UMLS:C0445299

The study investigates the adherence to stepped care management for knee pain and its impact on recurrence and healthcare utilization. The data was collected from 60,730 participants from the Military Health System Data Repository. The results showed that 89.7% of participants received Step 1 care, 18.1% received Step 2, and 6.9% received Step 3. Adherence to the stepped care resulted in cost savings, fewer knee-related visits, fewer episodes of knee pain, fewer knee surgeries, and fewer opioid prescriptions.


UMLS:C1171369


UMLS:C1527374

The paper discusses the implementation of Group-Based Opioid Treatment (GBOT) models in different outpatient settings across a large academic health care system. The study presents four cases of GBOT implementation, detailing the pros and cons, personnel and resources involved, patient mix and group format, workflow logistics, monitoring and management, and sustainability components. The study concludes that there is no one-size-fits-all approach to GBOT implementation, but a team-based, patient-centered medical home approach is commonly feasible. The study suggests that future research should focus on identifying the core and malleable components to implementation, their evidence base, and how they might be influenced by site-specific resources, culture, and other contextual factors.


UMLS:C3710571


UMLS:C1138603

The paper discusses the implementation of Group-Based Opioid Treatment (GBOT) for patients with opioid use disorder (OUD). It identifies six core components for successful GBOT implementation: consistent group expectations, team-based approach to care, safe and confidential space, billing compliance, regular monitoring, and regular patient participation. The paper also identifies 14 malleable components and provides a conceptual framework for their application. The blueprint provided can help in the implementation of GBOT and in monitoring its influence on treatment outcomes.


UMLS:C5560051


UMLS:C1527374


UMLS:C0242402

The paper reviews the current literature on opioid overdose risk factors, with a focus on new factors contributing to the opioid crisis. The proliferation of fentanyl in the opioid market is driven by both market supply and a subpopulation of opioid users actively seeking it. Harm reduction techniques like fentanyl testing strips, naloxone education and distribution, drug sampling behaviors, and supervised injection facilities are being increasingly used and researched. Interventions such as medication for opioid use disorder and peer recovery coaching programs are also being used more to prevent opioid overdose. The opioid epidemic is a dynamic crisis that requires ongoing research to identify new overdose risk factors and develop new interventions for at-risk populations.


PUBCHEM.COMPOUND:3345


UMLS:C0808232


UMLS:C0035173

The study collected and analyzed tweets mentioning opioid-related keywords from seven cities in the United States between March 17th to July 17th, 2020. The distribution of these keywords varied by city, with New York having the highest percentage (29%) and Orange County, CA having the lowest (1%). The types of opioids and topics mentioned also varied by region. The findings suggest that social media data could be used to inform opioid surveillance efforts, highlighting potential regional and time-varying differences in discussions.


UMLS:C2936193


UMLS:C3179065


UMLS:C5392141

The paper discusses the impact of COVID-19 pandemic and related social distancing policies on people with substance use disorders (SUD). It introduces conversational agents, a type of social technology, and discusses their role in the prevention and treatment of SUD in the context of social distancing. The paper also discusses the potential benefits and limitations of designing and implementing such technology in the prevention and care for patients with SUD.


UMLS:C1445753


UMLS:C1956226

The study investigates the potential of integrating real-time social/behavioral data (Google Trends) and traditional healthcare data (Medicaid prescription drug utilization) to predict geographic and longitudinal trends in opioid-related Emergency Department (ED) visits. The data collected from January 2005 to December 2015 showed that models combining Google and Medicaid variables were more accurate in predicting sharp and state-specific changes in ED visits during the transition from heroin to fentanyl post 2013. This integrated model could inform policy efforts about regional medical treatment preferences and needs.


UMLS:C0919189


UMLS:C0205195

Regional medical treatment preferences and needs


UMLS:C3081469

Treatment seeking for Opioid Use Disorder

The paper discusses the potential impact of digital inequality on the treatment seeking behavior for opioid use disorder. It suggests that limited access to technology, lack of skills to use technology effectively, and limited social resources may contribute to negative health outcomes. The paper also highlights the importance of health literacy in understanding online information related to opioid medication. The shift towards telemedicine and online counseling due to the COVID-19 pandemic necessitates further research into the digital inequalities faced by those who misuse opioids.


UMLS:C2362527

Opioid medication-related online information


UMLS:C5540804

Shift toward telemedicine and online counseling


UMLS:C0035168

Digital inequalities faced by those who misuse opioids


UMLS:C0154478

The study examined the association between preoperative opioid use and postoperative outcomes among chronic opioid users. The researchers hypothesized that decreasing preoperative opioid use would improve outcomes, while increasing use would worsen them. The study found that patients with decreasing preoperative opioid use were slightly less likely to fill an opioid prescription postoperatively compared to those with stable use. However, the average daily doses were similar among patients who continued to use opioids postoperatively. There were no significant differences in several postoperative outcomes, including postoperative opioid use, based on changes in preoperative opioid use.


UMLS:C3508320

Patients with decreasing preoperative opioid utilization


UMLS:C2030292

Patients with increasing preoperative opioid utilization


UMLS:C0678270

Changes in preoperative opioid utilization

not associated with significant differences in


MESH:D017207

The study investigates the impact of fentanyl self-administration on brain immune responses in male Sprague-Dawley rats. The research found that short-term abstinence from fentanyl self-administration alters the expression of innate immune markers. Increased expression of certain cytokines, chemokines, tumor necrosis factor α, and interferon proteins was observed in the nucleus accumbens, while decreased expression was seen in the hippocampus. The study also found correlations between cumulative fentanyl intake and the expression of certain immune markers. The study suggests that the stimulator of interferon genes (STING) could be a novel target for immunomodulation during short-term abstinence from fentanyl self-administration.


PUBCHEM.COMPOUND:3345


UMLS:C1689842

The study shows that a vaccine for Fentanyl-associated disorders could be a potential therapeutic strategy. The vaccine, when administered to male and female rats, produced significant levels of anti-Fentanyl antibodies that effectively neutralized Fentanyl-induced antinociception. The vaccine also reduced Fentanyl brain levels and blocked Fentanyl-induced rate-disrupting effects. It also prevented decreases in physiological measures such as oxygen saturation and heart rate. The vaccine did not react with morphine, methadone, buprenorphine, or oxycodone, suggesting its specificity for Fentanyl.


UMLS:C0236514


UMLS:C1689842


UMLS:C0388088

The study investigates the analgesic potential of fingolimod, a drug used to slow down the progression of multiple sclerosis (MS), an autoimmune-inflammatory neurodegenerative disease often accompanied by severe neuropathic pain. The research used a mouse model of MS and found that daily doses of fingolimod reduced signs of central neuropathic pain in a dose-dependent and reversible manner. The drug also reduced cellular markers of central sensitization of neurons in the spinal cord. The study concludes that fingolimod acts as an agonist to the sphingosine-1-phosphate receptor 1 (S1PR1) to reduce pain in MS by reversing central sensitization of spinal nociceptive neurons.


UMLS:C0388088


UMLS:C5555014


UMLS:C0531971


PUBCHEM.COMPOUND:3675

The study explores the antinociceptive (pain-relieving) effects of the antidepressant phenelzine (PLZ). The research indicates that PLZ selectively inhibits ongoing inflammatory pain without affecting transient reflexive and acute nociception. The study also found that PLZ increases serotonin immunoreactivity, suggesting that it works as a monoamine-oxidase inhibitor. The research further shows that PLZ inhibits the activation of spinal nociresponsive neurons, reducing Fos expression in the superficial dorsal horn and glutamate-evoked calcium responses. This effect was blocked by the 5HT1A-receptor antagonist WAY-100,635, but not the alpha-2 adrenergic antagonist idazoxan, indicating that PLZ's antinociceptive effects are mediated through a 5-HT/5HT1AR-dependent inhibition of neuronal responses within nociceptive circuits of the dorsal horn.


PUBCHEM.COMPOUND:3675


PUBCHEM.COMPOUND:3675

Fos expression in the superficial dorsal horn


PUBCHEM.COMPOUND:3675

5-HT/5HT1AR-dependent inhibition of neuronal responses


UBERON:0002883

The study investigates the role of the left and right central nucleus of the amygdala (CeA) in neuropathic pain following peripheral nerve injury. The researchers found that the left CeA contributes to mechanical allodynia and hyperalgesia following right-sided peripheral nerve injury. The study also found that the control of neuropathic pain by the CeA is not strictly limited to the right CeA as previously assumed, but depends on the type of pain, side of injury, and the sensory modality.


PUBCHEM.COMPOUND:3676


MESH:D001060

The study investigates the preemptive analgesic effects of endomorphins, the endogenous mu-opioid agonists, in a mouse model of inflammatory pain. The results show that preemptive intrathecal administration of endomorphins significantly attenuates inflammatory pain. This is achieved through the regulation of the production of inflammatory cytokines in dorsal root ganglion (DRG) neurons via inhibition of p38 MAPK phosphorylation.


MESH:D001060


PUBCHEM.COMPOUND:5743

The study investigates the efficacy of combining Dexamethasone (DEX), a glucocorticoid used in epidural injections, and eplerenone (EPL), a selective mineralocorticoid receptor (MR) antagonist, in treating low back pain in a rat model. The results show that the combination of DEX and EPL is more effective in reducing mechanical and spontaneous pain behaviors than either alone. The combination also rescues glucocorticoid receptor (GR) immunoreactivity, which is downregulated by inflammation, and reduces a marker for satellite glia activation/neuroinflammation. This suggests that EPL may enhance the effectiveness of epidural steroid injections by enhancing the availability of the GR.


PUBCHEM.COMPOUND:443872


UMLS:C2080521

Dexamethasone (DEX) and Eplerenone (EPL)


NCIT:C3137


UMLS:C0037492

The study investigates the role of sodium channels in chronic low back pain, a common cause of chronic pain and disability. The research used rodents and induced low back pain by compressing the lumbar dorsal root ganglia (DRG) with small metal rods. The study found that the NaV1.6 and NaVβ4 sodium channel isoforms play key roles in the hyperexcitability of sensory neurons and the resulting pain. Knockdown of either subunit significantly reduced spontaneous pain and mechanical and cold hypersensitivity. The study suggests that targeting the abnormal spontaneous activity generated by these sodium channels may have therapeutic value.


