Background: Certain limitations of the existing opioid substitution therapies necessitate exploration of other options for maintenance of patients with opioid dependence. This study aimed to present the experience of use of tramadol for long-term treatment of patients with opioid dependence.
Methods: This was a cross-sectional interview-based observational study conducted in Uttar Pradesh state in India. Patients with opioid dependence who received oral tramadol treatment for a period of more than 6 months were recruited. Outcome was assessed in terms of self-reported abstinence on tramadol.
Results: A total of 102 participants were recruited in the study, with a mean age of 41.3 years. All the participants were males. Abstinence to extraneous opioids was reported by 58.8% of the sample, and the median dose of tramadol at which abstinence was achieved was 350 mg/d. Those who reported to be taking natural opioids (raw opium or poppy husk) at the time of seeking treatment had higher rates of achieving abstinence.
Conclusions: Tramadol may be a possible option for the maintenance treatment among some opioid-dependent individuals. Further studies are required to establish its efficacy vis-à-vis other medications used in opioid substitution treatment.
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http://dx.doi.org/10.1080/10826084.2018.1521427 | DOI Listing |
Pediatr Qual Saf
January 2025
From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Wash.
Introduction: Supracondylar fractures are among the most common injuries in the pediatric population. Recently, there has been increased interest in developing opioid-free anesthetic protocols that achieve these same goals without the risks associated with opioid use, such as postoperative nausea and vomiting (PONV), delayed discharges, and respiratory depression.
Methods: Seattle Children's Hospital implemented opioid-free anesthesia (OFA) for pediatric supracondylar fracture repairs in January 2021.
Cureus
December 2024
Anesthesia and Intensive Care Unit, Giuseppe Mazzini Hospital, Teramo, ITA.
The management of postoperative pain in pediatric patients undergoing emergency surgical procedures, particularly in non-pediatric hospitals, presents significant challenges due to the unique physiological requirements of children. The utilization of opioid analgesia may result in severe complications, necessitating a transition toward multimodal analgesia, which integrates various pain management strategies to enhance effectiveness while mitigating adverse effects. Locoregional anesthesia techniques, such as fascial plane blocks, provide targeted pain alleviation, reducing dependence on opioids.
View Article and Find Full Text PDFCureus
December 2024
Emergency Medicine, Henry Ford Health System, Detroit, USA.
Shoulder arthroscopic and arthroplastic surgeries are associated with significant postoperative pain, which can delay recovery and increase opioid consumption. Interscalene blocks (ISBs) are a commonly used method to manage this pain, either as single-shot injections or continuous catheter infusions (CISBs). This review synthesizes findings from studies conducted in the past five years, comparing the efficacy, complications, and outcomes of single-shot ISBs versus CISBs for postoperative pain management in shoulder surgeries.
View Article and Find Full Text PDFAIDS Behav
January 2025
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.
The psychological experiences and needs of people with human immunodeficiency virus (HIV) who use methadone maintenance treatment and have common mental disorders in Hanoi, Vietnam remain unknown. Due to limited services for common mental disorders, optimal delivery methods for psychotherapy are also unknown. Accordingly, this qualitive study explored both symptoms of common mental disorders among this population and the preferred qualifications and characteristics of a mental health counselor.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Importance: Academic detailing (interactive educational outreach) is a widely used strategy to encourage evidence-based prescribing by clinicians.
Objective: To evaluate academic detailing programs targeted at improving prescribing behavior and describe program aspects associated with positive outcomes.
Evidence Review: A systematic search of MEDLINE from April 1, 2007, through December 31, 2022, was performed for randomized trials and nonrandomized studies of academic detailing interventions to improve prescribing.
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