Relevant bibliographies by topics / Opioid dependence

Academic literature on the topic 'Opioid dependence'

Author: Grafiati
Published: 4 June 2021
Last updated: 25 January 2023

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Journal articles on the topic "Opioid dependence"

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Lazcano, A. I. López, L. Ortega, A. Fauli, C. Busquets, and A. Lligoña. "Prescription opioid abuse, addiction and psychopathology in a pain clinic." European Psychiatry 41, S1 (April 2017): s869. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1744.

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IntroductionThere has been an escalation of therapeutic use and abuse of opioids. Aberrant drug related behaviors (ADRB) have prevalence between 2.8% and 62.2% in chronic pain patients treated with opioids and dependence is estimated around 3.27%.ObjectivesTo estimate the prevalence of dependence, ADRB, risk of opioid abuse, and co-occurring disorders in patients with chronic pain in our environment.MethodsA total of 115 (n = 115) patients attending our pain clinic were screened to evaluate the risk of opioid abuse and presence of dependence including a clinical interview, hamilton depression scale (HAD), opioid risk tool (ORT), diagnostic criteria for substance abuse and dependence (DSM IV-TR) and a checklist of ADRB.ResultsAmong the patients, 78.26% were taking opioids, aberrant opioid related behaviors were detected in 20% and 8.9% met criteria for abuse or dependence; 11.3% had high risk and 20% moderate risk of opioid abuse (ORT). The most prevalent substance use disorders were sedative (11.3%) and alcohol (5.2%). There was a significant difference in means (t = -3.20 P < 0.005) in ORT scores between patients with current opiod dependence (x = 7.70 [s.d. = 3.07]) and without it (x = 2.88 [s.d = 3.58]); 30.4% had anxiety, 20% depression and 3.5% adjustment disorders; 57.5% and 48.3% had a score > 10 on anxiety and depression respectively on the HAD.ConclusionsA systematic screening of risk of opioid abuse and of dependence as well as psychotherapy to treat comorbid psychopathology should be part of the treatment protocol.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Daoust, R., J. Paquet, J. Morris, A. Cournoyer, E. Piette, J. Lessard, V. Castonguay, S. Gosselin, and J. Chauny. "P026: Opioid use and dependence three months after an emergency department visit for acute pain." CJEM 20, S1 (May 2018): S66. http://dx.doi.org/10.1017/cem.2018.224.

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Introduction: Most studies evaluating prescription opioid dependence or misuse are retrospective and are based on prescription filling rates from pharmaceutical databases. These studies cannot evaluate if opioids are really consumed nor differentiate if used for a new pain, chronic pain, or for misuse/dependence. The aim of this study was to assess the opioid consumption in emergency department (ED) patients three months after discharge with an opioid prescription. Methods: This prospective cohort study was conducted in the ED of a tertiary care centre with a convenience sample of patients aged 18 years and older, recruited 24/7, who consulted and were discharged for an acute pain condition ( 2 weeks). We excluded patients who: did not speak French or English, were using opioid medication prior to their ED visit, with an ED stay > 48 hours, or suffering from cancer or chronic pain. Three months post-ED visit, participants were contacted by phone for a structured interview on their past two-week opioid use, their reasons for consuming them, and also answered the Rapid Opioid Dependence Screen (RODS) questionnaire. Results: In the 524 participants interviewed at three months (mean age ± SD: 51±16 years, 47% women), 44 (8.4%) patients consumed opioids in the previous two weeks. Among those, 72% consumed opioids for their initial pain, 19% for a new unrelated pain, and 9% for another reason. In this entire cohort, only five patients (1%) tested positive to opioid dependence from the RODS test. The low dependence incidence could be affected by a social desirability bias. Conclusion: This study suggests that opioid use at 3-month, for patients initially treated for acute pain, is associated with opioid dependency in 1% or possible misuse in only 9%. Additional prospective studies using multiple methods to measure opioids consumption, misuse, and dependence are needed.
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Colson, James. "Office-Based Opioid Dependence Treatment." July 2012 3S;15, no. 3S;7 (July 14, 2012): ES231—ES236. http://dx.doi.org/10.36076/ppj.2012/15/es231.

