when extensive neuronal maturation and development also occurs. Early exposure to ethanol is a risk factor for AUD, but the effects of adolescent drinking and the basis for the individual susceptibility to AUD are not fully understood. The interactions between genotype and environmental factors determine the individual risk for AUD and this thesis aimed to examine the environmental impact. The specific aims were to investigate 1) how early-life conditions affect adolescent voluntary ethanol drinking, behavioural profiles, endogenous opioids and response to treatment with an opioid antagonist (naltrexone), and 2) whether alterations detected in the offspring may be mediated by variations in maternal behaviour. A rodent maternal separation (MS) model was used to mimic a protective and risk-inducing early-life environment, respectively, with the use of 15 min (MS15) or 360 min (MS360) of daily MS. The main findings were 1) the MS360, but not the MS15 rats, responded to naltrexone following adolescent ethanol drinking; all adolescent rats had a high voluntary ethanol intake independent of early environmental conditions whereas in the adult groups the MS360, but not the MS15 rats, increased their ethanol intake and preference over time; adolescent ethanol exposure resulted in higher dynorphin levels in hippocampus and higher Met-enkephalin-Arg6Phe7 in the amygdala, independently of rearing conditions, 2) behavioural profiling using the multivariate concentric square field™ test showed: the young MS360 rats had increased risk assessment and risk taking behaviour compared to the young MS15 rats; the young MS15 rats increased, whereas the young MS360 rats decreased, their risk assessment and risk taking behaviour over time; differences in pup-retrieval strategies where the MS360 dams retrieved some pups into a safe area but as compared to MS15 rats they left more pups in a risk area; increased risk assessment behaviour in the MS360 dams immediately after weaning. Taken together, early-life environmental conditions alter adult but not adolescent drinking, the response to naltrexone, and behaviour in dams and offspring. Adolescent rats consumed more ethanol independent of rearing conditions and displayed increased opioid levels in brain areas related to cognition and addiction.
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Lvovschi, Virginie-Eve. "Titration morphinique inhalée aux Urgences : modernisation de la prise en charge des douleurs sévères de l'adulte Targeting moderate pain in healthy volunteers by individual calibration of a nociceptive flexion reflex model Proposer un "modèle" de douleur provoquée par Electromyogramme pour optimiser les outils antalgiques aux urgences Nebulized versus intravenous morphine titration for the initial treatment of severe acute pain in the emergency department : study protocol for a multicenter, prospective randomized and controlled trial, CLIN-AEROMORPH Inhaled versus intravenous opioid dosing for the initial treatment of severe acute pain in the emergency department : pharmacological intermediate results of the CLIN-AEROMORPH french study Toward new eligibility criteria for ontravenous morphine in the French Emergency Department : Evaluation of physicians' bedside rationalization of opioid titration protocols Analysis of bedside determinisms leading to under-prescription of morphine titration in the Emergency Department : EPIMORPH study Medico-economic study of pain in an emergency department : a targeted literature review Opioid reflex at triage is not a solution for opioid-naive patients in emergency departments A systemic approach to complete the multimodal assessment model of pain Intravenous morphine titration to treat severe pain in the ED Morphine consumption is not modified in patients with severe pain and classified by the DN4 score as neuropathic Prise en charge de la douleur aiguë spontanée de l'adulte aux urgences." Thesis, Normandie, 2020. http://www.theses.fr/2020NORMR013.

