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Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies.

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Title: Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies.
Authors: Bisaga, Adam, Mannelli, Paolo, Sullivan, Maria A., Vosburg, Suzanne K., Compton, Peggy, Woody, George E., Kosten, Thomas R.
Source: American Journal on Addictions. Apr2018, Vol. 27 Issue 3, p177-187. 11p. 1 Diagram, 2 Charts.
Subjects: Drug abuse treatment, Opioid abuse, Public health, Health of people with drug addiction, Medical care of people with drug addiction, Management, Substance abuse & psychology, Substance abuse treatment, Substance abuse diagnosis, Analgesics, Compulsive behavior, Drug withdrawal symptoms, Narcotics, Pharmacodynamics
Abstract: Background and Objectives: Opioid use disorder (OUD) is a chronic condition with potentially severe health and social consequences. Many who develop moderate to severe OUD will repeatedly seek treatment or interact with medical care via emergency department visits or hospitalizations. Thus, there is an urgent need to develop feasible and effective approaches to help persons with OUD achieve and maintain abstinence from opioids. Treatment that includes one of the three FDA-approved medications is an evidence-based strategy to manage OUD. The purpose of this review is to address practices for managing persons with moderate to severe OUD with a focus on opioid withdrawal and naltrexone-based relapse-prevention treatment.Methods: Literature available on PubMed was used to review the evolution of treatment strategies from the 1960s onward to manage opioid withdrawal and initiate treatment with naltrexone.Results: Emerging practices for extended-release naltrexone induction include the use of agonist tapers and adjuvant medications. Clinical challenges frequently encountered when initiating this therapy include managing withdrawal and ongoing opioid use during treatment. Clinical factors may inform decisions regarding patient selection and length of naltrexone treatment, such as recent opioid use and patient preferences.Conclusions and Scientific Significance: Treatment strategies to manage opioid withdrawal have evolved, but many patients with OUD do not receive medication for the prevention of relapse. Clinical strategies for induction onto extended-release naltrexone are now available and can be safely and effectively implemented in specialty and select primary care settings. (© 2018 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP);27:177-187). [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies.
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  Data: <searchLink fieldCode="AR" term="%22Bisaga%2C+Adam%22">Bisaga, Adam</searchLink><br /><searchLink fieldCode="AR" term="%22Mannelli%2C+Paolo%22">Mannelli, Paolo</searchLink><br /><searchLink fieldCode="AR" term="%22Sullivan%2C+Maria+A%2E%22">Sullivan, Maria A.</searchLink><br /><searchLink fieldCode="AR" term="%22Vosburg%2C+Suzanne+K%2E%22">Vosburg, Suzanne K.</searchLink><br /><searchLink fieldCode="AR" term="%22Compton%2C+Peggy%22">Compton, Peggy</searchLink><br /><searchLink fieldCode="AR" term="%22Woody%2C+George+E%2E%22">Woody, George E.</searchLink><br /><searchLink fieldCode="AR" term="%22Kosten%2C+Thomas+R%2E%22">Kosten, Thomas R.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+on+Addictions%22">American Journal on Addictions</searchLink>. Apr2018, Vol. 27 Issue 3, p177-187. 11p. 1 Diagram, 2 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Drug+abuse+treatment%22">Drug abuse treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Opioid+abuse%22">Opioid abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Public+health%22">Public health</searchLink><br /><searchLink fieldCode="DE" term="%22Health+of+people+with+drug+addiction%22">Health of people with drug addiction</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+of+people+with+drug+addiction%22">Medical care of people with drug addiction</searchLink><br /><searchLink fieldCode="DE" term="%22Management%22">Management</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+%26+psychology%22">Substance abuse & psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+treatment%22">Substance abuse treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+diagnosis%22">Substance abuse diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Analgesics%22">Analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Compulsive+behavior%22">Compulsive behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+withdrawal+symptoms%22">Drug withdrawal symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotics%22">Narcotics</searchLink><br /><searchLink fieldCode="DE" term="%22Pharmacodynamics%22">Pharmacodynamics</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Background and Objectives: </bold>Opioid use disorder (OUD) is a chronic condition with potentially severe health and social consequences. Many who develop moderate to severe OUD will repeatedly seek treatment or interact with medical care via emergency department visits or hospitalizations. Thus, there is an urgent need to develop feasible and effective approaches to help persons with OUD achieve and maintain abstinence from opioids. Treatment that includes one of the three FDA-approved medications is an evidence-based strategy to manage OUD. The purpose of this review is to address practices for managing persons with moderate to severe OUD with a focus on opioid withdrawal and naltrexone-based relapse-prevention treatment.<bold>Methods: </bold>Literature available on PubMed was used to review the evolution of treatment strategies from the 1960s onward to manage opioid withdrawal and initiate treatment with naltrexone.<bold>Results: </bold>Emerging practices for extended-release naltrexone induction include the use of agonist tapers and adjuvant medications. Clinical challenges frequently encountered when initiating this therapy include managing withdrawal and ongoing opioid use during treatment. Clinical factors may inform decisions regarding patient selection and length of naltrexone treatment, such as recent opioid use and patient preferences.<bold>Conclusions and Scientific Significance: </bold>Treatment strategies to manage opioid withdrawal have evolved, but many patients with OUD do not receive medication for the prevention of relapse. Clinical strategies for induction onto extended-release naltrexone are now available and can be safely and effectively implemented in specialty and select primary care settings. (© 2018 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP);27:177-187). [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=128766840
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        Value: 10.1111/ajad.12711
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        Text: English
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        PageCount: 11
        StartPage: 177
    Subjects:
      – SubjectFull: Drug abuse treatment
        Type: general
      – SubjectFull: Opioid abuse
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      – SubjectFull: Public health
        Type: general
      – SubjectFull: Health of people with drug addiction
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      – SubjectFull: Medical care of people with drug addiction
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      – SubjectFull: Drug withdrawal symptoms
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      – SubjectFull: Pharmacodynamics
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      – TitleFull: Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies.
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              Text: Apr2018
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