Articles related to OPIOIDS

Opvee Reverses Remifentail-induced Respiratory Depression Within 5 Minutes As the opioid crisis continues to evolve, so too does your arsenal of interventions. The FDA’s recent approval of Opvee, a nalmefene-based nasal spray, introduces a new tool for physicians in the fight against opioid overdose.

Understanding Xylazine: The Rising Challenge in Opioid Crisis Management As physicians, it’s crucial to stay informed about emerging drug threats. Xylazine, a powerful livestock tranquilizer mixed into fentanyl, is one such threat that’s gaining momentum.

This case study applies the newly revised CDC Clinical Practice Guideline for Prescribing Opioids for Pain to a patient with chronic neck pain. The patient, Joanna, is a 78-year-old woman who has undergone two neck surgeries and experiences worsening pain. Her pain ranges from 6 to 7 on average and can increase up to 8. She has tried various non-pharmacologic modalities, such as heat, ice, TENS, physical therapy, and massage therapy, but insurance limitations and cost have hindered her access to these treatments. Considering Joanna’s medical history, physical therapy and topical analgesics are identified as potential options. However, due to limitations and contraindications with other medications, the only feasible options for her are low-dose acetaminophen and topical analgesics. As a result, initiating a low-dose opioid therapy is considered appropriate, in addition to low-dose acetaminophen, OTC menthol and methyl salicylate cream, and a referral to physical medicine and rehabilitation. Before initiating opioids, the patient’s risk of side effects, including overdose, addiction, constipation, and hypogonadal axis suppression, should be discussed. Joanna’s Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) score indicates a risk class of 4 out of 7, with a 15% estimated probability of an opioid-induced respiratory depression event […]

A study using Medicare claims data examined racial and ethnic disparities in the use of medications for opioid use disorder (OUD) among fee-for-service beneficiaries in the United States. The study found that after an OUD-related event, such as an overdose or hospitalization, Black patients had lower rates of receiving medications to treat OUD compared to White patients. In the 180 days following the index event, Black patients received buprenorphine after 12.7% of events, while Hispanic patients received it after 18.7% of events and White patients after 23.3% of events. Similar patterns were observed with naloxone and benzodiazepines. These racial and ethnic differences in medication receipt did not change significantly from 2016 to 2019, and all groups had multiple ambulatory visits despite the disparities. The study highlights substantial and persistent racial and ethnic disparities in accessing medications for OUD among Medicare beneficiaries with disability. Black patients, in particular, had lower rates of receiving medications compared to White patients. These disparities remained consistent over time, suggesting that efforts to improve equity in medication access for OUD are needed. The findings emphasize the need to address systemic barriers and biases in healthcare delivery to ensure equal access to evidence-based treatments for OUD among […]

The Eat, Sleep, Console care approach dramatically reduced the number of days before infants with newborn opioid withdrawal syndrome were medically ready for discharge when compared to conventional care, without worsening specified unfavorable outcomes.

The study authors highlight that buprenorphine can be safely started in an emergency department without triggering withdrawal, even among individuals who use stronger opioids like fentanyl. They note, “this study provides further evidence that all emergency department physicians can and should be using buprenorphine to help individuals take the first steps into treatment and toward recovery.”