BACKGROUND Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population remain under-investigated. The current project seeks to develop and pilot the implementation of a screening tool for opioid risk at American Coll...

Pain and its control are still a daunting problem. Although drugs such as morphine have been around since ancient times and recent years have seen the introduction of a number of additional painkillers, many gaps remain in our ability to control the suffering of pain. Pain is an emotional response that is triggered by nociceptive inputs from the periphery that are transmitted centrally to the s...

The Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) is an often-used device for assessment of adult antisociality. This research examined generalizability by replicating the 2-factor model for a sample of 326 male prisoners and assessing its congruence and relative reliability and specificity among 620 substance-dependent patients. Generality was assessed also across addiction subtypes ...

BACKGROUND AND AIMS Integrating psychiatric services within substance abuse treatment settings is a promising service delivery model, but has not been evaluated using random assignment to psychiatric treatment setting and controlled delivery of psychiatric care. This study evaluates the efficacy of on-site and integrated psychiatric service delivery in an opioid-agonist treatment program on psy...

within its Opioid Treatment Program (OTP) for behavioral health care organizations. The Joint Commission added five new elements of performance (EPs) and two new Notes—and edited an existing EP—to maintain alignment with Center for Substance Abuse Treatment (CSAT) regulations and guidelines and thus retain its status as a Substance Abuse and Mental Health Services Administration (SAMHSA)–approv...

C describe the concept of multimodal analgesia and give examples Abstract Opium is the natural substance to which modern narcotics owe their existence. First discovered in the 1500s, opium was the most potent analgesic compound in use, held in high regard, hence its Latin name laudanum (to praise). Subsequent studies into the effects of opium led to the discovery of the opioid receptors, and th...

The rising rate of prescription opioid misuse, abuse, and opioid-related fatalities has prompted the development of a number of guidelines for prescribing opioids to patients with chronic noncancer pain, including the recently published US Centers for Disease Control and Prevention Guidelines for Prescribing Opioids for Chronic Pain [1]. These guidelines outline a number of core opioid risk mit...

BACKGROUND Psychiatric comorbidity can adversely affect opioid dependence treatment outcomes. While the prevalence of psychiatric comorbidity among patients seeking methadone maintenance treatment has been documented, the extent to which these findings extend to patients seeking primary care office-based buprenorphine/naloxone treatment is unclear. AIMS To determine the prevalence of mood and...

BACKGROUND & OBJECTIVE Relapse is a common and distressing aspect of substance dependence mediated by several biological and psychosocial factors. This study examined the association between demographic variables, clinical parameters and certain psychosocial factors and relapse among patients with either alcohol or opioid dependence. METHODS Structured assessments of clinical/demographic para...

In the two decades since the discovery of the nociceptin opioid receptor (NOP) and its ligand, nociceptin/orphaninFQ (N/OFQ), steady progress has been achieved in understanding the pharmacology of this fourth opioid receptor/peptide system, aided by genetic and pharmacologic approaches. This research spawned an explosion of small-molecule NOP receptor ligands from discovery programs in major ph...