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Background: Opioid misuse and abuse occurring in association with the treatment of chronic non-cancer pain are not new phenomena, but their increasing prevalence in recent years is unprecedented. Advancements in pharmaceutical technologies have provided opioid-related drugs, which lack the pure mu agonist activity characteristic of the typical opioid congeners. This absent or altered mu receptor activity imparts an opioid receptor antagonistic or partial agonistic pharmacologic action, which serves to modulate the development of opioid-induced tolerance and physical dependence and facilitate detoxification and withdrawal from opioids. Opioid antagonists and partial agonists are being used in abuse deterrent strategy regimens to prevent opioid tolerance and the development of dependence, as well as in the management of opioid detoxification and treatment of withdrawal. The specific opioid antagonists and partial agonists used in these various therapeutic modalities will be the focus of this review. Objectives: Evaluate the comparative therapeutic utility of opioid antagonists and partial agonists in preventing the development of opioid tolerance and treating opioid dependence, detoxification, and withdrawal. A primary focus is the use of opioid antagonists and partial agonists within an office-based practice. Methods: A narrative review of the current literature involving the therapeutic use of opioid antagonists and partial agonists in the management of opioid tolerance, dependence, detoxification, and withdrawal. A computerized literature search in the PubMed, EMBASE, BioMed, and Cochrane Library review databases from 2008 through 2010 was performed. This search included systematic and narrative reviews, prospective and retrospective studies, as well as cross-references from bibliographies of notable primary and review articles and abstracts from scientific meetings. US Food and Drug Administration records and pharmaceutical manufacturers’ product literature were also used in the search. Conclusion: Opioid dependency, whether it results from the misuse or abuse of prescription or street drugs, continues to be a significant public health issue. Passage of DATA 2000 and US Food and Drug Administration approval of buprenorphine and buprenorphine/ naloxone has revolutionized opioid dependence therapy. The traditional addiction medicine therapy regimen of methadone maintenance, with its inherent legal limitations and restrictions, has been challenged by an office-based dependence practice with buprenorphine serving as a prominent therapeutic tool. Key words: opioid antagonist, opioid partial agonist, tolerance, dependence, detoxification, withdrawal, hyperalgesia, buprenorphine, suboxone, naloxone, naltrexone, methylnaltrexone, nalmefene, tramadol, butorphanol, nalbupine, pentazocine.
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Levin, Marc, Michael G. Roskies, and Jamil Asaria. "Perspectives of Facial Plastic Surgeons on Opioid Dependence in Rhinoplasty Patients." Facial Plastic Surgery 35, no. 05 (July 10, 2019): 540–45. http://dx.doi.org/10.1055/s-0039-1693133.

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AbstractUnderstanding the perspectives and opinions of facial plastic surgeons on opioid dependence is critical in a national epidemic of opioid overuse. Findings may encourage surgeon education so that facial plastic surgeons may be able to judiciously prescribe opioids, improving patient outcomes and reducing healthcare opioid-related spending. The objective of this study is to understand facial plastic surgeons' perspectives on opioid dependence in rhinoplasty patients. A key secondary objective was to quantify facial plastic surgeons' opioid prescribing patterns. This was a prospective survey study. A nine-question survey was sent to all members of the American Academy of Facial Plastic and Reconstructive Surgery in July of 2018, and analysis of the data was completed in August of 2018. The primary study outcome measurement was surgeon perspectives on opioid dependence. This was measured by an online survey. A total of 164 facial plastic surgeons responded to the survey (response rate: 6.6%). The majority were experienced surgeons in practice for more than 10 years (61.96%) who perform less than five rhinoplasties per week (84.15%). Of the facial plastic surgeons, 89.51% prescribe some variation of opioids following rhinoplasty. Most surgeons believe that opioid dependence is not a problem in rhinoplasty patients (86.96%), but that it is a problem among surgical patients in general (61.11%). The majority (52.45%) of surgeons prescribe between 11 and 25 tablets of opioids following rhinoplasty, with 25.17% of surgeons prescribing > 25 tablets of opioids. Facial plastic surgeons do not believe opioid dependence to be a problem among rhinoplasty patients. Resultantly, many facial plastic surgeons can prescribe more than 25 tables of opioids following rhinoplasty. The findings suggest that facial plastic surgeons may require further education and complete more research regarding opioid dependence among the rhinoplasty population. Additionally, the findings are important for health policy in that they encourage the creation of rhinoplasty specific opioid prescription guidelines.
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Owais Kareem, Muhammad Asif, Sohaib Hassan, Muqaddas Abaid, Muhammad Ashrib, and Muhammad Arqam Arshad. "Severity of opioid dependence and its relation with psychosocial factors of users." Professional Medical Journal 28, no. 11 (October 31, 2021): 1604–10. http://dx.doi.org/10.29309/tpmj/2021.28.11.6638.

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Objectives: To determine the relationship between severe opioid dependence and psychosocial factors of users Study Design: Descriptive Cross Sectional study. Setting: Department of Psychiatry Nishtar Hospital Multan. Period: Nov 2018 to May 2020. Material & Methods: 196 participants were enrolled through non probability purposive sampling technique. Pearson chi square test was applied to identify significant relationship between severe opioid dependence and psychosocial factors. Result: Mean age of study cases was 30.86 ± 1.66. The frequency of severe opioid dependence was noted in 159 (81.1%) of study participants. Statistical significant relation of severe opioid dependence was noted with age, literacy status, literacy level, marital status, monthly income, route of opioid use, frequency of opioid use per day, previous detoxification treatment and encounters with law enforcement agencies Conclusion: The severity of opioid dependence was high in patients admitted for treatment of opioid use. Severe opioid dependence was related with certain psychosocial factors such as user’s age, literacy status, literacy level, marital status, monthly income, route of opiod use, frequency of opioid use, previous detoxification treatment for opioid use and encounters with law enforcement agencies. This suggests that optimal treatment of severe opioid dependence should include interventions based on individual’s psychosocial needs.
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Williams, John T., MacDonald J. Christie, and Olivier Manzoni. "Cellular and Synaptic Adaptations Mediating Opioid Dependence." Physiological Reviews 81, no. 1 (January 1, 2001): 299–343. http://dx.doi.org/10.1152/physrev.2001.81.1.299.

