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The first five years of implementing Missouri's medication first approach to opioid use disorder treatment: Plateaus, regressions, and underbellies of progress.
J Subst Use Addict Treat
January 2025
University of Missouri-St. Louis, Addiction Science, Missouri Institute of Mental Health, 1 University Blvd., Benton Hall, Room 206, St. Louis, MO 63121, USA.
Introduction: Missouri's Medication First ("MedFirst") approach promotes same-day and long-term low-threshold access to medications for opioid use disorder (MOUD). Since 2017, Missouri's SAMHSA-funded State Targeted and State Opioid Response (STR/SOR) grants have supported MedFirst services (both medical and psychosocial) for uninsured individuals with opioid use disorder at state-contracted treatment programs. Though MedFirst demonstrated early success, results - with attention to possible racial disparities - must be revisited after five years of implementation.
View Article and Find Full Text PDFPrehospital buprenorphine in treating symptoms of opioid withdrawal - a descriptive review of the first 131 cases in San Francisco, CA.
Prehosp Emerg Care
January 2025
EMS Bridge, Public Health Institute, Oakland, CA.
Objectives: Opioid use disorder (OUD) remains a common cause of overdose and mortality in the United States. Emergency medical services (EMS) clinicians often interact with patients with OUD, including during or shortly after an overdose. The aim of this study was to describe the characteristics and outcomes of patients receiving prehospital buprenorphine for the treatment of opioid withdrawal in an urban EMS system.
View Article and Find Full Text PDFPharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.
J Clin Med
December 2024
Department of Pharmacy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
: As long-term prescription opioid use is associated with increased morbidity and mortality, timely dose reduction of prescription opioids should be considered. However, most research has been conducted on patients using heroin. Given the differences between prescription and illicit opioid use, the aim of this review was to provide an overview of pharmacological strategies to reduce prescription opioid use or improve clinical outcomes for people who experience long-term prescription opioid use, including those with opioid use disorder.
View Article and Find Full Text PDFRacial and Ethnic Differences in Long-Term Outcomes among Individuals with Opioid Use Disorder at Opioid Treatment Programs.
J Racial Ethn Health Disparities
December 2024
Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Objectives: Racial and ethnic differences in long-term outcomes associated with medications for opioid use disorder (MOUD) are poorly understood.
Methods: The present analyses were based on 751 participants with opioid use disorder (OUD) who were initially recruited from opioid treatment programs located in California, Connecticut, Oregon, Pennsylvania, and Washington and participated in a randomized controlled trial and at least one follow-up interview. 9.
Opioid-induced respiratory depression: clinical aspects and pathophysiology of the respiratory network effects.
Am J Physiol Lung Cell Mol Physiol
December 2024
The author is retired. The positions and affiliations are those prior to his retirement.
Important insights and consensus remain lacking for risk prediction of opioid-induced respiratory depression (OIRD), reversal of respiratory depression (RD), the pathophysiology of OIRD, and which sites make the most significant contribution to its induction. The ventilatory response to inhaled carbon dioxide is the most sensitive biomarker of OIRD. To accurately predict respiratory depression (RD), a multivariant RD prospective trial using continuous capnograph and oximetry examining 5 independent variables: age ≥60, sex, opioid naivety, sleep disorders, and chronic heart failure (PRODIGY trial), was undertaken.
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