A prospective cohort study of prescription opioid use and change in generalized anxiety in non-cancer pain.

Comparison of 4 local anesthetic techniques for open radical cystectomy: A prospective, randomized controlled trial.

This study examined whether an organization's investment in opioid use disorder services complements or detracts from its capacity to provide alcohol use services. Using data from the 2022 National Survey of Accountable Care Organizations (N=200 respondents to alcohol-related questions), the authors estimated the percentage of organizations participating in accountable care organization contracts that provided alcohol-related services (brief counseling or medications), either by direct provision or via referral. They tested whether organizations offering buprenorphine for opioid use disorder were more or less likely to offer alcohol-related services. Most respondents (81%) reported that their organization provided brief counseling directly, but less than half (45%) provided medications for alcohol use disorder directly. Respondents providing buprenorphine (62%) had higher rates of alcohol-related service provision. Although medications for alcohol use disorder were provided less frequently than buprenorphine, no evidence suggests that treatment services for opioid use disorder crowded out those for alcohol use disorder.

Pain control and opioid use as a function of workflow in MRI-guided interstitial cervix brachytherapy.

Access to medications for opioid use disorder among primary care patients with homeless experience in the Department of Veterans Affairs.

Factors associated with higher inpatient opioid consumption after primary total knee arthroplasty: a retrospective tertiary centre analysis.

Mayo versus ankle block in minimally invasive hallux valgus surgery: A comparative study.

"If he did it, I can do it, too. I can change my life around": The social model of recovery within the context of recovery homes accepting residents prescribed medications for opioid use disorder.

Treatment and Referral of Youth With Opioid Addiction in the Pediatric Emergency Department: A Pilot Study.

Non-tobacco nicotine dependence is associated with increased postoperative pain and opioid requirement following arthroscopic rotator cuff repair.

Tobacco smoking and alcohol use disorder (AUD) are highly prevalent among individuals receiving medication for opioid use disorder (MOUD) treatment, yet their combined impact on treatment outcomes remains underexplored. This study investigates the differences in clinical profiles and treatment outcomes based on smoking and AUD status among individuals initiating MOUD. This secondary analysis utilized data from a multi-site randomized clinical trial (CTN-0027) evaluating the hepatotoxicity during 24 weeks of buprenorphine or methadone treatment. Participants were categorized into four groups based on baseline smoking and AUD status: Non-AUD/Non-smoker, Smoker Only, AUD Only, and AUD+Smoker. Clinical profiles and treatment outcomes were compared across groups. Among 973 participants (68.6% male, 70.5% White, mean age 37.5 years), 50% were Smoker Only, 16% AUD+Smoker, 8% AUD Only, and 27% Non-AUD/Non-smoker. Smoking prevalence was high (66%), while AUD prevalence was lower (24%). AUD+Smoker and AUD Only groups had significantly higher rates of additional substance use disorders (p < .01). However, treatment outcomes-measured by urinalysis results, retention, and completion-did not differ significantly across groups. Smoking and AUD status were not associated with poorer MOUD outcomes, but the high prevalence of smoking, and the clustering of additional substance use disorders among individuals with AUD suggest the need for integrated care. These findings support inclusion of adjunctive behavioral and public health interventions within MOUD programs. This study uniquely examines the joint impact of smoking and AUD on MOUD outcomes, offering insight into clinical complexity not previously explored in combination.

Should we be scoring pain differently for rib fractures? A comparison of two scoring systems.