UMLS:C1568495

Spontaneous pain and mechanical and cold hypersensitivity


UMLS:C1568495


PUBCHEM.COMPOUND:5284596

The study investigates the pharmacokinetics of naloxone, an opioid receptor antagonist, and its main metabolite naloxone-3-glucuronide (N3G) in humans. Eight healthy volunteers were given a high-dose naloxone infusion and their plasma concentrations of naloxone and N3G were measured over time. The study found that Yassen's model accurately predicted naloxone pharmacokinetics, while Dowling's model over-predicted naloxone concentrations. The researchers developed two covariate models that may be used for high-dose naloxone infusion in experimental and clinical practice.


PUBCHEM.COMPOUND:5284596


NCIT:C92845


UMLS:C5544426


NCBIGene:4280

The study introduces a mouse model for chronic ocular pain and corneal neuropathy following corneal surface injury (CSI). The CSI was induced by applying an alkali solution, which caused partial corneal deinnervation and subsequent reinnervation. The regenerated nerves showed increased tortuosity, beading, and branching. The CSI also enhanced eye-wiping behavior in response to hypertonic saline, indicating increased sensitivity. This hypersensitivity was found to be dependent on central and peripheral opioid receptors, as administration of opioid antagonists reinstated the eye-wiping behavior.


UMLS:C0451504


UMLS:C0395429


PUBCHEM.COMPOUND:5360515


UMLS:C0384842

The study investigates the mechanisms of latent sensitization, a long-lasting effect of peripheral inflammation on spinal nociceptive neurons. The researchers used a four-step approach and found that the neuropeptide Y Y1 receptor antagonist BIBO3304 reinstated pain hypersensitivity, indicating an unmasking of latent sensitization. This reinstatement was not observed in AC1 knockout mice and was prevented with a blocker to the NMDAR, AC1, PKA, TRPA1, TRPV1, or Epac. The study concludes that PKA and Epac are sufficient to maintain latent sensitization, which is kept in remission by the NPY-Y1 receptor system. The study also identified two novel molecular signaling pathways in the dorsal horn that drive latent sensitization in chronic inflammatory pain.


UMLS:C3467903


PR:000013729


UMLS:C4285670


PR:000001612

The study investigates the role of mu (MOR), delta (DOR), and kappa (KOR) opioid receptors in managing chronic postoperative pain. The results suggest that MOR and KOR, but not DOR, help maintain latent pain sensitization (LS) in a state of remission, reducing the intensity and duration of postoperative pain. The study also found that the endogenous KOR analgesia is more effective in female mice than in male mice.


PR:000001590


MESH:C097234

phosphorylated signal-regulated kinase (pERK)


MESH:C097234

reinstates hyperalgesia and pERK expression to a greater degree


UMLS:C0030705

The study investigates the impact of re-surgery and pharmacotherapy on patients suffering from severe persistent pain after groin hernia repair. The study found that both re-surgery and pharmacotherapy significantly improved the patients' quality of life over a five-year period. However, the improvement was significantly larger in the group that underwent re-surgery.


UMLS:C0030705


UMLS:C0035110


UMLS:C0013216


UMLS:C0678133

The study found that the chemotherapeutic agent Paclitaxel, used in cancer treatment, can directly activate astrocytes, a type of brain cell. This activation leads to the release of tumor necrosis factor-α (TNF-α) and stromal-derived cell factor 1 (SDF-1), which in turn cause acute pain, a condition known as Paclitaxel-associated acute pain syndrome (P-APS). The pain was significantly reduced by an astrocytic inhibitor, suggesting that targeting astrocytes and these cytokines could offer new treatments for P-APS.


CHEBI:83822


UMLS:C0034809

upregulated in skin tissue and downregulated in L5 DRG due to

The study investigates the regulation of the glucocorticoid receptor (GR) in a rat model of inflammatory pain. The researchers found that GR is widely expressed in normal dorsal root ganglia (DRG) and skin tissues. However, inflammation caused by the injection of complete Freund's adjuvant (CFA) into the hind paw of the rats led to an upregulation of GR in the skin tissue on the first day post-injection, but a significant reduction in the GR signal in the L5 DRG. This downregulation was still evident 14 days after inflammation. The study suggests that the observed downregulation of GR in sensory neurons may impact the use of steroids as treatment in these conditions and on the regulatory effects of endogenous glucocorticoids.


UMLS:C0027883


UMLS:C0069811

may have contributed to the downregulation of


PUBCHEM.COMPOUND:148124

The study investigates the role of 1-deoxysphingolipids (1-deoxySL) in the neurotoxicity caused by docetaxel chemotherapy. The research found that docetaxel treatment in mice led to an increase in neurotoxic 1-deoxySL in the nervous system. This accumulation was observed in the dorsal root ganglia (DRG) but not in the sciatic nerve. The study also found that the neurotoxic effects of 1-deoxySL on axons could be reversed with sphingosine-1-phosphate (S1P).


UMLS:C3896581


CHEBI:35786


UMLS:C0161479

The study reveals that the interruption of endogenous neuropeptide Y (NPY) signaling reinstates hypersensitivity in mice, indicating that nerve injury establishes a long-lasting latent sensitization of spinal nociceptive neurons. This mechanism extends beyond the sensory component of nociception, affecting the affective component of pain. The study also identifies new mediators of latent sensitization: TRPA1 and TRPV1. The research concludes that NPY acts at spinal Y1 to inhibit a molecular NMDAR➔AC1 intracellular signaling pathway in the dorsal horn, which is induced by peripheral nerve injury and drives both the sensory and affective components of chronic neuropathetic pain.


UMLS:C0394477

The study investigates the efficacy of Spinal Cord Stimulation (SCS) in managing pain after spinal cord injury (SCI) in rats. The results show that both conventional SCS and 1200 Hz, low-intensity SCS modestly reduced below-level mechanical hypersensitivity after SCI. However, the effects were short-lived and modest. The study also found that conventional SCS did not inhibit wide-dynamic range (WDR) neuronal responses, suggesting that pain inhibition was not associated with the inhibition of WDR neurons.


UMLS:C0394477


MONDO:0043797


UMLS:C3878228

The study evaluated the effect of green light exposure on patients with episodic or chronic migraines. The patients were exposed to white light for 10 weeks, followed by a 2-week washout period, and then exposed to green light for 10 weeks. The primary outcome was the number of headache days per month. Secondary outcomes included changes in the intensity and frequency of headaches, quality of life measures, and changes in pain medications. The study found that green light exposure significantly reduced the number of headache days and improved secondary outcomes, including quality of life and intensity and duration of headaches. No side effects were reported, suggesting that green light therapy could be a potential treatment option for migraine patients.


UMLS:C3878228


UMLS:C0030705

The study evaluated the trends of infections, related complications, and outcomes following the treatment of infection in patients with Chronic Pain Spinal Implantable Electronic Devices (CPSIEDs) from 2005-2014. The majority of the patients were treated without surgical intervention, and a smaller proportion underwent complete system explantation. Complications of CPSIED infection were higher among patients that did not undergo device removal. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in a small percentage of patients. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days.


UMLS:C1400684


MESH:D000086402

The study found that the spike protein of the SARS-CoV-2 virus can block the signaling of VEGF-A/neuropilin-1 receptor (NRP-1), a process that usually triggers pain. This "silencing" of pain could potentially explain why some infected individuals remain asymptomatic, which may contribute to the virus's widespread transmission.


PR:000036821


GO:0036323


MESH:D000086402


NCBIGene:381974

The study investigates the development of tolerance to MrgC agonist-induced pain inhibition in neuropathic rats. The findings suggest that repeated administration of MrgC agonist JHU58 leads to tolerance, reducing its ability to inhibit mechanical and heat hypersensitivity. This tolerance development may involve increased coupling of MrgC to β-arrestin-2 and ubiquitin-mediated receptor degradation. Pretreatment with TAK-243, an inhibitor of the ubiquitin-activating enzyme, attenuated the development of tolerance to JHU58. Interestingly, a cross-tolerance to morphine analgesia was also observed in rats that had become tolerant to JHU58, which was also attenuated by TAK-243.


UMLS:C1870193


UMLS:C1172887


UMLS:C0181532

The study investigates the effect of green light-emitting diodes (GLED) on patients suffering from fibromyalgia, a functional pain disorder. The study found that exposure to GLED for 1 to 2 hours daily for 10 weeks resulted in a significant reduction in pain intensity and improved quality of life. The therapy was not associated with any side effects. The results support the efficacy and safety of GLED therapy, suggesting the need for a larger clinical trial.


UMLS:C0181532


PUBCHEM.COMPOUND:5284596

The study aimed to examine the relationship between injury-induced secondary hyperalgesia and naloxone-induced unmasking of latent sensitization. 80 healthy volunteers were subjected to a cutaneous heat injury and then divided into 'high-sensitizers' and 'low-sensitizers' based on their secondary hyperalgesia areas. They were then given naloxone or a placebo. The results showed no significant differences in secondary hyperalgesia areas between naloxone and placebo treatments, or between 'high-sensitizers' and 'low-sensitizers'. However, in a mixed-effects model, secondary hyperalgesia areas were significantly larger following naloxone as compared to placebo for 'high-sensitizers'.


UMLS:C0458393


UMLS:C3878577

have larger secondary hyperalgesia areas following treatment with


UMLS:C3850135


UMLS:C2074900


UMLS:C4288292

The study investigates the therapeutic effects of resolvin D3 (RvD3), a lipid mediator derived from omega-3 fatty acids, on psoriasis. The research found that RvD3 reduced TRPV1-dependent acute pain and itch in mice. It inhibited capsaicin-induced TRPV1 currents in dorsal root ganglion (DRG) neurons via the N-formyl peptide receptor 2 (ALX/FPR2), a G-protein coupled receptor. Systemic administration of RvD3 reversed itch and prevented the development of psoriasiform itch and skin inflammation. The study also showed that RvD3 significantly inhibited capsaicin-induced TRPV1 activity and CGRP release in human DRG neurons, suggesting its potential as a novel therapeutic target to treat psoriasis.


UMLS:C4288292


NCBITaxon:10114

The study uses a rat mid-thoracic contusion model to examine at-level tactile allodynia, a type of pain that develops after spinal cord injury (SCI). The model is advantageous as not all animals develop hypersensitivity, allowing for the study of pain-like behavior separately from injury mechanisms. The study aimed to identify where hypersensitivity and spasticity develop and use this information to separate animals that develop hypersensitivity from those that do not. A hypersensitivity score was developed to separate these animals. The time course and prevalence of hypersensitivity phenotypes produced by this model were similar to that observed in humans with SCI. However, the amount of spared spinal matter in the cord did not explain the development of hypersensitivity.


UMLS:C5384831


UMLS:C0020454


UMLS:C0429891


UBERON:0002318


UMLS:C2960337

Intrathecal drug delivery systems (IDDS)

The study analyzed complications and adverse events associated with intrathecal drug delivery systems (IDDS) using the FDA's Manufacturer and User Facility Device Experience (MAUDE) database. The analysis included 1001 reports from February 2018 to August 2020. The top three reasons for adverse reports were infection/erosion, motor stall, and adverse medication reactions. Five deaths were reported among patients with IDDS, with three resulting from epidural hematoma after IDDS surgery. The study found that programming errors, medication concentration discrepancies, and failure to turn on the pump after reprogramming were preventable causes of medication-related IDDS adverse events.


UMLS:C2960337


NCIT:C87047


MESH:C477819

The study investigates the role of Prostaglandin 15d-PGJ2 in preventing muscle hyperalgesia (excessive sensitivity to pain) in rats. The research found that 15d-PGJ2 targets both PPARγ and opioid receptors to prevent muscle hyperalgesia. The study suggests that local PPARγ receptors could be important pharmacological targets for treating inflammatory muscle pain.


MESH:C097240


UMLS:C0166417


UMLS:C1555846

The study analyzed prescription drug claims from the Medicare Part D program associated with Pain Medicine Physicians (PMP). In 2017, there were 3280 unique PMP-prescribed drugs with an associated expense of 652 million dollars. Prescriptions related to PMP account for 0.4% of the program's drug expenditure. Opioids, anticonvulsants, and gabapentinoids were the most claimed and expensive drugs. Brand-named opioid drugs, despite being a small fraction of claims (8%), had higher expenses than generic drugs. The top 5% of PMP prescribers had 10 times more claims than the average PMP and prescribed a higher proportion of branded medications.


UMLS:C0919189


UMLS:C1456651


UMLS:C4542877


UMLS:C0384842

The study investigates the role of Neuropeptide Y Y1 receptor-expressing neurons in the dorsal horn of the spinal cord in chronic pain. Using Y1eGFP reporter mice, the researchers found that under hyperpolarized conditions, most Y1eGFP neurons exhibited fast A-type potassium currents and delayed, short-latency firing (DSLF). These neurons were rapidly adapting and often exhibited rebound spiking, characteristics of spinal pain neurons under the control of T-type calcium channels. The findings suggest that tissue or nerve injury might downregulate the channels that underlie A-currents, leading to membrane hyperexcitability in Y1-expressing dorsal horn neurons and persistent pain.


CL:4023012


UMLS:C0010957


UMLS:C0161479


PUBCHEM.COMPOUND:71566519


UMLS:C0814034


MONDO:0008383

The paper reviews the literature and explores the mechanisms underlying the expression of pain in both males and females in preclinical models of rheumatoid arthritis. It highlights the recent direct examination of the correlation between pain and sex in rheumatoid arthritis.


UMLS:C1522384


UMLS:C0740223

Preclinical models of rheumatoid arthritis


PR:000001612

The study investigates the role of µ-opioid receptor (MOR) activity in the central nucleus of the amygdala (CeA) in preventing chronic postoperative pain. The researchers induced hindpaw inflammation in mice, waited for hypersensitivity to resolve, and then injected opioid receptor inhibitors. The inhibitors reinstated hypersensitivity and produced signs of withdrawal, indicating latent sensitization and endogenous opioid dependence. In particular, the capsular subdivision of the right CeA showed increased Fos expression and reinstated mechanical hypersensitivity when naltrexone was injected. The study concludes that MORs in this area prevent the transition from acute to chronic postoperative pain.


UBERON:0002883


UMLS:C0233834


NCBIGene:4280

The study investigates the role of protein kinase C (PKC) isoforms in migraines using a mouse model. Migraine-like ongoing pain was identified in mice after chronic intermittent treatment with nitroglycerin (NTG). The peptide antagonist of calcitonin gene-related peptide α-CGRP (8-37) effectively blocked this pain. A significant activation of PKCδ was observed in these mice, and its functional inhibition significantly reduced the ongoing spontaneous pain. The NTG-triggered migraine behavior was replicated in wild-type mice, but not in PKCδ-null mice. The study concludes that PKCδ plays a critical regulatory role in migraine pathophysiology, suggesting new pharmacological targets for antimigraine treatment.


UMLS:C0054454

Calcitonin gene-related peptide α-CGRP (8-37)


PR:000002210


NCBIGene:18753


UMLS:C0181532

The study investigates the effects of green light-emitting diodes (GLED) on chronic pain management. It was found that exposure to GLED stimulates the release of β-endorphin and proenkephalin in the central nervous system of male rats. The µ- and δ-opioid receptors were identified as necessary for the antinociceptive effect of green light. The study suggests that GLED could be a potential therapy for managing pain, especially in HIV patients, without adverse side effects.


UMLS:C0181532


UMLS:C0066908


UMLS:C0140057


NCBIGene:36727

The study investigates the role of voltage-gated Ca2+ (CaV) channels and Cdk5, a neuron-specific kinase, in neuropathic pain caused by L5-6 spinal nerve ligation (SNL). The research found that while the total levels of Cdk5 and CaV3.2 did not increase in the dorsal root ganglia (DRG) L3-4, their subcellular distribution changed, concentrating on the neuronal soma. This change in CaV channels location and function in L3-4 afferent fibers is associated with Cdk5-mediated phosphorylation after L5-6 SNL, which may contribute to nerve injury-induced allodynia.


UMLS:C0196844


UMLS:C1707116


UMLS:C0114439


UMLS:C1295075

The paper is a systematic review of the contact burn injury model, a physiological pain model used in drug efficacy research. The study found inconsistencies in the application of the model across different studies, which challenges its validity. The model was found to induce consistent levels of primary and secondary hyperalgesia, but had limited sensitivity in testing analgesic drug response. There was also a weak correlation between experimental and clinical pain intensity variables. The authors propose an improved testing paradigm and provide recommendations for future use of the model.


UMLS:C1295075


UMLS:C0197526

The study investigates the genetic and epigenetic basis of chronic pain in the peripheral nervous system using rat models. Two persistent pain models were used: chronic constriction injury (CCI) of the sciatic nerve and intra-plantar injection of complete Freund's adjuvant (CFA). RNA-seq studies identified various biological processes related to synapse organization, membrane potential, transmembrane transport, and ion binding. Genes encoding transcriptional regulators were found to be downregulated in both models. ATAC-seq data revealed changes in chromatin accessibility in the dorsal root ganglion (DRG), with 1123 regions showing changes in one or both models. Functional annotation of these regions suggested different chromatin structure alterations following sciatic nerve injury and hind paw inflammation. Motif analysis identified DNA sequences known to bind transcription factors in the differentially accessible regions (DARs). The study enhances understanding of chromatin accessibility changes in chronic pain states, potentially identifying regulatory genomic elements that modulate gene expression in the DRG.


UMLS:C2077057

Intra-plantar injection of complete Freund's adjuvant (CFA)


UMLS:C0017337


UMLS:C1718741


UMLS:C0963088

The study found that the administration of IL-23 produces mechanical pain in female mice but not in male mice. This pain is promoted by estrogen and suppressed by androgen, indicating the involvement of sex hormones. The pain is produced through the IL-23/IL-17A/TRPV1 axis, which requires C-fiber nociceptors and TRPV1 but does not directly activate nociceptor neurons. Instead, IL-23 requires IL-17A release from macrophages to evoke mechanical pain in females. The deletion of the estrogen receptor subunit α (ERα) in TRPV1+ nociceptors abolishes this pain, demonstrating that the IL-23/IL-17A/TRPV1 axis regulates female-specific mechanical pain via neuro-immune interactions.


UMLS:C0963088


CHEBI:59779

The study identifies a compound called kenpaullone (KP) that enhances the expression and function of Kcc2/KCC2, a neuroprotective ion transporter, in rodent and human neurons. This is achieved by inhibiting GSK3ß. KP was found to effectively reduce pain-like behavior in mouse models of nerve injury and bone cancer. The study also discovered a genetically-encoded mechanism involving delta-catenin, a phosphorylation-target of GSK3ß in neurons, which activates the Kcc2 promoter via KAISO transcription factor. This mechanism, along with KP, can help re-normalize disrupted inhibitory neurotransmission.


CHEBI:59779


UMLS:C2699128


PUBCHEM.COMPOUND:9635825


UMLS:C0127798

The study investigates the potential of Methocinnamox (MCAM) as a long-lasting, non-surmountable antagonist for opioid overdose treatment. MCAM has been found to have a long duration of antagonist action at mu opioid receptors. In tests, MCAM's antagonism of mu agonist-inhibition of cAMP production was time-dependent, non-surmountable, and non-reversible. In vivo, MCAM antagonized mu agonist-mediated inhibition of thermal allodynia for up to 96 hours. MCAM also shifted the concentration-response curves of mu agonists in a ligand-dependent manner, suggesting that MCAM acts allosterically to alter the affinity and/or intrinsic efficacy of mu agonists.


UMLS:C0127798

mu agonist-mediated inhibition of thermal allodynia


NCBIGene:13609

The study investigates the role of Sphingosine-1-phosphate receptor 1 (S1PR1) in the central amygdala (CeA), a brain region associated with fear learning, aversive memory, and pain. The researchers used S1PR1 agonist SEW2871 and antagonist NIBR to study the effects on neurons in the lateral division of the CeA that express somatostatin (Sst). They identified two types of Sst neurons, regular-firing (type A) and late-firing (type B). SEW2871 application increased input resistance in type A neurons and altered several properties in type B neurons. NIBR application had no effect, indicating the absence of tonic S1P-induced S1PR1. The findings suggest that S1PR1 activation affects different subtypes of Sst neurons in the CeA.


UMLS:C0531971


UMLS:C0439924


NCBIGene:101929447

The study investigates the role of Cannabinoid type-1 receptors (CB1Rs) in pain modulation. The researchers created Pirt-CB1R conditional knockout mice to selectively delete CB1Rs in primary sensory neurons. The study found that the knockout did not alter mechanical or heat nociceptive thresholds, inflammation, or heat hyperalgesia. However, the systemic administration of CB-13, a peripherally restricted CB1/CB2R dual agonist, inhibited nociceptive pain and inflammation. This effect was diminished in the knockout mice. The study concludes that peripheral CB1Rs are important for the analgesic effects of systemically administered CB-13, suggesting that peripherally restricted CB1R agonists could be useful for pain treatment.


