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OPIOIDS 2009 <874>
Database EMBASE
Accession Number 2010017669
Authors Mannelli P. Patkar A. Rozen S. Matson W. Krishnan R. Kaddurah-Daouk R.
Institution
(Mannelli, Patkar, Krishnan, Kaddurah-Daouk) Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, United States.
(Rozen, Krishnan) Duke-NUS Graduate Medical School Singapore, Singapore, Singapore.
(Matson) Bedford Veterans Administration Medical Center, Bedford, MA, United States.
(Kaddurah-Daouk) Center for Pharmacometabolomics, Duke University Medical Center, Durham, NC 27705, United
States.
Country of Publication
United Kingdom
Title
Opioid use affects antioxidant activity and purine metabolism: Preliminary results.
Source
Human Psychopharmacology. 24(8)(pp 666-675), 2009. Date of Publication: 2009.
Publisher
John Wiley and Sons Ltd
Abstract
Objective: More must be learned about metabolic and biochemical alterations that contribute
to the development and expression of drug dependence. Experimental opioid administration
influences mechanisms and indices of oxidative stress, such as antioxidant compounds and
purine metabolism. We examined perturbations of neurotransmitter-related pathways in opioid
dependence (OD). Methods: In this preliminary study, we used a targeted metabolomics
platform to explore whether biochemical changes were associated with OD by comparing OD
individuals (n = 14) and non-drug users (n = 10). Results: OD patients undergoing short-term
methadone detoxification showed altered oxidation-reduction activity, as confirmed by higher
plasma levels of alpha- and gamma- tocopherol and increased GSH/GSSG ratio. OD
individuals had also altered purine metabolism, showing increased concentration of guanine
and xanthosine, with decreased guanosine, hypoxanthine and hypoxanthine/xanthine and
xanthine/xanthosine ratios. Other drug use in addition to opioids was associated with partly
different biochemical changes. Conclusions: This is a preliminary investigation using
metabolomics and showing multiple peripheral alterations of metabolic pathways in OD.
Further studies should explore the metabolic profile of conditions of opioid abuse, withdrawal
and long-term abstinence in relation to agonist and antagonist treatment and investigate
biochemical signatures of opioid substances and medications. Copyright copyright 2009 John
Wiley & Sons, Ltd.
ISSN 0885-6222
Publication Type Journal: Article
Journal Name Human Psychopharmacology
Volume 24
Issue Part 8
Page 666-675
Year of Publication 2009
Date of Publication 2009
OPIOIDS 2009 <869>
Database EMBASE
Accession Number 2009592847
Authors Smith H.S.
Institution
(Smith) Albany Medical College, Department of Anesthesiology, MC 131, 47 New Scotland Avenue, New York, NY
12208, United States.
Country of Publication
United Kingdom
Title
Future of minimizing opioid adverse effects while maintaining or improving opioidrelated analgesia.
Source
Therapy. 6(5)(pp 667-683), 2009. Date of Publication: September 2009.
Publisher
Future Medicine Ltd.
Abstract
Opioids are potent broad-spectrum analgesics that may provide significant relief from severe
pain and suffering. However, unfortunately, opioids possess certain qualities and adverse
effects that may detract from their potential benefits or even contribute to patients
discontinuing chronic opioid therapy despite obtaining significant opioid-induced analgesia.
Opioid-induced adverse effects represent a significant obstacle in achieving appropriate
analgesia and/or patient comfort. Investigators continue major efforts to develop novel opioids
and other analgesics and strategies, as well as efforts to improve existing analgesics such as
opioids. Multiple efforts to modify opioid analgesic agents aiming to improve analgesia and/or
minimize unwanted effects are ongoing. These strategies include the development of
combination opioid analgesics, 'alternative opioids' and peripherally acting opioids. copyright
2009 Future Medicine Ltd.
ISSN 1475-0708
Publication Type Journal: Review
Journal Name Therapy
Volume 6
Issue Part 5
Page 667-683
Year of Publication 2009
Date of Publication September 2009
OPIOIDS 2009 <878>
Database EMBASE
Accession Number 2010000865
Authors Messinis L. Lyros E. Andrian V. Katsakiori P. Panagis G. Georgiou V. Papathanasopoulos P.
Institution
(Messinis, Lyros, Papathanasopoulos) Department of Neurology, Neuropsychology Section, University of Patras
Medical School, Greece.
(Andrian, Katsakiori) OKANA Detoxification Unit Patras, Greece.
(Georgiou) Heudiasy, Universite Technologie de Campiegne, Campiegne, France.
(Panagis) Department of Psychology, Laboratory of Behavioral Neuroscience, University of Crete, Greece.
Country of Publication
United Kingdom
Title
Neuropsychological functioning in buprenorphine maintained patients versus
abstinent heroin abusers on naltrexone hydrochloride therapy.