Opioid agonist therapies (OAT) reduce adverse outcomes of illicit opioid use, with individual preferences potentially improving treatment outcomes. We explored preferences for OAT and associated factors in a national sample of people with opioid dependence. This cross-sectional study recruited 400 participants (October 2020-April 2021) across Australia (excluding Tasmania) through snowball sampling. Participants completed an interviewer-administered questionnaire on sociodemographic and drug use characteristics. Multivariable logistic regression assessed factors associated with methadone preference (vs. buprenorphine). Among all participants (median age 45, 41% female, 87% ever received OAT), 92% (n = 366) indicated a preference for receiving OAT (vs. not receiving OAT) and 96% of those (n = 352) preferred a particular type of OAT. Among 366 with a stated preference, 61% (n = 216) preferred methadone and 39% (n = 136) preferred buprenorphine. Among those preferring buprenorphine (n = 136), 50% (n = 68) preferred buprenorphine ± naloxone and 50% (n = 68) preferred long-acting injectable buprenorphine. Independent correlates of preferring methadone included past month heroin use (aOR 1.78, 95% CI 1.06-3.00) and non-prescribed pharmaceutical opioid use (aOR 2.23, 95% CI 1.07, 4.95), and any prior receipt of methadone treatment (aOR 6.54, 95% CI 2.66, 17.91). Among those receiving OAT, a higher proportion of people currently receiving buprenorphine preferred their medication (61/66, 92%) compared to methadone recipients (180/235, 77%). Nearly all participants preferred OAT, mostly reflecting prior experiences, underscoring the need for expanded access to OAT in Australia. Given the multiple stated preferences, OAT options should include a variety of treatment options aligned with patient preferences, including expanded take-home options.

ABSTRACT Objective: To assess the effects of cannabis and its synthetically derived products on temporomandibular disorders (TMD) treatment and explore the potential mechanisms underlying these effects in various TMD nociception models. Material and Methods: Electronic searches in five databases were conducted for publications up to August 2024. Clinical and animal studies about the use of cannabinoids for TMD-related pain control were included. Letters to the editor, conference proceedings, protocol articles, historical reviews, in vitro studies, and unpublished articles were excluded. Results: A total of 2,708 unique citations were found. Following the screening, 31 studies were evaluated as full-text copies, and 13 (nine pre-clinical, two observational, and two interventional studies) were included. The pre-clinical studies demonstrated that cannabinoid compounds effectively reduce nociceptive behavior in the temporomandibular joints (TMJ) and masseter muscle using different animal models. Moreover, all the included studies using formalin-induced TMJ nociception reported that cannabinoid agonist-induced antinociception in the TMJ region was mediated by the central activation of CB1 but not CB2 receptors. The observational and interventional studies reported pain reduction, improvement in function, and better health quality with cannabis use. Furthermore, the use of cannabis for chronic pain appears to be an effective alternative to the use of opioids and other pain control drugs associated with unwanted side effects. Conclusion: The use of cannabis and its synthetically derived products seems to be effective in reducing nociceptive behavior in TMJ and masseter muscle. However, further clinical and mechanistic studies are necessary to thoroughly investigate the therapeutic potential of cannabinoid compounds in TMD.

Post-traumatic stress disorder is associated with increased rates of opioid prescriptions following primary total shoulder arthroplasty: a propensity-matched analysis.

Comparing physician and advanced care provider use of opioids for treatment of acute chest pain in the emergency department.

Opioid Dispensing Trends Among Children and Adolescents Aged ≤ 19 Years in the United States: 2018-2022.

The use of oxycodone, recommended as a second-line treatment after morphine, has risen strongly over the last years. Considering its addictive potential, the aim of this study was to evaluate the appropriateness of use of oxycodone for acute pain. A retrospective cross-sectional study was conducted using a university hospital clinical data warehouse and included all patients with at least one administration of oxycodone or morphine in surgery and obstetrics wards in 2022. The population was analysed using automatically collected data, and a random 100-patient sample was analysed through an extensive clinical record review. The appropriate use of oxycodone implies four cumulative conditions which are represented by the primary outcomes carried out on the random 100-patient sample. Firstly, 74% of stays received oxycodone not preceded immediately by morphine: 21% had received oxycodone immediately after morphine, but 44% received oxycodone as first strong opioid and 27% received oxycodone combined with morphine as first opioid treatment, with justification found in less than 5%. Secondly, of the 1035 oxycodone administrations recorded in our sample, 398 (38.5%) were immediate-release forms administered for mild pain or without pain assessment. Thirdly, 28% were not combined with any other analgesic (no multimodal analgesia) and 42% were combined with another opioid. Finally, 60.6% were not combined with a laxative. The majority of patients treated with oxycodone in surgery had inappropriate prescribing. Considering the known risk of developing opioid use disorder after a first administration in surgery, important educational effort seems needed.

Septoplasty opioid prescription trends following the publication of opioid prescribing clinical practice guidelines.

Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats.