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  • Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial

    Abstract Full Text
    JAMA. 2017; 318(17):1661-1667. doi: 10.1001/jama.2017.16190

    This randomized clinical trial compares the efficacy of 4 oral combination analgesics among adult patients treated for moderate to severe acute extremity pain at 2 urban emergency departments in the United States.

  • Opioid vs Nonopioid Acute Pain Management in the Emergency Department

    Abstract Full Text
    JAMA. 2017; 318(17):1655-1656. doi: 10.1001/jama.2017.16725
  • Interpretation of Urine Drug Screens: Metabolites and Impurities

    Abstract Full Text
    JAMA. 2017; 318(17):1704-1705. doi: 10.1001/jama.2017.10910

    A comprehensive urine drug screen for a 50-year-old woman taking daily methadone, immediate-release morphine, gabapentin, duloxetine, and celecoxib for pain was positive for methadone and morphine but also codeine and hydromorphone. How do you interpret the results?

  • Intervention Improves Adherence to Opioid Prescribing Guidelines

    Abstract Full Text
    JAMA. 2017; 318(16):1532-1532. doi: 10.1001/jama.2017.15789
  • Reframing the Opioid Epidemic as a National Emergency

    Abstract Full Text
    JAMA. 2017; 318(16):1539-1540. doi: 10.1001/jama.2017.13358

    This Viewpoint discusses the president’s recent declaration of a public health emergency in response to the opioid crisis in the United States.

  • JAMA October 11, 2017

    Figure: Opioid Use and Overdose and Fentanyl Drug Reports, 1999-2015

    aSource: National Center for Health Statistics at the US Centers for Disease Control and Prevention. WONDER online database: prescription opioid overdose deaths include fatal overdoses related to natural and semisynthetic opioids or methadone. Illicit opioid-related overdose deaths are related to heroin or synthetic nonmethadone opioids, and some overdose deaths are related to prescribed fentanyl or other prescribed synthetic opioids.bSource: Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health. https://www.samhsa.gov/data/population-data-nsduh/reports?tab=38.cSources: Dashed line from 1999 to 2005 (Drug Enforcement Administration. Automation of Reports and Consolidated Orders System: sales to pharmacies, hospitals, and practitioners for codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, and oxycodone. Paulozzi LJ, et al. MMWR Morb Mortal Wkly Rep. 2011;60:1487-1492). Solid line from 2006 to 2015 (QuintilesIMS estimates of opioid prescriptions dispensed in the United States to 59 000 pharmacies, representing 88% of US prescriptions. Guy GP Jr, et al. MMWR Morb Mortal Wkly Rep. 2017;66:697-704).dSource: Drug Enforcement Administration. Fentanyl, 2001-2015. https://www.deadiversion.usdoj.gov/nflis/2017fentanyl.pdf. The number of fentanyl drug reports reflects the number of encounters by law enforcement that tested positive for fentanyl. Therefore, fentanyl drug reports provide an indication of the available supply of illicitly manufactured fentanyl.
  • Underlying Factors in Drug Overdose Deaths

    Abstract Full Text
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    JAMA. 2017; doi: 10.1001/jama.2017.15971

    In this Viewpoint, authors from the US CDC’s National Center for Injury Prevention and Control discuss infrastructure investments, legal changes, and clinical and public health strategies for reducing overdose deaths among opioid users.

  • Injectable Buprenorphine Halts Effects of Opioids and May Deter Abuse

    Abstract Full Text
    JAMA. 2017; 318(12):1099-1099. doi: 10.1001/jama.2017.14120
  • Urine Drug Screens to Monitor Opioid Use for Managing Chronic Pain

    Abstract Full Text
    JAMA. 2017; 318(11):1061-1062. doi: 10.1001/jama.2017.10593

    A 53-year-old woman with chronic low back pain presented for a prescription refill of hydrocodone/acetaminophen. She had partial paralysis from a thoracic spinal cord infarction secondary to aortic dissection from prior cocaine use and reported taking hydrocodone on that day but no recent illicit drug use. Urine immunoassay drug screen results were negative overall but positive for cocaine. How would you proceed?

  • Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000-2015

    Abstract Full Text
    JAMA. 2017; 318(11):1065-1067. doi: 10.1001/jama.2017.9308

    This study uses US National Vital Statistics mortality data to assess change in US life expectancy from 2000 to 2015 attributable to opioid-involved poisonings.

  • Community-Based Prevention and Strategies for the Opioid Crisis

    Abstract Full Text
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    JAMA. 2017; 318(11):993-994. doi: 10.1001/jama.2017.13767
  • JAMA September 19, 2017

    Figure: Contributions of Selected Causes of Death to the Change in Life Expectancy in the United States, 2000-2015

    aIn ranked cause-of-death classification, drug, opioid, and alcohol poisoning are not considered to be unique cause-of-death categories. Instead, poisoning deaths are classified as either accidental poisonings (which contribute to unintentional injuries), suicides, or homicides (ranked 16th in leading causes of death). Contributions from drug, opioid, and alcohol poisoning deaths overlap with both unintentional injury deaths and suicides and cannot be summed with these leading ranked causes of death.
  • Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid

    Abstract Full Text
    JAMA. 2017; 318(8):750-752. doi: 10.1001/jama.2017.7818

    This study uses Medicaid data to compare prescription opioid use, duration of opioid use, and rates of medication-assisted treatment (buprenorphine, methadone, or naltrexone) among enrollees before and after an overdose event.

  • Both Urgency and Balance Needed in Addressing Opioid Epidemic: A Report From the National Academies of Sciences, Engineering, and Medicine

    Abstract Full Text
    JAMA. 2017; 318(5):423-424. doi: 10.1001/jama.2017.10046

    This Viewpoint describes the National Academies of Sciences, Engineering, and Medicine’s new report on the harms associated with opioid misuse and the effects of strategies to reduce those harms, and discusses the importance of balancing patients’ pain management and addressing the current opioid epidemic.

  • Opioid Should Come Off the Market

    Abstract Full Text
    JAMA. 2017; 318(3):232-232. doi: 10.1001/jama.2017.8435
  • Management of Chronic Pain in the Aftermath of the Opioid Backlash

    Abstract Full Text
    JAMA. 2017; 317(23):2365-2366. doi: 10.1001/jama.2017.4884

    This Viewpoint argues that abandoning opioids on principal may be premature and could harm patients successfully treating their chronic pain with opioids.

  • Postoperative Opioid Prescribing and the Pain Scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey

    Abstract Full Text
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    JAMA. 2017; 317(19):2013-2015. doi: 10.1001/jama.2017.2827

    This study uses insurance claims and HCAHPS data to investigate correlations between measures of pain and patient satisfaction after hospital discharge and postoperative opioid prescriptions.

  • JAMA May 9, 2017

    Figure: Investigation Into Opioid Crisis Targets Drug Companies

    Senate investigates whether drug company marketing may have contributed to the opioid epidemic.
  • Investigation Into Opioid Crisis Targets Drug Companies

    Abstract Full Text
    JAMA. 2017; 317(18):1826-1826. doi: 10.1001/jama.2017.5130
  • Certain Prescribing Patterns Lead to Long-term Opioid Use

    Abstract Full Text
    JAMA. 2017; 317(16):1616-1616. doi: 10.1001/jama.2017.3766