A systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling older adults the ageing global population and concomitant increase in the use of opioid analgesia have highlighted the need to evaluate the effectiveness of opioids for chronic pain in older people.a systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling people aged 65 years or more was conducted using PRISMA guidelines (...) . The databases MEDLINE, EMBASE, Pubmed and PsychINFO were searched. The quality of studies was assessed. Secondary aims were to assess correlates of opioid use and the decision-making processes of prescribers.seven studies were identified of low to high quality. The majority of older people experienced ongoing pain despite continuing opioid therapy. There were mixed results regarding benefits of opioids in terms of activities of daily living and social engagement. In nursing home residents, opioid use

Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Management Briefs eBrief-no166 -- Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Talk to the Veterans Crisis Line now An official website of the United States government Here's how you know The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're (...) eBrief-no166 -- Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain Health Services Research & Development Management eBrief no. 166 » Issue 166 January 2020 The report is a product of the VA/HSR&D Evidence Synthesis Program. Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain In response to the evolving public health crisis related to opioid use, many providers, health systems, and payers

is effective in treating opiate-induced respiratory depression, but is not as effective as IM naloxone. IN delivery of naxolone could reduce the risk of needl … R Chou et al. Ann Intern Med 167 (12), 867-875. 2017. PMID 29181532. - Review Higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in … AK Skulberg et al. Addiction 114 (5), 859-867. May 2019. PMID 30644628. Intranasal 1.4 mg naloxone (...) Effect of Intranasal vs Intramuscular Naloxone on Opioid Overdose: A Randomized Clinical Trial Effect of Intranasal vs Intramuscular Naloxone on Opioid Overdose: A Randomized Clinical Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health U.S

Multimodal opioid-sparing postoperative pain regimen compared with the standard postoperative pain regimen in vaginal pelvic reconstructive surgery: a multicenter randomized controlled trial Multimodal Opioid-Sparing Postoperative Pain Regimen Compared With the Standard Postoperative Pain Regimen in Vaginal Pelvic Reconstructive Surgery: A Multicenter Randomized Controlled Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set (...) to Collections Create a new collection Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Am J Obstet Gynecol Actions , 221 (5), 511.e1-511.e10 Nov 2019 Multimodal Opioid-Sparing Postoperative Pain Regimen Compared With the Standard Postoperative

Opioid Analgesia for Medical Abortion: A Randomized Controlled Trial

pain rises (Johannes et al ., 2010; Schofield, 2018) .10 Canadian Guidelines on Opioid Use Disorder Among Older Adults There are four alkaloid opioids (also called opiates) derived from opium that can be extracted from the poppy plant (Papaver somniferum): morphine, codeine, thebaine, and papaverine . Semi-synthetic opioids include hydromorphone and diacetylmorphine (heroin) . Synthetic mu opioid receptor agonists available by prescription in Canada for the management of pain include tramadol (...) Canadian guidelines on opioid use disorder among older adults Canadian Guidelines on Opioid Use Disorder Among Older Adults 2019 ccsmh.ca2 This publication is intended for information purposes only, and is not intended to be interpreted or used as a standard of medical practice. Best efforts were used to ensure that the information in this publication is accurate; however, the publisher and every person involved in the creation of this publication disclaim any warranty as to the accuracy

Associations Between Opioid Prescribing Patterns and Overdose Among Privately Insured Adolescents Little is known about the risk for overdose after opioid prescription. We assessed associations between the type of opioid, quantity dispensed, daily dose, and risk for overdose among adolescents who were previously opioid naive.Retrospective analysis of 1 146 412 privately insured adolescents ages 11 to 17 years in the United States captured in the Truven MarketScan commercial claims data set from (...) January 2007 to September 2015. Opioid overdose was defined as any emergency department visit, inpatient hospitalization, or outpatient health care visit during which opioid overdose was diagnosed.Among our cohort, 725 participants (0.06%) experienced an opioid overdose, and the overall rate of overdose events was 28 events per 100 000 observed patient-years. Receiving ≥30 opioid tablets was associated with a 35% increased risk for overdose compared to receiving ≤18 tablets (hazard ratio [HR] = 1.35

Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no160 -- Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Health Services Research & Development Management eBrief (...) no. 160 » Issue 160 October 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Brief: Managing Acute Pain in Patients Taking Medications for Opioid Use Disorder Acute pain management in patients with opioid use disorder (OUD) can be challenging due to several factors including increased pain sensitivity and higher opioid tolerance. Use of medications for OUD (MOUD) including methadone, buprenorphine/naloxone, or naltrexone adds to the complexity of acute pain management

Barriers and Facilitators to Use of Medications for Opioid Use Disorder Management Briefs eBrief-no159 -- Barriers and Facilitators to Use of Medications for Opioid Use Disorder Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no159 -- Barriers and Facilitators to Use of Medications for Opioid Use Disorder Health Services Research & Development Management eBrief no. 159 » Issue (...) 159 October 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Brief: Barriers and Facilitators to Use of Medications for Opioid Use Disorder As a component of VA’s overall response to the crisis of opioid-related morbidity and mortality, VA provides treatment for those with opioid use disorder (OUD; i.e. ICD-10 opioid dependence), a diagnosis made based on symptoms (i.e., drug cravings) and behaviors (i.e., inability to cut down or control substance use despite

Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients.To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain.For (...) this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched.Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also

Buprenorphine for Opioid Use Disorder: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Buprenorphine for Opioid Use Disorder: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Buprenorphine for Opioid Use Disorder: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Buprenorphine for Opioid Use Disorder: A Review of Comparative (...) Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Last updated: April 24, 2019 Project Number: RC1092-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of various buprenorphine or buprenorphine-naloxone (BUP-NAL) formulations versus other buprenorphine formulations for the treatment of opioid use disorder (OUD)? What is the clinical evidence regarding the safety of various