UMLS:C1541533


UMLS:C1541533

High-voltage activated calcium current (HVA-ICa)


PUBCHEM.COMPOUND:4829

The study investigates the effects of pioglitazone, a PPARγ agonist, on pain in both male and female subjects. The research found that pioglitazone decreased pain-like behaviors more effectively in females than in males across various mouse models of pain, including chemical-induced nociception, postsurgical pain, neuropathic pain, and painful diabetic neuropathy (PDN). However, in the ZDF rat model, pioglitazone decreased heat and mechanical hypersensitivity with no sex difference. The findings suggest that pioglitazone may have potential as a treatment for chronic pain conditions, particularly in women.


PUBCHEM.COMPOUND:4829


UMLS:C0332680

The study investigates the recovery dynamics of thermal hyperalgesia and dynamic weight bearing in a sciatic nerve entrapment injury model. The findings suggest that dynamic weight bearing provides a more clinically relevant behavioral measure for ongoing pain during nerve injury. The effect of sciatic nerve cuff on the ratio of weight bearing by the injured relative to uninjured hindlimbs more closely resembled that of thermal hyperalgesia, following a trend toward recovery by 30 days. The study also found an increase in the percent of body weight bearing by the contralateral paw that is not seen in the previously tested behaviors.


UMLS:C0332680


UMLS:C4505043


UMLS:C0463178


UMLS:C2976376

The study investigates the use of a selective A3 adenosine receptor (A3AR) agonist, MRS5980, in preventing and reversing neurotoxicities caused by cisplatin, a drug used to treat solid tumors. The neurotoxicities include cognitive impairments, sensorimotor deficits, and peripheral neuropathy. The study found that MRS5980 was effective in preventing these side effects and also in reversing them when administered after cisplatin treatment. The mechanism of action appears to be through the prevention of mitochondrial damage in the brain and the activation of repair pathways.


UMLS:C2976376


UMLS:C4739349

Summary not provided or could not be parsed.


NCBIGene:21813


NCBIGene:16410


NCBIGene:80312

The study investigates the role of TET1 in neuropathic pain caused by paclitaxel, a chemotherapy drug. The research found that overexpression of TET1 in the dorsal root ganglion (DRG) of male rats reduced the pain caused by paclitaxel. This was achieved by blocking the increase in the level of 5-methylcytosine and reversing the decrease in the amount of 5-hydroxymethylcytosine within the K2p1.1 promoter region, thereby rescuing the expression of K2p1.1. The findings suggest a potential avenue for managing chemotherapy-induced neuropathic pain.


UMLS:C5447517


UMLS:C0678133


MESH:D012908

The study investigates a deep-water clade of fish-hunting cone snails and discovers a diverse set of somatostatin (SS) analogs in their venom. These analogs, each optimized to elicit specific systemic physiological effects in prey, have increased metabolic stability, distinct SS receptor activation profiles, and chemical diversity. This makes them suitable leads for therapeutic application in conditions such as pain, cancer, and endocrine disorders. The findings establish the existence of SS-like peptides in animal venoms and highlight the synergy of combining molecular phylogenetics and behavioral observations in the discovery of natural products with biomedical potential.


UMLS:C0732165


PR:000015647


UMLS:C5392934

Molecular phylogenetics and behavioral observations

Discovery of natural products with biomedical potential


UMLS:C0161479

The study found that nerve trauma increases the levels of E74-like factor 1 (ELF1) in the dorsal root ganglion (DRG), but not in the spinal cord. This increase in ELF1 leads to an upregulation of matrix metallopeptidase 9 (MMP9) in the DRG, which contributes to nociceptive hypersensitivity, a characteristic of neuropathic pain. Preventing the increase of ELF1 attenuated the upregulation of MMP9 and the induction of nociceptive hypersensitivities. Conversely, artificially increasing ELF1 levels led to an upregulation of MMP9 and enhanced responses to stimuli. The findings suggest that ELF1 could be a new target for managing neuropathic pain.


UMLS:C1622262


UMLS:C1372634


UMLS:C4027542


UMLS:C0233834

The study demonstrates that latent sensitization (LS) of pain signaling, which can persist indefinitely after tissue injury, is driven by serotonergic neurons in the rostral ventral medulla (RVM) and is kept in remission by µ-opioid receptor constitutive activity (MORCA) in the dorsal horn of the spinal cord. The researchers found that hypersensitivity was accompanied by increased Fos expression in serotonergic neurons of the RVM, and this was abolished on chemogenetic inhibition of RVM 5-HT neurons. The study concludes that the 5-HT3 receptor is a promising therapeutic target for the development of drugs to prevent the transition from acute to chronic postsurgical pain.


PR:000001612

µ-opioid receptor constitutive activity (MORCA)


UMLS:C5418764


PR:000044661

is a promising therapeutic target for the prevention of


PR:000007694

contributes to the development and maintenance of

The study investigates the effect of the fat-mass and obesity-associated protein (FTO) inhibitor, meclofenamic acid (MA), on chronic constriction injury (CCI)-induced pain in female rats. The results show that intrathecal injection of MA reduced CCI-induced pain and hyperactivity of neurons and astrocytes in female rats, without affecting acute/basal pain and locomotor function. The study also found that MA prevented the CCI-induced increase in the histone methyltransferase G9a expression and reversed the G9a-controlled downregulation of mu-opioid receptor and Kv1.2 proteins. These findings suggest that FTO inhibitors could be used for the prevention and treatment of neuropathic pain in both men and women.


MESH:D058846


MESH:D058846

blocks the CCI-induced hyperactivations of


MESH:D058846

reverses the G9a-controlled downregulation of


HP:0012531

The paper discusses the multidimensional nature of pain, focusing on its aversive quality which is a major cause of suffering in patients with chronic pain. The research reviews the understanding of the organization of emotion, motivation, cognition, and descending modulation circuits for pain perception. It also describes the different types of neurons that shape the multidimensionality and aversive quality of pain. The paper further reviews how various interventions such as pharmacological, stimulation, neurofeedback, surgical, and cognitive-behavioral interventions can alter activity in these circuits to relieve chronic pain.


UMLS:C1720744


UMLS:C0027882


UMLS:C0808232


MESH:C090587

The study investigates the potential of argentatin C, a natural product derived from the medicinal plant Parthenium incanum, in managing postoperative pain. The research found that argentatin C inhibits the activity of voltage-gated sodium and T-type voltage-gated calcium channels, which play crucial roles in pain sensory processing. The compound was found to decrease sodium and T-type calcium currents, as well as excitability in rat and macaque dorsal root ganglion (DRG) neurons. It also reversed mechanical allodynia in a mouse model of postsurgical pain. These findings suggest that argentatin C could be a novel treatment for painful conditions.


MESH:C090587


UMLS:C0334910

The paper discusses the need for anesthesiologists to consistently develop and support the translation of their innovative and creative problem-solving skills into productive scientists. It aims to identify the gaps and develop a sustainable and diverse research pipeline in the field of anesthesiology.


UMLS:C0334910


UMLS:C1507395

The study found that a standardized order set in the emergency department (ED) significantly reduced hospital admission rates and the time to first non-opioid analgesic for adult patients with Sickle Cell Disease (SCD) presenting with pain. The order set did not affect the rate of return to the ED within 72 hours, ED elopement rate, or ED pain scores at discharge. The use of orally administered acetaminophen, celecoxib, tizanidine, and intravenous ketamine and ketorolac increased significantly. The potential cost reduction was $193,440 during the 12-month observation period.


UMLS:C1507395


UMLS:C1507395

Use of acetaminophen, celecoxib, tizanidine, ketamine, ketorolac


UMLS:C0038586

The paper reviews scientific studies evaluating addiction treatment programs in Latin America. It also provides a brief analysis of the available addiction prevention and treatment resources in the region, based on the ATLAS on Substance Use (ATLAS-SU) project led by the WHO. Substance use disorders (SUDs) are a major global health concern. Many initiatives have been proposed to reduce substance use and the impact of SUDs, including integrating treatments into healthcare systems, increasing access to treatment programs, and impacting outcome measures. In Latin America, several efforts have been made to improve addiction services and programs, but the impact of these efforts is not well known. Despite the availability of prevention and treatment strategies, information on the evaluation of the progress, results, and impact of these programs is limited.


UMLS:C0018696


UMLS:C0023122


UMLS:C0679698

evaluation of progress, results, and impact


UBERON:0007023

The study explores the severity of withdrawal and early response to treatment in 35 adult patients with opioid use disorder (OUD) during a 7-day transition to extended-release naltrexone (XR-NTX) using buprenorphine-naltrexone and ancillary medications. The results showed that withdrawal intensity improved consistently throughout treatment. Participants who received XR-NTX reported a greater reduction of symptoms by treatment day 2 and were less likely to be injection drug users. Adverse events were recorded in 20% of participants, most of which were single episodes of increased withdrawal that were well controlled using ancillary medications. One serious adverse event was unrelated to treatment. The study suggests that early opioid withdrawal changes may be a useful indicator of treatment response.


UMLS:C0679646


UMLS:C0877248


UMLS:C0156003

The study reveals that hospitalizations and valve surgeries due to drug use-associated infective endocarditis (DUA-IE) have increased more than 12-fold from 2007 to 2017, largely due to the opioid epidemic. Patients with DUA-IE were typically younger, more often female and white, and either insured by Medicaid or uninsured. Hospital stays for DUA-IE were longer and more expensive than for other patients with infective endocarditis.


UMLS:C0679646

The study investigates the co-use of tobacco and cannabis, focusing on quit interest, treatment preferences, and drug substitution during past cessation attempts. The study found that among the participants, 80% had tried to quit smoking cigarettes at least once, while 40% had tried to quit using cannabis at least once. Half of those who tried to quit reported an increase in their cannabis use during tobacco cessation and 62% reported an increase in their tobacco use during cannabis cessation. The study suggests that interventions should address tobacco use among cannabis-tobacco co-users, but also consider the lack of interest in cannabis cessation.


UMLS:C0808232


UMLS:C1552966

The study examines the differences in emergency department (ED) utilization between males and females with prescription opioid use disorder (POUD). Data from the 2005-2014 National Surveys on Drug use and Health were analyzed. The study found that 58.2% of adults with POUD reported past-year ED utilization. Females with POUD were more likely to use the ED than males. Factors such as older age, lower income, obtaining opioids from a physician, major depressive episode, and greater POUD severity were associated with increased odds of ED utilization among females. For males, public insurance and obtaining opioids from a physician were associated with ED utilization. Males with POUD who reported ED use had multiple substance use disorders. Treatment history for alcohol, drugs, or opioid use was associated with increased odds of ED use among both males and females with POUD.


