OBJECTIVE To illustrate a system-level, simulation-based approach for evaluating mitigation strategies to address the dramatic rise in abuse, addiction, and overdose deaths associated with the use of pharmaceutical opioid analgesics to treat chronic pain. SIMULATED INTERVENTIONS: Making available drug formulations with increased tamper-resistance, prescriber education programs, and programs tha...

Background: A good proportion of poisoned patients treated at poisoning wards are elderly. This study was designed to evaluate the epidemiologic pattern of acute poisoning in elderly in Hamadan, western Iran. Methods: In this retrospective cross-sectional study, poisoned patients aged 60 years and older treated at department of poisoning of Farshchian Hospital from March 2008 to March 2013 wer...

Pain is one of the most common symptoms in cancer patients. Opioids are widely prescribed for this and other purposes. Properly used, they are safe, but they have serious and potentially lethal side effects. Successful use of opioids to manage cancer pain requires adequate knowledge about opioid pharmacology and equianalgesia for the purpose of both drug rotation and route conversion. The aim o...

: Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription med...

BACKGROUND Classification of patients with pharmaceutical opioid use disorder and dependence varies depending on which definition is used. We compared how WHO's ICD-10 and proposed ICD-11 and the American Psychiatric Association's DSM-IV and DSM-5 classified individuals in a community-based sample of Australians with chronic non-cancer pain for which opioids have been prescribed. METHODS We s...

BACKGROUND Spinal anesthesia is widely used for caesarean section due to its rapid onset, low failure rate, complete analgesia. Addition of intrathecal ketamine and opioids to local anaesthetics seems to improve the quality of block and prolong the duration of analgesia. OBJECTIVES The purpose of this study was to compare the effect of intrathecal ketamine mixed with hyperbaric bupivacaine to...

Recent reports suggest that the illicit use of prescription medicines, particularly pharmaceutical opioids (e.g. oxycodone), is increasing in Australia. This raises questions about how these drugs are channelled out of the medical system for unsanctioned use. The aim of the current study was to use police data to examine: (a) whether this increase is reflected in police crime data; (b) some of ...