PubMed Update June 2016

Summer holiday. A mere 10 articles this month!

1) Community pharmacist knowledge, attitudes and confidence regarding naloxone for overdosereversal.

Nielsen S, Menon N, Larney S, Farrell M, Degenhardt L.

Addiction. 2016 Jul 1. doi: 10.1111/add.13517. [Epub ahead of print]

Comment: Most pharmacists in Australia would provide naloxone, but a minority feel comfortable selecting patients and educating about naloxone use and overdose.

2) Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain.

Coffin PO, Behar E, Rowe C, Santos GM, Coffa D, Bald M, Vittinghoff E.

Ann Intern Med. 2016 Jun 28. doi: 10.7326/M15-2771. [Epub ahead of print]

Comment: Naloxone can be successfully prescribed to primary care patients on longterm opioids for chronic pain, and receipt of naloxone is associated with a remarkable reduction in opioid-related emergency department visits.

3) Opioid Use Disorders.

Sharma B, Bruner A, Barnett G, Fishman M.

Child Adolesc Psychiatr Clin N Am. 2016 Jul;25(3):473-87. doi: 10.1016/j.chc.2016.03.002. Epub 2016 Apr 9. Review.

Comment: Review of opioid use disorder and treatments.

4) Predictors of seeking emergency medical help during overdose events in a provincial naloxone distribution programme: a retrospective analysis.

Ambrose G, Amlani A, Buxton JA.

BMJ Open. 2016 Jun 21;6(6):e011224. doi: 10.1136/bmjopen-2016-011224.

Comment: Respondents administering naloxone to overdoses on the street were more likely to call for medical assistance than those doing so in a private residence. This makes a lot of sense. Imaging if giving a breathing treatment for asthma in a home versus on the street – the latter setting is more likely to result in seeking assistance.

5) A qualitative study of reasons for seeking and ceasing opioid substitution treatment in prisons in New South Wales, Australia.

Larney S, Zador D, Sindicich N, Dolan K.

Drug Alcohol Rev. 2016 Jun 21. doi: 10.1111/dar.12442. [Epub ahead of print]

Comment: Fascinating paper on why many people want to stop opioid treatment while in correctional settings.

6) Weighing the Risks and Benefits of Chronic Opioid Therapy.

Lembke A, Humphreys K, Newmark J.

Am Fam Physician. 2016 Jun 15;93(12):982-90.

Comment: Interesting article on opioid therapy, noting that the presence of a use disorder does not necessarily obviate the value of opioids.

7) Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain.

Ray WA, Chung CP, Murray KT, Hall K, Stein CM.

JAMA. 2016 Jun 14;315(22):2415-23. doi: 10.1001/jama.2016.7789.

Comment: I haven’t reviewed how they did the propensity matching, but if these findings hold, they raise some real concerns for this medical intervention.

8) The Evolution of Recommended Naloxone Dosing for Opioid Overdose by Medical Specialty.

Connors NJ, Nelson LS.

J Med Toxicol. 2016 Jun 7. [Epub ahead of print]

Comment: Interesting that the dose for reversing an overdose in medical specialty literature is an order of magnitude different – from 0.05mg to 0.4mg IV – and we have yet another order of magnitude higher variation for lay reversal products.

9) Training law enforcement to respond to opioid overdose with naloxone: Impact on knowledge, attitudes, and interactions with community members.

Wagner KD, Bovet LJ, Haynes B, Joshua A, Davidson PJ.

Drug Alcohol Depend. 2016 Aug 1;165:22-8. doi: 10.1016/j.drugalcdep.2016.05.008. Epub 2016 May 18.

Comment: This is the most detailed study looking at law enforcement naloxone to-date; nice job.

10) Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists.

Lim JK, Bratberg JP, Davis CS, Green TC, Walley AY.

J Addict Med. 2016 Jun 3. [Epub ahead of print]

Comment: Nice review of lay naloxone.