UMLS:C0337575


UMLS:C2188865


UMLS:C5202687


UMLS:C3250485

The study found that patients with both type 2 diabetes mellitus (T2DM) and hypertension who also have a substance use disorder (SUD) are at a greater risk for T2DM complications and all-cause mortality. The substance use disorders studied included tobacco use disorder (TUD), opioid use disorder (OUD), cocaine use disorder, cannabis use disorder (CUD), and alcohol use disorder (AUD). The complications of T2DM studied were cerebrovascular accident, diabetic neuropathy, diabetic renal disease, and myocardial infarction.


UMLS:C0038586


UMLS:C0181962

The study investigates the clinical profile of cannabis users who smoke blunts compared to those who smoke joints. The study found that the frequency of blunt use in the past month significantly predicted the average amount of cannabis used per day, the estimated average cost of cannabis, and the severity of withdrawal symptoms. However, the frequency of joint use did not significantly predict any of these factors. The study suggests that blunt smokers may have more intense withdrawal symptoms and may benefit more from treatment that targets physiological and mood-related withdrawal symptoms.


UMLS:C0450436


UMLS:C0181962


UMLS:C0450436

Cannabis use characteristics or consequences


UMLS:C4505402

ACCENT (Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment)


UMLS:C1301664

Substance use disorders, Diabetes, Hypertension

The study uses electronic health records to examine the relationship between substance use disorders, diabetes, and hypertension. It identifies these as high-severity, high-cost conditions. The study suggests that improving the quality and validation of data can enhance the ability to screen for substance use disorders and treat their complications among patients with multiple chronic illnesses.


UMLS:C0677237

Medical record-based screening of substance use disorders


UMLS:C0586813

Patients with multiple chronic illnesses


UMLS:C5574920

The paper reviews research on Black participants in the National Drug Abuse Treatment Clinical Trials Network (CTN). Despite over 5,000 Black individuals being enrolled in CTN trials since 2000, there has been no synthesis of the findings or suggestions for future research. The review found 50 articles, mostly focusing on baseline characteristics, substance use treatment outcomes, HIV/risky sex behaviors, retention, comorbid conditions, and measurement issues. The review emphasizes the need to understand and treat substance misuse among Black people, and the need to identify the most effective treatments for Black individuals who use substances.


UMLS:C5574920


UMLS:C0205653

The study examined the prevalence and health characteristics of prescription opioid use, misuse, and use disorders among U.S. adolescents using data from the 2015, 2016, and 2017 National Surveys on Drug Use and Health. It was found that multiple substance use was common among adolescents with past-year prescription opioid use and nonmedical prescription opioid use. The most frequently used prescription opioids were hydrocodone, codeine, oxycodone, and other opioids. Cannabis use disorder and alcohol use disorder were prevalent among opioid misusers. Several correlates of prescription opioid use, nonmedical prescription opioid use, and prescription opioid use disorder were identified, including demographics, other substances used, lifetime medical conditions, major depressive episode, and survey year.


UMLS:C0205653


UMLS:C5392920


UMLS:C0813947

Long-acting injectable and implantable medications

The study aimed to understand the preferences of individuals with opioid use disorders (OUD) for long-acting injectable and implantable medications versus short-acting formulations. The study found mixed evaluations, with some participants expressing a preference for long-acting formulations, while others preferred short-acting ones. Concerns about the long-acting formulations included invasive administration and loss of control over treatment. However, some participants felt that long-acting formulations could reduce medication-related burdens and the risk of misuse. The results suggest that a variety of medication formulations should be made available to patients, and shared decision-making could help patients choose the best treatment for them.


UMLS:C4505307


UMLS:C0030705


UMLS:C0220847

The study conducted a vulnerability assessment for Hepatitis C Virus (HCV) infections associated with injection drug use (IDU) in Utah, using data from 2015-2017. The Centers for Disease Control and Prevention (CDC) suggested using HCV cases as a proxy for IDU. The Social Vulnerability Index was used to identify vulnerable areas to HCV outbreaks and Geographical Information System (GIS) was applied to identify hot spots of HCV infections. Factors such as rates of skin infection, buprenorphine prescription, administered naloxone, teen birth, and per capita income were associated with HCV infections. The study suggests frequent vulnerability assessments using updated data to better target resources and evaluate the impact of HCV screening on controlling HCV outbreaks.


MONDO:0021201


UMLS:C5451882


PUBCHEM.COMPOUND:5284596


UMLS:C0682070


UMLS:C0948769


UMLS:C0242191

The study reveals that Pacific Islander (PI) young adults have a high rate of hazardous drinking and alcohol-related harms. Survey data from 156 PI young adults in Los Angeles County and Northwest Arkansas showed a 78% lifetime rate of alcohol use, with 56% screening positive for hazardous drinking, 49% for possible alcohol use disorders (AUD), and 40% experiencing significant alcohol-related harm. Despite these high rates, only 25% of participants reported a past-year need for substance use disorder (SUD) treatment. The study suggests the need for culturally grounded interventions to reduce the elevated rates of hazardous drinking and alcohol-related harms among PI young adults.


UMLS:C0242191


UMLS:C0042610

The study investigates the primary care experiences of patients with opioid use disorder (OUD), other substance use disorders (SUDs), and no SUD in the Veterans Health Administration. It was found that patients with OUD reported the least positive experiences with access and medication decision-making, and the most negative experiences with self-management support and provider communication. Compared to other groups, patients with OUD reported fewer positive and/or more negative experiences in several areas. However, among OUD-diagnosed patients, buprenorphine treatment was associated with more positive experiences in care comprehensiveness, medication decisions, and care coordination.


UMLS:C4746449


PUBCHEM.COMPOUND:644073


UMLS:C0242402

The paper discusses the ethical and clinical implications of mandating opioid dose reduction in patients who have been on long-term opioid treatment. It highlights the increase in addiction and overdose cases involving opioids, which has led to a clinical recalibration by healthcare providers and policy-making agencies favoring forced opioid reduction. However, the paper argues that neither the 2016 Guideline issued by the Centers for Disease Control and Prevention nor clinical evidence supports such policies as safe or effective.


UMLS:C3494697

Centers for Disease Control and Prevention


UMLS:C3494697


UMLS:C0857121

The study found that hypertensive patients with substance use disorders (SUDs) have a significantly higher risk of morbidity and mortality. This includes increased risk of cerebrovascular accident, renal failure, myocardial infarction, and all-cause mortality. The substances of interest were tobacco, alcohol, cocaine, opioids, and cannabis. The findings suggest the importance of managing SUDs in patients with hypertension.


UMLS:C0038586


UMLS:C2936305

The paper discusses the impact of the COVID-19 pandemic on opioid use disorder treatment in Indigenous communities in the United States and Canada. The pandemic has likely worsened opioid use problems, particularly among individuals with acute distress, comorbid mental illness, or those requiring withdrawal management or residential services. The paper highlights the increased access to medications for opioid use disorder due to greater prescription flexibility, the expansion of telemedicine services, and the challenges with restricted participation in traditional Indigenous healing practices. The authors also express concern about the pandemic's impact on patients' mental health and safety. They suggest that some treatment transformations may be beneficial even post-pandemic, such as enhancing access to community-grounded treatment, reducing stigma, and promoting patient self-efficacy.


UMLS:C0581047


UMLS:C5392141

Traditional Indigenous healing practices


UMLS:C1138603


UMLS:C1554215

Community-grounded treatment, stigma, patient self-efficacy


UMLS:C0031323

The study presents the development and implementation of the Brief Intervention Medication Therapy Management (BIMTM) model to detect and address opioid misuse. The model consists of 9 sessions, one of which is delivered by a pharmacist and the rest by a patient navigator. The study found that there is a lack of training and resources for pharmacists to address misuse, which led to the development of the BIMTM model. The model was successful in identifying opioid misuse in 15% of screened patients, 98% of whom had health conditions that contribute to the risk of misuse. The study also found high levels of satisfaction with the BIMTM model.


UMLS:C1709488


UMLS:C0884590

Brief Intervention Medication Therapy Management (BIMTM)


UMLS:C2958300

The study evaluates the Safe Station program, a community-based response to the opioid crisis in New Hampshire, launched by the Manchester Fire Department (MFD) in 2016. The program aims to reduce barriers to accessing resources for people with substance use and related problems. The study used a mixed-methods design to identify key components of the program that are engaging, effective, replicable, and sustainable. Key program characteristics identified include firefighter compassion, low-threshold access, and immediacy of service linkage. Community partnerships were identified as key to the program's success, although there were mixed evaluations of the quality of communication among the organizations.


UMLS:C2958300

reduces barriers to accessing resources for


UMLS:C0680453


UMLS:C2958300

offers immediate, non-judgmental access to services for persons with


UMLS:C2362565

The paper suggests that physical therapists should play a more significant role in managing patients with opioid use and misuse, particularly those with musculoskeletal conditions and chronic pain. The American Physical Therapy Association (APTA) has emphasized physical therapy over the use of prescription opioids for pain management, but has not highlighted the role that physical therapists could play in monitoring opioid use and screening for misuse. The paper presents simulated patient cases and provides recommendations to increase physical therapists' knowledge and skills related to managing patients taking prescription opioid medications for pain.


UMLS:C2362565


UMLS:C4035111

American Physical Therapy Association (APTA)


UMLS:C3693657

The paper discusses the use of the estimand framework in substance use disorder (SUD) clinical trials. The estimand framework, as per the International Council for Harmonization (ICH) addendum, provides a common language and structure for aligning trial objectives, design, conduct, and analysis. The framework focuses on estimands, which describe the treatment effect and link the trial objective with the scientific question and the analytic approach. The use of estimands can help SUD researchers and clinicians to address events that affect measurement and interpretation at the beginning of the trial. The paper emphasizes the need for resources to understand and apply estimands to optimize the use of this new framework.


UMLS:C0014503

Trial objectives, Scientific question, Analytic approach


UMLS:C0681916


UMLS:C1144854

The study provides cost data on the implementation and first-year operations of a syringe services program (SSP) based in an academic institution, using both fixed and mobile strategies. The study found that the total cost for the fixed site was $407,217.22 or $729.72 per participant, and $311,625.52 or $2415.70 per participant for the mobile unit. The largest cost component was time-dependent costs (personnel and overhead), while intervention materials were less than 15% of the total program cost. The study suggests that the implementation and operation of new SSP models are low cost compared to the treatment for the multitude of harms people who inject drugs face without access to evidence-based prevention.