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Notre objectif était d’optimiser la prise en charge de la douleur aiguë sévère en médecine d’urgence. La titration morphinique intraveineuse qui fait actuellement référence doit se moderniser pour répondre aux nouveaux enjeux de la pratique en même temps que l’on doit garantir une balance bénéfice risque inchangée dans la lutte contre l’oligoanalgésie. Le travail décrit dans cette thèse, constitue une première étape d’évaluation d’une alternative nébulisée à la titration morphinique, à travers 3 études cliniques (AEROMORPH1, CLIN-AEROMORPH, EPIMORPH) et l’étude de son contexte dans la littérature. Des travaux chez le volontaire sain ont permis d’établir un mode opératoire avec une technique aérosol simple et accessible, de courte durée (5 min), que l’on peut répéter en titration (toutes les 10 min). Sa faisabilité est en voie d’être confirmée à grande échelle dans une étude multicentrique clinique et sa non-infériorité en termes d’efficacité est en cours d’évaluation. Des données pharmacologiques chez le volontaire sain et chez les patients confirment une concentration sanguine en morphine proche des concentrations efficaces observées en intraveineux (1 à 120 ng/ml dans CLIN-AEROMORPH), ce qui est déjà un résultat positif démontré par nos travaux. Par ailleurs, sur le plan de son éligibilité, nos données observationnelles et de simulation de décision, associées aux données médico-économiques que nous avons analysées dans la littérature, suggèrent la nécessité de baser son indication autrement que sur la simple évaluation par EVA/EN à l’accueil. Dans ce travail nous montrons que la pratique des praticiens témoigne aujourd’hui de leur manque d’adhésion au déclenchement systématique de la prescription d’opiacés Iv titrés par l’autoévaluation de la douleur sévère (de 6 à 20% de respect des critères SFMU, 61% de réinterprétation des scores EVA/EN). Si la titration aérosol est uniquement proposée en starter de la titration morphinique sans moderniser les algorithmes de décision de prescription opiacée dans les protocoles d’urgences, il est probable que cette nouvelle proposition thérapeutique ne résoudra qu’une partie de la problématique actuellement posée. Une prise en charge pharmacologique la plus individualisée possible est plus que jamais pertinente, avec une prescription ciblée de la titration morphinique selon la typologie du patient, en plus d’une priorisation par typologie douloureuse. En développant un « modèle douleur » original chez le volontaire sain, nous avons d’ailleurs mis en lumière des profils de patients « hyperesthésiques » et « endurants », sur le plan neurophysiologique et biochimique, qui sont sûrement retrouvés en pratique clinique quotidienne. L’ensemble de ces éléments doivent donc être pris en compte pour améliorer la prise en charge de la douleur en médecine d’urgence, avec une vision plus systémique, et davantage d’études dédiées, utilisant des méthodes d’évaluation innovantes mêlant critères quantitatifs robustes et qualitatifs exhaustifs
Our goal was to optimize the management of severe acute pain in emergency medicine. Intravenous morphine titration, which is currently the referent method, must be modernised to meet the new challenges of practice while at the same time, we must keep guaranteeing an unchanged risk-benefit balance in the fight against oligoanalgesia. Our work, described in this thesis, has been a cornerstone for the evaluation of a nebulized alternative solution to emergencies through 3 clinical studies, (AEROMORPH1, CLIN-AEROMORPH, EPIMORPH), and study of its contextualisation in literature. Work in healthy volunteers allowed us to establish a simple and accessible procedure for aerosol, of short duration (5 min), which can be repeated in titration procedures (every 10 min). Its feasibility is likely to be confirmed on our multicentre clinical study at a large scale and its efficacy, by a non-inferiority design of study is being evaluated. Pharmacological data in healthy volunteers and in patients confirm a blood morphine concentration close to the effective blood concentrations observed by intravenous administration (CLIN-AEROMORPH: 1-20 ng/ml), which is already a positive result demonstrated by our work. Moreover, regarding eligibility, our observational study, combined to a experiment about decision mechanisms, combined with the analysis of medico-economic data in literature, suggest the need to base its indication on more than just the simple VAS/NRS assessment at triage. In this work we showed that emergency practitioners’ practice today underlines their lack of adherence to the systematic initiation of intravenous morphine titration by patient self-assessment of severe pain (compliance with SFMU criteria 6 to 20%, re-assessment of VAS/NRS scores 61%). If nebulized morphine titration is only proposed as a starter for morphine titration without modernising the algorithms for opiate prescription decision in emergency protocols, it is likely that this new therapeutic proposal will only solve part of the current problem. Targeted pharmacological management, as individualised as possible, is more relevant than ever, with prescription of morphine titration according to the patient's typology, in addition to prioritisation by pain typology. By developing an original pain model in healthy volunteers, we have also highlighted profiles of "pain sensitive" and "enduring" patients, according to neurophysiological and biochemical data, that are certainly represented in daily clinical practice. Therefore, all these components should be taken into account to improve pain management in emergency medicine, with a more systemic vision and more dedicated studies using innovative evaluation methods, combining robust quantitative criteria with comprehensive qualitative criteria
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Books on the topic "Opioid consumption"

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Bannister, Kirsty. Opioid-induced hyperalgesia. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0061.

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The landmark paper discussed in this chapter is ‘Opioid-induced hyperalgesia: Abnormal or normal pain?’, published by Simonnet and Rivat in 2003. Morphine remains the analgesic of choice for those patients suffering moderate-to-severe pain, but it is increasingly recognized that worsening pain can be associated with chronic opioid consumption—the so-called phenomenon of opioid-induced hyperalgesia (OIH). This paper combined knowledge from clinical studies and experimental evidence from animal research in order to delve deeper into the workings of OIH and ask whether it represented normal or abnormal pain. The authors, intrigued by evidence indicating that exogenous opioids could activate both inhibitory and facilitatory pain systems, looked to reassess the role of such enhancement in pain sensitivity. As the debate regarding the very existence of OIH rages on, we pain specialists can take comfort in the knowledge that for many before us, over a decade ago, the reality of OIH was never in question.
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Armstrong, Sarah L., and Gary M. Stocks. Postoperative analgesia after caesarean delivery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0024.

