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Literatura científica selecionada sobre o tema "Opioid Use Disorder Market Share"
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Artigos de revistas sobre o assunto "Opioid Use Disorder Market Share"
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Alías-Ferri, Maria, Manuela Pellegrini, Emilia Marchei, Roberta Pacifici, Maria Concetta Rotolo, Simona Pichini, Clara Pérez-Mañá et al. "New Psychoactive Substances Consumption in Opioid-Use Disorder Patients". Biology 11, n.º 5 (22 de abril de 2022): 645. http://dx.doi.org/10.3390/biology11050645.
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(1) Background: Since the beginning of the 21st century, the large number and wide chemical variety of new psychoactive substances (NPS) that enter the market every year has become a public health problem. Given the rapidity with which the drug market is changing, many NPS are not clinically investigated and their effects and health risks are unknown. Drug testing is a very useful tool for this purpose, but, unfortunately, it is not very widespread in individuals with opioid-use disorder under detoxification treatment. The aim of this study is to investigate the use of illicit drugs and NPS in opioid-use disorder (OUD) patients on opioid agonist treatment. (2) Methods: A multicenter, descriptive, cross-sectional study was conducted at two addiction care services in Barcelona and Badalona, Spain. Urine samples were collected from OUD individuals attending these two centers, who anonymously donated a urine sample at the time of a periodical visit. Samples were analyzed by high-sensitivity gas chromatography-mass spectrometry (GC-MS) and ultra-high-performance liquid chromatography-high –resolution mass spectrometry (UHPLC-HRMS). (3) Results: Out of the 187 collected and analyzed urine samples, 27.3% were positive for any type of NPS and 8.6% were positive for new synthetic opioids, including fentanyl and its derivatives (NSO). Other frequently detected substances were benzodiazepines in 46.0% of samples, antipsychotics in 27.8% of samples, or cocaine and cannabis in 23.5% of samples. (4) Conclusion: A wide number of NPS, including NSO, have been detected in urine samples from an OUD population. A lack of NPS detection in standard drug screening among drug users can hide the identification of a potential public health problem.
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Kavanaugh, Philip R., e Katherine McLean. "Motivations for Diverted Buprenorphine Use in a Multisite Qualitative Study". Journal of Drug Issues 50, n.º 4 (22 de julho de 2020): 550–65. http://dx.doi.org/10.1177/0022042620941796.
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Drawing on a multisite sample of 40 persons who sell, share, or use diverted buprenorphine to manage opioid use disorder, in this study we describe why individuals seek to obtain buprenorphine outside of formal treatment contexts, and between-site variation regarding their motives and means. Findings indicate that both the provision and purchase of diverted buprenorphine support user-defined risk minimization strategies to avoid withdrawal, reduce heroin use, and satiate opioid cravings in periods of lowered tolerance. We also found that a subset of the sample used buprenorphine recreationally, and that it functioned to extend or augment illicit drug use careers. Implications of the findings are discussed in light of federal and state drug control and treatment policies.
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Gedeon, Charlotte, Mikael Sandell, Inge Birkemose, Johan Kakko, Valgerður Rúnarsdóttir, Kaarlo Simojoki, Thomas Clausen, Fred Nyberg, Richard Littlewood e Hannu Alho. "Standards for opioid use disorder care: An assessment of Nordic approaches". Nordic Studies on Alcohol and Drugs 36, n.º 3 (27 de janeiro de 2019): 286–98. http://dx.doi.org/10.1177/1455072518815322.
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Aims: Outcomes in opioid use disorder (OUD) in Nordic countries have improved with integrated treatment and harm-reduction programmes. Approaches and the standard of care are different across the region. Evidence of treatment needs and current approaches are defined from evidence to inform development of a common standard. Method: Evidence of population sizes and treatment approach collected. Common standards for care (harm reduction, pharmacotherapy, psychology/social therapy) defined for each country. Results: Evidence defines number in treatment; potential population needing treatment not defined for all countries. Populations sizes, treatment access (ratio in treatment programme compared to total country population) defined: Sweden 4,000 in OUD care (access ratio 40); Finland 3,000 (55); Norway 8,000 (154); Denmark 7,500 (132). Approach to treatment similar: integrated treatment programmes standard. Care provided by specialists in outpatient clinics/primary care; secondary care/inpatient services are available. Harm reduction is limited in Sweden but available and more accessible elsewhere. Treatment entry criteria: access relatively unlimited in Norway and Denmark, more limited in Finland and Sweden. Standards of care defined: easy access to high-quality services, individual planning, care not limited by time, management of relapse, education for patients, continuous engagement, holistic approach including management of comorbidities, needle equipment programmes without limit, treatment in prisons as community. Conclusion: There are opportunities to improve OUD care in the Nordics. Policy makers and clinicians can advance OUD care and share common success factors. Collaborative work across the Nordic countries is valuable. Further research in clinical practice development can yield important results for the benefit of patients with OUD.
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Sivolap, Yury P. "Opioid crisis in the USA and Canada: how and why did this happen?" Neurology Bulletin LV, n.º 4 (15 de janeiro de 2024): 18–24. http://dx.doi.org/10.17816/nb623231.
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In the last few decades, there has been an epidemic increase in opioid use disorder and fatal opioid overdose in the United States and Canada, which allows us to state the presence of an opioid crisis. The opioid epidemic is believed to have begun due to a significantly low threshold for prescribing narcotic analgesics to treat chronic pain. This subsequent tightening of medical opioid dispensation led to the resurgence of the unlawful drug market, which included heroin and fentanyl. The review article provides data from a special commission established with the supporting of Stanford University and The Lancet Journal to understand and overcome the opioid crisis in North America, as well as analyzes other literary sources.
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Li, Zhengyi, Xiangyu Du, Xiaojing Liao, Xiaoqian Jiang e Tiffany Champagne-Langabeer. "Demystifying the Dark Web Opioid Trade: Content Analysis on Anonymous Market Listings and Forum Posts". Journal of Medical Internet Research 23, n.º 2 (17 de fevereiro de 2021): e24486. http://dx.doi.org/10.2196/24486.
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Background Opioid use disorder presents a public health issue afflicting millions across the globe. There is a pressing need to understand the opioid supply chain to gain new insights into the mitigation of opioid use and effectively combat the opioid crisis. The role of anonymous online marketplaces and forums that resemble eBay or Amazon, where anyone can post, browse, and purchase opioid commodities, has become increasingly important in opioid trading. Therefore, a greater understanding of anonymous markets and forums may enable public health officials and other stakeholders to comprehend the scope of the crisis. However, to the best of our knowledge, no large-scale study, which may cross multiple anonymous marketplaces and is cross-sectional, has been conducted to profile the opioid supply chain and unveil characteristics of opioid suppliers, commodities, and transactions. Objective We aimed to profile the opioid supply chain in anonymous markets and forums via a large-scale, longitudinal measurement study on anonymous market listings and posts. Toward this, we propose a series of techniques to collect data; identify opioid jargon terms used in the anonymous marketplaces and forums; and profile the opioid commodities, suppliers, and transactions. Methods We first conducted a whole-site crawl of anonymous online marketplaces and forums to solicit data. We then developed a suite of opioid domain–specific text mining techniques (eg, opioid jargon detection and opioid trading information retrieval) to recognize information relevant to opioid trading activities (eg, commodities, price, shipping information, and suppliers). Subsequently, we conducted a comprehensive, large-scale, longitudinal study to demystify opioid trading activities in anonymous markets and forums. Results A total of 248,359 listings from 10 anonymous online marketplaces and 1,138,961 traces (ie, threads of posts) from 6 underground forums were collected. Among them, we identified 28,106 opioid product listings and 13,508 opioid-related promotional and review forum traces from 5147 unique opioid suppliers’ IDs and 2778 unique opioid buyers’ IDs. Our study characterized opioid suppliers (eg, activeness and cross-market activities), commodities (eg, popular items and their evolution), and transactions (eg, origins and shipping destination) in anonymous marketplaces and forums, which enabled a greater understanding of the underground trading activities involved in international opioid supply and demand. Conclusions The results provide insight into opioid trading in the anonymous markets and forums and may prove an effective mitigation data point for illuminating the opioid supply chain.
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Blum, Kenneth, Abdalla Bowirrat, Eric R. Braverman, David Baron, Jean Lud Cadet, Shan Kazmi, Igor Elman et al. "Reward Deficiency Syndrome (RDS): A Cytoarchitectural Common Neurobiological Trait of All Addictions". International Journal of Environmental Research and Public Health 18, n.º 21 (2 de novembro de 2021): 11529. http://dx.doi.org/10.3390/ijerph182111529.
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Alcohol and other substance use disorders share comorbidity with other RDS disorders, i.e., a reduction in dopamine signaling within the reward pathway. RDS is a term that connects addictive, obsessive, compulsive, and impulsive behavioral disorders. An estimated 2 million individuals in the United States have opioid use disorder related to prescription opioids. It is estimated that the overall cost of the illegal and legally prescribed opioid crisis exceeds one trillion dollars. Opioid Replacement Therapy is the most common treatment for addictions and other RDS disorders. Even after repeated relapses, patients are repeatedly prescribed the same opioid replacement treatments. A recent JAMA report indicates that non-opioid treatments fare better than chronic opioid treatments. Research demonstrates that over 50 percent of all suicides are related to alcohol or other drug use. In addition to effective fellowship programs and spirituality acceptance, nutrigenomic therapies (e.g., KB220Z) optimize gene expression, rebalance neurotransmitters, and restore neurotransmitter functional connectivity. KB220Z was shown to increase functional connectivity across specific brain regions involved in dopaminergic function. KB220/Z significantly reduces RDS behavioral disorders and relapse in human DUI offenders. Taking a Genetic Addiction Risk Severity (GARS) test combined with a the KB220Z semi-customized nutrigenomic supplement effectively restores dopamine homeostasis (WC 199).
