Concomitant use of benzodiazepines in chronic pain patients adherent to extended-release tapentadol or oxycodone treatment—A retrospective claims analysis

2020 ◽  
Vol 16 (6) ◽  
pp. 461-479
Author(s):  
Vladimir Zah, PhD ◽  
Martina Imro, MSc ◽  
Simona Tatovic, MSc ◽  
Michael DeGeorge, PharmD ◽  
Steven D. Passik, PhD ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Extended Release ◽  
Day Treatment ◽  
Opioid Overdose ◽  
Overdose Death ◽  
Opioid Treatment ◽  
National Mortality ◽  
Chronic Pain Patients ◽  
The Us ◽  
Pain Patients

Objective: To compare concomitant benzodiazepine (BZDs) use among chronic pain patients adherent to extended-release tapentadol (TapER) or oxycodone (OxnER) and estimate the number of lives potentially saved by switching patients to the less BZD coprescribed treatment.Design: Retrospective database study.Setting: Patients were identified using the IBM MarketScan® Commercial Database. The opioid overdose death estimates were obtained from the US national mortality register and were used to estimate the number of lives potentially saved by switching patients to the opioid treatment with lower rates of BZD coprescribing.Patients, Participants: The authors identified 30,213 chronic pain patients between October 2012 and March 2016. After propensity score matching, N = 2,355 and N = 6,761 patients were adherent (proportion of days covered ≥80 percent) to TapER and OxnER, respectively.Interventions: TapER versus OxnER, during the 180-day treatment. Main Outcome Measure(s): Proportions of BZD coprescribing, BZD dosing patterns in matched patients, and the estimated number of lives potentially saved by the opioid treatment switch.Results: TapER patients were less coprescribed BZDs during the treatment period (38.9 percent versus 49.2 percent, OR = 0.659, p 0.001), and had fewer days of BZD supply per patient (mean: 49.6 versus 70.2 days, p 0.001) with similar BZD average daily dose. Due to less frequent coprescribing of BZDs with TapER, it is estimated that ~800 deaths may have been avoided in the U.S. as a result of switching patients from OxnER to TapER.Conclusions: Among treatment-adherent patients, TapER patients had fewer BZD coprescriptions than OxnER patients had. Moreover, when BZDs were coprescribed, those BZD prescriptions were for shorter periods of time. Prospective studies are warranted to explore rates and consequences of BZD coprescribing among opioids.

scholarly journals Is Kratom the New ‘Legal High’ on the Block?: The Case of an Emerging Opioid Receptor Agonist with Substance Abuse Potential

2017 ◽  
Vol 1 (21;1) ◽  
pp. E195-E198 ◽  
Author(s):  
George C. Chan ge Chien
Keyword(s):  
Substance Abuse ◽  
Chronic Pain ◽  
Opioid Receptor ◽  
Receptor Agonist ◽  
Abuse Potential ◽  
Herbal Extract ◽  
Opioid Overdose ◽  
Opioid Receptor Agonist ◽  
Chronic Pain Patients ◽  
Pain Patients

Kratom is an unscheduled herbal extract that contains alkaloids with opioid receptor agonist activity. It is currently available in the form of dietary supplements and is used and abused by chronic pain patients on prescription opioids. Active alkaloids isolated from Kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu and delta opioid receptors as well as alpha 2 adrenergic and 5-HT2A receptors. Animal studies suggest that Kratom may be more potent than morphine. Consequently, Kratom consumption produces analgesic and euphoric feelings among users. Some chronic pain patients on opioids take Kratom to counteract the effects of opioid withdrawal. Although the Food and Drug Administration has banned its use as a dietary supplement, Kratom continues to be widely available and easily accessible on the internet at much lower prices than other opioid replacement therapies like buprenorphine. There are no Federal regulations monitoring the sale and distribution of this substance. Consumption of Kratom has been associated with hallucination, delusion, depression, myalgia, chill, nausea/vomiting, respiratory depression, hepatotoxicity, seizure, coma and death. A search of the pain literature shows past research has not described the use and potential deleterious effects of this extract. Many pain physicians are not familiar with Kratom. As providers who take care of high-risk chronic pain patients using prescribed opioids, knowledge of all current substances with opioid receptor agonists with abuse potential is of paramount importance. The goal of this article is to introduce Kratom to pain specialists and identify issues for further studies that will be required to help better understand the clinical and long-term effects of Kratom use among chronic pain patients. Key words: Opioid receptor agonist, Kratom, Mitragynine, opioid overdose, chronic pain, substance abuse :

scholarly journals Survey of Spinal Cord Stimulation Hardware Currently Available for the Treatment of Chronic Pain in the United States

2020 ◽  
Vol 1 ◽  
Author(s):  
Josephine A. Clingan ◽  
Ashish Patel ◽  
Dermot P. Maher
Keyword(s):  
United States ◽  
Spinal Cord ◽  
Chronic Pain ◽  
The United States ◽  
Analysis Techniques ◽  
Chronic Pain Patients ◽  
The Us ◽  
Optimal Patient Care ◽  
Pain Patients ◽  
Selection Of

Background: The number of spinal cord stimulator (SCS) units sold in the United States (US) for the treatment of chronic pain has increased with a corresponding expansion in the number of different SCS platforms available. Each marketed stimulator has several unique features, indications, and limitations, which distinguish one from the other and makes the selection of appropriate hardware possible for optimal patient care. There are an even greater number of similar and overlapping features between SCS.Measures: We used market analysis techniques to survey the currently available SCS technology. We then reviewed published device specifications and manuals for comparison of features.Outcomes: As of 2020, there are nine commonly used SCS platforms made by four manufacturers including four SCS units from Abbott, three from Boston Scientific, and one each from Medtronic and Nevro.Conclusions: A working understanding of each SCS product's nuances is needed for selecting the most appropriate device with which to manage chronic pain patients. Here we present a brief survey of currently available SCS hardware in the US and the features that make each product unique.

scholarly journals YouTube viewers’ comments on the opioid epidemic offer solutions to help chronic pain patients

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Bacon ◽  
L Ivanitskaya ◽  
E Erzikova ◽  
T Veverka
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Control ◽  
Alternative Therapies ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Background Approximately 34.3 million people used prescription opioids for non-medical reasons globally in 2016. In addition, many of the 1.5 billion people worldwide who suffer from chronic pain use opioids. According to the United Nations Office on Drugs and Crime, 76% of overdose deaths are caused by prescription and non-prescription opioids. Opioid use disorder and addiction encompass many aspects; such as, economic forces, cultural forces and individual genetic makeup. Because of this complexity, policymakers will have to address chronic pain and social determinants of health. Understanding the public's perspectives on the opioid epidemic is critical for policymakers to create awareness and treatment programs to decrease opioid related deaths while treating pain. Methods This inductive, iterative approach to content analysis of secondary data collected 8,761 comments posted by viewers on ten videos regarding the opioid epidemic on CNN's YouTube Channel and ten videos on Fox News' YouTube channel posted between January 1, 2017 and December 31, 2018. Results After analyzing 8,761 comments, from 20 videos, results indicated 618 (7%) were pain patients, 926 (10.6%) of the comments indicated stigma, (54.5% social stigma and 30% structural stigma). 5,453 (62.2%) of the comments posted claims regarding the opioid epidemic and 1,881 (21.5%) offered solutions. Three of the major solutions offered include legalizing cannabis (608, 7%), developing alternative therapies (174, 1.9%), and kratom (105, 1.2%). Conclusions Reducing access to opioids is harming legitimate pain patients. Policymakers need to take the public's opinions into consideration when developing policies and programs that help reduce opioid overdose. These policies must ensure that the 1.5 billion chronic pain patients worldwide receive adequate pain control in order to have a good quality of life that allows them to be contributing members of society. Key messages Worldwide, 1.5 billion people suffer from chronic pain, many without access to adequate pain control. Solutions posted by viewers include cannabis, alternative therapies and kratom. Understanding the public’s perspectives will help policymakers create programs that improve quality of life for chronic pain patients that minimize social, internalized and structural stigma.

scholarly journals PROJECTING THE COST, UTILIZATION, AND PATIENT CARE IMPACT OF PRESCRIBING EXTENDED RELEASE NON- ABUSE-DETERRENT OPIOIDS TO CHRONIC PAIN PATIENTS

2016 ◽  
Vol 19 (3) ◽  
pp. A247
Author(s):  
A.G. White ◽  
M. Yenikomshian ◽  
M.E. Carson ◽  
L.P. Garrison ◽  
G. Oderda ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Patient Care ◽  
Extended Release ◽  
Chronic Pain Patients ◽  
Cost Utilization ◽  
The Cost ◽  
Pain Patients

scholarly journals Postmarketing studies program to assess the risks and benefits of long-term use of extended-release/long-acting opioids among chronic pain patients

2019 ◽  
Vol 132 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Paul M. Coplan ◽  
M. Soledad Cepeda ◽  
Kenneth R. Petronis ◽  
Angela DeVeaugh-Geiss ◽  
Alexandra I. Barsdorf ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Extended Release ◽  
Risks And Benefits ◽  
Chronic Pain Patients ◽  
Long Acting ◽  
Pain Patients

Tapentadol Extended Release for Chronic Pain Patients

2013 ◽  
Vol 30 (1) ◽  
pp. 14-27 ◽  
Author(s):  
Robert Taylor ◽  
Joseph V. Pergolizzi ◽  
Robert B. Raffa
Keyword(s):  
Chronic Pain ◽  
Extended Release ◽  
Chronic Pain Patients ◽  
Pain Patients
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