BACKGROUND The use of opioids for noncancer pain is widespread, and more than 16,000 die of opioid-related causes in the United States annually. The patients at greatest risk of death are those receiving high doses of opioids. Whether sex influences the risk of dose escalation or opioid-related mortality is unknown. METHODS AND FINDINGS We conducted a cohort study using healthcare records of ...

OBJECTIVE Substance use disorders are prevalent in emergency departments in medical and psychiatric services, reaching rates of 28% of cases in medical emergency departments. However, professionals in the emergency department identify less than 50% of cases of alcohol-related problems. This article aims to provide evidence-based interventions for the specific treatment to patients who meet diag...

Before the advent of neuroleptics, opioids such as morphine were used occasionally in the treatment of schizophrenia and other mental disorders. Recent interest in the possible therapeutic role of endogenous opioid peptides in various mental states has prompted a new look at the opioids. The present paper summarizes the research to date in the author's laboratory on opioid-hallucinogen interact...

The registrar of the College of Physicians and Surgeons of Ontario stated in 2010 that “opioids are an important part of the modern arsenal for treating chronic non-cancer pain.”1 He noted that clear guidance on the prescribing of opioids was needed and that the National Opioid Use Guideline Group had led a project to develop the Canadian Guideline for Safe and Effective Use of Opioids for Chro...

Background Despite abundant research demonstrating good efficacy, pharmacotherapies for substance use disorders are underutilized. Buprenorphine holds promise to significantly increase the availability of medication-assisted therapy for opioid use disorder; yet despite dramatic increases in overdose deaths driven largely by prescription opioid use, only about half of DATA-waivered physicians pr...

Background: The opioid epidemic continues to generate a significant mental and physical health burden on patients, claims the life of almost 150 Americans daily. Making matters worse, an increase in relapses and/or opioid-related deaths has been reported more than 40 U.S. states since start COVID-19 pandemic. Opioid use disorder (OUD) is one single most expensive disorders United States, genera...

All functions of the human brain are consequences of altered activity of specific neural pathways and neurotransmitter systems. Although the knowledge of "system level" connectivity in the brain is increasing rapidly, we lack "molecular level" information on brain networks and connectivity patterns. We introduce novel voxel-based positron emission tomography (PET) methods for studying internal ...

BACKGROUND The dosing of opioid receptor agonist medications adequately and on an individual basis is crucial in the pharmacotherapy of opioid dependence. Clinical tools that are able to measure dose appropriateness are sorely needed. The recently developed and validated Opiate Dosage Adequacy Scale (ODAS) comprehensively evaluates the main outcomes relevant for methadone dose optimization, nam...