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Although opioids are highly effective for the treatment of pain, they are also known to be intensely addictive. There has been a massive research investment in the development of opioid analgesics, resulting in a plethora of compounds with varying affinity and efficacy at all the known opioid receptor subtypes. Although compounds of extremely high potency have been produced, the problem of tolerance to and dependence on these agonists persists. This review centers on the adaptive changes in cellular and synaptic function induced by chronic morphine treatment. The initial steps of opioid action are mediated through the activation of G protein-linked receptors. As is true for all G protein-linked receptors, opioid receptors activate and regulate multiple second messenger pathways associated with effector coupling, receptor trafficking, and nuclear signaling. These events are critical for understanding the early events leading to nonassociative tolerance and dependence. Equally important are associative and network changes that affect neurons that do not have opioid receptors but that are indirectly altered by opioid-sensitive cells. Finally, opioids and other drugs of abuse have some common cellular and anatomical pathways. The characterization of common pathways affected by different drugs, particularly after repeated treatment, is important in the understanding of drug abuse.
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&NA;. "Opioid dependence." Inpharma Weekly &NA;, no. 1168 (December 1998): 4. http://dx.doi.org/10.2165/00128413-199811680-00004.

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Benich, Joseph J. "Opioid Dependence." Primary Care: Clinics in Office Practice 38, no. 1 (March 2011): 59–70. http://dx.doi.org/10.1016/j.pop.2010.11.005.

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Burks, T. F., C. C. Bihm, G. C. Rosenfeid, and C. L. Williams. "Opioid Dependence." Japanese Journal of Pharmacology 82 (2000): 38. http://dx.doi.org/10.1016/s0021-5198(19)47632-4.

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Perimbeti, Stuthi Pavani, Kevin Ye Hou, Sabarina Ramanathan, Adonas Woodard, Daniel Kyung, Priyadarshini Pathak, Rishi Shrivastav, Kristine Ward, and Michael Styler. "Opioid Dependency Significantly Increases Complications and Mortality in Sickle Cell Disease." Blood 132, Supplement 1 (November 29, 2018): 4701. http://dx.doi.org/10.1182/blood-2018-99-120012.

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Abstract Introduction: According to the National Center for Health Statistics, there was a twenty-one percent increase in deaths from drug overdose in the USA, with opioids contributing to about two-thirds of these deaths. Despite nationwide efforts to reduce opioid use, narcotic pain medications are still the most frequently used method of pain control in patients with sickle cell disease (SCD). We sought to examine the burden and complications of opioid dependence in patients with SCD. Methods: The National Inpatient Sample (NIS) for the years 1999 to 2014 was queried to yield adult admissions with a primary diagnosis of sickle cell disease (ICD-9 codes: 2826, 28260, 28261, 28262, 28263, 28264, 28268, 28269) and the admissions were stratified based on the presence of opioid dependence (ICD-9 codes: 30400-30403, 30470-30473, 30550-30553). Univariate and bivariate analyses were performed using the Chi square test. Cox proportional hazard regression was used to control for multiple confounders in calculating the hazard ratios of occurrence of complications and mortality. Results A total of 216,438 (Weighted N=1,066,536) admissions were identified between 1999 and 2014, out of which 1.6% (N=3603) had opioid dependence. The median age of patients with opioid dependence was 26 years, compared to 31 years in patients without opioid dependence. Average cost and length of hospitalization for patients with and without opioid dependence was $29,883 & $20,638 and 6.4 days & 5.1 days, respectively. The rates of various complications and Hazard Ratio (HR) of event occurrence among patients with and without opioid dependence are depicted in Table 1. After adjusting for demographics, hospital characteristics (region, bed size, location), and baseline comorbidities, SCD patients with opioid dependence had a 50% increased risk of in-hospital mortality (H.R 1.5, 95% C.I. 1.2-1.6, p<0.001) compared to those without. Conclusions: There is a correlation between opioid dependence and SCD complications among patients hospitalized with a diagnosis of SCD. Perhaps, patients predisposed to vaso-occlusive events require more frequent use of narcotics and become opioid dependent. Alternatively, the dependence on opioids may increase the incidence of complications from sickle cell disease. Regardless, patients with opioid dependence have significantly higher in-hospital mortality. The main limitation of this study is the use of ICD codes for identifying opioid dependence. In our opinion, the abnormally low incidence of opioid dependence in our data is a poor representation of the actual population. Opioid abuse is a serious concern that has heavy financial, social and public health implications on the welfare of the community, particularly those with SCD. This study highlights the need for more effective disease modifying agents for the treatment of this chronic and debilitating disorder. Disclosures No relevant conflicts of interest to declare.
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Dissertations / Theses on the topic "Opioid dependence"

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Nosyk, Bohdan. "Empirical studies in opioid dependence." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/23718.