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Caesarean delivery (CD) is one of the most common operations in the world and providing effective pain relief is important not only for humanitarian reasons but also to speed up recovery and reduce postoperative complications. An understanding of the anatomy and physiology of pain transmission after CD has led to a multimodal approach to analgesia. This involves combining analgesics which work by different mechanisms resulting in an additive effect whilst at the same time reducing side effects. In contemporary practice, most CDs are carried out under neuraxial anaesthesia and neuraxial techniques using either intrathecal or epidural opioids have become central to the provision of effective postoperative analgesia. They reduce the need for systemic opioid analgesia and have few side effects, respiratory depression being the most significant but extremely uncommon. In circumstances where it is not possible to use neuraxial analgesia, for example, after general anaesthesia, other techniques such as intravenous patient-controlled analgesia using opioids and the transversus abdominis plane block have been shown to be effective. As part of the multimodal analgesic approach, many patients will require systemic analgesics to further improve pain relief and to limit side effects. Paracetamol and non-steroidal anti-inflammatory drugs are now widely established in the management of postoperative CD pain where they have been shown to potentiate opioid effects, decrease opioid consumption, reduce side effects, and complement the somatic pain relief provided by opioids. As part of a step-down approach after primary management with neuraxial or intravenous opioids, oral opioids are often required as part of a multimodal regimen.
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Polomano, Rosemary Carol. THE RELATIONSHIP OF PAIN CHARACTERISTICS, TYPE OF CANCER, AND OPIOID CONSUMPTION TO QUALITY OF LIFE, PSYCHOLOGICAL DISTRESS, AND PAIN OUTCOMES. 1995.

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Oliver, Jodi-Ann, Lori-Ann Oliver, Michael Casimir, and Caroline Walker. Pain Management for General Pediatric Surgery. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0013.

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As the misconception that children and infants do not experience pain in the same way as adults has been vastly discredited, the management of perioperative pain in the pediatric population has become a rapidly developing field. Inadequate treatment of perioperative pain in this population can lead to serious long-term or permanent sequela for not only the patients but also their families. Postoperative pain management in children is best accomplished using a multimodal approach in which different classes of drugs such as opioids (short or long acting), non-opioid adjuncts (nonsteroidal anti-inflammatory drugs, acetaminophen), and antineuroleptics (gabapentin) are used alone or in combination with regional anesthesia techniques (peripheral nerve blocks, caudals, epidurals, or spinals). When placed prior to surgical incision, the use of peripheral and central blocks is beneficial not only in decreasing the total opioid consumption in the perioperative period but also in preventing activation of pain pathways that are ultimately responsible for the development of chronic pain.
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Gary, Cyril S., Samuel Kim, and Deepak Narayan. Pain Management in Body Contouring Procedures. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0011.

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Body contouring procedures, including abdominoplasty, liposuction, implant placement, body contouring following bariatric surgery, and gluteal augmentation with autologous fat grafting, continue to be some of the most popular plastic surgery operations performed. Given that these surgeries frequently involve perturbing large areas of the body, postoperative pain can be significant, and effective perioperative pain management (with a particular emphasis on multimodal pain management strategies aimed at minimizing opioid consumption) is crucial for optimizing outcomes and patient satisfaction. Subsequently, the first half of this chapter addresses general management strategies for body contouring procedures, and the second half covers specific considerations for each aforementioned body contouring procedure.
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Crandall, Russell. Drugs and Thugs. Yale University Press, 2020. http://dx.doi.org/10.12987/yale/9780300240344.001.0001.

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How can the United States chart a path forward in the war on drugs? This book uncovers the full history of this war that has lasted more than a century. The book provides an essential view of the economic, political, and human impacts of U.S. drug policies. It takes readers from Afghanistan to Colombia, to Peru and Mexico, to Miami International Airport and the border crossing between El Paso and Juarez to trace the complex social networks that make up the drug trade and drug consumption. Through historically driven stories, the book reveals how the war on drugs has evolved to address mass incarceration, the opioid epidemic, the legalization and medical use of marijuana, and America's shifting foreign policy.
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Book chapters on the topic "Opioid consumption"

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Cooper, S. J., and T. C. Kirkham. "Opioid Mechanisms in the Control of Food Consumption and Taste Preferences." In Opioids II, 239–62. Berlin, Heidelberg: Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77540-6_10.