UMLS:C1144854


UMLS:C1511972


UMLS:C0039402


UMLS:C0696612

The study validates the use of the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) tool in community pharmacy settings for identifying patients with substance use, particularly those prescribed opioid medications. The TAPS tool showed fair or better discrimination between moderate-risk use and high-risk use for tobacco, alcohol, and prescription opioids. It also showed fair or better discrimination between low-risk and moderate-risk use in five of eight subscales, including tobacco, alcohol, marijuana, stimulants, and heroin. The TAPS tool could be a valuable assessment for screening illicit drug use among community pharmacy patients prescribed opioid medications.


UMLS:C0696612


UMLS:C0030705

The study investigates the association between the coprescription of opioids and benzodiazepines (BDZ) and mortality rates among patients with and without opioid use disorder (OUD) in a large healthcare system. The study found that about 10.5% of the patients died on or before December 31, 2014, and about 17.7% were prescribed BDZ during the final month of observation. Patients with OUD were prescribed higher average BDZ and opioid doses than those without OUD. Increased prescribed doses of BDZ and opioids were positively associated with mortality. Non-OUD patients who received both BDZ and opioid prescriptions had a higher mortality than those who received only BDZ or opioids.


UMLS:C4746449


UMLS:C5397313


UMLS:C0518087

The study examined the relationship between pain severity and substance use among patients prescribed opioids in Indiana and Ohio community pharmacies. The study found that increased pain severity and interference were associated with increased use of non-medical prescription opioids, sedatives, and tobacco, and decreased use of alcohol. The study also found that gender played a significant role in the associations between pain and alcohol, tobacco, and cannabis use.


UMLS:C4295166


UMLS:C0518087


UMLS:C0079399


NCBIGene:33866

EMA, smartphone and smartwatch sensor data, social media data

The study, D-TECT, aims to evaluate the feasibility of collecting data from ecological momentary assessment (EMA), smartphone and smartwatch sensors, and social media among patients undergoing medication treatment for opioid use disorder (MOUD). The study also aims to examine the utility of these data sources in predicting MOUD treatment retention, opioid use events, and medication adherence. This is the first project to include all three sources of digitally derived data in understanding the clinical trajectories of patients in MOUD treatment. The results may help in understanding the relationship between digital data sources and OUD treatment outcomes and may inform approaches to enhancing outcomes measurement in clinical trials.


UMLS:C2919366

EMA, smartphone and smartwatch sensor data, social media data

MOUD treatment retention, opioid use events, medication adherence


UMLS:C1622900


NCBIGene:314623

The Medicaid Outcomes Distributed Research Network (MODRN) was developed to conduct multi-state analyses without sharing individual-level data across states. It uses a common data model and standardized measure specifications and statistical software code to conduct analyses. The network has been successful in informing Medicaid policy, particularly in improving opioid use disorder treatment. Since its inception in 2017, MODRN has created 21 opioid use disorder quality measures in 13 states. The network has demonstrated its utility and addressed barriers to conducting multi-state analyses of Medicaid administrative data.


NCBIGene:314623


UMLS:C4324621

The study reveals that the current quality measures for opioid use disorder (OUD) treatment lack patient-centeredness. Only two out of 31 endorsed OUD quality measures incorporated patient preferences and needs. The study also found that evidence varied for practices of patient-centered care. The researchers developed a new taxonomy, EQuIITable Care, which includes six classifications to address this issue and provide a roadmap for future research and quality measure development.


UMLS:C0204640


UMLS:C0035173


UMLS:C0581567


UMLS:C0556025

The study used machine learning algorithms to identify high-priority areas in Florida for the implementation of syringe services programs (SSPs), which are crucial in reducing disease transmission and combating the overdose crisis among people who inject drugs (PWID). The model used acute Hepatitis C (HCV) infection cases as an indicator of injection drug use and identified three significant variables: the number of drug-associated skin and soft tissue infection hospitalizations, the number of chronic HCV infections in people aged 18-39, and the number of drug-associated endocarditis hospitalizations. The study found that both urban and rural communities outside of current Ending the HIV Epidemic counties were high-priority areas for SSP implementation.


UMLS:C0556025


UMLS:C1144854


MONDO:0100371


UMLS:C5392974

The study investigates the effectiveness of Patient Navigation (PN) in engaging people living with HIV who report substance use (PLWH-SU) in care. The study identifies three latent profiles of barriers to care and finds that PN interventions are most effective for PLWH-SU with fewer, less severe healthcare barriers. However, individuals with a history of abuse, intimate partner violence, and discrimination may require additional interventions.


UMLS:C5392974


UMLS:C1562364

Individuals with a history of abuse, intimate partner violence, and discrimination

may require additional interventions beyond


UMLS:C1828298

The study uses Reddit to understand the experiences of drug users during the COVID-19 lockdown. The researchers used machine learning to analyze posts and comments from opioid-related communities on Reddit from March to May 2020. The most common topics in COVID-19-related discussions were medication for opioid use disorder experiences and access issues, recovery, and drug withdrawal. The pandemic impacted drug users in several ways, including forced or intentional withdrawal, confusion between withdrawal and COVID-19 symptoms, issues with take-home medication for opioid use disorder, and barriers to recovery.


UMLS:C1828298


UMLS:C4324621

The study used two different multiplier methods to estimate the prevalence of opioid use disorder (OUD) in the United States from 2010 to 2019. The findings suggest that the prevalence of OUD increased from 2010 to 2014, then stabilized and slightly declined annually. The highest prevalence was 4.0% in 2015 according to survey data with multiplier, and 2.35% in 2016 according to death data with a multiplier and correction. The estimated number of US adolescents and adults with OUD in 2019 was between 6.7-7.6 million.


UMLS:C4324621


PUBCHEM.COMPOUND:3345


UMLS:C0815266

The opioid/overdose crisis in the United States and Canada, which has resulted in hundreds of thousands of deaths, is largely attributed to three factors: the unethical marketing practices of pharmaceutical companies promoting prescription opioids, the despair and marginalization resulting from deindustrialization and joblessness, and an increase in occupationally-induced pain and injuries. These factors can be traced back to the "one-sided class war" that began in the 1970s and was institutionalized as neo-liberalism in the 1980s. This socio-political shift enabled pharmaceutical misconduct, nurtured individualistic ideologies that led to despair and drug use, weakened community social support, and reduced workplace safety, leading to more injuries and pain. Understanding these roots can help in developing effective interventions and policies to mitigate or reverse the opioid/overdose outbreak.


UMLS:C1135946


UMLS:C0237707


UMLS:C4740281

The paper reviews the role and impact of peer recovery support specialists in assisting individuals with substance use disorders at various stages of their recovery. These specialists work in different settings such as community, hospitals, emergency departments, jails, prisons, and treatment and recovery agencies. The paper also discusses the future expansion of peer recovery support services, addressing issues like supervision needs, compassion fatigue, burnout, and scope of practice. Recommendations are made for the broad implementation of these services as a sustainable part of harm reduction and addiction services, and for further research to evaluate the effectiveness of these interventions.


UMLS:C4740281

Community, Hospitals and emergency departments, Jails and prisons, Treatment and recovery agencies


UMLS:C0814331


UMLS:C4740281


UMLS:C0478677

The study reveals that incarceration and compulsory rehabilitation in Vietnam negatively impact the treatment of opioid use disorder (MOUD) and HIV. The data was collected from a clinical trial testing the effects of MOUD on HIV viral suppression in six Vietnamese HIV clinics. The study found that those who were incarcerated or sent to compulsory rehabilitation were less likely to receive MOUD and engage in HIV clinic treatment. The study suggests that prioritizing evidence-based strategies to support engagement in care for people who use drugs could potentially expand HIV and Opioid Use Disorder treatment access more effectively than reliance on incarceration or compulsory rehabilitation.


UMLS:C1145185


UMLS:C0478677


UMLS:C1510541

HIV and Opioid Use Disorder treatment access


UMLS:C4083280

The study investigates the relationship between fentanyl use and the initiation and retention of medications for opioid use disorder (MOUD) among people with uncontrolled HIV disease. The study found that participants who tested positive for fentanyl were 11 times less likely to initiate extended-release naltrexone (XR-NTX) treatment. However, fentanyl use did not impact the likelihood of treatment as usual (TAU; buprenorphine or methadone) initiation. Once initiated, fentanyl use did not affect retention on any MOUD.


UMLS:C4083280


UMLS:C0679255

The study used electronic health record (EHR) data to identify prescription opioid misuse in an integrated health system and examined predictors of misuse and overdose. The study found that 2.7% of the 396,452 patients were identified with opioid misuse and 1044 had an overdose event. Older patients were less likely to misuse or overdose. Whites were more likely to misuse, but not to overdose. Alcohol and drug disorders were related to higher risk of misuse and overdose, except marijuana disorder which was not related to opioid misuse. Higher daily opioid dosages and benzodiazepine use increased the risk of both opioid misuse and overdose.


UMLS:C4048284


UMLS:C4505254


UMLS:C0678248

The study investigates the relationship between medical comorbidity and the initiation and engagement of treatment for alcohol and other drug (AOD) use disorders. Data from 7 US healthcare systems was used to identify patients with AOD use disorders. The study found that patients with a Charlson/Deyo comorbidity index score of 2 or more were less likely to initiate treatment. However, patients with prior-year diagnoses of cirrhosis and pancreatic disease were more likely to initiate treatment. Higher comorbidity scores were associated with a lower likelihood of engagement in treatment. The study concludes that interventions are needed to improve AOD treatment initiation and engagement for patients with comorbidities.


UMLS:C2598122

Patients with prior-year diagnoses of cirrhosis and pancreatic disease


UMLS:C0009488


UMLS:C0808232

AOD treatment initiation and engagement for patients with comorbidities


UMLS:C1518563

The study examined factors associated with the initiation and engagement of treatment among patients with opioid use disorder (OUD) across seven health systems. The study found that the prevalence of OUD varied across health systems, as did rates of treatment initiation and engagement. Patients diagnosed in the emergency department or psychiatry/alcohol and other drug (AOD) treatment were more likely to initiate treatment compared to those diagnosed in primary care. Older patients and women were less likely to initiate treatment. Patients diagnosed in psychiatry/AOD treatment were more likely to engage in treatment, while those identified in an inpatient setting, those with medical comorbidity, and older patients were less likely to engage in treatment. The study concludes that there is room for improvement in the rates of initiation and engagement for OUD patients.


UMLS:C5555297

The study compared the Healthcare Effectiveness Data and Information Set (HEDIS) measures of alcohol and other drug (AOD) use disorder treatment initiation and engagement among people living with HIV and patients without an HIV diagnosis. The study found that the rates of AOD use disorder treatment initiation and engagement were low in both groups, and HIV status was not significantly associated with either AOD use disorder treatment initiation or engagement.


