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Yue Z, Xue X, Qian J. The association between polypharmacy and health-related quality of life among older adults with prostate cancer. J Geriatr Oncol 2024; 15:101772. [PMID: 38676976 DOI: 10.1016/j.jgo.2024.101772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/25/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Older adults with prostate cancer (PC) are at risk of polypharmacy, which further complicates disease management and health-related quality of life (HRQoL). This study evaluated the association between polypharmacy and HRQoL among Medicare beneficiaries with PC. MATERIALS AND METHODS This observational, retrospective study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) Medicare Health Outcomes Survey (MHOS) data resource. Beneficiaries aged ≥65 and enrolled in Medicare Advantage Organizations were included if they had a PC diagnosis and continuously enrolled in Part D for 12 months prior to the completion of MHOS. Polypharmacy was determined based on the unique number of concurrent Part D prescriptions during 12 months before survey: no polypharmacy (NP, n = 0-4), polypharmacy (PP, n = 5-9), and excessive polypharmacy (EPP, n ≥ 10). HRQoL was assessed using the Physical and Mental Component Summary T-scores (PCS and MCS, respectively) in MHOS. ANOVA and Pearson's Chi-Square tests were performed to assess variances between polypharmacy and continuous/categorical variables. Multivariate linear regression models with generalized estimating equations were used to assess the association between polypharmacy and HRQoL. The severely impaired HRQoL cohort was identified based on normalized z-scores of PCS and MCS. Odds ratios were calculated to prioritize drug-drug and class-class pairs associated with patients with severely impaired HRQoL. RESULTS Data from 16,573 beneficiaries (24,126 records) showed that 44.4% had PP and 10.1% had EPP. Beneficiaries with PP and EPP had significantly lower mean PCS and MCS scores compared to those without polypharmacy (p < 0.001). After adjusting for covariates, beneficiaries with EPP had clinically significantly lower PCS (adjusted marginal difference: -8.47 [-9.00, -7.94]) and MCS (adjusted marginal difference: -4.32 [-4.89, -3.75]) compared to the NP group. Top-ranked drug-drug pairs like tiotropium bromide and oxycodone/acetaminophen exhibited significant associations with HRQoL decline. Analysis of class-class pairs highlighted (1) corticosteroid hormone receptor agonists and opioid agonists and (2) benzodiazepines and adrenergic beta2-agonists as having significant associations with HRQoL decline. DISCUSSION Polypharmacy exhibits a significant association with HRQoL declines among older adults with PC.
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Affiliation(s)
- Zongliang Yue
- Auburn University Harrison College of Pharmacy, Auburn, AL, USA
| | - Xiangzhong Xue
- Auburn University Harrison College of Pharmacy, Auburn, AL, USA
| | - Jingjing Qian
- Auburn University Harrison College of Pharmacy, Auburn, AL, USA.
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2
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Jiang Z, Mahmood EA, Harofteh NZ, Ebadi AG, Toughani M, Vessally E. Methods for Direct Reductive N-Methylation of Nitro Compounds. Top Curr Chem (Cham) 2022; 380:27. [PMID: 35606628 DOI: 10.1007/s41061-022-00382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
Direct reductive N-methylation of inexpensive and readily available nitro compounds as raw material feedstocks is more attractive and straightforward compared with conventional N-methylation of amines to prepare biologically and pharmaceutically important N-methylated amine derivatives. This strategy for synthesis of N-methylamines avoids prepreparation of NH-free amines and therefore significantly shortens the separation and purification steps. In recent years, numerous methylating agents and catalytic systems have been reported for this appealing transformation. Thus, it is an appropriate time to summarize such advances. This review elaborates on the most important discoveries and advances in this research arena, with special emphasis on the mechanistic aspect of reactions that may provide new insights into catalyst improvement.
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Affiliation(s)
- Zhijie Jiang
- School of Chemistry and Chemical Engineering, Shaanxi Xueqian Normal University, Xi'an, 710100, China.
| | - Evan Abdulkareem Mahmood
- Medical Laboratory Sciences Department, College of Health Sciences, University of Human Development, Sulaymaniyah, Iraq
| | - Nazanin Zare Harofteh
- General Medicine Department, Faculty of Medicine, Saint Petersburg State University, Saint Petersburg, Russia
| | - Abdol Ghaffar Ebadi
- Department of Agriculture, Jouybar Branch, Islamic Azad University, Jouybar, Iran
| | - Mohsen Toughani
- Department of Fishery, Babol Branch, Islamic Azad University, Babol, Iran
| | - Esmail Vessally
- Department of Chemistry, Payame Noor University, P.O. Box 19395-4697, Tehran, Iran.