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Rimondini, Roberto, and Gabriele Campana. "Induction of a High Alcohol Consumption in Rats and Mice: Role of Opioid Receptors." In Methods in Molecular Biology, 309–12. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-1708-2_26.

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Juárez, Jorge, and Luz M. Molina-Martínez. "Opioid System and Alcohol Consumption." In Neuroscience of Alcohol, 435–42. Elsevier, 2019. http://dx.doi.org/10.1016/b978-0-12-813125-1.00045-3.

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Buresh, Megan, and Darius A. Rastegar. "Medical Care for Patients with Substance Use Disorders." In ASAM Handbook of Addiction Medicine, 313–48. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780197506172.003.0014.

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Primary care clinicians commonly encounter patients with substance use disorders and can provide effective treatment for their problems. Many of the medical complications associated with drug use are due to the use of needles; these include transmission of HIV and hepatitis C, soft tissue infections, and endocarditis. Harm reduction strategies reduce the harms associated with drug use without targeting use itself; these include syringe distribution, safe consumption facilities, naloxone distribution, and pre-exposure HIV prophylaxis. Patients on opioid agonist treatment may develop a number of problems, including hypogonadism, constipation, and psychomotor impairment; those on methadone may develop prolonged QT syndrome. Other issues include drug interactions, treatment of acute pain, and perioperative care. Treating pain in patients with substance use disorder can be complicated; for many, especially those with opioid use disorder, treatment with buprenorphine or enrollment in methadone maintenance is the best option.
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McAnally, Heath B., and Beth Darnall. "The Primacy of Motivation in Preoperative Optimization." In Preoperative Optimization of the Chronic Pain Patient, 39–76. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190920142.003.0003.

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Surgical patients with chronic pain frequently neglect basic health behaviors (e.g., maintenance of appropriate diet, sleep hygiene, exercise patterns) while engaging in harmful ones (e.g., tobacco use, alcohol excess, chronic opioid consumption) all of which have been shown to confer poor postoperative outcomes. Effective preoperative optimization of patients suffering with chronic pain requires at least a basic understanding of the complex and heterogeneous motivation behind deliberative (and subconscious) behaviors, and the application of interventions supporting self-determined elimination of toxic cognitive-behavioral patterns and their replacement with healthy ones. This chapter begins with an overview of motivational interviewing and select positive literature reviews addressing the utility of the method in modifying behaviors pertinent to this program. A survey of the development of our understanding of core common elements of human motivation is presented, followed by a biopsychosocial-spiritual framework for considering interpersonal variance; the chapter concludes with a brief consideration of dynamic intrapersonal variables affecting motivation within the individual.
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K., Carsten, and Selena E. "The Role of Delta Opioid Receptors in Ethanol Consumption and Seeking: Implications for New Treatments for Alcohol Use Disorders." In Neuroscience - Dealing With Frontiers. InTech, 2012. http://dx.doi.org/10.5772/32239.

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Conference papers on the topic "Opioid consumption"

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Gedda, C., L. Hoffström, M. Soop, A. Thorell, and J. Nygren. "ESRA19-0327 Perioperative gabapentin reduces opioid consumption after colorectal surgery." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.433.

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Batova, Tatiana. "Cultural Dimensions, Consumption of Opioid Pain Medications, and Designing Educational Information Products." In 2019 IEEE International Professional Communication Conference (ProComm). IEEE, 2019. http://dx.doi.org/10.1109/procomm.2019.00034.

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Andjelković Juvan, L., A. Hostnik, and I. Potočnik. "215 Opioid consumption and neuropathic pain in adjuvant anaesthesia with dexmedetomidine and lidocaine." In ESRA 2021 Virtual Congress, 8–9–10 September 2021. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/rapm-2021-esra.215.

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Gómez-Carreño, Carlos Rodríguez, Antonio Ramírez García, Luis Beato Fernández, Irene Díaz Quero, and Estefanía Segura Escobar. "Craving and Priming of alcohol in depressive disorders. Bibliographic review and new therapies." In 22° Congreso de la Sociedad Española de Patología Dual (SEPD) 2020. SEPD, 2020. http://dx.doi.org/10.17579/sepd2020p140.

