Review
Pharmacology & Pharmacy
Simona Zaami, Silvia Graziano, Roberta Tittarelli, Renata Beck, Enrico Marinelli
Summary: Benzodiazepines and Z-drugs are widely used medications for the treatment of various conditions, but they also pose risks of abuse and dependence. The non-medical use of BDZs has become a serious public health issue, and the new synthetic BDZs may carry high risks for users.
CURRENT PHARMACEUTICAL DESIGN
(2022)
Review
Biochemistry & Molecular Biology
Stefania Chiappini, Alessio Mosca, Andrea Miuli, Francesco Maria Semeraro, Gianluca Mancusi, Maria Chiara Santovito, Francesco Di Carlo, Mauro Pettorruso, Amira Guirguis, John Martin Corkery, Giovanni Martinotti, Fabrizio Schifano, Massimo Di Giannantonio
Summary: This study reviewed the misuse of centrally acting anticholinergics, highlighting its widespread and popular nature. Healthcare professionals should be vigilant and monitor potential misusing issues due to the associated adverse effects.
Article
Clinical Neurology
Jeffrey F. Scherrer, Joanne Salas, Richard Grucza, Mark D. Sullivan, Patrick J. Lustman, Laurel A. Copeland, Jane C. Ballantyne
Summary: Patients with depression and chronic pain and POD used BUP less frequently and were more likely to experience >30 day gaps in BUP treatment, indicating a potential association between depression and early dropout from BUP treatment.
JOURNAL OF AFFECTIVE DISORDERS
(2021)
Article
Medicine, General & Internal
Max Jordan Nguemeni Tiako, Abby Dolan, Matthew Abrams, Kehinde Oyekanmi, Zachary Meisel, Shoshana V. Aronowitz
Summary: This qualitative study examines the prior authorization requirements for Medicaid payment for buprenorphine in all 50 US states. The study finds that these requirements often include patient surveillance, behavioral health treatment recommendations, patient education, and dosing guidance. These findings suggest that the bureaucratic burdens of prior authorization may limit access to buprenorphine for opioid use disorder.
Article
Substance Abuse
Madelyn J. McDonald, Angela M. DeVeaugh-Geiss, Howard D. Chilcoat, Jennifer R. Havens
Summary: This study examined motivations for nonprescribed buprenorphine use among rural residents. Results showed that many individuals used buprenorphine without a prescription for self-treatment purposes rather than to get high. The findings highlight the need to provide targeted care for those with opioid use disorder in rural areas to address the opioid crisis.
JOURNAL OF ADDICTION MEDICINE
(2023)
Article
Neurosciences
Joseph Sadek
Summary: Attention deficit hyperactivity disorder (ADHD) assessment is challenging due to malingering or feigning of symptoms, as well as the abuse and diversion of stimulant medication. Recent literature suggests several reasons for malingering and faking ADHD symptoms, including obtaining drugs for performance enhancement, accessing additional services and benefits, recreational use, and illegal selling. Self-report rating measures have proven to be easily simulated by patients without ADHD, making it difficult to detect false positives. This article highlights clinical factors for detecting malingering during ADHD assessment and discusses available tests.
Article
Oncology
Katie Fitzgerald Jones, Dmitry Khodyakov, Robert Arnold, Hailey Bulls, Emily Dao, Jennifer Kapo, Diane Meier, Judith Paice, Jane Liebschutz, Christine Ritchie, Jessica Merlin
Summary: This qualitative study aims to establish consensus among palliative care and addiction specialists on the appropriateness of various opioid management strategies in individuals with advanced cancer-related pain and opioid misuse or OUD. The findings provide urgently needed guidance for clinicians and highlight critical research and policy gaps.
