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Opioids & SU
The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
12581 Results
11821
Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: Research has examined the safety, efficacy, feasibility, and cost-effectiveness of buprenorphine for the treatment of opioid dependence, but few studies have examined patient and provider experiences, especially in community health centers. Using de-identified electronic health record system (EHRS) data from 70 OCHIN community health centers (n = 1825), this cross-sectional analysis compared the demographics, comorbidities, and service utilization of patients receiving buprenorphine to those not receiving medication-assisted treatment (MAT). Compared to non-MAT patients, buprenorphine patients were younger and less likely to be Hispanic or live in poverty. Buprenorphine patients were less likely to have Medicaid insurance coverage, more likely to self-pay, and have private insurance coverage. Buprenorphine patients were less likely to have problem medical comorbidities or be coprescribed high-risk medications. It is important for providers, clinic administrators, and patients to understand the clinical application of medications for opioid dependence to ensure safe and effective care within safety net clinics.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links: 
View the DOI record for Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data
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View the PubMed citation for Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data11823
Treating Opioid Use Disorder in Puerto Rico During the COVID-19 Pandemic: Providers' Leadership Efforts in Unprecedented Times
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
: Opioid use disorder (OUD) is an unprecedented medical and public health issue both in Puerto Rico (PR) and the greater US with an increase incidence of opioid use every year. Unprecedented and compounded emergencies in PR such as those caused by hurricanes, earthquakes, and the COVID-19 pandemic coupled with limited national and local governmental support, has forced most clinics in PR to take action to be able to continue providing care. This commentary summarizes the leadership and clinical initiatives of 3 community organizations in PR to maintain services for people with OUD during the COVID-19 pandemic. Local legislation that supported the continuity of OUD care is summarized, along with unique experiences specific to each organization. In addition, the vulnerability of economically disadvantaged people or experiencing homelessness as well as those affected by these compounded events in PR is discussed, with an emphasis on how some challenges were addressed and future directions for continuity of care as our country adjusts to new demands caused by the COVID-19 pandemic.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Healthcare Policy
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, Opioids & Substance Use
See topic collection
11825
Treating pain in addicted patients: recommendations from an expert panel
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Clinicians may face pragmatic, ethical, and legal issues when treating addicted patients. Equal pressures exist for clinicians to always address the health care needs of these patients in addition to their addiction. Although controversial, mainly because of the lack of evidence regarding their long-term efficacy, the use of opioids for the treatment of chronic pain management is widespread. Their use for pain management in the addicted population can present even more challenges, especially when evaluating the likelihood of drug-seeking behavior. As the misuse and abuse of opioids continues to burgeon, clinicians must be particularly vigilant when prescribing chronic opioid therapy. The purpose of this article is to summarize recommendations from a recent meeting of experts convened to recommend how primary care physicians should approach treatment of chronic pain for addicted patients when an addiction specialist is not available for a referral. As there is a significant gap in guidelines and recommendations in this specific area of care, this article serves to create a foundation for expanding chronic pain guidelines in the area of treating the addicted population. This summary is designed to be a practical how-to guide for primary care physicians, discussing risk assessment, patient stratification, and recommended therapeutic approaches.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
See topic collection
Reference Links:
View the DOI record for Treating pain in addicted patients: recommendations from an expert panel
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View the PubMed citation for Treating pain in addicted patients: recommendations from an expert panel11826
Treating Pain in an Established Patient: Sifting Through the Guidelines
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The CDC Guideline for Prescribing Opioids for Chronic Pain, published last March, provided major steps toward bringing the medical community together to address the opioid epidemic in the U.S. However, the Guideline focuses primarily on treatment of new inductions into opioid therapy for pain. Physicians may have difficulty figuring out how to apply the CDC's recommendations to patients who are already receiving opioid maintenance therapy for chronic pain. Patients already maintained on opioids for chronic pain should not be subjected to abrupt cessation or rapid tapers, and the CDC's Guideline confirms this. Physicians should not balk from treating opioid-dependent patients with chronic pain, and the CDC's recommendations do contain helpful information if one reads through them carefully. This article attempts to distill the major points from the Guideline for the treatment of chronic-pain patients already on long-term opioid therapy.[Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
Topic(s):
Opioids & Substance Use
See topic collection
View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
Reference Links: View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
11827
Treating Pain in an Established Patient: Sifting Through the Guidelines