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Acute alcohol consumption produces positive reinforcement effects, through activation of brain reward circuit, includes limbic system structures (accumbens system and hippocampus). The comorbidity of depressive episode and alcohol abuse makes it necessary to propose new strategies for the treatment of this frequent clinical situation. We conducted a literature review of the combined treatments for major depressive disorder (MDD) with alcohol abuse. We review current literature on the use of new treatments in alcohol consumption with pattern of abuse (binge drinking). Recent studies support the potential clinical importance of NMDA receptor antagonism among the mechanisms underlying the subjective effects of ethanol in humans. The efficacy of medications for alcohol dependence remains modest, and there are no strong clinical predictors of treatment response. We analyze approved medications used today: Acamprosate (NMDA modulator), disulfiram (acetaldehyde dehydrogenase inhibitor), naltrexone (opioid antagonist), nalmefene (opioid antagonist). Promising current studies suggest the glutamatergic pathway and medications such as ketamine could have a hopeful future in the treatment of alcohol use disorder associated with affective disorders.
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Milligan, A., and S. McKinlay. "ESRA19-0316 Effect of intrathecal morphine dose on perioperative opioid consumption in upper gastrointestinal surgery." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.135.

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Egan, Katie, Elizabeth Muenks, Niaman Nazir, Michelle De Souza, and Richard Korentager. "Abstract P1-15-01: A brief intervention decreases opioid consumption following mastectomy with implant-based breast reconstruction." In Abstracts: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, Texas. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.sabcs19-p1-15-01.

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Sort, R., LL Hald, S. Brorson, JK Nielsen, S. Hougaard, I. Gögenur, and AM Møller. "ESRA19-0380 Peripheral nerve blocks compared with spinal anaesthesia do not reduce opioid consumption related to initial rebound pain in ankle fracture surgery." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.127.

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Ito, H. "ESRA19-0061 Association of multilevel thoracic retrolaminar paravertebral blocks for midcab surgery through left anterior small thoracotomy (LAST) with decreased opioid consumption: 2 case reports." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.206.

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Jambi, Aseel, Ahmed Alhartani, and Ali Al-Blowi. "13 Impact of implementation of ‘sickle cell disease acute painful crisis clinical pathway’ at KFAFH on reducing the number of ER visits, admission, readmission rates, opioid consumption, and cost." In Patient Safety Forum 2019, Conference Proceedings, Kingdom of Saudi Arabia, Ministry of National Guard Health Affairs. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/bmjoq-2019-psf.13.

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Reports on the topic "Opioid consumption"

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Vadasz, Csaba, Mariko Saito, and Balapal Basavarajappa. 99HRT Protection Against Excessive Alcohol Consumption by Opioid Receptor Kappa 1. Fort Belvoir, VA: Defense Technical Information Center, October 2001. http://dx.doi.org/10.21236/ada398380.

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Lumpkin, Shamsie, Isaac Parrish, Austin Terrell, and Dwayne Accardo. Pain Control: Opioid vs. Nonopioid Analgesia During the Immediate Postoperative Period. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0008.

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Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to providing adequate pain relief, the predicted cost burden of an opioid-free or opioid-sparing approach is significantly less than traditional methods. Methods The following groups were considered in our inclusion criteria: those who speak the English language, all races and ethnicities, male or female, home medications, those who are at least 18 years of age and able to provide written informed consent, those undergoing inpatient or same-day surgical procedures. In addition, our scoping review includes the following exclusion criteria: those who are non-English speaking, those who are less than 18 years of age, those who are not undergoing surgical procedures while admitted, those who are unable to provide numeric pain score due to clinical status, those who are unable to provide written informed consent, and those who decline participation in the study. Data was extracted by one reviewer and verified by the remaining two group members. Extraction was divided as equally as possible among the 11 listed references. Discrepancies in data extraction were discussed between the article reviewer, project editor, and group leader. Results We identified nine primary sources addressing the use of ketamine as an alternative to opioid analgesia and post-operative pain control. Our findings indicate a positive correlation between perioperative ketamine administration and postoperative pain control. While this information provides insight on opioid-free analgesia, it also revealed the limited amount of research conducted in this area of practice. The strategies for several of the clinical trials limited ketamine administration to a small niche of patients. The included studies provided evidence for lower pain scores, reductions in opioid consumption, and better patient outcomes. Implications for Nursing Practice Based on the results of the studies’ randomized controlled trials and meta-analyses, the effects of ketamine are shown as an adequate analgesic alternative to opioids postoperatively. The cited resources showed that ketamine can be used as a sole agent, or combined effectively with reduced doses of opioids for multimodal therapy. There were noted limitations in some of the research articles. Not all of the cited studies were able to include definitive evidence of proper blinding techniques or randomization methods. Small sample sizes and the inclusion of specific patient populations identified within several of the studies can skew data in one direction or another; therefore, significant clinical results cannot be generalized to patient populations across the board.
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Maher, Liam, Leanne Orians, Gabrielle Pappas, and Lanny Coker. Transversus Abdominis Plane Block: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0011.

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