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Naloxone - Europe PMC

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Last Updated: 13 August 2022

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Outpatient Opioid and Naloxone Prescribing Practices at an Academic Medical Center during the COVID-19 Pandemic.

Although improving opioid availability has been a national priority, the coronavirus disease 2019 pandemic has been linked to an increase in opioid use. Adult patients receiving opioid therapy from outpatient clinics within a Texas health system from August 2020 to October 2020 were included in a retrospective chart review. During the study period, 1,368 patients received an opioid prescription, the majority of which were prescribed for chronic pain management. Although 31. 1% of patients were given gabapentinoid prescriptions, only 1% received benzodiazepine or Z-hypnotic prescriptions. During the COVID-19 pandemic, naloxone was rarely prescribed for outpatients receiving opioid prescriptions.

Source link: https://europepmc.org/article/MED/35916655


Patient Satisfaction With Standard Methadone and Flexible Buprenorphine/Naloxone Models of Care: Results From a Pragmatic Randomized Controlled Clinical Trial.

Introduction Patient satisfaction is a key indicator of quality of care across health professions because it can influence clinical outcomes. Objectives This study was designed to investigate longitudinal patient satisfaction in people with opioid use disorder, according to participants who were randomly assigned either standard methadone or flexible buprenorphine/naloxone models of care, their predictors, and relationship with dropout/illicit drug use. Methods This research looked at patient satisfaction as a secondary result of a large phase IV pragmatic randomized controlled trial involving a large phase IV pragmatic randomized controlled trial. Patients with prescription-type OUD were compared to a standard methadone model of care in patients with flexible take-home buprenorphine/naloxone dispensation strategy. Patients with OUD on either standard methadone or flexible buprenorphine were generally satisfied with their treatment, with no difference in patient satisfaction based on treatment allocation.

Source link: https://europepmc.org/article/MED/35916430


Buprenorphine-naloxone versus Buprenorphine for Treatment of Opioid Use Disorder in Pregnancy.

Objects data regarding pregnancy relief using buprenorphine-naloxone are limited. Methods This single-center, retrospective cohort research looked at birthing person-infant dyads treated with BUP-NX versus BUP. The primary birthing individual's outcome was a return to opioid use in pregnancy. The most notable neonatal result was the need for pharmacologic intervention for neonatal opioid withdrawal syndrome. respectively, the Bup-NX and BUP treatment groups contained 33 and 73 dyads. In the final regression models, neither the birthing individual nor the neonatal outcomes differed. There was no proximate return to use or a requirement for dose increase among a subgroup of people who went from BUP to BUP-NX mid-pregnancy from BUP to BUP-NX mid-pregnancy in a subgroup of patients transitioned from BUP to BUP-NX mid-pregnancy among a subgroup of people who went from BUP to BUP-NX mid-pregnancy in a subgroup of BUP-NX mid-Bup to use or need for dose increase or requirement for dose increase for dose increase in a subgroup of people who went from BUP-NX mid-NX mid-BUP-NX mid-NX mid-pregnancy. NOWS-Pett notwithstanding BUP-NX's pregnancy is not associated with a higher risk of opioid use or a higher demand for pharmacological care in comparison to BUP-NX.

Source link: https://europepmc.org/article/MED/35916423


Successful Buprenorphine/Naloxone Low-dose Induction in Pregnancy: A Case Report.

Background with methadone or buprenorphine/naloxone is a prescription for opioid use disorder in pregnant women with OUD. Patients must be in moderate withdrawal before the first dose of medication in order to reduce the likelihood of precipitated withdrawal, according to Traditional buprenorphine/naloxone induction. In 2016, a low-dose buprenorphine "microinduction" strategy was introduced, but it involves giving small doses of buprenorphine to patients for whom opioid withdrawal was not appropriate. Case description A 24-year-old woman with a severe heroin and stimulant use disorder began on buprenorphine/naloxone in her first pregnancy and developed a low-dose induction method. Discussion This is the first documented case of successful buprenorphine/naloxone low-dose induction in pregnancy. Patients who present in withdrawal are still needing traditional buprenorphine/naloxone induction. This is a new way of introducing medications for OUD, which may have a better choice and collaboration between health care professionals and women affected by substance use in pregnancy.

Source link: https://europepmc.org/article/MED/35916416


The Naloxone Component of Buprenorphine/Naloxone: Discouraging Misuse, but at What Cost?

Since opioid use disorder suffers in the United States, opioid overdose deaths in the United States continue to rise, it is critical to increase patient access to buprenorphine, which treats opioid use disorder and reduces mortality. A poorly connected buprenorphine therapy is the main obstacle to buprenorphine therapy, according to undercover barrier to buprenorphine therapy. buprenorphine monoproduct: Because naloxone has such low sublingual bioavailability in comparison to buprenorphine, adverse effects are typically mild and rare.

Source link: https://europepmc.org/article/MED/35913990


Design details for overdose education and take-home naloxone kits: Codesign with family medicine, emergency department, addictions medicine and community.

