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Description of implementing a mail-based overdose education and naloxone distribution program in community supervision settings during COVID-19.
J Subst Use Addict Treat
December 2024
Department of Pharmacy Practice & Science, Center for the Advancement of Pharmacy Practice, University of Kentucky, 789 S. Limestone, Lexington, KY 40508, USA. Electronic address:
Introduction: This study uses the Exploration, Preparation, Implementation, and Sustainment (EPIS) model to retrospectively describe the mail-based overdose education and naloxone distribution (OEND) program developed in collaboration with the Kentucky Department of Corrections (DOC) for use in the HEALing Communities Study in Kentucky (HCS-KY) and details the reach of this innovative delivery model.
Methods: HCS-KY is a community-engaged cluster-randomized trial assessing the effects of implementing evidence-based practices, including OEND, on overdose death reduction across 16 communities highly impacted by the opioid epidemic in Kentucky. The study launch coincided with the COVID-19 pandemic.
Oral fentanyl consumption and withdrawal impairs fear extinction learning and enhances basolateral amygdala principal neuron excitatory-inhibitory balance in male and female mice.
Addict Neurosci
December 2024
Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
The number of opioid overdose deaths has increased over the past several years, mainly driven by an increase in the availability of highly potent synthetic opioids, like fentanyl, in the un-regulated drug supply. Over the last few years, changes in the drug supply, and in particular the availability of counterfeit pills containing fentanyl, have made oral use of opioids a more common route of administration. Here, we used a drinking in the dark (DiD) paradigm to model oral fentanyl self-administration using increasing fentanyl concentrations in male and female mice over 5 weeks.
View Article and Find Full Text PDFTramadol as a fentanyl adulterant: Prevalence and management in a ToxIC Fentalog study prospective cohort.
Am J Emerg Med
December 2024
Icahn School of Medicine at Mount Sinai, Center for Research on Emerging Substances, Poisoning, Overdose, and New Discoveries (RESPOND), NYC Health + Hospitals/Elmhurst, New York, NY, USA.
Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.
Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.
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.
View Article and Find Full Text PDFTrends in naloxone co-prescriptions.
Drug Alcohol Depend
December 2024
Stanford University School of Medicine, Office of PA Education, 300 Pasteur Drive, Stanford, CA, United States; Stanford University School of Medicine, Department of Medicine, Division of Primary Care and Population Health, 300 Pasteur Drive, Stanford, CA, United States; Kaiser Permanente Mountain View Medical Offices, Department of Internal Medicine, 555 Castro Street, Mountain View, CA, United States. Electronic address:
Background: The opioid epidemic remains a significant public health crisis in the United States. Naloxone has been identified as a critical component in combating this crisis. However, co-prescription rates among patients receiving opioids remain suboptimal, especially among certain high-risk populations.
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