Article
Medicine, General & Internal
Julie M. Donohue, Marian P. Jarlenski, Joo Yeon Kim, Lu Tang, Katherine Ahrens, Lindsay Allen, Anna Austin, Andrew J. Barnes, Marguerite Burns, Chung-Chou H. Chang, Sarah Clark, Evan Cole, Dushka Crane, Peter Cunningham, David Idala, Stefanie Junker, Paul Lanier, Rachel Mauk, Mary Joan McDuffie, Shamis Mohamoud, Nathan Pauly, Logan Sheets, Jeffery Talbert, Kara Zivin, Adam J. Gordon, Susan Kennedy
Summary: The study found that the prevalence of medication use for the treatment of opioid use disorder among Medicaid enrollees in 11 states in the US increased from 2014 through 2018. Further research is needed to understand the situation in other states.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Medicine, General & Internal
Elizabeth J. Austin, Jessica Chen, Elsa S. Briggs, Lori Ferro, Paul Barry, Ashley Heald, Joseph O. Merrill, Geoffrey M. Curran, Andrew J. Saxon, John C. Fortney, Anna D. Ratzliff, Emily C. Williams
Summary: This study explores the experiences and perspectives of multidisciplinary primary care (PC) teams in initiating or expanding medication for opioid use disorder (MOUD). The results suggest that PC teams face challenges in providing rapid access to care and engaging patients with MOUD, as well as maintaining clinician confidence. Attitudes towards MOUD expansion vary among PC teams. The study highlights the need for flexibility in appointment scheduling, effective patient engagement, and ongoing training to address evolving opioid-related clinical issues.
Review
Pharmacology & Pharmacy
Joao P. De Aquino, Suprit Parida, Mehmet Sofuoglu
Summary: Expanding access to buprenorphine for opioid-use disorder treatment has increased healthcare system capacity but starting this medication poses significant challenges. Microinduction, a novel approach utilizing buprenorphine's pharmacological profile, shows promise in improving clinical outcomes for patients with OUD by potentially circumventing the need for prolonged opioid tapers and reducing the risk of precipitated withdrawal. Despite diverse evidence, including variable buprenorphine formulations and dosages, preliminary data support the feasibility of microinduction and offer new insights for future research in pharmacotherapy development.
CLINICAL DRUG INVESTIGATION
(2021)
Article
Medicine, General & Internal
Xubin Zheng, Li Wang, Lina Davies Forsman, Yangyi Zhang, Yuhang Chen, Xuejiao Luo, Yidian Liu, Judith Bruchfeld, Yi Hu, Jan-Willem C. Alffenaar, Wei Sha, Biao Xu
Summary: This study aims to investigate the drug exposure distribution for key antimycobacterial drugs in patients with MAC lung disease and analyze the relationship between drug exposure and treatment outcome.
Article
Pediatrics
Monica Sarfi, Marie Eikemo, Carolien Konijnenberg
Summary: In this study, the researchers followed 36 women enrolled in an opioid maintenance treatment program and their children, comparing them with 36 age-matched mother-child pairs from a community sample. The study found significantly different trajectories of child behavior problems and parenting stress between the opioid maintenance treatment group and the comparison group. The long-term direct effects of prenatal opioid exposure on behavior problems are likely modest, given a stable caregiving environment conducive to healthy development.
FRONTIERS IN PEDIATRICS
(2022)
Article
Medicine, General & Internal
Tara Gomes, Tonya J. Campbell, Sophie A. Kitchen, Ria Garg, Nikki Bozinoff, Siyu Men, Mina Tadrous, Charlotte Munro, Tony Antoniou, Dan Werb, Jennifer Wyman
Summary: A retrospective cohort study in Ontario, Canada during the COVID-19 pandemic found that providing increased take-home doses of opioid agonist therapy was associated with lower risks of treatment interruption and discontinuation. The study did not show a significant increase in opioid-related overdoses over 6 months of follow-up.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)
Review
Anesthesiology
Garrett W. Burnett, Amir Taree, Lily Martin, Ethan O. Bryson
Summary: This study aimed to describe the demographic characteristics of medical professionals misusing propofol and the outcomes associated with such misuse. Anesthesiologists and certified registered nurse anesthetists were commonly identified as misusers. Death was a common indication of misuse, while rehabilitation and death were common final outcomes associated with propofol misuse.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Review
Pharmacology & Pharmacy
Kirk E. Evoy, Sarvnaz Sadrameli, Jillian Contreras, Jordan R. Covvey, Alyssa M. Peckham, Megan D. Morrison
Summary: The studies confirm a rising trend of gabapentinoid misuse/abuse, leading to significant patient harm.