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Background: Opioid dependence is a chronic disease characterized by periods of relapse and remission. Methadone maintenance treatment (MMT) can be effective, though not all patients can be successfully maintained in treatment. Further, treatment entrants often use multiple illicit drugs, a fact whose motive and effect are under-studied. Rigorous evaluation at the aggregate- and patient-level is required to maximize the public health benefits of substance abuse treatment. Objectives: (1) identify the determinants of the time to discontinuation of MMT across multiple treatment episodes; (2) determine the effect of price on drug consumption among polydrug users; (3) identify trends in compliance to MMT dosing guidelines in British Columbia, Canada from 1996-2007; (4) provide a comparative analysis of the psychometric properties of eight measures of health status for opioid users; (5) evaluate differences in trajectories of health status among opioid users following treatment enrolment. Methods: We draw upon longitudinal data collected in administrative databases (study 1 and 3), experimental (study 4 and 5) and observational cohort studies (study 2) to shed light on the life course of treatment and relapse that opioid addicts experience, their decisions to consume addictive substances, and treatment evaluation at the aggregate- and patient-levels. Results: This collection of studies found (1) patients experiencing multiple treatment episodes tended to stay in treatment for progressively longer periods in later episodes; (2) While heroin and crack cocaine were price inelastic polydrug users treated crack cocaine as a substitute for heroin. In terms of treatment evaluation at the aggregate-level, compliance to minimally effective dose guidelines, along with 12-month retention figures have fallen in the past 5 years in British Columbia (study 3). At the patient-level each of the health status measures assessed in the North American Opiate Medication Initiative (NAOMI) trial showed limitations (study 4), however health status can be meaningfully improved through effective, patient-centered opioid substitution treatment (study 5). Conclusions: The results of these novel empirical studies suggest that while MMT can be an effective treatment option for opioid dependence, the individual and program-related factors that limit its effectiveness must be addressed to maximize the public health impact of this treatment.
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Edmund, Christine Hilary. "Correctional Nurses: Adult Opioid Dependence Referral Process." NSUWorks, 2017. https://nsuworks.nova.edu/hpd_con_stuetd/26.

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Background: Correctional nurses make up a large part of the corrections workforce and have increasing responsibility for making decisions about patient care in the opioid dependent incarcerated patients. The National Commission on Correctional Health Care (NCCHC) has intoxication and withdrawal standards that advocate individuals entering a correctional facility under the influence or undergoing withdrawal from opioids have their therapy continued, or a plan for appropriate referral for treatment. The NCCHC standard that incarcerated opioid dependent inmates have their therapy continued or a plan for appropriate referral for treatment is not adhered to consistently, as the current process lacks organization. Purpose: The purpose of this quality improvement project was to develop an adult opioid dependence referral for treatment tool for opioid use dependent patients to be utilized by correctional nurses and providers working in the corrections intake medical facility with posttest evaluation. Theoretical Framework: Peplau’s nurse-patient relationship theory was used. Methods: A descriptive, exploratory design was utilized. Results: A majority of the nurses acknowledged the usefulness of the Nursing Opioid Referral for Treatment Algorithm (NORTA) in facilitating the adult opioid dependence referral process. In addition, of the 20 nurses surveyed, 18 nurses agreed that the NORTA tool was relevant to the adult opioid dependence referral process. Most claimed that the NORTA facilitated the opioid dependence referral process. Conclusion: The pain management algorithm is an effective referral method for opioid users as it contributes to patient safety through safe prescription and careful assessment of patient risk regarding opioid use. The findings from this project may impact nursing practice by identification of a new organized approach to enhance the current opioid dependence referral process.
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Bilsky, Edward James 1967. "Studies on opioid delta receptor mediated antinociception, opioid antinociceptive tolerance and physical dependence." Diss., The University of Arizona, 1997. http://hdl.handle.net/10150/282311.

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The central hypothesis of this dissertation is that agonists and antagonists acting at the delta opioid receptor will have therapeutic applications in treating acute and chronic pain states and in the treatment of drug addiction. It is further hypothesized that delta compounds will have better therapeutic profiles than currently available opioids that act predominantly at the mu receptor. In advancing the central hypothesis, selective nonpeptidic delta compounds, that readily cross the blood brain barrier after systemic administration, were tested. BW373U86, a nonpeptidic ligand with moderate selectivity and activity at delta opioid receptors represented a lead compound. A structurally related molecule, SNC80, displayed an improved selectivity and activity profile compared to BW373U86. Importantly, SNC80 produced antinociception following systemic administration which was blocked by delta, but not mu, selective antagonists. The pharmacology of delta opioid receptors was further studied using antisense oligodeoxynucleotides that disrupted the synthesis of delta receptors in vivo and in vitro. The experiments provided further evidence for distinct delta receptor subtypes and demonstrated the utility of the antisense approache in studying neurochemical processes in vivo. Several studies addressed the phenomenon of opioid tolerance and physical dependence, two processes which compromise the clinical application of currently available opioid analgesics. The observation that NMDA receptor antagonists block the development of antinociceptive tolerance to repeated administrations of morphine was confirmed. The results were extended by demonstrating that NMDA antagonists did not block antinociceptive tolerance to more selective delta or mu agonists. These studies caution against the generalization that an effect seen with morphine is applicable to all opioid agonists. Further hypotheses regarding the mechanisms of opioid tolerance and physical dependence were tested using inhibitors of protein kinases and putative neutral and inverse opioid antagonists. These studies advanced the hypothesis that opioid receptor phosphorylation may play a critical role in the development of opioid antinociceptive tolerance and physical dependence. In summary, this dissertation has provided strong evidence that nonpeptidic delta selective opioid agonists and antagonists can be developed and that these compounds will have therapeutic applications in the treatment of pain and addictive disorders.
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Weich, Lize, Charles Perkel, Zyl Nicolette Van, S. T. Rataemane, and Lochan Naidoo. "Medical management of opioid dependence in South Africa." Health and Medical Publishing Group (HMPG), 2008. http://hdl.handle.net/10019.1/7055.

