Opioid Use Disorder
Wiki Number: PW144
Diagnosis: Opioid Use Disorder
US Patients: About 27 million in 2016
Sex Ratio: M+;F
Age Onset: Young adults
Brain Area: Opioids reduce dopamine in nucleus accumbens. Neuroimaging affects in the orbitofrontal area-reducing reward-behaviors
Symptoms: strong desire to use oioids, tolerance, withdrawal symptoms & living normal lives; most US heroin users began with prescriptions
Progression: Long term use shows dysregulation of brain circuits for emotion, distress and high impulsivity.
Medications: opioid replacement threrapy uses methadone or buprenophine and naltrexone; heroin withdrawal symptoms from 2 days-2 weeks
Therapies: CBT; Lohr’s “Calming My Pain!” (DVD or Download from this website) helps to retrain the brain to reduce pain without opioids.
4 CURRENT ARTICLES
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PubMed article’s summary-abstract.
- ACMT Position Statement: Allow Optimal Treatment for Healthcare Professionals with Opioid Use Disorderby Ryan T Marino on October 26, 2021
- Is extended release naltrexone superior to buprenorphine-naloxone to reduce drinking among outpatients receiving treatment for opioid use disorder? A secondary analysis of the CTN X:BOT trialby John D Roache on October 26, 2021
CONCLUSIONS: An overall improvement in drinking occurred for treatment of OUD using both agonist and antagonist approaches indicating that the hypothesis that XR-NTX would be superior to BUP-NX was not supported. The study is limited by low levels of comorbid AUD or heavy drinking observed in X:BOT trial participants seeking treatment for opioid use disorder.
- Norbuprenorphine Interferences in Urine Drug Testing LC-MS/MS Confirmation Methods From Quetiapine Metabolitesby Ana Celia Muñoz-Muñoz on October 26, 2021
Norbuprenorphine interferences were observed in urine drug testing LC-MS/MS confirmation methods used to assess patient compliance with prescribed buprenorphine for chronic pain and opioid use disorder. The interferences were observed in the norbuprenorphine MS/MS transitions, m/z 414.4/83.1 and 414.4/187.2, at and near the norbuprenorphine retention time at multiple laboratories using different sample preparation procedures and chromatographic conditions. When the interferences were present, a...
- Opioid-Associated Anorectal Dysfunction in Chronic Constipationby Nayna A Lodhia on October 26, 2021
CONCLUSION: Recent opioid use was an independent risk factor for rectal hyposensitivity and DD on HRAM in patients with constipation, but that effect may decrease with discontinuation of use. Anorectal physiology testing should be considered in patients with opioid-associated constipation.