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Ahmedani, Brian K. "Policies and Events Affecting Prescription Opioid Use for Non-Cancer Pain Among an Insured Patient Population". Pain Physician 3;17, n.º 3;5 (14 de maio de 2014): 205–16. http://dx.doi.org/10.36076/ppj.2014/17/205.
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Background: Rising prescription opioid use and abuse have prompted widespread concern. However, to date there have been few rigorous investigations into the policies and events which may have contributed to these trends. Objective: This study investigates trends in opioid use and related adverse events among individuals with non-cancer pain before and after implementation of major national policies. Study Design: The study used a longitudinal prospective study design. The analysis was limited to adults (age ≥ 18 years) without a recorded cancer diagnosis. Pharmacy claims were used to assess rates of prescription opioid use, the strength of opioids dispensed, the proportion using opioids chronically, and related adverse events. Time trend analysis was used to identify changes in these rates over time. The study was Institutional Review Board approved. Setting: Study patients were members of a large, health maintenance organization in southeast Michigan, with longitudinal records of prescription opioid use. Results: The analysis comprised 523,623 individuals and 1,066,700 opioid pharmacy fills from January 1, 1997, to December 31, 2011. Contemporaneous with the implementation of health organization accreditation criteria requiring assessment and treatment of pain in all patients beginning January 2001, we observed a consistent and unabated increase in the rate of opioid fills and the proportion of chronic use. A parallel increase in the annual rate of adverse events was also observed. Similarly, we observed a continuous rise in the average strength of opioid fills following January 2001 with the exception of a single drop in December 2010, which was attributable to the withdrawal of propoxyphene from the U.S. market. Limitations: This was an observational study and not a trial. Other long-term opioid-related benefits or harms, including functional status, quality of life, and substance use disorder, were not assessed. Conclusions: This study provides temporal evidence for a rise in prescription opioid use after implementation of health organization accreditation criteria requiring standardized management of all individuals with pain. Key words: Opioid analgesics, chronic pain, chronic drug use, prescription drugs, pain management, propoxyphene, Joint Commission, adverse drug events, morphine dose equivalents, opioid epidemic
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Renfro, Mandy L., Lindsey J. Loera, Carlos F. Tirado e Lucas G. Hill. "Lofexidine for acute opioid withdrawal: A clinical case series". Mental Health Clinician 10, n.º 5 (1 de setembro de 2020): 259–63. http://dx.doi.org/10.9740/mhc.2020.09.259.
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Abstract Introduction Maintaining abstinence through the opioid withdrawal period is a substantial barrier to treatment for patients with opioid use disorder. The alpha-2 agonist lofexidine has demonstrated efficacy and safety in clinical trials, but pragmatic studies describing its use in clinical practice are lacking. This case series describes the use of lofexidine for opioid withdrawal symptoms in an inpatient addiction treatment facility. Methods Seventeen patients receiving at least 1 dose of lofexidine during inpatient treatment for opioid withdrawal were included in this study. A retrospective chart review was conducted for clinical, subjective, and objective data. Adverse events, total daily dose, clinical opioid withdrawal scale (COWS) scores, vital signs, and reasons for early discontinuation of lofexidine are reported. Results Patients treated with lofexidine experienced mild withdrawal symptoms throughout treatment. Most patients (65%) experienced a decrease in their average daily COWS scores from intake to discharge. Two patients (12%) left treatment against medical advice, and 5 patients (29%) discontinued treatment prior to day 7 due to resolution of symptoms. Average daily blood pressure readings remained stable, and daily average heart rate decreased over time. Discussion Lofexidine can be successfully incorporated into a conventional withdrawal management protocol. The cost of lofexidine and its recent introduction to the market remain barriers to accessibility in the United States. Studies evaluating patient-reported outcomes as well as direct comparisons with other alpha-2 agonists are needed to inform optimal clinical use of lofexidine.
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Trinidad, Antolin C., e Benjamin Bregman. "Pharmacotherapy of Major Depressive Disorder: Focus on Desvenlafaxine Succinate". Clinical Medicine Insights: Therapeutics 2 (janeiro de 2010): CMT.S74. http://dx.doi.org/10.4137/cmt.s74.