Buprenorphine for Opioid Use Disorders during Pregnancy: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Buprenorphine for Opioid Use Disorders during Pregnancy: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Buprenorphine for Opioid Use Disorders during Pregnancy: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Buprenorphine (...) for Opioid Use Disorders during Pregnancy: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines Last updated: May 9, 2019 Project Number: RC1111-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of various buprenorphine or buprenorphine-naloxone formulations versus other buprenorphine formulations for the treatment of opioid use disorders during pregnancy

Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder (...) : A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: July 31, 2019 Project Number: RC1150-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of buprenorphine-naloxone tablets compared with methadone

Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Last updated: June 28, 2019 Project Number (...) : RA1041-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the clinical effectiveness of prescribing opioids in smaller quantities for patients with chronic non-cancer pain? What are the evidence-based guidelines associated with opioid prescribing for patients with chronic non-cancer pain? Key Message One non-randomized study and three evidence-based guidelines were identified regarding short-term prescribing of opioids for patient with chronic non

Opioid Agonist Treatments for Opioid Use Disorders: A Rapid Qualitative Review Opioid Agonist Treatments for Opioid Use Disorders: A Rapid Qualitative Review | CADTH.ca Find the information you need Opioid Agonist Treatments for Opioid Use Disorders: A Rapid Qualitative Review Opioid Agonist Treatments for Opioid Use Disorders: A Rapid Qualitative Review Last updated: April 30, 2019 Project Number: RC1100-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result (...) type: Report Question How do people with opioid use disorders, and their health care providers, understand, communicate, and make decisions related to opioid agonist treatments? How have people with opioid use disorders experienced treatment with opioid agonists? What are their perspectives on and preferences for programs that offer opioid agonist treatments? How have health care providers who care for people with opioid use disorders experienced supporting opioid agonist treatment? What

Programs for the Treatment of Opioid Addiction in Canada Programs for the Treatment of Opioid Addiction in Canada | CADTH.ca Find the information you need Programs for the Treatment of Opioid Addiction in Canada Programs for the Treatment of Opioid Addiction in Canada Last updated: September 6, 2019 Project Number: ES0335-000 Product Line: Research Type: Device Result type: Report CADTH undertook an Environmental Scan to understand the current context surrounding opioid addiction programs (...) , including both opioid agonist therapies and other non-pharmacological programming, and care setting transitions across Canada. The key objectives of this Environmental Scan were to: describe the opioid addiction treatment programs that are currently available for use in Canada and internationally identify the recommended wait times for opioid addiction treatment programs in Canada summarize the factors influencing wait times for opioid addiction treatment programs in Canada identify the patient

Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Acute Pain: Clinical Effectiveness and Guidelines Last updated: June 14, 2019 Project Number: RA1039-000 Product Line: Research Type: Drug Report (...) Type: Reference List Result type: Report Question What is the clinical effectiveness of prescribing opioids in smaller quantities for patients with acute pain? What are the evidence-based guidelines associated with opioid prescribing for patients with acute pain? Key Message One systematic review of guidelines, two non-randomized studies, and four evidence-based guidelines were identified regarding smaller quantity opioid prescribing for acute pain. Files Rapid Response Reference List Published

Spread the Word: Widespread Distribution of Naloxone to Decrease Opioid-Related Deaths September 16, 2019 (en français) Love Tools for Practice? Want to see it in conference format? You're in luck! Visit the ACFP website for more information. Spread the Word: Widespread Distribution of Naloxone to Decrease Opioid-Related Deaths Clinical Question: Does population-based or programmatic provision of naloxone kits decrease the risk of opioid- related deaths in people who use opioids? Bottom Line (...) : Offering naloxone kits and overdose related education for people who use opioids and their community may decrease opioid related deaths by ~7 per 100,000 population over one year. Effectiveness is likely influenced by magnitude of opioid problem in a given community and other confounders (like co-ingestions, co- morbidities, type and dose of opioid used). Evidence: • Randomized controlled trial: o 1676 inmates being released from prison were randomized to kit with single dose naloxone versus

Buprenorphine (Buvidal) - for the treatment of opioid dependence Final Appraisal Recommendation Advice No: 1119 – September 2019 Buprenorphine (Buvidal ® ) 8 mg, 16 mg, 24 mg, 32 mg, 64 mg, 96 mg and 128 mg prolonged-release solution for subcutaneous injection Submission by Camurus AB In reaching the above recommendation AWMSG has taken account of the appraisal documentation prepared by the AWMSG Secretariat (reference number 3977), which includes the AWMSG Secretariat Assessment Report (ASAR (...) ), the Preliminary Appraisal Recommendation (PAR) and the applicant company’s response to the PAR, clinical expert opinion (where available), the views of patients/patient carers (where available) and the lay member perspective. This recommendation has been ratified by Welsh Government and will be considered for review every three years. Recommendation of AWMSG Buprenorphine (Buvidal ® ) is recommended as an option for use within NHS Wales for the treatment of opioid dependence within a framework of medical

Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder 4 August 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Medical Center Portland, OR Mark Helfand, MD, MPH, MS, Director Evidence Brief: Barriers and Facilitators to Use of Medication s for Opioid Use Disorder Authors: Katherine (...) report are welcome and can be sent to Nicole Floyd, Deputy Director, ESP Coordinating Center at Nicole.Floyd@va.gov. Recommended citation: Mackey K, Veazie S, Anderson J, Bourne D, and Peterson K. Evidence Brief: Barriers and Facilitators to Use of Medications for Opioid Use Disorder. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-009; 2009. Posted final reports