Academic literature on the topic 'Opioid habit'
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Journal articles on the topic "Opioid habit"
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Jain, Khushboo, Akansha Singh, Poonam Singh, and Sanjana Yadav. "An Improved Supervised Classification Algorithm in Healthcare Diagnostics for Predicting Opioid Habit Disorder." International Journal of Reliable and Quality E-Healthcare 11, no. 1 (January 2022): 1–16. http://dx.doi.org/10.4018/ijrqeh.297088.
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Opioid Habit Disorder (OHD), which has become a mass health epidemic, is defined as the psychological or physical dependency on opioids. This study demonstrates how supervised machine learning procedures help us investigate and examine massive data to discover the hidden patterns in any disease to deliver adapted dealing and predict the disease in any patient. This work presents a generalized model for forecasting a disease in the healthcare sector. The proposed model was investigated and tested using a reduced feature-set of the Opioid Habit Disorder (OHD) dataset collected from the National Survey on Drug Use and Health (NSDUH) using an improved Iterative Dichotomiser 3 (pro-IDT) algorithm. The proposed healthcare model is also compared with further machine learning algorithms such as ID3, Random Forest, and Bayesian Classifier in Python programming. The performance of the proposed work and other machine-learning algorithms has estimated accuracy, precision, misclassification rate, recall, specificity, and F1 score.
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Wassum, K. M., I. C. Cely, N. T. Maidment, and B. W. Balleine. "Disruption of endogenous opioid activity during instrumental learning enhances habit acquisition." Neuroscience 163, no. 3 (October 2009): 770–80. http://dx.doi.org/10.1016/j.neuroscience.2009.06.071.
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Greiner, Rebecca S., Danielle Boselli, Jai N. Patel, Mariam Salib, Connie Edelen, and Declan Walsh. "Opioid Risk Screening in an Oncology Palliative Medicine Clinic." JCO Oncology Practice 16, no. 11 (November 2020): e1332-e1342. http://dx.doi.org/10.1200/op.20.00043.
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PURPOSE: Little information exists on factors that predict opioid misuse in oncology. We adopted the Screener and Opioid Assessment for Patients With Pain–Short Form (SOAPP-SF) and toxicology testing to assess for opioid misuse risk. The primary objective was to (1) identify characteristics associated with a high-risk SOAPP-SF score and noncompliant toxicology test, and (2) determine SOAPP-SF utility to predict noncompliant toxicology tests. METHODS: From July 1, 2017, to December 31, 2017, new patients completed the Edmonton Symptom Assessment Scale (ESAS), SOAPP-SF, and narcotic use agreement. Toxicology test results were collected at subsequent visits. RESULTS: Of 223 distinct patients, 96% completed SOAPP-SF. Mean age was 61 ± 12.7 years, 58% were female, 68% were White, and 28% were Black. Eighty-three eligible patients (38%) completed toxicology testing. Younger age, male sex, and increased ESAS depression scores were associated with high-risk SOAPP-SF scores. Smoking habit was associated with an aberrant test. An SOAPP-SF score ≥ 3 predicted a noncompliant toxicology test. CONCLUSION: Male sex, young age, and higher ESAS depression score were associated with a high SOAPP-SF score. Smoking habit was associated with an aberrant test. An SOAPP-SF of ≥ 3 (sensitivity, 0.74; specificity, 0.64), not ≥ 4, was predictive of an aberrant test; however, performance characteristics were decreased from those published by Inflexxion, for ≥ 4 (sensitivity, 0.86; specificity, 0.67). The specificity warrants caution in falsely labeling patients. The SOAPP-SF may aid in meeting National Comprehensive Cancer Network recommendations to screen oncology patients for opioid misuse.
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Nnachi, Oluomachi Charity, Chinedu Obasi Akpa, Favour Ogonna Nwani, and Oghenevwogaga Obukohwo Edenya. "Pentazocine Misuse among Sickle Cell Disease Patients and The Role of Lack of Enforcement of Opioid Dispensing Regulations by Community Pharmacies: A Descriptive Observational Study." Advances in Public Health 2022 (January 30, 2022): 1–6. http://dx.doi.org/10.1155/2022/3877882.
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Introduction. Sickle cell disease (SCD) is a chronic disease characterized by debilitating bone pains which commonly necessitate the use of analgesic drugs including opioids and psychotropic substances such as pentazocine which are controlled medicines in Nigeria. Opioid misuse including dependence and addiction is an increasing trend among SCD patients, and it has serious adverse implications on their social, economic, and physical well-being. The role of lack of implementation of existent regulation on the dispensing of opioids by pharmacies has not been adequately investigated. Objective. The primary objective of this study is to define the sociodemographic and clinical implications of pentazocine misuse among patients with SCD and to describe the contributions of lack of enforcement of opioid dispensing regulations to this menace. Materials and Methods. The study was a descriptive observational study. A 29-item pretested and prevalidated questionnaire was administered to 21 SCD patients with an established history of pentazocine misuse and addiction to establish their demographics, details of opioid use, and their clinical effects. Nine community pharmacies were interviewed to ascertain their knowledge of controlled medicines and their compliance to existent regulations on the dispensation of opioids. Results. The median (interquartile range) age of the SCD subjects was 24 years. The majority of subjects (14, 66.7%) had tertiary education. Fifteen (71.4%) of them had a history of pentazocine misuse for over two years. All subjects source pentazocine injection from local pharmacies and patent medicine shops without prescription, while 19.0% get home deliveries. Seventeen (80.9%) of the SCD subjects desired to discontinue the habit; however, inadequate medical support was reported to contribute to their inability to overcome this practice in 14 (54.3%) patients. Most of the local pharmacies/drug shop proprietors are aware of drug laws guiding controlled medicines in Nigeria. However, about 77.9% of pharmacies interviewed retail pentazocine without prescription. A lack of enforcement by the state and federal taskforce was reported to contribute to this practice. Conclusion. Pentazocine misuse is a serious problem in patients with SCD. Inadequate medical support and lack of enforcement of regulations on dispensing opioids by community pharmacies are contributors to this menace.
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Benéitez, M. Cristina, and M. Esther Gil-Alegre. "Opioid Addiction: Social Problems Associated and Implications of Both Current and Possible Future Treatments, including Polymeric Therapeutics for Giving Up the Habit of Opioid Consumption." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/7120815.
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Background. Detoxification programmes seek to implement the most secure and compassionate ways of withdrawing from opiates so that the inevitable withdrawal symptoms and other complications are minimized. Once detoxification has been achieved, the next stage is to enable the patient to overcome his or her drug addiction by ensuring consumption is permanently and completely abandoned, only after which can the subject be regarded as fully recovered. Methods. A systematic search on the common databases of relevant papers published until 2016 inclusive. Results and Conclusion. Our study of the available oral treatments for opioid dependence has revealed that no current treatment can actually claim to be fully effective. These treatments require daily oral administration and, consequently, regular visits to dispensaries, which in most cases results in a lack of patient compliance, which causes fluctuations in drug plasma levels. We then reviewed alternative treatments in the available scientific literature on polymeric sustained release formulations. Research has been done not only on release systems for detoxification but also on release systems for giving up the habit of taking opioids. These efforts have obtained the recent authorization of polymeric systems for use in patients that could help them to reduce their craving for drugs.
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Li, Yingcen, Yunliang Miao, Xufang Liang, and Shan He. "Functional Characterization and Molecular Marker Development of the Proenkephalin as Biomarker of Food Addiction in Food Habit Domestication of Mandarin Fish (Siniperca Chuatsi)." Fishes 7, no. 3 (May 27, 2022): 118. http://dx.doi.org/10.3390/fishes7030118.
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Proenkephalin (PENK), as the precursor of endogenous opioid enkephalin (ENK), is widely present in the nervous system and plays an important role in animal food addiction and rewarding behavior. In our study, we intend to study the functional characterization and molecular marker development of the penk gene related to food habit domestication of mandarin fish. We found that the penk gene of mandarin fish had three types of endogenous opioid peptide sequences. Compared with other tissues, penk mRNA was highly expressed in the whole brain. Intracerebroventricular (ICV) injection of lysine or methionine significantly increased the expression of penk mRNA. The expression of penk mRNA in the brain of mandarin fish that could be easily domesticated from eating live prey fish to artificial diets was significantly higher than those that could not. After feeding with high-carbohydrate artificial diets, the expression of penk mRNA showed no significant difference between mandarin fish with hypophagia and those that still ate normally. A total of four single nucleotide polymorphisms (SNP) loci related to easy domestication toward eating artificial diets were screened from the mandarin fish population. Additionally, the TT genotype at one of the loci was significantly correlated with the food habit domestication of mandarin fish.
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Bechara, Antoine, Kent C. Berridge, Warren K. Bickel, Jose A. Morón, Sidney B. Williams, and Jeffrey S. Stein. "A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction." Psychological Science in the Public Interest 20, no. 2 (October 2019): 96–127. http://dx.doi.org/10.1177/1529100619860513.
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Two major questions about addictive behaviors need to be explained by any worthwhile neurobiological theory. First, why do people seek drugs in the first place? Second, why do some people who use drugs seem to eventually become unable to resist drug temptation and so become “addicted”? We will review the theories of addiction that address negative-reinforcement views of drug use (i.e., taking opioids to alleviate distress or withdrawal), positive-reinforcement views (i.e., taking drugs for euphoria), habit views (i.e., growth of automatic drug-use routines), incentive-sensitization views (i.e., growth of excessive “wanting” to take drugs as a result of dopamine-related sensitization), and cognitive-dysfunction views (i.e., impaired prefrontal top-down control), including those involving competing neurobehavioral decision systems (CNDS), and the role of the insula in modulating addictive drug craving. In the special case of opioids, particular attention is paid to whether their analgesic effects overlap with their reinforcing effects and whether the perceived low risk of taking legal medicinal opioids, which are often prescribed by a health professional, could play a role in the decision to use. Specifically, we will address the issue of predisposition or vulnerability to becoming addicted to drugs (i.e., the question of why some people who experiment with drugs develop an addiction, while others do not). Finally, we review attempts to develop novel therapeutic strategies and policy ideas that could help prevent opioid and other substance abuse.
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Greiner, Rebecca, Danielle Boselli, Mariam Salib, and Jai Narendra Patel. "Examination of the Screener and Opioid Assessment for Patients with Pain-Short Form (SOAPP-SF) in an oncology palliative medicine clinic." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 196. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.196.
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196 Background: The National Comprehensive Cancer Network states opioids can be used to treat cancer pain and prescribers should identify patients at risk for opioid misuse; research in this area is limited. In the non-cancer population, SOAPP-SF is a validated tool to predict aberrant drug behavior; a score of ≥ 4 (out of 20) is considered high risk. We performed a retrospective observational study to determine the utility of the SOAPP in identifying opioid misuse in the oncology population as measured by a non-compliant toxicology screen. Methods: Consecutive consults seen during a 6-month period completed the 5-question SOAPP-SF and Edmonton Symptom Assessment System (ESAS) form. Toxicology screens assessed non-compliance (i.e., absence of prescribed medications and/or presence of non-prescribed or illegal substances). Logistic regression models estimated the associations of composite and individual SOAPP-SF scores and ESAS symptom scores with non-compliant screens. Threshold analysis were conducted to identify an optimal SOAPP-SF cutoff. Results: Of 192 consults, 64 patients providing SOAPP-SF score and toxicology screen were evaluable. Mean age was 59 ± 9.8 years: 56% were female, 34% and 62% were African American and Caucasian respectively. Median SOAPP-SF score was 2 (range: [0, 12]). Non-compliant screens were observed in 31% of patients. The area under the curve (AUC) was 0.65. The validated SOAPP-SF cutoff score of ≥ 4 was associated with a sensitivity and specificity of 0.43 and 0.79, respectively (p = 0.082). Sensitivity (0.76) and specificity (0.72) were maximized at a cutoff score of ≥ 3 (p < 0.001). When evaluated individually, the SOAPP-SF question about smoking habit was associated with a non-compliant screen (p = 0.020). Increased ESAS pain scores were associated with SOAPP-SF score ≥ 3 (p = 0.013). Conclusions: SOAPP-SF can identify oncology patients at risk for opioid misuse. Preliminary analyses suggest a more appropriate threshold of identification is a score of ≥ 3 not ≥ 4. Future work will increase numbers of evaluable patients and examine other factors associated with opioid misuse.
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Halepas, Steven, Cameron Christiansen, Alia Koch, Shahid R. Aziz, David M. Shafer, and Elie M. Ferneini. "Opioid-Prescribing Patterns in Connecticut and New Jersey Following Third Molar Extractions." Anesthesia Progress 69, no. 4 (December 1, 2022): 9–14. http://dx.doi.org/10.2344/anpr-69-02-12.
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Objective In recent years, opioid misuse has resulted in much scrutiny on providers' prescribing habits. The purpose of this study was to analyze prescribing habits in the context of third molar extractions as a model for promoting better postsurgical pain management. Methods This was a cross-sectional survey of oral maxillofacial surgeons in Connecticut and New Jersey. A total of 291 practitioners were contacted to complete an online survey using Qualtrics Research Services to determine prescribing habits following third molar extractions. Results The most common approach for postoperative analgesia was nonsteroidal anti-inflammatory drugs (NSAIDs) and an opioid/acetaminophen (APAP) combination as 2 separate prescriptions, reported by 36% of participants. The combination of hydrocodone/APAP was the most common opioid formulation, and an average of 10.93 ± 4.51 opioid pills were prescribed with a maximum of 20 pills reported. Most providers (79%) consistently provided patients with opioid information. Only 22% reported always checking opioid-monitoring programs; however, providers were more likely to check if prescribing more than ∼11 opioid pills (P = .0228). Most reported using dexamethasone (82%) and bupivacaine (56%) intraoperatively, while ketorolac was less common (15%). No association was found between the quantity of opioids prescribed and the use of intraoperative ketorolac, steroids, or bupivacaine (P > .05). Conclusion There remains to be a universal standard for using opioids for postoperative pain management in dentistry. Providers should be mindful when prescribing opioids and consider using NSAIDs and APAP for baseline pain plus a separate opioid prescription for breakthrough pain. Additional focus on minimizing the quantity of opioids prescribed and self-reflecting on prescribing and practice habits to further reduce opioid-related complications is warranted.
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Schinas, MSc, Anna, Shein Nanji, BSc, Kira Vorobej, MSc, Catherine Mills, MSc, Dawn Govier, BSc, and Beatrice Setnik, PhD. "Key characteristics and habits of the recreational opioid user." Journal of Opioid Management 15, no. 6 (November 1, 2019): 507–20. http://dx.doi.org/10.5055/jom.2019.0542.
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Objective: To identify key characteristics and habits of recreational opioid users.Design: The data were compiled from volunteers who participated in clinical studies at a contract research organization in Toronto, Ontario, Canada.Interventions: Data were collected from 5,018 male and female recreational opioid users via telephone and face-to-face screening interviews. Five recreational opioid users participated in a live interview broadcast on the internet.Main outcome measures: Demographic data, recreational drug use history, routes of recreational drug administration, alcohol use, and smoking status. A subset of the demographic information and recreational drug use history was summarized separately using data collected between 2013 and 2016 from 114 recreational opioid users who were not dependent on opioids. Interview excerpts were included from five recreational opioid users who described their real-world experiences with drug abuse, including the impact of abuse-deterrent opioid formulations on their drug abuse behavior.Results: The preferred route of administration of opioids was oral (52 percent), followed by intranasal (36 percent), intravenous (10 percent), and buccal (chewing on a patch; 2 percent). Other substances used included nicotine, alcohol, and non-opioid psychoactive drugs (primarily cannabis). Oxycodone was the most frequently reported opioid of abuse.Conclusions: Recreational opioid users have distinct drug-related behaviors and preferences. Monitoring current trends and examining these behaviors is an important component to understand the potential safety risks associated with recreational opioid use.
Dissertations / Theses on the topic "Opioid habit"
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Fundytus, Marian Elaine. "Central nervous system and peripheral signs of opioid abstinence." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56639.
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It was hypothesized that a metabolite of morphine, morphine-3-glucuronide (M3G), contributes to the expression of symptoms seen during withdrawal from morphine. To test this hypothesis, the behaviors observed during precipitated withdrawal from morphine and sufentanil were compared. Sufentanil was chosen because, like morphine, it acts primarily at the mu opioid receptor, but has different metabolites. Differences in the abstinence syndromes produced by the two drugs may therefore be attributable to the actions of metabolites, rather than the primary opioid actions of morphine and sufentanil. Although there were some differences in the occurrence of symptoms, morphine and sufentanil withdrawal were very similar. Therefore, the evidence was inconclusive as to the contribution of metabolites during withdrawal.Systemic administration of M3G alone and in combination with morphine produced no withdrawal-like behaviors. However, when these drugs were given centrally, withdrawal-like behaviors were observed in conjunction with seizures. The seizures were not attenuated by naloxone (but were alleviated by an anti-convulsant), indicating that they were not mediated by opioid receptors. The behaviors resembled those seen by previous investigators following high doses of morphine. The results suggest that M3G may play a role in the toxic effects of high doses of morphine.
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Maloney, Elizabeth Ann National Drug & Alcohol Research Centre Faculty of Medicine UNSW. "Opioid dependence: associations with suicidal behaviour and other psychiatric comorbidity." Publisher:University of New South Wales. National Drug & Alcohol Research Centre, 2008. http://handle.unsw.edu.au/1959.4/41455.
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Suicide attempts and opioid dependence are important clinical issues, as both are associated with a high degree of psychiatric morbidity and elevated risk of mortality. Research has identified a number of risk factors for suicide attempts among the general population, and to a lesser extent, among heroin users. Due to a lack of case-control studies, however, it is still not known to what extent opioid dependence per se is a risk factor for suicide attempts. This thesis comprised the first study to directly examine whether opioid dependence is a unique risk factor of suicide attempts. This thesis examined suicide attempts, associated risk factors, and related comorbidity among an opioid-dependent case group and a non-opioid-dependent control group. A structured interview was used to collect data from 726 opioid-dependent cases and 399 non-opioid-dependent controls. This thesis identified a number of important findings. Firstly, although opioid-dependent individuals were more likely to report lifetime suicide attempts compared to controls, the risk factors were largely the same for both groups. It appeared that opioid-dependent individuals were characterised by a higher likelihood of the same risk factors for suicide attempts, rather than having different risks. Cases appeared to be at increased risk of suicide attempts because of increased levels of multiple risk factors. Secondly, borderline personality disorder (BPD) and impulsivity were identified as important risk markers for suicidal behaviour, especially among opioid-dependent individuals. The study concluded that the treatment of BPD should be prioritised among this group. Third, self-mutilation was identified as a clinically significant problem in its own right, however, when combined with a history of attempted suicide, the psychological dysfunction observed was found to be very high. Fourth, non-fatal opioid overdose and suicide attempts were found to be distinct behaviours. The risk factors for each were completely different. While drug-related risks were associated with non-fatal overdose, the risk markers for suicide attempts were related to the presence of psychological disorders. This thesis has highlighted important areas of concern for clinical interventions as well as for future research to explore. Considering this is the first study of its kind, future research should focus on its replication.
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Lawrinson, Peter School of Public Health & Community of Medicine UNSW. "Development And Piloting Of A Treatment Outcome Monitoring system for opioid maintenance pharmacotherapy services In New South Wales, Australia." Awarded by:University of New South Wales. School of Public Health and Community of Medicine, 2004. http://handle.unsw.edu.au/1959.4/20546.
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Policy-makers, funding bodies and treatment providers need current, comparable and accurate information on the activities and outcomes of alcohol and other drug (AOD) treatment services to respond to the needs of the sector. If meaningful comparisons are to be made at the jurisdictional level, a standardised treatment outcome monitoring system must be developed and implemented, that takes into account differences in client characteristics, treatment settings and modes of service provision. A brief, multi-dimensional instrument, the Brief Treatment Outcome Measure (BTOM) has been developed for routine, ongoing treatment outcome monitoring with clients receiving opioid maintenance pharmacotherapy (OMP) services in New South Wales (NSW), and for use in treatment evaluation research. This is the first time in Australia that an attempt has been made to integrate outcome monitoring into routine clinical practice across an AOD treatment sector. The BTOM contains thirty-three items across the domains of dependence, blood-borne virus exposure risk, drug use, health/psychological functioning and social functioning. The internal reliability of the BTOM is satisfactory; retest reliabilities for the measures are good to excellent and concurrent validation of BTOM scales yielded acceptable agreement. Average completion times of the BTOM were 14.5 minutes when administered by researchers and 21 minutes by clinicians. A 30-month feasibility trial was conducted in selected NSW OMP treatment agencies to determine the practicability of implementing an OMS; to identify issues that would impact on the quality of the data; and identify administrative processes that could facilitate implementation whilst minimising the burden on agency staff. In addition, clinicians who had administered the BTOM were surveyed 18 months into the trial to ascertain their attitudes towards the clinical utility, acceptability of content and the level of support given to them to administer the BTOM as part of routine clinical practice. Results from the trial indicate that the BTOM measures are sensitive to change over time; that the change observed is consistent with that reported in the OMP treatment outcome literature; and that clinicians, whilst generally being positively predisposed towards using the instrument, express concerns relating to the burden of administering and the clinical utility of conducting outcome monitoring.
