OPIOIDS 2007 <412>
Database EMBASE
Accession Number 2008203683
Authors Moulin D.E.
Institution
(Moulin) Pain and Symptom Management, London Regional Cancer Program, London, Ont., Canada.
Country of Publication
United Kingdom
Title
Opioid analgesics in the management of neuropathic pain.
Source
European Journal of Pain Supplements. 1(1)(pp 57-60), 2007. Date of Publication: September 2007.
Publisher
W.B. Saunders Ltd
Abstract
Neuropathic pain affects 2 to 3% of the population in developed countries and can be particularly severe and debilitating. There has been considerable controversy regarding the role of opioid analgesics in the management of this disabling condition. However, a recent systematic review of high-quality randomized controlled trials (RCTs) utilizing opioid analgesics in the treatment of chronic neuropathic pain showed clinically significant benefit. These studies demonstrate, on average a 20 to 30% reduction in pain intensity. RCTs in patients with postherpetic neuralgia given controlled-release oxycodone or controlled-release morphine showed a significant reduction in pain intensity with variable improvement in sleep and disability. Trials of controlled-release oxycodone in painful diabetic neuropathy showed more consistent improvement in pain, sleep and ability to function. Nausea and constipation are common side effects, but can usually be controlled with anti-emetics and a bowel regimen, respectively. Psychological dependence or addiction is unusual in the absence of a history of substance abuse. Methadone may be particularly useful when conventional opioid analgesics have failed due to its N-methyl-D-aspartate (NMDA) antagonist properties. When antidepressants and anticonvulsants fail to provide adequate pain control for neuropathic pain, opioid analgesics are emerging as an important treatment option - in some cases, this class of drugs can make the difference between bearable and unbearable pain. copyright 2007 European Federation of Chapters of the International Association for the Study of Pain.
ISSN 1754-3207
Publication Type Journal: Article
Journal Name European Journal of Pain Supplements
Volume 1
Issue Part 1
Page 57-60
Year of Publication 2007
Date of Publication September 2007
OPIOIDS 2007 <413>
Database EMBASE
Accession Number 2008203682
Authors Cho M.-S. Kim M.-S. Kim S.-W. Kim S.-H.
Institution
(Cho, Kim, Kim, Kim) Department of Neurosurgery, Yeungnam University Hospital, Daegu, South Korea.
Country of Publication
United Kingdom
Title
Opioids in non-cancer chronic pain.
Source
European Journal of Pain Supplements. 1(1)(pp 53-56), 2007. Date of Publication: September 2007.
Publisher
W.B. Saunders Ltd
Abstract
The objective of this review is to evaluate the efficacy and safety of oxycodone administration for chronic non-cancer pain. We have started to use oxycodone for 107 patients with intractable pain (mean NRS 7.8) not sufficiently relieved by other medical treatment from January 2004 to December 2005. The data were extracted by one independent investigator. The average pain duration was 13.7 (3-46) months. The most common etiology of pain was spinal cord injury, followed by degenerative spine and failed back surgery syndrome, peripheral nerve injury, post-herpetic neuralgia, spine fracture, spine infection, and post-stroke pain. The average duration and dosage of oxycodone were 3.9 months and 30.6 mg/day. Seventeen (15.9%) patients reported their pain was not relieved with oxycodone. Less than 50% pain relief was seen in 19 (17.8%) patients and more than 50% pain relief in 56 (52.3%) patients. Four (3.7%) patients complained of lack of effectiveness but were still using it, and in 12 (11.2%) patients, the pain has been controlled with continuous use for over 12 months. It seemed to be less effective in post-herpetic neuralgia and severe pain from spinal cord injury. There were no addiction problems with oxycodone. Side effects of oxycodone were not frequent and not life-threatening. The most common adverse event was dizziness. Eleven (10.3%) patients refused to use it because of trouble with the drug rather than its effect. Oxycodone is a useful drug for the management of chronic non-cancer pain. copyright 2007 European Federation of Chapters of the International Association for the Study of Pain.
ISSN 1754-3207
Publication Type Journal: Article
Journal Name European Journal of Pain Supplements
Volume 1
Issue Part 1
Page 53-56
Year of Publication 2007
Date of Publication September 2007
OPIOIDS (A) 2007 <473>
Database EMBASE
Accession Number 2008310212
Authors Korostynski M. Piechota M. Kaminska D. Solecki W. Przewlocki R.
Institution
(Korostynski, Piechota, Kaminska, Solecki, Przewlocki) Department of Molecular Neuropharmacology, Institute of Pharmacology PAS, Smetna 12, 31-343 Krakow, Poland.
Country of Publication
United Kingdom
Title
Morphine effects on striatal transcriptome in mice.
Source
Genome Biology. 8(6), 2007. Article Number: R128. Date of Publication: 28 Jun 2007.