Article
Neurosciences
Marion A. Coe, Michelle R. Lofwall, Victoria Vessels, Paul A. Nuzzo, Sharon L. Walsh
Summary: This study found that the NK1 antagonist tradipitant did not significantly attenuate the abuse liability and analgesic effects of oxycodone in opioid-experienced individuals, and had minimal impact on the main effects of oxycodone. This suggests that NK1 antagonists may not be a useful treatment for opioid use disorder.
PSYCHOPHARMACOLOGY
(2021)
Article
Substance Abuse
Elisabeth D. Root, Svetla Slavova, Marc LaRochelle, Daniel J. Feaster, Jennifer Villani, Jolene Defiore-Hyrmer, Nabila El-Bassel, Rosa Ergas, Kitty Gelberg, Rebecca Jackson, Kara Manchester, Megha Parikh, Peter Rock, Sharon L. Walsh
Summary: The national stay-at-home order had different impacts on emergency department encounters for suspected opioid overdose in Massachusetts, New York, and Ohio. These states experienced statistically significant declines in the rate of ED encounters for suspected opioid overdose after the declaration of the national public health emergency for COVID-19. However, the trends in ED encounters varied between the states, with some experiencing sustained increases in the rate of encounters post-declaration.
DRUG AND ALCOHOL DEPENDENCE
(2021)
Article
Neurosciences
Shanna Babalonis, Sandra D. Comer, Jermaine D. Jones, Paul Nuzzo, Michelle R. Lofwall, Jeanne Manubay, Kevin W. Hatton, Robert A. Whittington, Sharon L. Walsh
Summary: This pilot study compared the IV abuse potential of the mu opioid analgesic oxymorphone with other opioids in individuals with opioid use disorder. The results showed that oxymorphone was more potent in terms of drug liking and respiratory depression compared to hydromorphone and oxycodone. Despite the small sample size, the study detected robust effects of oxymorphone, suggesting its higher abuse potential relative to other opioids.
PSYCHOPHARMACOLOGY
(2021)
Article
Medicine, General & Internal
Jennifer R. Havens, Takako Schaninger, Hannah Fraser, Michelle Lofwall, Michele Staton, April M. Young, Ardis Hoven, Sharon L. Walsh, Peter Vickerman
Summary: The Kentucky Viral Hepatitis Treatment Study (KeY Treat) aims to eliminate HCV transmission in a county in Appalachian Kentucky by removing barriers to accessing HCV treatment. This phase IV, open-label, single-arm clinical trial provides free pharmacologic treatment and medical care to viraemic HCV infected residents, with the goal of assessing treatment effectiveness and eliminating HCV transmission.
Article
Public, Environmental & Occupational Health
Svetla Slavova, Patricia R. Freeman, Peter Rock, Candace Brancato, Sarah Hargrove, Madison Liford, Dana Quesinberry, Sharon L. Walsh
Summary: The increasing drug overdose mortality among non-Hispanic Black people in the United States in the past 5 years underscores the need for tailored programs and services. The study in Kentucky reveals that opioid-involved overdose deaths have been rising among non-Hispanic Black residents, along with a significant increase in psychostimulant involvement. Understanding the social, cultural, and illicit market circumstances driving these trends is crucial for effective drug overdose prevention efforts.
PUBLIC HEALTH REPORTS
(2023)
Article
Psychology, Clinical
Robyn Lewis Brown, Evan Batty, Michelle Lofwall, Marc Kiviniemi, Amber Kizewski
Summary: This study examined two measures, one for public stigma towards opioid misuse and another for clinician stigma associated with medication for opioid use disorder (MOUD). The results suggest that both measures are reliable and valid for assessing bias among healthcare providers in relation to opioid misuse and MOUD treatment.
AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE
(2022)
Article
Psychiatry
Jennifer R. Havens, Hannah K. Knudsen, Justin C. Strickland, April M. Young, Shanna Babalonis, Michelle R. Lofwall, Sharon L. Walsh
Summary: The study found that there has been a significant increase in methamphetamine use among rural people who use drugs in Appalachian Kentucky over the past decade, particularly in recent years. In contrast, nonmedical prescription opioid use and heroin use have decreased during the same time period. These findings highlight the dual epidemics of methamphetamine use and nonmedical opioid use and emphasize the need for effective treatment options for methamphetamine use disorder.