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Gardner, Janet Rose. "Authenticating & repairing personhood : the experiences of opioid dependent back pain sufferers." Monash University, Dept. of Community Medicine, 2003. http://arrow.monash.edu.au/hdl/1959.1/5574.
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Byrum, Mary Kristine. "America Addicted: The Relationship Between Dental School Education and the Opiate Prescribing Practices of Dentists in Ohio." Walsh University Honors Theses / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=walshhonors1524605016944778.
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Newcombe, David A. L. "An examination of the pharmacodynamics and pharmacokinetics of Levo-alpha-acetylmethadol ( LAAM ), compared to methadone, in opioid maintenance patients." 2006. http://hdl.handle.net/2440/37871.
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Methadone is currently the most widely used agent to manage opioid dependence, but clinical experience has highlighted some limitations with its use. In particular, a relatively high proportion of patients complain of breakthrough withdrawal symptoms ( non - holding ) at apparently adequate methadone doses. Levo - alpha - acetylmethadol ( LAAM ) is a long acting opioid that is likely to benefit methadone non - holders ; however, relatively little is known about its pharmacology at steady state. The primary aim of this thesis was to evaluate LAAM as an alternative maintenance pharmacotherapy to methadone for the treatment of non - holders ; subsidiary aims were to elucidate the pharmacodynamics and pharmacokinetics of LAAM and its active metabolites ( nor - and dinor - LAAM ), and to examine the in vitro activity of LAAM, nor - and dinor - LAAM. Sixteen methadone maintenance patients ( non - holders = 8 ) were recruited to participate in a randomised, crossover trial of LAAM and methadone. At steady state there were two testing sessions ( 24 h for methadone and 48 h for LAAM ) that featured the concurrent measurement of plasma drug concentrations and both subjective and physiological indices of opioid effect. Cognitive and psychomotor functions were also assessed once during each inter - dosing interval study. Ten age - and gender - matched controls were also tested. The peak magnitude of methadone ' s and LAAM ' s effects were similar. Compared to methadone, LAAM was associated with more stable and less severe withdrawal and mood disturbance. The general pattern of symptom complaints and cognitive function was similar for both drugs. Severity of mood disturbance and withdrawal was similar in holders on methadone and LAAM, but was greater in non - holders when they were taking methadone than LAAM. In comparison to plasma ( R ) - ( - ) methadone, plasma nor - and dinor - LAAM concentrations fluctuated little over the dosing interval. Furthermore, nor - and dinor - LAAM were both more potent in the guinea - pig ileum bioassay, and had greater affinity for mu opioid receptors in receptor binding studies, than LAAM. In conclusion, LAAM converted methadone non - holders into LAAM holders. It is proposed that it is the relatively flat plasma concentration - time profile for nor - and dinor - LAAM that confer stability of opioid effect, minimising withdrawal. Therefore, LAAM may have a role in selected patients, whose response to methadone is suboptimal.Thesis (Ph.D.)--School of Medical Sciences, 2006.
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Newcombe, David A. L. "An examination of the pharmacodynamics and pharmacokinetics of Levo-alpha-acetylmethadol ( LAAM ), compared to methadone, in opioid maintenance patients." Thesis, 2006. http://hdl.handle.net/2440/37871.
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Methadone is currently the most widely used agent to manage opioid dependence, but clinical experience has highlighted some limitations with its use. In particular, a relatively high proportion of patients complain of breakthrough withdrawal symptoms ( non - holding ) at apparently adequate methadone doses. Levo - alpha - acetylmethadol ( LAAM ) is a long
acting opioid that is likely to benefit methadone non - holders ; however, relatively little is known about its pharmacology at steady state. The primary aim of this thesis was to evaluate LAAM as an alternative maintenance pharmacotherapy to methadone for the treatment of non - holders ; subsidiary aims were to elucidate the pharmacodynamics and pharmacokinetics of LAAM and its active metabolites ( nor - and dinor - LAAM ), and to examine the in vitro activity of LAAM, nor - and dinor - LAAM. Sixteen methadone maintenance patients ( non - holders = 8 ) were recruited to participate in a randomised, crossover trial of LAAM and methadone. At steady state there were two testing sessions ( 24 h for methadone and 48 h for LAAM ) that featured the concurrent measurement of plasma drug concentrations and both subjective and physiological indices of opioid effect. Cognitive and psychomotor functions were also assessed once during each inter - dosing interval study. Ten age - and gender - matched controls were also tested. The peak magnitude of methadone ' s and LAAM ' s effects were similar. Compared to methadone, LAAM was associated with more stable and less severe withdrawal and mood disturbance.