Abstract
Background: Chronic opiate use produces molecular and cellular adaptations in the nervous system that lead to tolerance, physical dependence, and addiction. Genome-wide comparison of morphine-induced changes in brain transcription of mouse strains with different opioid-related phenotypes provides an opportunity to discover the relationship between gene expression and behavioral response to the drug. Results: Here, we analyzed the effects of single and repeated morphine administrations in selected inbred mouse strains (129P3/J, DBA/2J, C57BL/ 6J, and SWR/J). Using microarray-based gene expression profiling in striatum, we found 618 (false discovery rate < 1%) morphine-responsive transcripts. Through ontologic classification, we linked particular sets of genes to biologic functions, including metabolism, transmission of nerve impulse, and cell-cell signaling. We identified numerous novel morphine-regulated genes (for instance, Olig2 and Camk1g), and a number of transcripts with strain-specific changes in expression (for instance, Hspa1a and Fzd2). Moreover, transcriptional activation of a pattern of co-expressed genes (for instance, Tsc22d3 and Nfkbia) was identified as being mediated via the glucocorticoid receptor (GR). Further studies revealed that blockade of the GR altered morphine-induced locomotor activity and development of physical dependence. Conclusion: Our results indicate that there are differences between strains in the magnitude of transcriptional response to acute morphine treatment and in the degree of tolerance in gene expression observed after chronic morphine treatment. Using whole-genome transcriptional analysis of morphine effects in the striatum, we were able to reveal multiple physiological factors that may influence opioid-related phenotypes and to relate particular gene networks to this complex trait. The results also suggest the possible involvement of GR-regulated genes in mediating behavioral response to morphine. copyright 2007 Korostynski et al.; licensee BioMed Central Ltd.
ISSN 1474-7596
Publication Type Journal: Article
Journal Name Genome Biology
Volume 8
Issue Part 6
Year of Publication 2007
Date of Publication 28 Jun 2007
OPIOIDS 2007 <619>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17270059
Status PubMed-not-MEDLINE
Authors Michels II. Stover H. Gerlach R.
Authors Full Name Michels, Ingo Ilja. Stover, Heino. Gerlach, Ralf.
Institution
Office of the Federal Drug Commissioner, Federal Ministry of Health, Berlin, Germany.
Title
Substitution treatment for opioid addicts in Germany.
Source
Harm Reduction Journal. 4:5, 2007.
Journal Name
Harm Reduction Journal
Other ID
Source: NLM. PMC1797169
Country of Publication
England
Abstract
BACKGROUND: After a long and controversial debate methadone maintenance treatment (MMT) was first introduced in Germany in 1987. The number of patients in MMT--first low because of strict admission criteria--increased considerably since the 1990s up to some 65,000 at the end of 2006. In Germany each general practitioner (GP), who has completed an additional training in addiction medicine, is allowed to prescribe substitution drugs to opioid dependent patients. Currently 2,700 GPs prescribe substitution drugs. Psychosocial care should be made available to all MMT patients. RESULTS: The results of research studies and practical experiences clearly indicate that patients benefit substantially from MMT with improvements in physical and psychological health. MMT proves successful in attaining high retention rates (65% to 85% in the first years, up to 50% after more than seven years) and plays a major role in accessing and maintaining ongoing medical treatment for HIV and hepatitis. MMT is also seen as a vital factor in the process of social re-integration and it contributes to the reduction of drug related harms such as mortality and morbidity and to the prevention of infectious diseases. Some 10% of MMT patients become drug-free in the long run. Methadone is the most commonly prescribed substitution medication in Germany, although buprenorphine is attaining rising importance. Access to MMT in rural areas is very patchy and still constitutes a problem. There are only few employment opportunities for patients participating in MMT, although regular employment is considered unanimously as a positive factor of treatment success. Substitution treatment in German prisons is heterogeneous in access and treatment modalities. Access is very patchy and the number of inmates in treatment is limited. Nevertheless, substitution treatment plays a substantial part in the health care system provided to drug users in Germany. CONCLUSION: In Germany, a history of substitution treatment spanning 20 years has meanwhile accumulated a wealth of experience, e.g. in the development of research on health care services, guidelines and the implementation of quality assurance measures. Implementing substitution treatment with concomitant effects and treatment elements such as drug history-taking, dosage setting, co-use of other psychoactive substances (alcohol, benzodiazepines, cocaine), management of 'difficult patient populations', and integration into the social environment has been arranged successfully. Also psychosocial counseling programmes adjuvant to substitution treatment have been established and, in the framework of a pilot project on heroin-based treatment, standardised manuals were developed. Research on allocating opioid users to the 'right' form of therapy at the 'right' point in time is still a challenge, though the pilot project 'heroin-based treatment' brought experience with patients who do not benefit from methadone treatment. There is also expertise in the treatment of specific co-morbidity such as HIV/AIDS, hepatitis and psychiatric disorders. The promotion and involvement of self-help groups plays an important part in the process of successful substitution treatment.
Publication Type Journal Article.