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The original publication is available at http://www.samj.org.za
Medical practitioners in South Africa are increasingly confronted with requests to treat patients with opioid use disorders. Many do not possess the required knowledge and skills to deal with these patients effectively. This overview of the medical treatment of opioid dependence was compiled by an elected working group of doctors working in the field of substance dependence. Recommendations are based on current best practice derived from scientific evidence and consensus of the working group, but should never replace individual clinical judgement.
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Fundytus, Marian Elaine. "Contribution of metabotropic glutamate receptors to opioid dependence." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ29938.pdf.

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Johansson, Anna. "Dependence-induced changes in opioid-receptor gene expression." Thesis, Linköpings universitet, Institutionen för fysik, kemi och biologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-90034.

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Using drugs such as alcohol and morphine among others can be addictive in some individuals, and progress into a substance abuse disorder. The mesolimbic dopaminergic system (MD-system) is involved in the reward process during the development of drug addiction. The MD-system is critical for survival and affects different behaviors in both man and animal. Neurochemical pathways drive for instance physical activity, food intake, love and reproduction and are part of the natural reward process involved partly in the release of dopamine (DA) into frontal lobes. Within the MD-system opioid receptors throughout the brain are affected by drug intake, and activation of these receptors modulate DA-release in brain regions involved in reward-behavior. The aim of this study was to evaluate gene expression of MOR and DOR within the endogenous opioid system (EO-system) in relation to voluntary physical activity, a natural reinforcer. Further on investigations of the drug alcohol was compared to the natural reinforcer sucrose using voluntary consumption. For both experiments qRT-PCR was used to measure mRNA levels of MOR and DOR from brain areas of interest. We found a small significant up regulation in NAc, PFC and VTA but for DOR in VTA a down regulation in gene expression of physical exercising mice. Additionally these two different genes OPRM1- and the OPRD1- gene are down regulated in VTA and NAc due to alcohol- and sugar-intake. This implicate that the natural reward system and their ORs point in the direction of earlier findings; the opioid receptors have a key role in regulate alcohol intake and the natural rewarding stimuli as food intake.
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Fundytus, Marian Elaine. "Contribution of metabotropic glutamate receptors to opioid dependence." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=42034.

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We investigated the role of metabotropic glutamate receptors (mGluRs), and related intracellular second messengers, in the development of morphine tolerance and dependence. The mGluRs are divided into three groups: group I mGluRs are positively coupled to phosphatidylinositol (PI) hydrolysis, while group II and III mGluRs are negatively coupled to cyclic adensoine-3$ sp prime$,5$ sp prime$-monophosphate (cAMP) production. Opioid receptors are also coupled to these same systems, and have been shown to elicit changes in these messenger systems during chronic treatment.
We showed that chronic intracerebroventricular (i.c.v.) administration of selective group II and III mGluR antagonists concurrently with subcutaneous (s.c.) morphine significantly reduced the severity of precipitated withdrawal symptoms. Conversely, acute i.c.v. injection of a selective group II mGluR antagonist just prior to the precipitation of withdrawal significantly exacerbated the severity of abstinence symptoms. In addition, acute i.c.v. injection of a selective group II mGluR agonist just prior to the precipitation of withdrawal significantly reduced abstinence symptoms. From these results we hypothesized that chronic opioid treatment may induce a desensitization of group II mGluRs.
We also demonstrated that chronic i.c.v. infusion of a selective group I mGluR antagonist concurrently with s.c. morphine significantly attenuated the precipitated withdrawal syndrome. In addition, we showed that chronic i.c.v. antagonism of $ delta$-opioid receptors with a highly selective antagonist also decreased the development of morphine dependence, as well as tolerance. Since both group I mGluRs and $ delta$-opioid receptors are positively coupled to PI hydrolysis, further evidence for a role of products of PI hydrolysis in the development of morphine dependence was obtained when we showed that selective chronic inhibition of protein kinase C (PKC) activation, as well as selective chronic inhibition of intracellular Ca$ sp{2+}$ release, concurrently with morphine treatment significantly reduced the severity of abstinence symptoms. Thus, compensatory changes usually elicited by chronic opioid treatment may be counteracted by antagonizing receptors positively coupled to PI hydrolysis, as well as by inhibiting products of PI hydrolysis.
In the General Discussion, we propose a model based on the possible interaction of mGluRs and opioid receptors, via related intracellular second messengers, to explain the development of morphine dependence.
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Grivas, Konstantinos. "Analogues of buprenorphine as treatment for opioid dependence." Thesis, University of Bristol, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294430.

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Higgins, Cassandra. "Comorbid opioid dependence and chronic pain : clinical implications." Thesis, University of Dundee, 2018. https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312.

