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Early Results of Implementing Rapid Methadone Titration for Hospitalized Patients: A Case Series.
J Gen Intern Med
January 2025
University of California, San Francisco, CA, USA.
Objectives: With the increase in illicit fentanyl use in the USA, hospitals face challenges managing opioid withdrawal and opioid use disorder (OUD). To improve opioid withdrawal and OUD treatment among hospitalized patients with daily fentanyl use, we developed a rapid methadone titration (RMT) protocol. We describe development, implementation, and outcomes during the first 12 weeks.
View Article and Find Full Text PDFMental Health Consequences of Opioid Pain Medication Use Behaviors and Motives Among Adolescents and Young Adults With Cancer: Results From a National Survey.
Psychooncology
January 2025
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA.
Background: Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population.
View Article and Find Full Text PDFAnalysis of Analgesics and Adjuvant Medications on Psychiatric Comorbidities in Patients With Complex Regional Pain Syndrome 1.
Cureus
December 2024
Psychiatry, Drexel University College of Medicine, West Reading, USA.
Complex regional pain syndrome (CRPS) is a chronic pain disorder characterized by severe, disproportionate pain relative to an inciting event. The disorder's pathophysiology is complex, involving both central and peripheral nervous system alterations, alongside genetic, inflammatory, and psychological factors. Using data from TriNetX, this study investigated the impact of analgesic and adjuvant therapies on psychiatric outcomes in CRPS patients.
View Article and Find Full Text PDFLow-dose naltrexone as a treatment for vulvodynia: A case series.
Case Rep Womens Health
March 2025
Division of Minimally Invasive Gynecology Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 460 Waterstone Drive, Hillsborough, NC 27278, USA.
Vulvodynia is a chronic vulvar pain condition that can be challenging to treat and often requires multi-modal interventions for symptom management. Low-dose naltrexone (LDN) is a reversible competitive antagonist at opioid receptors and may have utility in treating chronic pain conditions. In a specialty gynecology clinic at an academic medical center, patients with poorly controlled vulvodynia who had failed standard treatments were offered LDN as an adjunct pain treatment.
View Article and Find Full Text PDFEffects of a Revision to the Standard Admission Order Set on Laxative Prescribing for Opioid-Induced Constipation.
J Adv Pract Oncol
November 2024
From Memorial Sloan Kettering Cancer Center, New York, New York.
Purpose: Opioid-induced constipation (OIC) is highly prevalent in patients with cancer-related pain on opioid analgesics and has negative consequences on physical and psychological well-being and quality of life. Oncology clinical practice guidelines recommend the use of osmotic and stimulant laxatives for the prevention and management of opioid-induced constipation, not stool softeners such as docusate sodium. Prescribing practices continue to fall behind these recommendations.
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