Abstract:
BACKGROUND:Buprenorphine/naloxone has been shown to be an effective treatment of opioid use disorder. According to the Canadian National clinical practice guideline on the management of opioid use disorders, given the superior safety profile of buprenorphine/naloxone and its potential for flexible take-home dosing in comparison to other opioid agonist medication it is strongly recommended to initiate opioid agonist treatment with buprenorphine/naloxone as the preferred first-line treatment when possible. Due to its pharmacological properties induction can be challenging, requiring the cessation of all opioids for a certain amount of time to avoid the risk of precipitated withdrawal symptoms. For this reason, buprenorphine/naloxone is not initiated for the treatment of opioid use disorder in critically ill patients where continuous infusion of opioids are required for maintenance of sedation resulting in a missed opportunity for first line treatment of that patient's opioid use disorder. CASE SUMMARY:We present a case of a 29-year-old female with opioid use disorder admitted for infective endocarditis and septic shock requiring intubation for hypoxic respiratory failure secondary to bilateral lung septic emboli with a high opioid debt requiring higher than typical doses of fentanyl and dexmedetomidine infusions to maintain sedation with clinical objective sign of inadequate treatment of her pain and opioid withdrawal. She was successfully started on buprenorphine/naloxone using a rapid micro-induction technique that did not cause precipitated withdrawal or require cessation of her fentanyl infusion. CONCLUSION:This case illustrates a new method for starting buprenorphine/naloxone in a critically ill intubated patient, where buprenorphine/naloxone was never a consideration in this specific patient population. SCIENTIFIC SIGNIFICANCE:This method can be used to minimize barriers to opioid agonist therapy in intubated patients.
journal_name
J Addict Medjournal_title
Journal of addiction medicineauthors
Hamata B,Griesdale D,Hann J,Rezazadeh-Azar Pdoi
10.1097/ADM.0000000000000675subject
Has Abstractpub_date
2020-12-01 00:00:00pages
514-517issue
6eissn
1932-0620issn
1935-3227pii
01271255-202012000-00034journal_volume
14pub_type
杂志文章abstract:OBJECTIVES:Cocaine is a known risk factor for several vascular ischemic events. The underlying mechanisms leading to the complications are not fully understood, although thrombus formation and accelerated atherosclerosis are prominent findings. Evidence of endothelial dysfunction (ED), a key phenomenon in the pathogene...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000109
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:Although smoking is a major health issue among depressed psychiatric inpatients and interest in quitting is high, successful quit rates remain low among this population. We sought to understand preferences that depressed inpatient smokers may have for cessation treatments. METHODS:Eighty smokers (60% women,...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000027
更新日期:2014-03-01 00:00:00
abstract::The purpose of this study was to examine the correlates of recreational gambling in lower-income compared with middle/higher-income groups. We examined, by logistic regression, a nationally representative U.S. adult sample (n = 2417) from the 1998 Gambling Impact and Behavior Study (GIBS) to investigate the influence ...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e318125088f
更新日期:2007-09-01 00:00:00
abstract::This case study of the development and implementation of an opioid overdose prevention program is based on an actual clinic's experience, but information about the clinic, including details of implementation and outcome measures, has been changed. Four experts reflect on the medical, administrative, peer-support, comm...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000032
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:Although the relation between impulsivity and smoking is well-documented, one model of impulsivity that has received little attention in the addiction literature separates impulsivity into 2 dimensions: functional impulsivity (tendency to make quick effective decisions) and dysfunctional impulsivity (tendenc...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31825e2a67
更新日期:2012-09-01 00:00:00
abstract::: Approximately 5% of adolescents in the US meet criteria for a substance use disorder (SUD), and many of them benefit from residential treatment programs at points in the course of the disorder to achieve early sobriety and stabilization. Youth with chronic medical conditions use alcohol, marijuana, and other substan...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000557
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Individuals in the criminal justice system engage in behaviors that put them at high risk for HIV. This study sought to identify characteristics of individuals who are under community corrections supervision (eg, probation) and at risk for HIV. METHODS:Approximately 25,000 individuals under community correct...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3182781806
更新日期:2013-01-01 00:00:00
abstract::Standardized patient placement criteria such as those developed by the American Society of Addiction Medicine are increasingly common in substance abuse treatment, but it is unclear what factors are associated with their use or with treatment units' provision of related services. This study examined these issues in th...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31818ebb6f
更新日期:2009-09-01 00:00:00
abstract::Previous studies have demonstrated that cocaine use alters availability of brain dopamine D2 receptors (D2R) and transporters (DAT). The present study examined the effects of low doses of cocaine on this neuroadaptation. Using positron emission tomography (PET), D2R and DAT availability in the caudate nucleus (Cd), pu...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e318045c038
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:Publicly funded addiction treatment organizations have been slow to adopt pharmacotherapies. Few studies have examined the organizational factors associated with adoption of different types of medication in this treatment sector. This study identifies organization-level facilitators and barriers to the use o...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181b41a32
更新日期:2010-06-01 00:00:00
abstract:PURPOSE:: This study was designed to conduct a needs assessment concerning methadone counselors' experiences working with methadone-maintained patients with chronic pain and measure counselors' interest in receiving specialized training to treat such patients. METHODS:: A survey, developed by the authors, was administ...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31815ec240
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Individuals with psychiatric disease, substance abuse, and/or housing instability have a high prevalence of chronic hepatitis C virus (HCV) infection. However, such individuals are often excluded from treatment for HCV infection because of a perceived inability to adhere to the rigorous medication regimen re...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31829b1a6c
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:To prospectively evaluate QTc changes among methadone maintenance treatment (MMT) patients. METHODS:All 512 opiate addicts newly admitted to 2 MMT clinics had been prospectively studied for 4.5 years. Ninety-one patients were excluded because they were admitted from other MMTs, and 26 were excluded because ...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3182a8a4f2
更新日期:2013-11-01 00:00:00
abstract::Hepatitis C Virus (HCV) infection is treated with peg-interferon α2a or α2b and ribavirin. International studies show that drug user adherence to treatment is 40% to 60% and increases if the patient is in addiction treatment. The aim of the Together To Take Care (TTTC) study was to achieve better adherence to HCV ther...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181cae4d0
更新日期:2010-12-01 00:00:00
abstract::Opioid dependent pregnant and post-partum women and their infants are a complex and vulnerable population requiring individualized, comprehensive and multidisciplinary treatment. Though methadone maintenance in the setting of comprehensive service provision during pregnancy significantly improves pregnancy outcomes fo...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31817e6105
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:The primary outcome of this study is to identify characteristics of study participants in a large opioid treatment program (OTP) for opioid use disorder (OUD) who used take-home naloxone to perform 1 or more opioid overdose (OD) reversal(s) in the community. METHODS:This 6-month prospective cohort study prov...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000461
更新日期:2019-03-01 00:00:00
abstract::: Acknowledging the needs and challenges of women with opioid use disorder is an essential step to reduce the opioid epidemic in the United States. Efforts that can help women include increasing psychosocial services to address trauma, increasing access to medication treatment for opioid use disorder, reducing barrier...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000622
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Patients with substance use disorders (SUDs) prescribed long-term opioid therapy (LtOT) are at risk for overdose and mortality. Prior research has shown that receipt of LtOT in accordance with clinical practice guidelines has the potential to mitigate these outcomes. Our objective was to determine whether the...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000255
更新日期:2016-11-01 00:00:00
abstract::Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating altered mental status, hallucinations, ...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000081
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:In 2017, an academic health center in Chicago launched the multidisciplinary Substance Use Intervention Team (SUIT) to address opioid misuse across 18 inpatient units and in a new outpatient addiction medicine clinic. This report assesses the first 5 months of implementation and associations with patient heal...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000520
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Prescription Drug Monitoring Programs (PDMPs) are intended to help reduce prescription drug misuse and opioid overdose, yet little is known about the longitudinal patterns of opioid prescribing that may be associated with mortality. This study investigated longitudinal opioid prescribing patterns among patien...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000458
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:Examine energy drink/shot and regular and diet soft drink use among United States secondary school students in 2010-2011, and associations between such use and substance use. METHODS:We used self-reported data from cross-sectional surveys of nationally representative samples of 8th-, 10th-, and 12th-grade s...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/01.ADM.0000435322.07020.53
更新日期:2014-01-01 00:00:00
abstract:UNLABELLED:Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence. OBJECTIVES:To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy o...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31826d1df3
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:The aim of the study is to determine length of stay and length of treatment in infants with neonatal abstinence syndrome (NAS) in the neonatal intensive care unit (NICU) compared to those in the pediatric floor. METHODS:Retrospective cohort of infants ≥34 weeks gestation admitted with diagnosis of NAS at a s...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000455
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To determine whether the methadone maintenance treatment (MMT) affects sleep. METHODS:We prospectively followed up the sleep pattern of 23 opiate addicts when admitted to MMT and after 6 and 12 months of treatment. Pittsburgh Sleep Quality Index, pain self-report questionnaires, urine for drug abuse, and one...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181e8b6c4
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:We assessed sex differences in a sample of first-admission psychiatric inpatients with and without comorbid substance use disorder (SUD) to identify possible risk factors and targets for sex-tailored treatment interventions. METHODS:A retrospective study of first admissions to the University Psychiatry Ward...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000062
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Despite growing legal control, a wide range of synthetic cannabis analogues is currently used for recreational purposes, notwithstanding their well adverse outcomes, which appear to be more frequent and more serious than those associated with cannabis use. We present the case report of a patient with paran...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000335
更新日期:2017-09-01 00:00:00
abstract::Four young ketamine abusers with lower urinary tract symptoms presented to regional hospitals in Shenzhen, China. Investigations demonstrated contracted bladders and other urinary tract abnormalities. There have been few reports of similar findings in ketamine abusers in the Chinese mainland. We followed up each patie...
journal_title:Journal of addiction medicine
pub_type: 杂志文章,评审
doi:10.1097/ADM.0b013e3182312863
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:To assess methadone maintenance treatment (MMT) patients' willingness to use, and perceived efficacy of, conventional and unconventional group stress reduction treatments. METHODS:A survey, developed by the authors, was administered to 150 MMT patients. RESULTS:Levels of treatment willingness and perceived...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181ee77cl
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:Screening, Brief Intervention, and Referral to Treatment (SBIRT) has demonstrated efficacy for addressing unhealthy alcohol use in primary care, yet recent research indicates weaker efficacy for drug use as well as very limited success in referral to specialty care for patients with substance use disorder (S...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000663
更新日期:2020-12-01 00:00:00