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Context Chronic pain and opioid dependence confer substantial individual and societal burdens and are notoriously difficult to treat effectively. Their comorbid presentation further complicates effective treatment through complex physiological and environmental interactions. Objectives (1) What are the clinical characteristics and treatment outcomes associated with comorbid chronic pain in ORT patients? (2) Does the patient-attributed direction of the causal relationship in the development of opioid dependence and chronic pain identify two clinically-distinct treatment populations? (3) What is the incidence of iatrogenic opioid dependence or abuse following opioid analgesic treatment? (4) Is there evidence of opioid-induced hyperalgesia in humans? Methods Primary data Participants were 467 treatment-seeking, opioid-dependent patients. Materials comprised standardised instruments – focusing on illicit substance use and mental health characteristics – completed by medical staff at study inception, and extracts of routinely-collected clinical datasets spanning the follow-up period. Procedures involved the use of a health informatics approach. Electronic linkage of data collected at study inception with routinely-collected clinical datasets spanning the 5-year follow-up period. Secondary data Systematic searches were undertaken using six electronic research databases, supplemented by manual searches. Study quality was assessed using instruments developed by NIH. Data synthesis using random effects models (DerSimonian-Laird method) generated: (1) a pooled incidence of iatrogenic dependence or abuse following opioid analgesic treatment; and (2) a pooled effect of opioid exposure on the development of opioid-induced hyperalgesia. Additional analyses included assessment of heterogeneity in study effects, within- and between-study risk of bias and sensitivity analyses. Results A total of 246 (53%) patients reported comorbid chronic pain. This ‘comorbid’ group was associated with increased mortality, physical and mental health problems, service utilisation and illicit drug use, specifically benzodiazepines and cannabinoids. Within the ‘comorbid’ group, patients who reported a causal impact of opioid dependence on the development of pain were associated with increased illicit drug use and psychiatric morbidity. Secondary data analyses revealed a 4.7% incidence estimate of iatrogenic dependence or abuse following opioid analgesic treatment, and evidence of the development of opioid-induced hyperalgesia following therapeutic opioid exposure. Conclusions Elevated mortality, morbidity and illicit drug use in opioid-dependent patients with comorbid chronic pain reflects a patient population with substantial health burdens. The dynamic relationship between these severe and chronic conditions necessitates complex, multimodal treatment strategies and multiagency collaboration, including general psychiatric intervention. Whilst a substantial proportion reported that opioid dependence developed as a consequence of pain problems, there is evidence to suggest that the assumed risk of iatrogenic opioid dependence and abuse may be an overestimate; however, therapeutic opioids may lead to other problems that impact on treatment effectiveness, such as opioid-induced hyperalgesia.
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Cradick, Mary, Shannon DeGrote, Spencer Marsall, and Terri Warholak. "Suboxone for Medically Assisted Treatment for Opioid Dependence." The University of Arizona, 2014. http://hdl.handle.net/10150/614151.

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Class of 2014 Abstract
Specific Aims: To show that Suboxone is more effective than no MAT (Medically Assisted Treatment) in opioid dependence. Additionally, that Suboxone is as effective as methadone in MAT. Methods: This study was a retrospective chart review of probationer’s case files at The Pima County Adult Probation Office. Treatment groups included: Suboxone (n=16), methadone (n=15), and no MAT control group (n=15). The total sample size was 46 probationers. The primary dependent variables were the number of negative events and time to a negative event (i.e. missed/positive urinalysis, violation of terms of probation). The secondary outcome variables were the number of positive events and time to a positive event (i.e. finding employment, documented social/family improvement). Data analysis utilized chi-square for categorical data while t-tests were used for continuous data. Main Results: 46 probationers of Pima County with violations related to possession or use of an opioid substance were analyzed. No significant differences were found between Suboxone and placebo (no MAT) for any of the four outcomes (number of negative events p=0.82; time to first negative event p=0.41; number of positive events p=0.93; time to first positive event p=0.45). No significant differences were found between Suboxone and methadone as well (number of negative events p=0.34; time to first negative event p=0.52; number of positive events p=0.93; time to first positive event p=0.56). Conclusion: This study found no statistically significant differences between no MAT and Suboxone nor Suboxone and methadone. Differences in baseline characteristics between groups were found that could characterize the Suboxone group as being more severely ill.
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Books on the topic "Opioid dependence"

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McAnally, Heath B. Opioid Dependence. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-47497-7.

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C, Strain Eric, and Stitzer Maxine L, eds. Methadone treatment for opioid dependence. Baltimore: Johns Hopkins University Press, 1999.

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Greenwald, Mark. Human experimental therapeutic models in opioid dependence. New York: Nova Science Publishers, 2008.

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D, Blaine Jack, ed. Buprenorphine: An alternative treatment for opioid dependence. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute on Drug Abuse, 1992.

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Renner, John A., and Petros Levounis. Handbook of office-based buprenorphine treatment of opioid dependence. Washington, DC: American Psychiatric Pub., 2010.

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Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva, Switzerland: World Health Organization, 2009.

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M, Stine Susan, and Kosten Thomas R, eds. New treatments for opiate dependence. New York: Guilford Press, 1997.

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1942-, Cowan Alan, and Lewis John W, eds. Buprenorphine: Combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995.

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Asia, World Health Organization Regional Office for South-East. Operational guidelines for the management of opioid dependence in the South-east Asia region. New Delhi, India: World Health Organization, Regional Office for South-East Asia, 2008.