Introduction Overdose education and naloxone delivery services support people who are likely to experience an opioid crisis in order to provide first aid services in a safe way. Despite OEND's expansion into North America, overdose rates are on the rise, prompting concerns about how to develop OEND services. Methods We invited people who use opioids, frontline healthcare providers, and public health officials to attend codesign workshops on topics relating to THN-kit prototypes, instruction on how to use it, and deployment, including refinement of design artefacts using personas and journey maps, among other things. Results We hosted 13 codesign workshops to discover and address gaps in existing opioid education and THN-kits, as well as emphasize timely response and stigma in future THN-kit development. The THN-kit includes an integrated solution that includes ultra-brief training animation and physical packaging of nasal naloxone in family practice clinics, emergency services, addiction medicine clinics, and community settings.

Source link: https://europepmc.org/article/MED/35909312


Legal review of state emergency medical services policies and protocols for naloxone administration.

We wanted to collect comprehensive information on one such initiative: the ability of physicians at various emergency medical services licensure levels to administer naloxone. Emergency medical technician, advanced emergency medical technician, and paramedic are among the requirements regulated by We coded pertinent rules defining which, if any, administration routes and dosages of naloxone are allowed for each licensure level: emergency medical technician, emergency medical technician, and paramedic. Up from only two in 2013, thirty-nine states with an EMR licensure level and statewide protocol authorize naloxone administration by EMRs. Pervasive routes of administration have increased across all EMS provider levels, offering advanced life support companies with increased flexibility; however, authorization for intravenous and intramuscular administration remains relatively rare for basic life support providers. Conclusions Naloxone administration control is now widely distributed to EMS providers, according to EMS representatives. Most states now authorize naloxone at any licensed EMS provider level, a significant rise in EMRs and EMTs since 2013.

Source link: https://europepmc.org/article/MED/35932751


Treatment retention in opioid agonist therapy: comparison of methadone versus buprenorphine/naloxone by analysis of daily-witnessed dispensed medication in a Canadian Province.

Background The last decade has seen a dramatic rise in illicit opioid use in Canada and internationally, as well as large rises in opioid related morbidity and mortality. The aim of this review is to identify the relative success of first episode opioid replacement therapy between methadone and buprenorphine/naloxone for patients receiving daily dispensed medications in Nova Scotia. Methods A longitudinal descriptive research looked at secondary data from the Nova Scotia Prescription Monitoring Program on patients 18 years of age and older who started first episode opioid agonist therapy with methadone or buprenorphine/naloxone for opioid use disorder in Nova Scotia between 2014 and 2018. The date of the first opioid agonist prescription was not announced until there is a gap of greater than six days without getting opioid agonist medication at a pharmacy. Buprenorphine/naloxone use as compared to methadone led to an elevated risk of treatment fallout by 62%, according to a multivariate cox proportional hazards model. Patients under the age of 25 were treated with buprenorphine/naloxone for 37. 5 days, and methadone for patients was 69 days. Conclusions Our results show that methadone is a numerically superior drug for opioid use disorder when the metric of treatment retention is considered in isolation for our population in Nova Scotia. Patients with an opioid use disorder must start with these three medications.

Source link: https://europepmc.org/article/MED/35908052


Risk factors for opioid toxicity requiring naloxone rescue in adults: a case-control study.

Opioid-induced sedation and respiratory depression is a potentially life-threatening side effect of opioid analgesia. Aim In patients admitted to a large regional health board in New Zealand-Auckland District Health Board, the risk factors for OSRD in patients admitted to a large regional health board. Those that were prescribed opioids and received naloxone for OSRD were identified as cases, while others who had opioids but did not experience OSRD were considered controls. Compared to those exposed to opioids prior to hospital admission, the odds of experiencing OSRD were four times higher among opioid-nau00efve patients. A higher risk of OSRD was also associated with a higher serum creatinine level prior to the OSRD episode and a higher oral morphine milligram equivalent. Conclusion An elevated risk of OSRD was correlated with a higher OME, a higher serum creatinine level prior to the OSRD episode, and opioid naivety.

Source link: https://europepmc.org/article/MED/35896908


Disparities in naloxone prescriptions in a University Hospital during the COVID-19 pandemic.

In 2019 and 2020, the aim of this research was to determine the naloxone prescribing rate in patients with opioid use disorder at the University of Alabama at Birmingham Hospital. In 2019, 11,959 visits were made by 2962 unique patients with OUD, compared to 11,661 visits from 2,641 unique patients in 2020; 609 naloxone prescriptions were issued in 2019 and 619 in 2020. More naloxone prescriptions were provided to uninsured patients in 2020 in comparison to 2019, and more OUD patients were admitted to inpatient settings and received more naloxone prescriptions in the inpatient setting in 2020 than in 2019. Our findings also showed a lack of naloxone prescription; in black people and frequent users, a significant number of opioid-related emergency department visits and overdose deaths were noted.

Source link: https://europepmc.org/article/MED/35883136

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions