Are opioid use disorder assessments in the emergency department biased? An examination across sex, race, and employment status using item response theory.

Background: In acute care settings such as the emergency department (ED), the absence of test bias is essential for any assessment. Unbiased assessments of the DSM-5 criteria for opioid use disorder (OUD) are crucial to ensure valid comparison of OUD severity, though focused tests of potential bias are lacking.

Method: This study used item response theory (IRT) to examine potential test bias across patient characteristics (i.

Health outcomes in children with prenatal opioid exposure with and without neonatal abstinence syndrome in the first seven years of life: An observational cohort study.

Introduction: Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis of neonatal abstinence syndrome (NAS). Here, we aimed to describe the health outcomes of children with POE and with POE and NAS compared to unexposed children during the first 7 years of life.

The relations between impulsivity, opioid use, and nonmedical prescription opioid use motives: An examination within three large urban emergency departments.

Impulsivity is a transdiagnostic risk factor for multiple disorders, including opioid use disorders (OUDs). However, scant work has examined if impulsivity facets distinguish individuals reporting nonmedical opioid use from those who use opioids as prescribed, particularly in important settings such as emergency departments (EDs). Further, no studies, to our knowledge, have examined the relations between impulsivity facets and motives for nonmedical prescription opioid use (NMPOU).

In vivo pharmacokinetic, pharmacodynamic and brain concentration comparison of fentanyl and para-fluorofentanyl in rats.

In 2022, para-fluorofentanyl (pFF) rose to the 6th most reported drug and the most reported fentanyl analog in the United States according to the Drug Enforcement Administration (DEA). pFF differs from fentanyl by the addition of a single fluorine group. To date, pFF has not been extensively evaluated in vivo and is frequently seen in combination with fentanyl.

Opioid use disorder risk alleles in self-reported assigned African American/Afro-Caribbean and European biogeographical genetic ancestry groups and in males and females.

The influence of genetic variants related to opioid use disorder (OUD) was evaluated using multiple logistic regression analysis in self-reported assigned African American/Afro-Caribbean and European biogeographical ancestry groups (BGAGs) and by sex. From a sample size of 1301 adult patients (>18 years of age) seen in emergency departments of three medical centers in Ohio, six variants were found to be associated with OUD. Two of the variants, rs2740574 (CYP3A4) and rs324029 (DRD3), were included in the analysis having met criteria of at least five subjects for each BGAG, variant carrier status, and OUD status combinations.

Bile acids and the gut microbiome are involved in the hyperthermia mediated by 3,4-methylenedioxymethamphetamine (MDMA).

Hyperthermia induced by phenethylamines, such as 3,4-methylenedioxymethamphetamine (MDMA), can lead to life-threatening complications and death. Activation of the sympathetic nervous system and subsequent release of norepinephrine and activation of uncoupling proteins have been demonstrated to be the key mediators of phenethylamine-induced hyperthermia (PIH). Recently, the gut microbiome was shown to also play a contributing role in PIH.

Xylazine does not enhance fentanyl reinforcement in rats: A behavioral economic analysis.

The adulteration of illicit fentanyl with the alpha-2 agonist xylazine has been designated an emerging public health threat. The clinical rationale for combining fentanyl with xylazine is currently unclear, and the inability to study fentanyl/xylazine interactions in humans warrants the need for preclinical research. We studied fentanyl and xylazine pharmacodynamic and pharmacokinetic interactions in male and female rats using drug self-administration behavioral economic methods.

Dopamine Concentration Changes Associated with the Retrodialysis of Methylone and 3,4-Methylenedioxypyrovalerone (MDPV) into the Caudate Putamen.

Structural modifications to synthetic psychoactive cathinones (SPCs), a class of drugs that contain a β-keto modification of the phenethylamine pharmacophore of amphetamine, induce differences in dopamine transporter (DAT) activity. Here, in vivo retrodialysis was utilized to deliver the SPCs 3,4-methylenedioxypyrovalerone (MDPV, a DAT inhibitor) or methylone (a DAT substrate) into the caudate putamen of male Sprague-Dawley rats. Dialysate samples were collected prior to and post drug administration, and temporal changes in dopamine concentration were quantified using HPLC-EC methods.

Effects of the designer drug 4-methylamphetamine on core temperature and serotonin levels in the striatum and hippocampus of rats.

New psychoactive substances (NPS) are typically synthesized in clandestine laboratories in an attempt to chemically modify already federally regulated drugs in an effort to circumvent the law. Drugs derived from a phenethylamine pharmacophore, such as 4-chloroamphetamine and 3,4-methylenedioxymethamphetamine (MDMA), reliably induce thermogenesis and serotonergic deficits in the striatum and hippocampus of rodents. 4-methylamphetamine (4-MA), a relative newcomer to the NPS scene, was originally investigated in the mid-1900 s as a potential anorexigenic agent.

The dopamine 3 receptor as a candidate biomarker and therapeutic for opioid use disorder.

Here, we present recent studies suggesting that specific DRD3 single nucleotide polymorphisms (SNPs, e.g. rs324029 and rs2654754) might serve as prognostic biomarkers for opioid use disorder (OUD).

Screening for problematic opioid use in the emergency department: Comparison of two screening measures.

Study Objective: Earlier intervention for opioid use disorder (OUD) may reduce long-term health implications. Emergency departments (EDs) in the United States treat millions with OUD annually who may not seek care elsewhere. Our objectives were (1) to compare two screening measures for OUD characterization in the ED and (2) to determine the proportion of ED patients screening positive for OUD and those who endorse other substance use to guide future screening programs.

Influence of carbon side chain length on the in vivo pharmacokinetic and pharmacodynamic characteristics of illicitly manufactured fentanyls.

Since 2016, illicitly manufactured fentanyls and fentanyl analogs (referred to as IMFs) have contributed to an increase in drug overdoses. Although fentanyl has been characterized and evaluated extensively in animals and humans, many of the clandestinely synthesized analogs of fentanyl have not and users may unknowingly ingest these IMFs leading to overdose and potentially death. The pharmacodynamic (PD) and pharmacokinetic (PK) properties of four IMFs and fentanyl were evaluated in Sprague-Dawley rats.

Better together: utilizing an interprofessional course and escape room to educate healthcare students about opioid use disorder.

Background: The aim of the present study was to determine the impact of an innovative interprofessional educational activity on healthcare professional students' learning. The educational activity targeted student knowledge of opioid use disorder (OUD) and perceptions of working with an interprofessional team while caring for patients with OUD.

Methods: Students from nursing, pharmacy, physician assistant, dentistry, social work, and medicine programs were recruited to participate in the interprofessional educational activity.

Designer benzodiazepine rat pharmacokinetics: A comparison of alprazolam, flualprazolam and flubromazolam.

Designer benzodiazepines, including flualprazolam and flubromazolam, are clandestinely produced to circumvent federal regulations. Although flualprazolam and flubromazolam are structurally similar to alprazolam, they do not have an approved medical indication. Flualprazolam differs from alprazolam by the addition of a single fluorine atom.

Influence of adrenalectomy on the gut microbiome and MDMA-induced hyperthermia.

The increased use of the stimulant drug, 3,4-methylenedioxymethamphetamine (MDMA), more commonly known as Ecstasy, Molly or X, has been linked to the development of life-threatening hyperthermia in human and animal models. The current study aimed to investigate the role of the gut-adrenal axis in MDMA-induced hyperthermia by assessing the influence of the acute exogenous supplementation with norepinephrine (NE) or corticosterone (CORT) to adrenalectomized (ADX) rats following MDMA administration. MDMA (10 mg/kg, sc) resulted in significant increase of body temperature in SHAM animals compared to ADX animals at 30-, 60- and 90-min timepoints post-MDMA treatment.

Influence of fecal microbial transplant (FMT) between male and female rats on methamphetamine-induced hyperthermia.

Objective: To investigate the effect of bidirectional fecal microbial transplant (FMT) between male and female rats on methamphetamine (MA)-induced hyperthermia.

Methods: FMT was performed between male and female rats prior to MA (10 mg/kg, sc) treatment. Core body temperature, plasma drug and norepinephrine (NE) levels were measured and compared between treatment groups.

Reversal of temperature responses to methylone mediated through bi-directional fecal microbiota transplantation between hyperthermic tolerant and naïve rats.

The synthetic cathinone ("bath salt") methylone induces a hyperthermia response and with chronic administration tolerance to this hyperthermia has been reported. The microbiome-gut-brain axis has been implicated in multiple bodily systems and pathologies, and intentional manipulation of the gut-microbiome has yielded clinically significant results. Here, we examined the effects of bi-directional Fecal Microbiota Transplantation (FMT) between methylone-induced hyperthermic tolerant (MHT) and methylone-naïve (MN) rats.

COVID-19 economic impact payments and opioid overdose deaths.

Background: Given the global economic recessions mediated by the COVID-19 pandemic and that many countries have implemented direct income support programs, we investigated the timing of the COVID-19 economic impact payments and opioid overdose deaths.

Methods: A longitudinal, observational study design that included data from the Ohio Department of Health was utilized. Statistical change point analyses were conducted to identify significant changes in weekly number of opioid overdose deaths from January 1 of 2018 to August 1 of 2020.

HealthCare educational differences in pain management, adverse childhood experiences and their relationship to substance use disorder education.

Background: In order to assist the State of Ohio in the United States in addressing the opioid epidemic, the Ohio Attorney General appointed experts in a variety of academic disciplines to the Scientific Committee on Opioid Prevention and Education (SCOPE). The focus of SCOPE is the application of scientific principles in the development of prevention and educational strategies for reducing substance use disorder (SUD). One area of focus for SCOPE was SUD education of healthcare professionals.

Comparison of swab types for collection and analysis of microorganisms.

The human microbiome has begun to emerge as a potential forensic tool, with varied applications ranging from unique identification to investigative leads that link individuals and/or locations. The relative abundance of the combined DNA of the microbiome, compared to human nuclear DNA, may expand potential sources of biological evidence, especially in cases with transfer or low-copy number DNA samples. This work sought to determine the optimal swab type for the collection and analysis of microorganisms.