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The CDC Guideline for Prescribing Opioids for Chronic Pain, published last March, provided major steps toward bringing the medical community together to address the opioid epidemic in the U.S. However, the Guideline focuses primarily on treatment of new inductions into opioid therapy for pain. Physicians may have difficulty figuring out how to apply the CDC's recommendations to patients who are already receiving opioid maintenance therapy for chronic pain. Patients already maintained on opioids for chronic pain should not be subjected to abrupt cessation or rapid tapers, and the CDC's Guideline confirms this. Physicians should not balk from treating opioid-dependent patients with chronic pain, and the CDC's recommendations do contain helpful information if one reads through them carefully. This article attempts to distill the major points from the Guideline for the treatment of chronic-pain patients already on long-term opioid therapy.[Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
Topic(s):
Opioids & Substance Use
See topic collection
View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
Reference Links: View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
11828
Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
General Literature
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11829
Treating patients with functional somatic symptoms. A treatment guide for use in general practice
Type: Journal Article
Year: 2003
Publication Place: Norway
Abstract: Patients who experience body symptoms in response to psychosocial stress are a challenge for the general practitioner (GP). This paper is a contribution to the improved treatment of these patients. It presents a specific psychosocial treatment model provided by the GP including the following steps: (a) taking a thorough symptom history, conducting a psychosocial anamnesis and exploring the patient's own perception of the illness, (b) developing alternative perceptions of the illness by understanding the psycho-physiological relationship; and (c) reducing the impact of psychosocial stress. The application of these specific techniques requires a trustful, helping alliance between the doctor and the patient and cooperation with mental health services.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Treating patients with functional somatic symptoms. A treatment guide for use in general practice
11830
Treating patients with medically unexplained symptoms in primary care
Type: Journal Article
Year: 2003
Publication Place: United States
Abstract: BACKGROUND: There are no proven, comprehensive treatments in primary care for patients with medically unexplained symptoms (MUS) even though these patients have high levels of psychosocial distress, medical disability, costs, and utilization. Despite extensive care, these common patients often become worse. OBJECTIVE: We sought to identify an effective, research-based treatment that can be conducted by primary care personnel. DESIGN: We used our own experiences and files, consulted with experts, and conducted an extensive review of the literature to identify two things: 1). effective treatments from randomized controlled trials for MUS patients in primary care and in specialty settings; and 2). any type of treatment study in a related area that might inform primary care treatment, for example, depression, provider-patient relationship. MAIN RESULTS: We developed a multidimensional treatment plan by integrating several areas of the literature: collaborative/stepped care, cognitive-behavioral treatment, and the provider-patient relationship. The treatment is designed for primary care personnel (physicians, physician assistants, nurse practitioners) and deployed intensively at the outset; visit intervals are progressively increased as stability and improvement occur. CONCLUSION: Providing a comprehensive treatment plan for chronic, high-utilizing MUS patients removes one barrier to treating this common problem effectively in primary care by primary care personnel.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Treating patients with medically unexplained symptoms in primary care
11832
Treating perinatal opioid use disorder in rural settings: Challenges and opportunities
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Education & Workforce
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, Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Treating perinatal opioid use disorder in rural settings: Challenges and opportunities
View DOI Record
View the PubMed citation for Treating perinatal opioid use disorder in rural settings: Challenges and opportunities11838
Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children. METHODS: Three separate search methods were employed to identify peer-reviewed journal articles providing evidence on treatment methods for women with OUD who are pregnant or parenting, and for their children. Identified articles were reviewed for inclusion per study guidelines and relevant information was abstracted and summarized. RESULTS: Of the 1697 articles identified, 75 were included in the literature review. The perinatal use of medication for addiction treatment (MAT, also known as medication-assisted treatment), either methadone or buprenorphine, within comprehensive treatment is the most accepted clinical practice, as withdrawal or detoxification risks relapse and treatment dropout. Medication increases may be needed with advancing pregnancy, and are not associated with more severe neonatal abstinence syndrome (NAS). Switching medication prenatally is usually not recommended as it can destabilize opioid abstinence. Postnatally, breastfeeding is seen as beneficial for the infant for women who are maintained on a stable dose of opioid agonist medication. Less is known about ideal pain management and postpartum dosing regimens. NAS appears generally less severe following prenatal exposure to buprenorphine versus methadone. Frontline NAS medication treatments include protocol-driven methadone and morphine dosing in the context of nonpharmacological supports. CONCLUSIONS: Women with OUD can be treated with methadone or buprenorphine during pregnancy. NAS is an expected and manageable condition. Although research has substantially advanced, opportunities to guide future research to improve maternal and infant outcomes are provided.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
See topic collection
11839
Treating women with opioid use disorder during pregnancy in Appalachia: Initial neonatal outcomes following buprenorphine + naloxone exposure
Type: Journal Article
Year: 2018
Publication Place: England
Topic(s):
Opioids & Substance Use
See topic collection
, Healthcare Disparities
See topic collection