The general pattern of symptom complaints and cognitive function was similar for both drugs. Severity of mood disturbance and withdrawal was similar in holders on methadone and LAAM, but was greater in non - holders when they were taking methadone than LAAM. In comparison to plasma ( R ) - ( - ) methadone, plasma nor - and dinor - LAAM concentrations fluctuated little over the dosing interval. Furthermore, nor - and dinor - LAAM were both more potent in the guinea - pig ileum bioassay, and had greater affinity for mu opioid receptors in receptor binding studies, than LAAM. In conclusion, LAAM converted methadone non - holders into LAAM holders. It is proposed that it is the relatively flat plasma concentration - time profile for nor - and dinor - LAAM that confer stability of opioid effect, minimising withdrawal. Therefore, LAAM may have a role in selected patients, whose response to methadone is suboptimal.Thesis (Ph.D.)--University of Adelaide, School of Medical Sciences, 2006.
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Dyer, Kyle R. (Kyle Roydon). "Determinants of opioid effects and withdrawal among methadone maintenance patients / Kyle R. Dyer." 1999. http://hdl.handle.net/2440/19646.
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Bibliography: leaves 302-359.xxvi, 392 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2000?
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Dyer, Kyle R. (Kyle Roydon). "Determinants of opioid effects and withdrawal among methadone maintenance patients / Kyle R. Dyer." Thesis, 1999. http://hdl.handle.net/2440/19646.
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Mitchell, Timothy Brenton. "A comparison of methadone and slow-release oral morphine as maintenance pharmacotherapies for opioid dependence." Thesis, 2003. http://hdl.handle.net/2440/114871.
Full textBooks on the topic "Opioid habit"
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Cocaine addiction: Theory, research, and treatment. Cambridge, Mass: Harvard University Press, 1997.
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Quincey, Thomas De. Confessions of an English opium-eater. Oxford: Woodstock Books, 1989.
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Quincey, Thomas De. Confessions of an English opium-eater. Otley, England: Woodstock Books, 2002.
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Quincey, Thomas De. Confessions of an English opium-eater. New York: Dover, 1995.
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Confessions of an English opium-eater. London: Penguin, 1997.
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Levinthal, Charles F. Messengers of paradise: Opiates and the brain : the struggle over pain, rage, uncertainty, and addiction. New York: Anchor Press/Doubleday, 1988.
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K, Budd, Levy J, and Royal Society of Medicine Services (Great Britain), eds. Opioids: Use and abuse. London: Royal Society of Medicine Services, 1986.
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Platt, Jerome J. Cocaine Addiction: Theory, Research, and Treatment. Harvard University Press, 2000.
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Confessions of an English Opium-Eater. Waiheke Island: The Floating Press, 2009.
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The Confessions of an English Opium-eater. Digireads.com, 2006.
Find full textBook chapters on the topic "Opioid habit"
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Gray, Elizabeth Kelly. "Conclusion." In Habit Forming, 219—C10.P66. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/oso/9780190073121.003.0011.
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Abstract The Supreme Court ruled in 1919 that drug users could receive maintenance doses of their drug only if they suffered from an unrelated illness; users then sought out illicit markets, and a public health problem became a larger, more challenging social problem. After passage of the Harrison Anti-Narcotic Act, many doctors suggested that ending drug use was easy or theorized that only immoral people became addicted. Other physicians, meanwhile, defended habitués. They deemed it immoral to remove the drug supply from such individuals and traced cases of addiction to a lack of access to health care. Because most addicted people could not buy drugs legally, addiction became—and has remained—entwined with crime. The opioid epidemic that began in the late 1990s has exacerbated the problem. An enduring feature of America’s drug problem, however, is the inclination to sympathize with white, middle-class users while blaming poorer users and people of color for their plight.
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Crandall, Russell. "Opioid Nation." In Drugs and Thugs, 390–408. Yale University Press, 2020. http://dx.doi.org/10.12987/yale/9780300240344.003.0028.
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This chapter introduces narcotics that have been derived from chemical compounds in poppies and part of the American pharmacopeia since the early nineteenth century. It talks about the United States' first opiate-addiction epidemic that developed in the context of an extensively unregulated market for new compounds, which physicians prescribed for ailments from menstrual cramps to the common cold. It also references how researchers synthesized new opioids, such as hydrocodone and oxycodone, with the expectation that these new molecules would prove less habit-forming as federal and state governments cracked down on the runaway market in the early 1900s. The chapter recounts the production of Percocet and Vicodin in the 1970s by combining semisynthetic opiates with acetaminophen, which was considered an elusive quest for a non-addictive painkiller. It mentions how the norm started to shift in the 1980s and 1990s, wherein pain was increasingly described not only as a symptom but as an illness in itself.
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McAnally, Heath B., Lyn Freeman, and Beth Darnall. "Putting It All Together." In Preoperative Optimization of the Chronic Pain Patient, 239–54. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190920142.003.0011.
Full textAbstract:
Joint behavioral health and medical care is required for optimal success in preoperative optimization of the chronic pain patient. This effort basically comprises lifestyle modification issues, and habit breaking and replacement do not come easily. Physical and psychological dependence on tobacco, alcohol, and opioids adds to the complexity and requires skilled and individualized intervention. Nonetheless, some basic principles, goals and a template/plan for multidimensional “baby steps” can be implemented in every case. Given that many of these variables (e.g., sleep, exercise, diet, kinesiophobia, etc.) are interdependent, such a multidimensional approach is preferred in terms of efficacy. Correspondingly, current forward-thinking charters such as the US National Pain Strategy recognize that the mainstream passivity-inducing and frequently opioid-reliant chronic pain management culture with its failure to encourage biopsychosocial-spiritual health and proactive solutions fosters dependence on reactive efforts. It is no wonder patients suffering with chronic pain in this country should pursue stronger drugs, more procedures and surgery, which in the absence of improved baseline mind-body health status all too often results in worsening of their pain syndrome and opioid dependence. The individual patient and the system at large require recalibration, focusing on what our forebears called “fitness for surgery.”
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van den Brink, Wim, and Falk Kiefer. "Alcohol use disorder." In New Oxford Textbook of Psychiatry, edited by John R. Geddes, Nancy C. Andreasen, and Guy M. Goodwin, 498–506. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198713005.003.0050.
Full textAbstract:
Alcohol is one of the most frequently used substances, and alcohol-related disorders are common, especially in western societies. While there is no safe lower drinking level, a clear dose–response relationship has been shown between alcohol intake and organ damage. Conceptualization and diagnostic classification of alcohol use disorders have changed over time, focusing most recently on aspects of craving, loss of control, and continued use despite negative consequences. Alcohol acts via various binding sites in the brain and via downstream effects, including glutamatergic, GABAergic, serotonergic, dopaminergic, opioid, and neuroendocrine pathways. For its long-lasting, habit-forming effects, sensitization within the mesolimbic–mesocortical system is crucial. Psychological treatments traditionally focus on motivational enhancement, cognitive behaviour therapy, and the community reinforcement approach. Pharmacological treatment approaches range from aversive and reward-inhibiting to anti-craving compounds and cognitive enhancers, which target opioid, glutamatergic, and monoamine receptors. Improvement of treatment effects can be achieved by polypharmacy and use of personalized medicine, based on clinical characteristics, biomarkers, and genetic indicators.
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Doleys, Daniel M., and Nicholas D. Doleys. "Teenager With Disabling Leg Pain." In Psychological and Psychiatric Issues in Patients with Chronic Pain, edited by Daniel M. Doleys and Nicholas D. Doleys, 179–86. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197544631.003.0020.
Full textAbstract:
The incidence and prevalence of chronic pain among children and adolescents appears to be increasing. The treatment options are limited. Understandably, one would want to minimize, if not avoid, long-term use of opioids. There are a number of modality and nonopioid therapies available. One approach often overlooked and underutilized, with all age groups, in the use of nutritional and dietary supplements. Many painful conditions, especially neuropathic pain, can be initialed and maintained by neuroinflammatory substances. Certain nutritional and dietary supplements can alter the effect of these substances and the abnormal neuronal functioning associated with pain. Unfortunately, the increased incidence of obesity, even among the younger age groups, reflects a continued trend toward poor dietary habits and food selection. This, along with other lifestyle issues, results in a population that is more vulnerable to developing painful disorders. For this reason, nutritional pain management should be given serious consideration.