UMLS:C5555297


UMLS:C0740828


UMLS:C2958463

The paper discusses the importance of three factors in integrating measurement-based care for opioid use disorders into primary care. These factors include the integration with other behavioral health and substance use disorders care, the availability of a brief, valid measure that is responsive to change, and implementation in a manner that fosters accurate reporting.


UMLS:C2958463

Behavioral health and substance use disorders care


UMLS:C2958463


UMLS:C0030705

The study found that patients who have experienced a non-fatal opioid overdose (NFOO) are at a higher risk of experiencing another overdose, particularly if they have an opioid use disorder (OUD). The study also found that the rates of substance use treatment utilization increased after the first NFOO. However, the initiation rates for substance use treatment after a NFOO were low, indicating a need to address patient, provider, and system barriers.


UMLS:C4324621


UMLS:C0520804


UMLS:C0030705


UMLS:C0593607

The study evaluates the Single-Item Screen-Cannabis (SIS-C) as a tool for screening Cannabis Use Disorder (CUD) in routine primary care. The SIS-C asks about the frequency of past-year cannabis use and its responses are documented in patients' medical records. The study found that the SIS-C had excellent performance characteristics in routine care as a screen for CUD. However, while it accurately identifies patients without CUD, low positive predictive values indicate a need for further diagnostic assessment following positive results when screening for CUD in primary care.


UMLS:C0038586

The study investigates the relationship between cognitive functioning and treatment outcomes in a randomized controlled trial of an internet-based psychosocial intervention for substance use disorders, the Therapeutic Education System (TES). The study found that cognitive functioning did not moderate the treatment effect on abstinence or retention. However, impaired reasoning and cognitive flexibility were associated with lower retention. The study concludes that TES is equally effective across a spectrum of cognitive functioning among diverse patients.


UMLS:C0455803


UMLS:C0392335


UMLS:C0233830

Impaired reasoning and cognitive flexibility


UMLS:C4324621

The paper reviews the use of buprenorphine, a partial opioid agonist, in treating opioid use disorder, a condition affecting over 26 million people globally. Despite evidence of its effectiveness, most patients with opioid use disorder do not receive buprenorphine or any other medical treatment. The paper also discusses the different formulations of buprenorphine, including newer long-acting injectable versions that may reduce the risk of misuse and improve adherence.


UMLS:C3647215


PUBCHEM.COMPOUND:644073


PUBCHEM.COMPOUND:5360515

Extended-release injection naltrexone (XR-NTX)

The study investigates the effectiveness of extended-release injection naltrexone (XR-NTX) in treating opioid use disorder. The results show that XR-NTX reduces the risk of dropout from treatment after an episode of opioid use. Among patients receiving XR-NTX, a positive urine drug test (UDT) result did not significantly affect the risk of dropout, unlike in the placebo group. However, the hypothesis that XR-NTX would lead to a higher proportion of patients with no opioid-positive UDT results compared to placebo was not confirmed.


UMLS:C2922228

did not significantly affect the risk of dropout


UMLS:C0420256


UMLS:C5556427

did not lead to a higher proportion of patients with


UMLS:C0946429

The study investigates the current practices, barriers, and recommendations for substance use screening in rural primary care settings. The study was conducted in rural federally qualified health centers (FQHCs) in Maine, involving primary care providers (PCPs), medical assistants (MAs), and patients. The findings reveal that all stakeholders agree on the importance of universal screening for substance use. However, barriers to effective screening include a lack of rapport between patients and providers, concerns about trust, judgment, and privacy, and a lack of comfort, training, and preparedness among PCPs and MAs to address screening results and offer treatment. The study suggests that strong relationships with providers are crucial for patients, and in-clinic resources and training are needed to increase provider comfort and preparedness to address substance use.


MONDO:0010559


UMLS:C0043210

The study investigates the differences in demographic and clinical characteristics between opioid users (OU) and alcohol and other drug users (AOD) based on gender. The findings suggest that female OU are more likely to be younger, White, employed, and benzodiazepine users, and less likely to have children or use cocaine and cannabis than female AOD. Male OU, compared to male AOD, are more likely to be younger, White, start abusing substances at a younger age, use benzodiazepines, and report greater psychological distress, but are less likely to be involved in criminal justice or use stimulants.


UMLS:C1881845


UMLS:C0043210


UMLS:C1513129

Clinical and Translational Science Award Program

The paper discusses the potential of the Clinical and Translational Science Award (CTSA) Program and the National Institute on Drug Abuse (NIDA) to address the opioid crisis in the USA through collaborative research. The CTSA Program, funded by the National Center for Advancing Translational Sciences (NCATS), has over 50 academic research hubs that can provide a rapid response to health crises. The paper also presents the results of a Landscape Survey conducted among these hubs, describing best practices and ideas for collaborations.


UMLS:C1513899

Training grants and clinical trial networks


NCBIGene:56835


UMLS:C0695450

Best practices and ideas for collaborations


UMLS:C5389872

The paper discusses the impact of the Covid-19 pandemic on clinical research for substance use disorders (SUDs), which has been hindered due to stay-at-home mandates. The authors propose the use of digital health tools to continue SUD clinical trials research remotely, in line with Covid-19 precautions. They provide a roadmap for integrating digital health and SUD clinical trials, including methods for recruitment, screening, informed consent, and other study procedures. The authors argue that investment in digital clinical trials for SUDs can have long-term benefits for research and clinical care, including defining regulatory requirements for digital systems, developing standards and protocols for technology use, and gaining experience that can be applied to telehealth treatment of patients with SUDs in the community.


UMLS:C0021953


UMLS:C0596545


UMLS:C0946429

The study investigates the early implementation of substance use screening in rural primary care clinics using the Tobacco, Alcohol, and Prescription Medication Screening (TAPS) Tool and clinical decision support (CDS). The study found that while the screening is being used, the use of CDS was lower due to limited positive screens. The TAPS Tool was favorably assessed for its content, credibility, and ease of workflow integration. Challenges include screening only at annual visits and self-administered screening for certain patients.


UMLS:C1322605


UMLS:C0220908


UMLS:C0681814

The study investigates the feasibility and impact of introducing emergency department (ED)-initiated buprenorphine (BUP) for opioid use disorder (OUD) in high-need, low-resource settings. The study was conducted in three different ED settings, using a multi-faceted approach to develop and refine site-specific clinical protocols for OUD screening, ED-initiated BUP, and referral for treatment. The study used a participatory action research approach and mixed methods, including data from medical records, patient assessments, and qualitative and quantitative inquiry involving ED staff, patients, and other stakeholders. The study aims to provide understanding on how to identify OUD and initiate treatment with BUP in EDs in high-need, low-resource settings.


UMLS:C0038586

The study investigates the relationship between substance use disorders (SUD), trauma exposure, and suicidal thoughts and behaviors (STB) in women. Traditional methods of measuring STB have been found to be limited, and this study uses item response theory to generate STB severity scores. The study found that younger age, opioid dependence, and higher PTSD reexperiencing symptoms were predictors of elevated STB severity. The study suggests that clinicians should screen for and target opioid use disorders and reexperiencing symptoms when addressing STB in trauma-exposed individuals with SUDs.


UMLS:C0871685


UMLS:C0030705

The study explores the correlation between patient engagement with a digital therapeutic for substance use disorder (SUD) and abstinence outcomes. The digital therapeutic, Therapeutic Education System (TES), was used in conjunction with traditional treatment methods. The study found that the more modules of the TES program patients completed, the higher the probability of abstinence in the last four weeks of treatment. Each completed module increased the odds of abstinence by approximately 11% for those who completed the study and 9% for the full sample.


UMLS:C3880951


UMLS:C0439750


UMLS:C1515945

American Indian/Alaska Native (AI/AN) communities

The paper discusses the proceedings of a Collaborative Board (CB) meeting aimed at developing an implementation intervention for American Indian/Alaska Native (AI/AN) clinical programs to improve the delivery of medications to treat opioid use disorder (OUD). The CB, comprising of elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers, emphasized the importance of integrating traditional healing practices, ceremonies, and other cultural practices, as well as the involvement of family in the treatment process.


UMLS:C1948070

developing an implementation intervention to improve the delivery of


UMLS:C1948070

Traditional healing practices, ceremonies, and other cultural practices


UMLS:C2362914

Hamilton Depression Rating Scale (HAM-D)

The study analyzed depression levels in adults undergoing treatment for opioid use disorder (OUD). Three distinct depression trajectories were identified: High Recurring (10% of participants), Persistently High (5% of participants), and Low Declining (85% of participants). The majority of participants showed improvement in depression levels in the first 4 weeks of treatment, which then stabilized. However, 15% of participants had high initial depression levels that varied over time. The group with persistently high depression levels had higher rates of opioid relapse. The study suggests that depressive symptoms should be monitored in patients starting OUD treatment, and if persistent, should prompt further evaluation and consideration of antidepressant treatment.


UMLS:C0086133

Medication treatment for opioid use disorder (MOUD)


UMLS:C4319571


UMLS:C0086133


UMLS:C4542877

The study measures the total amount of buprenorphine care provided by active prescribers and how this varies across different specialties.


UMLS:C5230801


UMLS:C4511934

The paper discusses the evolution of treatment for opioid use disorder in the United States, which has been shaped by federal policy changes and scientific advancements. It mentions the establishment of inpatient care in 1935 and the emergence of outpatient clinics in the 1960s. The paper highlights the effectiveness of opioid agonist therapy (methadone or buprenorphine) and opioid antagonist therapy (extended-release naltrexone) in preventing relapse after opioid withdrawal. It also emphasizes the importance of prevention efforts such as public and prescriber education, prescription drug monitoring programs, and safe medication disposal options. The paper advocates for the integration of opioid use disorder prevention and treatment with physical and mental health care.


PUBCHEM.COMPOUND:5284596


UMLS:C4324621


UMLS:C0242402

The paper discusses public health policy strategies to combat the opioid epidemic. It emphasizes the need to address both the supply and demand of opioids. The increase in opioid prescriptions has been linked to a rise in opioid overdose fatalities. The paper suggests that enhanced access to opioid agonist treatment is necessary to reduce the demand driven by opioid use disorders. The multidimensional approaches adopted by Oregon have resulted in a 20% reduction in opioid prescribing and a 30% decrease in the opioid overdose fatality rate.


