COVID-19 necessitated rapid changes in methadone take-home policies in opioid treatment programs (OTPs); these changes markedly contrast with existing, long-standing federal mandates on OTP rules about take-home methadone. OTP providers describe how these changes have affected clinical decision-making, equity in patient care, and workflow. We also discuss implications for medical ethics and patient autonomy. We provide suggestions for future research that will examine the impact of COVID-19 on OTP treatment and its patients, as well as the effect of making methadone take-home polices patient centered, all of which may foreshadow larger changes in the ways OTPs deliver their services.
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http://dx.doi.org/10.1016/j.jsat.2020.108223 | DOI Listing |
BMJ Open
December 2024
Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, Changsha, Hunan, China.
Introduction: Opioid-induced constipation (OIC) affects up to 90% of patients with cancer receiving long-term opioid-related analgesic therapy, resulting in various potential complications, compromised pain management and decreased quality of life. Laxatives stimulate or facilitate bowel evacuation. Traditional laxatives, such as polyethylene glycol and lactulose, are widely used because of their low cost, easy accessibility and tolerability.
View Article and Find Full Text PDFBiol Psychiatry
December 2024
Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Addiction Institute of Mount Sinai, New York, New York, USA. Electronic address:
Background: Identifying neurobiological targets predictive of the molecular neuropathophysiological signature of human opioid use disorder (OUD) could expedite new treatments. OUD is characterized by dysregulated cognition and goal-directed behavior mediated by the orbitofrontal cortex (OFC), and next-generation sequencing could provide insights regarding novel targets.
Methods: Here, we used machine learning to evaluate human post-mortem OFC RNA-sequencing datasets from heroin-users and controls to identify transcripts predictive of heroin use.
Introduction: Methadone Maintenance Therapy (MMT) is commonly used to treat opioid addiction but can cause significant oral health issues, including poor oral hygiene, dental caries, periodontal disease, and bone resorption. These issues can negatively impact on overall quality of life, leading to both aesthetic and functional concerns.
Aim Of The Study: This research compares the oral health of individuals in methadone maintenance treatment (MMT) with those starting MMT.
J Craniofac Surg
October 2024
Department of Plastic Surgery, University of California, Irvine.
Enhanced recovery after surgery (ERAS) protocols have informed perioperative care across multiple surgical specialties, optimizing patient outcomes through surgical stress management and accelerated recovery. This study evaluates the familiarity and adoption of ERAS elements among craniofacial and oral and maxillofacial surgeons in pediatric orthognathic surgery, a field where a formal ERAS protocol has not been established. A closed-ended survey of 102 surgeons was conducted to assess familiarity with and utilization of 14 ERAS elements.
View Article and Find Full Text PDFHernia
December 2024
Department of Surgery, Cleveland Clinic, Cleveland, OH, USA.
Purpose: Despite efforts to minimize opioid prescribing, outpatient ventral hernia repair (VHR) with mesh remains notoriously painful, often requiring postoperative opioid analgesia. Here, we aim to characterize patterns of opioid prescribing for the heterogenous group of patients and procedures that comprise mesh-based, outpatient VHR.
Methods: The Abdominal Core Health Quality Collaborative registry was queried for patients undergoing VHR with mesh who were discharged the same or next day between January 2019 to October 2023.
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