FRONTIERS IN PSYCHIATRY
(2022)
Article
Substance Abuse
Hannah K. Knudsen, Jeanie Hartman, Sharon L. Walsh
Summary: Research findings suggest that the impact of Medicaid expansion on buprenorphine utilization varies depending on the type of payer, with overall Medicaid expansion not significantly affecting buprenorphine utilization.
DRUG AND ALCOHOL DEPENDENCE
(2022)
Article
Health Care Sciences & Services
Feitong Lei, Michelle R. Lofwall, Patricia R. Freeman, Emily Slade, Rachel Vickers-Smith, Svetla Slavova
Summary: With the COVID-19 pandemic, access to opioid use disorder (OUD) treatment becomes crucial. After the national COVID-19 emergency declaration, there were fluctuations in transmucosal buprenorphine prescribing rates in Kentucky, but eventually increased. Rural and urban residents showed differences in prescribing rates and unique patients with prescriptions.
JOURNAL OF RURAL HEALTH
(2023)
Article
Substance Abuse
Robyn Lewis Brown, Evan Batty, Michelle Lofwall, Marc Kiviniemi, Amber Kizewski
Summary: This study reveals the presence of stigma among healthcare providers as a significant barrier in treating patients with opioid use disorder (OUD). Providers who are less familiar with OUD and medication for opioid use disorder (MOUD), as well as medical students or residents, are more likely to hold stigmatizing views towards illicit opioid use. Moreover, higher levels of stigma are associated with a decreased willingness to provide or refer patients to MOUD treatment.
PSYCHOLOGY OF ADDICTIVE BEHAVIORS
(2023)
Article
Medicine, General & Internal
April M. Young, Jennifer L. Brown, Timothy Hunt, Linda S. Sprague Martinez, Redonna Chandler, Emmanuel Oga, T. John Winhusen, Trevor Baker, Tracy Battaglia, Rachel Bowers-Sword, Amy Button, Amanda Fallin-Bennett, Laura Fanucchi, Patricia Freeman, LaShawn M. Glasgow, Jennifer Gulley, Charles Kendell, Michelle Lofwall, Michael S. Lyons, Maria Quinn, Bruce David Rapkin, Hilary L. Surratt, Sharon L. Walsh
Summary: This paper describes a protocol for the Communities That HEAL intervention, which aims to support communities in expanding the uptake of evidence-based practices to reduce opioid-involved overdose deaths. The protocol outlines the process through which community coalitions select strategies to implement these practices locally.
Article
Substance Abuse
Redonna Chandler, Edward Nunes, Sylvia Tan, Patricia R. Freeman, Alexander Y. Walley, Michelle Lofwall, Emmanuel Oga, LaShawn Glasgow, Jennifer L. Brown, Laura Fanucchi, Donna Beers, Timothy Hunt, Rachel Bowers-Sword, Carter Roeber, Trevor Baker, T. John Winhusen
Summary: The HEALing Communities Study aims to reduce overdose deaths in highly impacted communities by implementing evidence-based practices. The ORCCA organizes strategies under three menus: OEND, MOUD, and SPDP. This paper examines strategy selection and tests two hypotheses related to OEND and MOUD strategies.
DRUG AND ALCOHOL DEPENDENCE
(2023)
Article
Infectious Diseases
Laura C. Fanucchi, Sean M. Murphy, Hilary Surratt, Shashi N. Kapadia, Sharon L. Walsh, James A. Grubbs, Alice C. Thornton, Paul Nuzzo, Michelle R. Lofwall
Summary: This study evaluates the efficacy and cost-effectiveness of an integrated care model combining Buprenorphine treatment of OUD with OPAT for SIRI (B-OPAT) compared with treatment as usual. The study is a single-site, randomized, parallel-group, superiority trial.
THERAPEUTIC ADVANCES IN INFECTIOUS DISEASE
(2022)
Article
Criminology & Penology
Michele Staton, Hannah K. Knudsen, Sharon L. Walsh, Carrie Oser, Erika Pike, Michelle Lofwall
Summary: This study illustrates the adaptation of XR-NTX protocol in a non-traditional community criminal justice setting using the ADAPT-ITT framework, as well as the expansion of services by a local FQHC provider. Findings suggest critical adaptations are needed in both content and context of the existing protocol for initiating XR-NTX in the jail and continuing administrations in the community.