UMLS:C4511934


UMLS:C4288564


UMLS:C3250667

The study found that the prevalence of menthol cigarette smoking among individuals in treatment for substance use disorders (SUD) was 53.3%, higher than in the general population. Factors associated with menthol smoking included being female, African American, Hispanic/Latino, and having a lower likelihood of possessing a college degree. Menthol smokers were more likely to report marijuana as their primary drug compared to alcohol and showed more interest in getting help for quitting smoking, although they were not more likely to have attempted quitting in the past year. The study suggests that regulatory policies targeting the manufacture, marketing, or sale of menthol cigarettes may benefit vulnerable populations, including smokers in SUD treatment.


UMLS:C1648680


UMLS:C0242402

The study analyzed the causes of death and contributing conditions among individuals who died from acute opioid, cocaine, or methamphetamine/amphetamine (MAMP) toxicity in San Francisco from 2005 to 2015. The findings revealed that there were 1252 opioid deaths and 749 stimulant deaths, with cocaine accounting for most stimulant deaths. Individuals with cardiac or cerebral hemorrhage deaths had higher odds of death due to acute stimulant toxicity versus acute opioid toxicity. No significant associations were found for cocaine compared to MAMP deaths. Significant contributing cardiac conditions were associated with higher odds of stimulant compared to opioid and cocaine compared to MAMP death. The study suggests that stimulant use be considered a cardio/cerebrovascular risk factor and clinical care be adjusted to address this heightened risk.


UMLS:C0358588


UMLS:C3506644

Individuals with cardiac or cerebral hemorrhage deaths


UMLS:C2015790

Significant contributing cardiac conditions


UMLS:C5234947


UMLS:C4759365

Community-based naloxone distribution program

The paper discusses a successful intervention by a community-based naloxone distribution program in San Francisco. The program identified the appearance of illicitly made fentanyl and increased outreach and naloxone distribution. As a result, the use of naloxone to reverse opioid-involved overdoses increased significantly, while the number of opioid-involved and fentanyl-involved overdose deaths did not increase.


UMLS:C4759365


UMLS:C0579142


UMLS:C0572088


UMLS:C1516168

The study examines the strategies employed by Oregon's Medicaid program, delivered through 16 Coordinated Care Organizations (CCOs), to reduce high-dose opioid prescribing. The CCOs were given the flexibility to develop their own targets and policies to achieve this. Most CCOs chose a target daily morphine milligram equivalent (MME) dose of 90mg. Strategies included issuing quantity limits, restricting specific drug formulations, and allowing for time-limited taper plan periods for patients over the threshold. Other methods included provider trainings, feedback reports, onsite technical assistance, incentive measures, electronic health record alerts, and toolkits with materials on local alternative therapy resources and strategies for patient communication. CCOs that collaborated with regional partners appeared to have a greater intensity of interventions than those operating independently.


UMLS:C1516168


UMLS:C0242402

The study investigates the relationship between the quantity of opioids used and the risk of overdose. The research was conducted on 63 participants over a period of 2014 to 2016. The study found that the volatility in the quantity of opioids used, i.e., using a different quantity than the average on more than 20% of all opioid use days, was significantly associated with the risk of opioid overdose.


UMLS:C0678251


UMLS:C4518791


NCBIGene:17250

The study discusses the barriers to adopting and implementing pharmacotherapy for substance use disorder and how they can be overcome. The Medication Research Partnership (MRP) successfully promoted the adoption of pharmacotherapy for opioid and alcohol use disorders in nine substance abuse treatment centers and a commercial health plan. The study found that these barriers can be overcome through incremental testing of organizational change strategies, expert coaching, and a learning community of professionals. The biggest challenges were overcoming abstinence-only philosophies, establishing a business case for pharmacotherapy, and working with payers and pharmaceutical representatives.


UMLS:C0687685

overcame obstacles to adopt and implement


UMLS:C0678273


UMLS:C0179664


UMLS:C2348942

Payers and pharmaceutical representatives


UMLS:C0681814

The systematic review assessed the acceptability and feasibility of prescribing naloxone, a medication used to counter opioid overdoses, in primary care settings. The review found that providers' willingness to prescribe naloxone increased over time. Most studies provided in-person naloxone training to prescribers and implemented universal prescribing, making anyone prescribed long-term opioids or at risk for overdose eligible for naloxone. Providers reported concerns around lack of knowledge in prescribing and educating patients about naloxone, but also noted benefits such as improving conversations around opioids and changing the culture around opioids and overdose. The review concluded that current literature supports the acceptability and feasibility of naloxone prescribing in primary care.


UMLS:C0681814


UMLS:C0543414

Comorbid physical and mental health conditions

The paper discusses the systemic barriers in the United States health care system that prevent patients with comorbid physical and mental health conditions from receiving necessary tobacco treatment. These barriers include insufficient training in the impact of tobacco use, misunderstanding about the effectiveness of tobacco treatment, lack of support from clinical staff, insufficient use of health information technology, and limited time and reimbursement for clinicians to provide treatment. The paper suggests evidence-based strategies to overcome these barriers and improve the quality of tobacco treatment.


UMLS:C0018696


UMLS:C0871685


UMLS:C3880136

Tobacco use identification and treatment


UMLS:C4324621

The study discusses the prevalence of opioid-use disorder in rural areas of the United States and its connection to HIV and hepatitis C transmission. It highlights the increased availability of heroin and fentanyl analogs over prescription opioids in these areas, contributing to the risk of HIV, hepatitis C, and overdose. The study also points out the lack of adequate treatment resources in rural areas, with only 18% of individuals having access to inpatient services and a mere 3% of primary care providers capable of prescribing buprenorphine. The paper emphasizes the need for implementing national models and resources in rural areas to prevent ongoing HIV and hepatitis C transmission and overdose.


UMLS:C3653393


UMLS:C0994078


UMLS:C0583420


UMLS:C1513906

The paper discusses the use of a single Institutional Review Board (IRB) for multi-site studies, as per recent NIH policy. The Western States Node of the Clinical Trials Network (CTN) used a single IRB for a clinical trial testing the use of an opioid antagonist versus opioid agonists for opioid use disorders among individuals living with HIV. The paper highlights the challenges and processes associated with the use of a single IRB and provides recommendations for effective use of single IRBs.


UMLS:C2346499


UMLS:C0935577


UMLS:C0027468

single Institutional Review Board (IRB) policy


UMLS:C4045969

The study identifies systemic barriers to the provision of buprenorphine treatment for opioid use disorders in Ohio. The barriers identified in 2012/2013 were negative attitudes towards buprenorphine among treatment providers, a lack of prescribers, and lack of funding. By 2015, the lack of prescribers had become the main barrier, while negative attitudes were no longer a problem. However, concerns about buprenorphine diversion had emerged as a new barrier. The study recommends policy efforts to increase the number of buprenorphine prescribers to make the best use of available funding to combat the opioid epidemic.


UMLS:C0242456


UMLS:C0006823

The study compares opioid agonist therapy (OAT) policies and practices in Canada and the United States, focusing on federal and local levels. It was found that in Canada, control of OAT policy has shifted from federal to provincial authorities, while in the U.S., federal authorities maintain primary control. Local health insurance coverage policies for OAT were significantly different between British Columbia and Oregon. British Columbia offered five OAT options, while Oregon only offered two with administrative limitations. The differences in local OAT access and coverage policies may be due to the differences in Canadian and U.S. federal OAT policies, specifically, the relaxation of special federal OAT regulatory controls in Canada. The study suggests that U.S. policymakers could consider adopting Canada's regulatory policy approach to expand OAT access and mitigate the harms of the ongoing opioid overdose epidemic.


UMLS:C0041703


UMLS:C5557205


UMLS:C0029195


UMLS:C0242170


UMLS:C0489538

Participants with a psychiatric diagnosis

The study aimed to identify factors that predict the initiation of opioid agonist therapy (OAT) among patients with and without HIV. The study found that only 4.9% of both groups initiated OAT within 30 days of a new opioid use disorder (OUD) clinical encounter. Factors such as having a psychiatric diagnosis, being a person with HIV (PWH), and living in a rural area were associated with a lower likelihood of OAT initiation. On the other hand, being African-American, having an alcohol-related diagnosis, being diagnosed between 2005-2008, and having Hepatitis C Virus (HCV) were associated with a greater likelihood of initiating OAT within 30 days.


UMLS:C5441680


UMLS:C4736228


UMLS:C0027361

The study investigates the use of digital technologies and the internet among individuals receiving treatment for opioid use disorder. The participants, who were from an urban opioid replacement therapy program, showed high rates of smartphone ownership (94%) and daily internet use (67%). 88% of participants reported searching online for health-related information in the past three months. Factors that predicted internet use for health-related purposes included higher technology acceptance for mobile internet use, younger age, current employment, and less bodily pain.


UMLS:C0027361


UMLS:C0679646


UMLS:C4704733

Internet use for health-related purposes

Technology acceptance for mobile internet use


UMLS:C4704733


UMLS:C2460953

Substance use disorder (SUD) treatment engagement

The study investigates the effect of a hospital-based addiction medicine consult service, the Improving Addiction Care Team (IMPACT), on post-hospital substance use disorder (SUD) treatment engagement. The study found that patients who participated in the IMPACT program were more likely to engage in SUD treatment following discharge than those who did not participate in the program. The study suggests that hospital-based addiction medicine consultation can improve SUD treatment engagement, which is associated with reduced substance use, mortality, and other important clinical outcomes.


UMLS:C5234947

Substance use disorder (SUD) treatment engagement


UMLS:C5234947


UMLS:C2718012

The study investigated the impact of the Affordable Care Act's 2014 Medicaid expansion on the treatment of opioid use disorders in Oregon. The results showed a significant increase in the number of Medicaid recipients and those diagnosed with opioid use disorders. More individuals received psychosocial services and medications for opioid use disorders. However, there was a decline in the proportion of individuals receiving care in opioid treatment programs.


UMLS:C0025071


UMLS:C1136321

The study investigates the impact of opioid-use disorders (OUD) on the immune system of people living with HIV (PLHIV), with or without hepatitis C or B co-infection (HEP). The findings reveal that PLHIV with OUD have higher frequencies of certain types of monocytes, regardless of HEP co-infection. Additionally, PLHIV with OUD and HEP specifically showed increased expression of soluble CD163 and monocyte cell surface CD163. The study also found that PLHIV with OUD, regardless of HEP co-infection, exhibited reduced production of certain cytokines in response to lipopolysaccharide (LPS) and phytohemagglutinin (PHA). The results suggest that OUD among PLHIV is associated with altered monocyte phenotypes and a dysregulated innate cytokine response.


UMLS:C1304454


UMLS:C1136321