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Stuart, Baker, ed. The twelve-step facilitation handbook: A systematic approach to early recovery from substance dependence. Center City, Minn: Hazelden, 2003.

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Book chapters on the topic "Opioid dependence"

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McAnally, Heath B. "An Epidemiologic Perspective." In Opioid Dependence, 3–19. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_1.

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McAnally, Heath B. "Opioid Dependence Risk Factors and Risk Assessment." In Opioid Dependence, 233–64. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_10.

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McAnally, Heath B. "Addressing Host Factors: Primary, Secondary, and Tertiary Prevention of Opioid Dependence." In Opioid Dependence, 265–90. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_11.

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McAnally, Heath B. "Understanding the Agent, Part I: Opioid Biology and Basic Pharmacology." In Opioid Dependence, 23–47. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_2.

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McAnally, Heath B. "Understanding the Agent, Part II: Adverse Effects." In Opioid Dependence, 49–71. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_3.

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McAnally, Heath B. "Understanding the Agent, Part III: Specific Drugs." In Opioid Dependence, 73–97. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_4.

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McAnally, Heath B. "Attenuating the Agent: Reducing Opioid “Virulence”." In Opioid Dependence, 99–118. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_5.

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McAnally, Heath B. "Best Practices Education, Part I: Pain Physiology, Psychology, and Alternatives to Opioids." In Opioid Dependence, 121–48. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_6.

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McAnally, Heath B. "Best Practices Education, Part II: Evidence for and Against Opioid Therapy." In Opioid Dependence, 149–73. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_7.

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McAnally, Heath B. "Best Practices Education, Part III: Regulatory and Advisory Issues Related to Opioid Therapy for Pain." In Opioid Dependence, 175–203. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47497-7_8.

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Conference papers on the topic "Opioid dependence"

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Nazarova, G. A., N. G. Bogdanova, E. V. Alekseeva, and S. K. Sudakov. "INTERMITTENT USE OF SOLUTIONS OF GLUCOSE, SODIUM CHLORIDE AND MONOSODIUM GLUTAMATE CAUSES ENDOGENOUS OPIOID DEPENDENCE." In MODERN PROBLEMS IN SYSTEMIC REGULATION OF PHYSIOLOGICAL FUNCTIONS. NPG Publishing, 2019. http://dx.doi.org/10.24108/5-2019-confnf-59.

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Mehtry, Vijay, Nizamuddin Parvez, Haque Nizamie, and Nityananda Pradhan. "Altered Brain Function as Evidenced by Electroencephalographic Power Spectral Analysis in Patients with Opioid Dependence." In Annual International Conference on Neuroscience and Neurobiology Research. Global Science & Technology Forum (GSTF), 2014. http://dx.doi.org/10.5176/2345-7813_cnn14.01.

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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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Haddad, Imad Y., Teresa L. Reyburn-Orne, Rima Abdouni, and Tarek H. Youssef. "Impact Of Standardized Clinical Practice Guideline On Methadone Exposure And Hospital Length Of Stay In Children With Latrogenic Opioid Dependence." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a2941.

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SANTOS, AMANDA CORDEIRO, ANA KAROLINE DE ALMEIDA MENDES, DANIELLE BRENA DANTAS TARGINO, RENATO MARCELO SILVA ALEXANDRE FILHO, LUIZA VITORIA DE SOUSA BARROS FONSECA, and CAIO RODRIGUES LIMA NEUENSCHWANDER. "DEPENDÊNCIA DE OPIOIDE NO TRATAMENTO DE DOR CRÔNICA." In Brazilian Congress. brazco, 2020. http://dx.doi.org/10.51162/brc.health2020-00056.

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A Associacao Internacional para o Estudo da Dor (IASP) define: A dor e uma experiencia sensorial e emocional desagradavel, associada a dano real ou potencial de tecidos ou descrita em termos de tal dano , e de acordo com o Ministerio da Saude (MS), consiste como fator alarmante de saude publica pelo numero acentuado de individuos acometidos. A dor cronica notabiliza-se por uso prolongado de tratamento com efeito analgesico. Dentre os farmacos, destacam-se os opioides, classe medicamentosa na qual a acao analgesica e produzida a nivel de sistema nervoso central, em areas especificas relacionadas a dor. Os opioides foram pesquisados por diferentes autores que explaram sobre o uso adequado e compulsivo dessas medicacoes, citando seus beneficios e maleficios, salientando a prevencao de agravantes, como o surgimento de disturbios associados ao uso da substancia nos casos de dor cronica, caracterizando o Transtorno Mental por Uso de Opioides. Esta revisao bibliografica teve como objetivo a descricao da dependencia de opioide no tratamento da dor cronica. Utilizou-se referenciais teoricos datados a partir de 2015, e ainda ferramentas de pesquisa academica em sitios da internet regulamentados para a area medica e cientifica.,
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Patil, Sushil G., Timothy J. Gale, and Clive R. Stack. "Design of Novel Assessment Techniques for Opioid Dependent Patients." In 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 2007. http://dx.doi.org/10.1109/iembs.2007.4353144.

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Tas, B., NJ Kalk, PSP Cho, M. Lozano-Garcia, GF Rafferty, M. Kelleher, J. Moxham, J. Strang, and CJ Jolley. "P85 Respiratory depression in opioid dependent chronic obstructive pulmonary disease patients." In British Thoracic Society Winter Meeting 2021 Online, Wednesday 24 to Friday 26 November 2021, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2021. http://dx.doi.org/10.1136/thorax-2021-btsabstracts.195.

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Taksibi, Milad, Leila Kashani-Vahid, Samira Vakili, and Hadi Moradi. "Effects of Computerized Cognitive Rehabilitation on the Working Memory of Opioid-dependent Patients." In 2020 International Serious Games Symposium (ISGS). IEEE, 2020. http://dx.doi.org/10.1109/isgs51981.2020.9375320.

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"TRATAMIENTO SUSTITUTIVO EN LA DEPENDENCIA DE OPIACEOS: METADONA Y BUPRENORFINA." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p079s.

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INTRODUCCIÓN Los opioides tienen efectos analgésicas y sedantes y en medicina se usan para el tratamiento del dolor, su consumo de forma ''lúdica'' produce euforia y sensación de placer. La dependencia de los opioides es un problema de gran relevancia a nivel mundial, se estima que unos 32 millones de personas utilizan los opioides de forma ilícita, incluyendo los recetados. De estos, 9,2 millones consumen heroína, siendo esta la responsable de que 300000 personas sean tratadas por dependencia, unas 25000 hayan muerto y 100000 hayan contraído el VIH. Lo cual incrementa la atención sanitaria, la mortalidad juvenil y la delincuencia OBJETIVOS Actualizar los conocimientos de la dependencia a opioides Identificar líneas de tratamiento farmacológico más utilizadas en España para los mismos METODOLOGÍA Se realizó una revisión bibliográfica en PUBMED, MEDLINE, SCIELO y COCHARANE. Los desc utilizados fueron; Tratamiento sustitución dependencia opiáceos , dependencia a la heroína. Booleano: AND RESULTADOS Y CONCLUSIONES La dependencia de opiáceos es una enfermedad multicausal y crónica. . El perfil del paciente a tratamiento en la sustitución de opiáceos es varón 43,2 años de media, educación primaria, parado y que acude a tratamiento por iniciativa propia. Las principales líneas farmacológicas en España son el tratamiento con metadona, actualmente es el más utilizado. Y la buprenorfina presenta una efectividad similar, siendo más segura pues causa menos depresión respiratoria y menos alteración a nivel de SNC. Cabe destacar que el uso de ambas es vía oral, sin embargo, recientemente se ha aceptado el uso de buprenorfina subcutánea. Lo cual produce un aumento de la calidad de vida del paciente. Resulta interesante seguir investigando, ya que dar una buena atención reduce el gasto sanitario ya que disminuye la comorbilidad tanto psiquiátrica como física, facilita el cambio del estilo de vida y reduce la actividad criminal.
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Tas, Basak, Peter S. P. Cho, Manuel Lozano Garcia, Gerrard F. Rafferty, Michael Kelleher, John Moxham, John Strang, and Caroline J. Jolley. "An observational study of the severity of respiratory depression (RDP) in opioid dependent patients (ODP)." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa3664.

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Reports on the topic "Opioid dependence"

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McDonagh, Marian S., Jesse Wagner, Azrah Y. Ahmed, Benjamin Morasco, Devan Kansagara, and Roger Chou. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: May 2021 Update. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccerplantpain3.

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Overview This is the third quarterly progress report for an ongoing living systematic review on cannabis and other plant-based treatments for chronic pain. The first progress report was published in January 2021 and the second in March 2021. The draft systematic review was available for public comment from May 19 through June 15, 2021, on the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care website. The systematic review synthesizes evidence on the benefits and harms of plant-based compounds (PBCs), such as cannabinoids and kratom, used to treat chronic pain, addressing concerns about severe adverse effects, abuse, misuse, dependence, and addiction. The purpose of this progress report is to describe the cumulative literature identified thus far. This report will be periodically updated with new studies as they are published and identified, culminating in an annual systematic review that provides a synthesis of the accumulated evidence. Main Points In patients with chronic (mainly neuropathic) pain with short-term treatment (4 weeks to <6 months): • Studies of cannabis-related products were grouped based on their tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio using the following categories: high THC to CBD, comparable THC to CBD, and low THC to CBD. • Comparable THC to CBD ratio oral spray is probably associated with small improvements in pain severity and may be associated with small improvements in function. There was no effect in pain interference or serious adverse events. There may be a large increased risk of dizziness and sedation, and a moderate increased risk of nausea. • Synthetic THC (high THC to CBD) may be associated with moderate improvement in pain severity and increased risk of sedation, and large increased risk of nausea. Synthetic THC is probably associated with a large increased risk of dizziness. • Extracted whole-plant high THC to CBD ratio products may be associated with large increases in risk of withdrawal due to adverse events and dizziness. • Evidence on whole-plant cannabis, low THC to CBD ratio products (topical CBD), other cannabinoids (cannabidivarin), and comparisons with other active interventions was insufficient to draw conclusions. • Other key adverse event outcomes (psychosis, cannabis use disorder, cognitive deficits) and outcomes on the impact on opioid use were not reported. • No evidence on other plant-based compounds, such as kratom, met criteria for this review.
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