Articles related to OPIOIDS

The I-WOTCH trial offers insightful findings on multimodal interventions for opioid-dependent chronic pain patients. Read on for a detailed examination of the trial’s significant impact on patient wellbeing and opioid cessation.

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 […]

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.”

Originally published in JAMA Psychiatry, a broad-based study shows nearly 7% of OUD patients are adding buprenorphine to urine sample to fake treatment adherence. Buprenorphine spiking suggests to the physician that the treatment plan is not working—especially in patients continuing illicit drug use.