Naloxone Administration in US Emergency Departments, 2000–2011

Frank, Janet C.; Levy, Cari; Calcaterra, Susan L.; Hoppe, Jason; Binswanger, Ingrid A.

doi:10.1007/s13181-015-0525-5

Cited by 19 publications

(14 citation statements)

References 36 publications

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“…These include deaths from multiple drugs and prescription drugs, injection of heroin or prescription opioids, and the use of opioids for pain or in combination with other pain medications (19)(20)(21)(22)(23)(24)(25)(26). Furthermore, the age-adjusted opioid-overdose death rates have steadily risen in rural areas for the past twenty years and data reveal that rural residents are less likely than urban residents to be administered naloxone during an opioid overdose in US emergency departments (27). Additionally, from 2007 to 2015, drug-overdose death rates were higher in rural than in urban counties, though this pattern recently reversed direction (28), with the steepest rise from 2016 to 2017 occurring among African Americans (29).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States

Lister

Weaver

Ellis

et al. 2019

The American Journal of Drug and Alcohol Abuse

164

112

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Background: Opioid-related deaths have risen dramatically in rural communities. Prior studies highlight few medication treatment providers for opioid use disorder in rural communities, though literature has yet to examine rural-specific treatment barriers. Objectives: We conducted a systematic review to highlight the state of knowledge around rural medication treatment for opioid use disorder, identify consumer-and provider-focused treatment barriers, and discuss rural-specific implications. Methods: We systematically reviewed the literature using PsycINFO, Web of Science, and PubMed databases (January 2018). Articles meeting inclusion criteria involved rural samples or urban/rural comparisons targeting outpatient medication treatment for opioid use disorder, and were conducted in the U.S. to minimize healthcare differences. Our analysis categorized consumer-and/or providerfocused barriers, and coded barriers as related to treatment availability, accessibility, and/or acceptability. Results: Eighteen articles met inclusion, 15 which addressed consumer-focused barriers, while seven articles reported provider-focused barriers. Availability barriers were most commonly reported across consumer (n = 10) and provider (n = 5) studies, and included the lack of clinics/providers, backup, and resources. Acceptability barriers, described in three consumer and five provider studies, identified negative provider attitudes about addiction treatment, and providers' perceptions of treatment as unsatisfactory for rural patients. Finally, accessibility barriers related to travel and cost were detailed in four consumer-focused studies whereas two provider-focused studies identified time constraints. Conclusions: Our findings consistently identified a lack of medication providers and rural-specific implementation challenges. This review highlights a lack of rural-focused studies involving consumer participants, treatment outcomes, or barriers impacting underserved populations. There is a need for innovative treatment delivery for opioid use disorder in rural communities and interventions targeting provider attitudes.

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Section: Introductionmentioning

confidence: 99%

A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States

Lister

Weaver

Ellis

et al. 2019

The American Journal of Drug and Alcohol Abuse

164

112

View full text Add to dashboard Cite

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“…Some studies have suggested that the combined application of naloxone and opioids may reduce opioid-related side effects. [13][14][15] A combination of low-dose epidural naloxone at 0.25 μg•kg −1 •h −1 with fentanyl is valid in attenuating undesired side effects, especially PONV, besides enhancing analgesia during the early postoperative period. [16] Intravenous infusion of naloxone at a low dose of 0.25 to 1.65 μg•kg −1 •h −1 reduces PONV in children, with greater evidence of its effectiveness as a preventative strategy than in the treatment of existing pruritus.…”

Section: Hy and Xg Contributed Equally To This Workmentioning

confidence: 99%

Preventing nausea and vomiting after gynecological laparoscopic surgery by patient-controlled intravenous analgesia with a naloxone admixture: A randomized controlled trial