Date of Publication 2007
Year of Publication 2007
Volume 4
Page 5
NEURO (A) 2007 <803>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 18047654
Status MEDLINE
Authors Ubeda-Banon I. Novejarque A. Mohedano-Moriano A. Pro-Sistiaga P. de la Rosa-Prieto C. Insausti R. Martinez-Garcia F. Lanuza E. Martinez-Marcos A.
Authors Full Name
Ubeda-Banon, Isabel. Novejarque, Amparo. Mohedano-Moriano, Alicia. Pro-Sistiaga, Palma. de la Rosa-Prieto, Carlos. Insausti, Ricardo. Martinez-Garcia, Fernando. Lanuza, Enrique. Martinez-Marcos, Alino.
Institution
Laboratorio de Neuroanatomia Humana, Departamento de Ciencias Medicas, Facultad de Medicina, Centro Regional de Investigaciones Biomedicas, Universidad de Castilla-La Mancha, 02006 Albacete, Spain.
Title
Projections from the posterolateral olfactory amygdala to the ventral striatum: neural basis for reinforcing properties of chemical stimuli.
Source
BMC Neuroscience. 8:103, 2007.
Journal Name
BMC Neuroscience
Other ID
Source: NLM. PMC2216080
Country of Publication
England
Abstract
BACKGROUND: Vertebrates sense chemical stimuli through the olfactory receptor neurons whose axons project to the main olfactory bulb. The main projections of the olfactory bulb are directed to the olfactory cortex and olfactory amygdala (the anterior and posterolateral cortical amygdalae). The posterolateral cortical amygdaloid nucleus mainly projects to other amygdaloid nuclei; other seemingly minor outputs are directed to the ventral striatum, in particular to the olfactory tubercle and the islands of Calleja. RESULTS: Although the olfactory projections have been previously described in the literature, injection of dextran-amines into the rat main olfactory bulb was performed with the aim of delimiting the olfactory tubercle and posterolateral cortical amygdaloid nucleus in our own material. Injection of dextran-amines into the posterolateral cortical amygdaloid nucleus of rats resulted in anterograde labeling in the ventral striatum, in particular in the core of the nucleus accumbens, and in the medial olfactory tubercle including some islands of Calleja and the cell bridges across the ventral pallidum. Injections of Fluoro-Gold into the ventral striatum were performed to allow retrograde confirmation of these projections. CONCLUSION: The present results extend previous descriptions of the posterolateral cortical amygdaloid nucleus efferent projections, which are mainly directed to the core of the nucleus accumbens and the medial olfactory tubercle. Our data indicate that the projection to the core of the nucleus accumbens arises from layer III; the projection to the olfactory tubercle arises from layer II and is much more robust than previously thought. This latter projection is directed to the medial olfactory tubercle including the corresponding islands of Calleja, an area recently described as critical node for the neural circuit of addiction to some stimulant drugs of abuse.
Publication Type Journal Article. Research Support, Non-U.S. Gov't.
Date of Publication 2007
Year of Publication 2007
Volume 8
Page 103
OPIOIDS 2007 <804>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 18036213
Status MEDLINE
Authors Reece AS.
Authors Full Name Reece, A S.
Institution
Southcity Family Medical Centre, University of Queensland, 39 Gladstone Rd., Highgate Hill, Brisbane, Queensland, 4101, Australia.
Title
Psychosocial and treatment correlates of opiate free success in a clinical review of a naltrexone implant program.
Source
Substance Abuse Treatment, Prevention, & Policy. 2:35, 2007.
Journal Name
Substance Abuse Treatment, Prevention, & Policy
Other ID
Source: NLM. PMC2211472
Country of Publication
England
Abstract
BACKGROUND: There is on-going controversy in relation to the efficacy of naltrexone used for the treatment of heroin addiction, and the important covariates of that success. We were also interested to review our experience with two depot forms of implantable naltrexone. METHODS: A retrospective review of patients' charts was undertaken, patients were recalled by telephone and by letter, and urine drug screen samples were collected. Opiate free success (OFS) was the parameter of interest. Three groups were defined. The first two were treated in the previous 12 months and comprised "implant" and "tablet" patients. A third group was "historical" comprising those treated orally in the preceding 12 months. RESULTS: There were 102, 113 and 161 patients in each group respectively. Groups were matched for age, sex, and dose of heroin used, but not financial status or social support. The overall follow-up rate was 82%. The Kaplan Meier 12 month OFS were 82%, 58% and 52% respectively. 12 post-treatment variables were independently associated with treatment retention. In a Cox proportional hazard multivariate model social support, the number of detoxification episodes, post-treatment employment, the use of multiple implant episodes and spiritual belief were significantly related to OFS. CONCLUSION: Consistent with the voluminous international literature clinically useful retention rates can be achieved with naltrexone, which may be improved by implants and particularly serial implants, repeat detoxification, meticulous clinical follow-up, and social support. As depot formulations of naltrexone become increasingly available such results can guide their clinical deployment, improve treatment outcomes, and enlarge the policy options for an exciting non-addictive pharmacotherapy for opiate addiction.