Source
Human Psychopharmacology. 24(7)(pp 524-531), 2009. Date of Publication: 2009.
Publisher
John Wiley and Sons Ltd
Abstract
Rationale: Methadone and buprenorphine are among the most widely employed
pharmacological treatments currently available for opioid addiction. Cognitive effects of
buprenorphine in abstinent heroin abusers are nevertheless far from being understood.
Methods: Neuropsychological performance of 18 buprenorphine-maintained patients (BMP)
was evaluated relative to that of 32 currently abstinent heroin abusers on naltrexone
hydrochloride therapy (FHAN), and 34 non-drug dependent controls. The three groups were
demographically balanced. Clinical groups reported histories of similar patterns of drug use
and had increased periods of abstinence from any illicit substance use including heroin.
Results: The BMP group performed poorer than controls on the RAVLT (encoding and
delayed recall of verbal information), CTT (conceptual flexibility, executive functions) and the
RBANS figure copy (visual perception) and delayed recall of visual information. There were
no significant differences in any of the cognitive measures between the BMP and FHAN
groups or between the FHAN group and controls. Furthermore, the non-differing percentage
of abnormal cases between the two patient groups led us to infer that treatment with either
BPM or FHAN is not accompanied by qualitative differences in the cognitive profiles of these
patients. Conclusion: Overall, results suggest that treatment with naltrexone in abstinent
heroin abusers may result in less impairment of cognitive functions compared to treatment
with buprenorphine. These findings are relevant for improved prognosis and treatment
strategies in opioid dependence. Copyright copyright 2009 John Wiley & Sons, Ltd.
ISSN 0885-6222
Publication Type Journal: Article
Journal Name Human Psychopharmacology
Volume 24
Issue Part 7
Page 524-531
Year of Publication 2009
Date of Publication 2009
OPIOIDS 2009 <910>
Database EMBASE
Accession Number 2010089534
Authors Sadeghian S. Karimi A. Dowlatshahi S. Ahmadi S.H. Davoodi S. Marzban M. Movahedi N. Abbasi K. Tazik
M. Fathollahi M.S.
Institution
(Sadeghian) Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of.
(Karimi, Ahmadi, Davoodi, Marzban, Movahedi, Abbasi) Cardiovascular Surgery Department, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
(Dowlatshahi, Tazik) Clinical Research Department, Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of.
(Fathollahi) Research Department, Tehran Heart Center, Tehran, Iran, Islamic Republic of.
Country of Publication
United Kingdom
Title
The association of opium dependence and postoperative complications following
coronary artery bypass graft surgery: A propensity-matched study.
Source
Journal of Opioid Management. 5(6)(pp 365-372), 2009. Date of Publication: NovemberDecember 2009.
Publisher
Weston Medical Publishing
Abstract
Objective: Opium is an overwhelming public health problem in some countries. Different
studies have suggested this drug as a risk factor for cardiovascular disease. Although the
effect of opium on immune system, lung disease, nephropathy, stroke, and cardiac arrhythmia
has been found in different studies, its effect on postoperation complications is not clear yet.
The authors conducted this study to assess the effect of opium on post operation in hospital
complications among patients who underwent coronary artery bypass graft. Design: The
authors retrospectively analyzed the data in this study. Setting: This study has been done at
Tehran Heart Center. Patients: A total of 4,398 patients who had undergone isolated CABG
were studied. Main outcome measure: Patients who fulfilled the DSM-IV-TR criteria for opium
dependence (by smoking) were enrolled as Opium Dependent Patients. Also outcome
variables were: Perioperative MI, septicemia, UTI, TIA, continuous coma, prolonged
ventilation, pulmonary embolism, renal failure, acute limb ischemia, heart block, AF, mortality.
Results: The prevalence of opium dependence was 15-6 percent among patients. The
authors used a propensity matched model to analyze the relationship between opium and
post operation complications. The authors adjusted opium and non-opium dependent patients
in all of the baseline preoperative risk factors, so all of the matched patients were same and
there was no bias in assessment. Conclusion: Opium dependent patients had significantly
longer resource utilization. However, no significant relationship was found between opium
dependence and other cardiac and non cardiac in hospital complications.
ISSN 1551-7489
Publication Type Journal: Article
Journal Name Journal of Opioid Management
Volume 5
Issue Part 6
Page 365-372
Year of Publication 2009
Date of Publication November-December 2009
OPIOIDS 2009 <911>
Database EMBASE
Accession Number 2010089530
Authors Tacke U. Uosukainen H. Kananen M. Kontra K. Pentikainen H.
Institution
(Tacke, Pentikainen) Addiction Psychiatry Unit, Kuopio University Hospital, Kuopio, Finland.
(Tacke, Uosukainen) Department of Pharmacology and Toxicology, University of Kuopio, Kuopio, Finland.
(Kananen, Kontra) Hospital Pharmacy, Kuopio University Hospital, Kuopio, Finland.
Country of Publication
United Kingdom
Title
A pilot study about the feasibility and cost-effectiveness of electronic compliance
monitoring in substitution treatment with buprenorphine-naloxone combination.
Source
Journal of Opioid Management. 5(6)(pp 321-329), 2009. Date of Publication: NovemberDecember 2009.
Publisher
Weston Medical Publishing
Abstract
Objectives: The purpose of the study was to investigate whether or not compliance
monitoring by microchip could offer a feasible method for reducing abuse and/or diversion of
medication from unsupervised substitution treatment for opioid addiction. Design: Naturalistic,
4-week pilot study in out patients. Patients and interventions: All our patients (N = 12) on
buprenorphine-naloxone combination (Suboxone) received their medication for 6 days in a
compliance-monitoring device (PharmaDDSi, StoraEnso), which registers date and time of
tablet removal. Patients were instructed to take all tablets as one dose. Time cues were
displayed and discussed with the patients during their weekly visits for supervised drug
administration and counseling. Main outcome measures: Regularity of registered time cues,
treatment costs in comparison with routine treatment, patients' answers from a questionnaire
on acceptability, and effect on drug diversion. Results: Six patients showed good compliance,
in two patients irregularities were minor, but in two others lack of adherence to treatment
instructions was detected. Patients with several comorbid psychiatric diagnoses showed on
an average the longest intervals between removal of first and last tablet of the daily dose.
One-fourth of the patients reported that compliance monitoring had helped to avoid diversion.
Total cost savings during the 4-week period was a reduction of 39 percent, which was mainly
due to fewer visits to the clinic. Conclusions: Compliance monitoring by PharmaDDSI with
weekly feedback was well accepted and subjectively increased compliance with substitution
treatment. Future studies will show whether a technical solution for compliance monitoring in
real time can help to reduce drug abuse and noncompliance in substitution treatment and
other opioid treatments.
ISSN 1551-7489
Publication Type Journal: Article
Journal Name Journal of Opioid Management
Volume 5
Issue Part 6
Page 321-329
Year of Publication 2009
Date of Publication November-December 2009
OPIOIDS 2009 <933>
Database EMBASE
Accession Number 2010037346
Authors McLean S. Bruno R. Brandon S. de Graaff B.
Institution
(McLean, Brandon) School of Pharmacy, University of Tasmania, Hobart, Tasmania, Australia.
(Bruno, de Graaff) School of Psychology, University of Tasmania, Hobart, Tasmania, Australia.
Country of Publication
United Kingdom
Title
Effect of filtration on morphine and particle content of injections prepared from slowrelease oral morphine tablets.
Source
Harm Reduction Journal. 6, 2009. Article Number: 37. Date of Publication: 22 Dec 2009.
Publisher
BioMed Central Ltd.
Abstract
Background: Injections of mixtures prepared from crushed tablets contain insoluble particles
which can cause embolisms and other complications. Although many particles can be
removed by filtration, many injecting drug users do not filter due to availability, cost or
performance of filters, and also due to concerns that some of the dose will be lost.Methods:
Injection solutions were prepared from slow-release morphine tablets (MS Contin) replicating
methods used by injecting drug users. Contaminating particles were counted by microscopy
and morphine content analysed by liquid chromatography before and after filtration.Results:
Unfiltered tablet extracts contained tens of millions of particles with a range in sizes from < 5
mum to > 400 mum. Cigarette filters removed most of the larger particles (> 50 mum) but the
smaller particles remained. Commercial syringe filters (0.45 and 0.22 mum) produced a
dramatic reduction in particles but tended to block unless used after a cigarette filter.
Morphine was retained by all filters but could be recovered by following the filtration with one
or two 1 ml washes. The combined use of a cigarette filter then 0.22 mum filter, with rinses,
enabled recovery of 90% of the extracted morphine in a solution which was essentially free of
tablet-derived particles.Conclusions: Apart from overdose and addiction itself, the harmful
consequences of injecting morphine tablets come from the insoluble particles from the tablets
and microbial contamination. These harmful components can be substantially reduced by
passing the injection through a sterilizing (0.22 mum) filter. To prevent the filter from blocking,
a preliminary coarse filter (such as a cigarette filter) should be used first. The filters retain
some of the dose, but this can be recovered by following filtration with one or two rinses with
1 ml water. Although filtration can reduce the non-pharmacological harmful consequences of
injecting tablets, this remains an unsafe practice due to skin and environmental contamination
by particles and microorganisms, and the risks of blood-borne infections from sharing
injecting equipment. copyright 2009 McLean et al; licensee BioMed Central Ltd.
Publication Type Journal: Article
Journal Name Harm Reduction Journal
Volume 6
Year of Publication 2009
Date of Publication 22 Dec 2009