Yang¹,

Gu²,

Xu³

et al. 2022

Medicine

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Background: Opioid-induced nausea and vomiting are common side effects of patient-controlled intravenous analgesia (PCIA). This study aimed to explore the inhibitory effect of a naloxone admixture on the incidence of sufentanil-induced postoperative nausea and vomiting (PONV). Methods: A total of 132 Uyghur American Society of Anesthesiologists I and II patients scheduled to undergo elective gynecological laparoscopic surgery were recruited; among these, 120 patients were enrolled and randomly allocated into 4 groups: patients receiving PCIA but no naloxone were included in the control group (group A); patients receiving PCIA with a low-dose naloxone admixture at 0.2 μg·kg−1·h−1 were included in group B; patients receiving PCIA with naloxone admixture at 0.4 μg·kg−1·h−1 were included in group C; patients receiving PCIA with naloxone admixture at 0.6 μg·kg−1·h−1 were included in group D. All patients were administered sufentanil at 0.04 kg−1·h−1, butorphanol at 2 kg−1·h−1, and dexmedetomidine at 0.08 kg−1·h−1 using a PCIA device within 2 days of surgery. The occurrence of nausea and vomiting, visual analogue scores for pain intensity, mean arterial pressure, heart rate, oxygen saturation, pruritus, lethargy, respiratory depression, etc, was recorded at 2, 8, 12, 24, and 48 hours postoperatively. Results: There was a significant difference in the PONV scores between the groups at 8, 12, and 24 hours after surgery (P < 0.01). At 8 and 12 hours, the score of group C/D was significantly lower than that of group A/B (P < 0.01). At 24 hours after surgery, the PONV score of group B/C/D was significantly lower than that of group A (P < 0.01). No significant difference was observed in the general data and visual analogue scores for postoperative pain between the 4 groups. Conclusion: Naloxone admixture administered at 0.4 to 0.6 μg·kg−1·h−1 can exert an effective inhibitory effect on the incidence and intensity of PONV in gynecological laparoscopic surgery.

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“…Naloxone, an opioid antagonist, has long been used to diagnose and manage respiratory depression related to opioid overdose. [ 10 ] Recently, some studies indicated that the combined application of naloxone and opioid may reduce opioid-related side effects. A study carried out by Xiao et al [ 11 ] proved that naloxone infusion could prevent the acute opioid tolerance, provide a quicker recovery of bowel function, and reduce the length of hospital stay after open colorectal surgery.…”

Section: Introductionmentioning

confidence: 99%

The effect of naloxone treatment on opioid-induced side effects

Jiang

2016

Medicine

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Background:To evaluate the effects of naloxone on opioid-induced side effects, the present meta-analysis was constructed.Methods:Electronic databases including PubMed, EMBASE, and CNKI (China National Knowledge Internet) were used for literature search. Studies on comparison of opioid-side effects between naloxone-treated group and placebo or normal saline-related group were included in the meta-analysis. Heterogeneity analysis was performed with Chi-square and I2 test. Pooled analysis was based on fixed-effects model, if heterogeneity between the eligible studies was negligible (I2 < 50%, P > 0.05), otherwise, random-effects model was used. Sensitivity analysis was applied to assess the robustness of the results and publication bias was evaluated by Begg and Egger test.Results:Thirteen studies including 1138 patients were included in the meta-analysis. Pooled analysis indicated that naloxone could significantly reduce the occurrence of pruritus (RR [risk ratio] = 0.252, 95% CI [confidence interval] = 0.137–0.464), nausea (RR = 0.323, 95% CI = 0.245–0.428), and vomiting (RR = 0.338, 95% CI = 0.192–0.593) which were induced by opioids. However, naloxone did not relieve pain (standardized mean difference [SMD] = −0.052, 95% CI = −0.453 to 0.348) and somnolence (RR = 0.561, 95% CI = 0.287 to 1.097) in patients received opioid treatment. Additionally, there were no significant publication bias between the included studies (Begg test, P = 0.602; Egger test, P = 0.388).Conclusion:Addition of naloxone might act as an effective treatment for prophylaxis of opioid-induced pruritus, nausea, and vomiting in clinical practice.

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Naloxone Administration in US Emergency Departments, 2000–2011

Cited by 19 publications

References 36 publications

A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States

A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States

Preventing nausea and vomiting after gynecological laparoscopic surgery by patient-controlled intravenous analgesia with a naloxone admixture: A randomized controlled trial

The effect of naloxone treatment on opioid-induced side effects

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