Objective: To determine whether first responders delivering naloxone by either the IM or intranasal (IN) route were at risk of contamination with inert powder simulating canine opioid exposure.
Design: Prospective, crossover design.
Setting: Research study (university setting).
Animals: Ten clinically normal working dogs ranging from 9 to 44 months were enrolled based on training to detect odor and ability to be restrained with minimal stress. All enrolled dogs completed both arms of the study without adverse effects.
Interventions: Dogs were randomly assigned to fentanyl reversal with either IM or IN naloxone and then the alternate treatment after a 7-day washout period. Prior to reversal, dogs' heads were brushed with an inert glow-in-the-dark powder. First responders (the same 2 individuals for all dogs) performing the reversal were photographed under ultraviolet light prior to and 5 min after administering the medication. Digital photographs were scored by body region for presence of glowing powder by observers blinded to timing of photograph (pre- or postreversal) and route of reversal (IM vs IN).
Measurements And Main Results: Compared to pretreatment, the inert powder scores were higher after treatment regardless of route of naloxone administration (P < 0.001). IN administration led to higher contamination than IM naloxone, particularly in the chest area (P = 0.012).
Conclusions: Both IN and IM naloxone administration to dogs with clinical signs of opioid exposure result in a risk of first responders becoming contaminated with powder, which could include opioids. Awareness, proper personal protective equipment, and appropriate posttreatment decontamination are important to reduce risk of inadvertent exposure of mucous membranes to these contaminating powders.
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http://dx.doi.org/10.1111/vec.13113 | DOI Listing |
J Clin Psychiatry
January 2025
Division of Pharmacotherapy and Translational Science, College of Pharmacy, University of Texas at Austin, San Antonio, Texas.
To evaluate weight change with a combination of olanzapine and samidorphan (OLZ/SAM) versus olanzapine by pooling data across clinical studies. This study was an individual patient data (IPD) meta-analysis of clinical trial data. EMBASE, MEDLINE, and PsycInfo were searched for randomized clinical trials (≥12 weeks) in adults with schizophrenia or bipolar I disorder in which weight change from baseline was the primary or secondary end point.
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March 2025
Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, VA 23219, USA.
Background: Evidence supports the common incidence of sleep disturbance in opioid use disorder (OUD) as a potential marker of disrupted orexin system functioning. This study evaluated the initial safety and tolerability of a challenge dose of lemborexant, a dual orexin antagonist, as an adjunct to buprenorphine/naloxone.
Methods: Patients (18-65 years old) with OUD receiving sublingual buprenorphine/naloxone, with a Pittsburgh Sleep Quality Index total score of 6 or higher, were recruited from outpatient clinics.
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.
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January 2025
Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, AZ.
Objectives: Buprenorphine is becoming a key component of prehospital management of opioid use disorder (OUD). It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine.
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
Co-Principal Investigator, EMS Bridge, Alameda Health System - Highland Hospital, Emergency Medicine, 1141 E 31st. St, Oakland, CA, 94602.
Objectives: Opioids kill tens of thousands of patients each year. While only a fraction of people with opioid use disorder (OUD) have accessed treatment in the last year, 30% of people who died from an overdose had an Emergency Medical Services (EMS) encounter within a year of their death. Prehospital buprenorphine represents an important emerging OUD treatment, yet limited data describe barriers to this treatment.
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