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The newest antidepressant, desvenlafaxine (DVS) was approved by the FDA in early 2008 and since then, has been available in the market for general use. DVS is dual acting, a serotonin-norepinepherine reuptake inhibitor (SNRI). Like its parent compound, venlafaxine (VEN), DVS inhibits the neuronal re-uptake of both serotonin and norepinepherine while having minimal affinity for muscarinic cholinergic, H1-histaminergic, alpha1-adrenergic and opioid receptors. DVS is moderately effective for MDD at doses ranging from 100–400 milligrams per day. Its possible advantage is its lower risk of drug-drug interaction. There is no extant evidence that it is especially effective over and above the other existing antidepressants. Its niche will be defined by time but one speculation, given preliminary but un-replicated proof of its efficacy in vasomotor instability in peri-menopause, is that it may have a future utility for depressed women entering menopause.
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Nakamoto, Carter H., Haiden A. Huskamp, Julie M. Donohue, Michael L. Barnett, Adam J. Gordon e Ateev Mehrotra. "Medicare Payment for Opioid Treatment Programs". JAMA Health Forum 5, n.º 7 (19 de julho de 2024): e241907. http://dx.doi.org/10.1001/jamahealthforum.2024.1907.
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ImportanceMedicare began paying for medications for opioid use disorder (MOUD) at opioid treatment programs (OTPs) that dispense methadone and other MOUD in January 2020. There has been little research describing the response to this payment change and whether it resulted in more patients receiving MOUD or just a shift in who pays for this care.ObjectiveTo describe how many and which Medicare beneficiaries receive care from OTPs and how this compares to those receiving MOUD in other settings.Design, Setting, and ParticipantsThis cross-sectional study included all patients receiving MOUD care identified in 2019-2022 100% US Medicare Parts B and D claims. Patients receiving care in an OTP who were dually insured with Medicare and Medicaid in the 2019-2020 Transformed Medicaid Statistical Information System were also included.ExposureReceiving MOUD care in an OTP.Main Outcomes and MeasuresComparisons of 2022 beneficiaries treated in OTPs vs other non-OTP settings in 2022.ResultsThe share of Medicare beneficiaries treated by OTPs rose steadily from 4 per 10 000 (14 160 beneficiaries) in January 2020 to 7 per 10 000 (25 596 beneficiaries) in August 2020, then plateaued through December 2022; of 38 870 patients (23% ≥66 years; 35% female) treated at an OTP in 2022, 96% received methadone. Patients in OTPs, compared to those receiving MOUD in other settings, were more likely be 65 years and younger (65% vs 62%; P < .001), less likely to be White (72% vs 82%; P < .001), and more likely to be an urban resident (86% vs 74%; P < .001). When Medicare OTP coverage began, there was no associated drop in the number of dually insured patients with Medicaid with an OTP claim. Of the 1854 OTPs, 1115 (60%) billed Medicare in 2022, with the share billing Medicare ranging from 13% to 100% across states.Conclusions and RelevanceThis study showed that since the initiation of Medicare OTP coverage in 2020, there has been a rapid increase in the number of Medicare beneficiaries with claims for OTP services for MOUD, and most OTPs have begun billing Medicare. Patients in OTPs were more likely to be urban residents and members of racial or ethnic minority groups than the patients receiving other forms of MOUD.
Livros sobre o assunto "Opioid Use Disorder Market Share"
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Opioid Use Disorder Market. https://www.fortunebusinessinsights.com/opioid-use-disorder-oud-market-102674, 2020.
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Butler, Jay C., e Michael R. Fraser, eds. A Public Health Guide to Ending the Opioid Epidemic. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190056810.001.0001.
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Few contributions to the field concerning the current opioid crisis in the United States focus sufficient attention on the public health aspects of the epidemic and share examples that practitioners can use to prevent opioid use disorder and the broader issues of substance misuse and addiction. A great deal of prior published work has concentrated on health care and clinical perspectives related to the crisis, including developing prescribing guidelines, enhancing prescription drug monitoring programs, scaling up access to overdose reversal medication, and making medication-assisted treatment more widely available nationwide. This book adds to and complements this prior work by addressing the central tenets of the public health approach to the opioid crisis. Topics include how to best support community-based, primary prevention of substance misuse and addiction in various settings with diverse populations and how to effectively address the cultural, social, and environmental aspects of health that are driving the epidemic. Chapters describe how governmental public health agencies play a significant role in responding to the epidemic, in both public health’s traditional approach to disease surveillance and control and contemporary approaches to health promotion that include building community resilience, addressing the impact of adverse childhood events, and mitigating the root causes of addiction community-wide. This volume can be used to explore what it means to address primary prevention of addiction and how public health practitioners have led efforts to promote “opioid stewardship” at the local, state, and federal levels.