Repeated measures analysis of opioid use disorder treatment on clinical opiate withdrawal scale in a randomized clinical trial: sex differences

Wang, Kesheng; Shafique, Saima; Xiao, Danqing; Walter, Suzy Mascaro; Liu, Ying; Piamjariyakul, Ubolrat; Xie, Changchun

doi:10.1080/10550887.2022.2131957

Cited by 3 publications

(1 citation statement)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 Another study of individuals with OUD found that female individuals had more significant withdrawal with higher COWS scores compared to male individuals. 24 It is possible that female patients in our study also had more significant withdrawal, or there may be other factors contributing to higher dosing. More research is needed to explore gender differences in hospital-based methadone dosing.…”

Section: Discussionmentioning

confidence: 99%

Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis

Casey,

Regan,

Gale

et al. 2023

Substance Abuse

View full text Add to dashboard Cite

Background: Outpatient methadone guidelines recommend starting at a low dose and titrating slowly. As fentanyl prevalence and opioid-related mortality increases, there is a need for individuals to rapidly achieve a therapeutic methadone dose. Hospitalization offers a monitored setting for methadone initiation, however dosing practices and safety are not well described. Methods: Retrospective, observational analysis of hospitalized patients with opioid use disorder seen by an inpatient addiction consult team in an academic medical center who were newly initiated on methadone between 2016 and 2022. We calculated initial daily dose, maximum daily dose, timing interval of dose escalation, whether patients were connected to an opioid treatment program (OTP) prior to discharge, whether adverse effects or safety events occurred during the hospitalization, and whether such events were definitely or probably related versus possibly related or unrelated to methadone. Results: One hundred twelve patients were included. The mean initial daily methadone dose administered was 32 mg (range: 10-90 mg). The mean maximum dose reached was 76.8 mg (range 30-165 mg). The mean number of days from initial to peak dose was 5.6 days (range 1-19 days). Overall, 30% of patients experienced a safety event, most commonly sedation. Only 4 safety events were deemed probably or definitely related to methadone. In regression analyses, there was no significant difference between starting doses among patients with or without sedation but there was a relationship between last dose and the likelihood of any possibly related event, with those ending at a dose of 100 mg or higher having a higher likelihood event, compared to those ending at lower doses (47.8% vs 12.4%, P < .001). Seventy-six percent were connected to OTP before discharge. Conclusion: Among hospitalized patients initiating methadone, rapid dose titration was infrequently associated with related safety events and most were connected to community-based methadone treatment before discharge.

show abstract

Section: Discussionmentioning

confidence: 99%

Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis

Casey,

Regan,

Gale

et al. 2023

Substance Abuse

View full text Add to dashboard Cite

show abstract

Neuronal biomarkers as potential therapeutic targets for drug addiction related to sex differences in the brain: Opportunities for personalized treatment approaches

Sardari,

Mohammadpourmir,

Hosseinzadeh Sahafi

et al. 2024

Progress in Neuro-Psychopharmacology and Biological Psychiatry

View full text Add to dashboard Cite

Revisiting dezocine for opioid use disorder: A narrative review of its potential abuse liability

Barr,

Schmidt,

Thakrar

et al. 2024

CNS Neurosci Ther

View full text Add to dashboard Cite

AimsOpioid use disorder (OUD) remains a serious public health problem. Opioid maintenance treatment is effective but under‐utilized, hard to access under existing federal regulations, and, once patients achieve OUD stability, challenging to discontinue. Fewer than 2% of persons with OUD stop using opioids completely. There have been calls from public advocacy groups, governmental agencies, and public health officials for new treatments for OUD. Dezocine, a non‐scheduled opioid previously used in the United States and currently widely prescribed in China for pain management, could be a candidate for a novel OUD treatment medication in the U.S. Nonetheless, to date, there have been no reviews of the clinical and preclinical literature detailing dezocine's abuse potential, a key consideration in assessing its clinical utility.DiscussionThere are no English language reports of human abuse, dependence, or overdose of dezocine, despite years of extensive clinical use. There are a few case reports of dezocine abuse in the Chinese literature, but there are no reports of overdose deaths. Dezocine is perceived as an opioid and is “liked” by opioid‐experienced human and non‐human primates, properties that are not dose‐dependent and are mitigated by ceiling effects—higher doses do not result in more “liking.” There is little withdrawal, spontaneous or precipitated, in humans, monkeys, rats, or mice treated chronically with dezocine alone. However, at some doses, dezocine can precipitate withdrawal in humans and monkeys dependent on other opioids. In rodents, dezocine reduces the severity of morphine withdrawal and the rewarding properties of other opioids.ConclusionsAlthough dezocine is reinforcing in humans and monkeys with prior or concurrent opioid use within a restricted dose range, there are only a few anecdotal reports of dezocine abuse despite of the long history of use in humans. Given the evidence of dezocine's limited abuse potential, it could be useful both as a treatment for OUD. However, in‐depth studies would be required for dezocine to be re‐considered for clinical use.

show abstract

Repeated measures analysis of opioid use disorder treatment on clinical opiate withdrawal scale in a randomized clinical trial: sex differences

Cited by 3 publications

References 32 publications

Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis

Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis

Neuronal biomarkers as potential therapeutic targets for drug addiction related to sex differences in the brain: Opportunities for personalized treatment approaches

Revisiting dezocine for opioid use disorder: A narrative review of its potential abuse liability

Contact Info

Product

Resources

About