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Jiang K, Li SJ, Liu QP, Yu N, Li YL, Zhou YQ, He KC, Lin J, Zheng TY, Lang J, Lan Y, Wei Y. Iminyl radical-triggered relay annulation for the construction of bridged aza-tetracycles bearing four contiguous stereogenic centers. Chem Sci 2022; 13:7283-7288. [PMID: 35799821 PMCID: PMC9214848 DOI: 10.1039/d2sc01548j] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022] Open
Abstract
Bridged tetracyclic nitrogen scaffolds are found in numerous biologically active molecules and medicinally relevant structures. Traditional methods usually require tedious reaction steps, and/or the use of structurally specific starting materials. We report an unprecedented, iminyl radical-triggered relay annulation from oxime-derived peresters and azadienes, which shows good substrate scope and functional group compatibility, and can deliver various bridged aza-tetracyclic compounds with complex molecular topology and four contiguous stereogenic centers (dr > 19 : 1) in a single operation. This transformation represents the first example of trifunctionalization of iminyl radicals through simultaneous formation of one C–N and two C–C bonds. DFT calculation studies were conducted to obtain an in-depth insight into the reaction pathways, which revealed that the reactions involved an interesting 1,6-hydrogen atom transfer process. A novel radical relay annulation is realized for the construction of various bridged aza-tetracyclic compounds with complex molecular topology and four contiguous stereogenic centers (dr > 19 : 1) in a single operation.![]()
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Affiliation(s)
- Kun Jiang
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Shi-Jun Li
- College of Chemistry, Institute of Green Catalysis, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Qing-Peng Liu
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Ning Yu
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Yu-Lin Li
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Yu-Qiang Zhou
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Kui-Cheng He
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Jing Lin
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Ting-Yu Zheng
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Jian Lang
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Yu Lan
- College of Chemistry, Institute of Green Catalysis, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Ye Wei
- School of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
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Heravi MM, Zadsirjan V. Prescribed drugs containing nitrogen heterocycles: an overview. RSC Adv 2020; 10:44247-44311. [PMID: 35557843 PMCID: PMC9092475 DOI: 10.1039/d0ra09198g] [Citation(s) in RCA: 355] [Impact Index Per Article: 88.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
Heteroatoms as well as heterocyclic scaffolds are frequently present as the common cores in a plethora of active pharmaceuticals natural products. Statistically, more than 85% of all biologically active compounds are heterocycles or comprise a heterocycle and most frequently, nitrogen heterocycles as a backbone in their complex structures. These facts disclose and emphasize the vital role of heterocycles in modern drug design and drug discovery. In this review, we try to present a comprehensive overview of top prescribed drugs containing nitrogen heterocycles, describing their pharmacological properties, medical applications and their selected synthetic pathways. It is worth mentioning that the reported examples are actually limited to current top selling drugs, being or containing N-heterocycles and their synthetic information has been extracted from both scientific journals and the wider patent literature.
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Affiliation(s)
- Majid M Heravi
- Department of Chemistry, School of Science, Alzahra University PO Box 1993891176, Vanak Tehran Iran +98 21 88041344 +98 21 88044051
| | - Vahideh Zadsirjan
- Department of Chemistry, School of Science, Alzahra University PO Box 1993891176, Vanak Tehran Iran +98 21 88041344 +98 21 88044051
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Yang JC, Roman-Urrestarazu A, Brayne C. Responses among substance abuse treatment providers to the opioid epidemic in the USA: Variations in buprenorphine and methadone treatment by geography, operational, and payment characteristics, 2007-16. PLoS One 2020; 15:e0229787. [PMID: 32126120 PMCID: PMC7053738 DOI: 10.1371/journal.pone.0229787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 02/14/2020] [Indexed: 01/04/2023] Open
Abstract
Objective To identify the geographic, organisational, and payment correlates of buprenorphine and methadone treatment among substance abuse treatment (SAT) providers. Methods Secondary analyses of the National Survey of Substance Abuse Treatment Services (NSSATS) from 2007–16 were conducted. We provide bivariate descriptive statistics regarding substance abuse treatment services which offered buprenorphine and methadone treatment from 2007–16. Using multiple logistic regression, we regressed geographic, organisational, and payment correlates on buprenorphine and methadone treatment. Results Buprenorphine is increasingly offered at SAT facilities though uptake remains comparatively low outside of the northeast. SAT facilities run by tribal governments or Indian Health Service which offer buprenorphine remain low compared to privately operated SAT facilities (AOR = 0.528). The odds of offering buprenorphine among facilities offering free or no charge treatment (AOR = 0.838) or a sliding fee scale (AOR = 0.464) was lower. SAT facilities accepting Medicaid payments showed higher odds of offering methadone treatment (AOR = 2.035). Conclusions Greater attention towards the disparities in provision of opioid agonist therapies is warranted, especially towards the reasons why uptake has been moderate among civilian providers. Additionally, the care needs of Native Americans facing opioid-related use disorders bears further scrutiny.
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Affiliation(s)
- Justin C. Yang
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
- Department of Epidemiology and Applied Clinical Research, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
- * E-mail:
| | | | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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Luo Z, Miao J, Shu S, Wang Y, Zhu X, Hu C, Shen Y. Pharmacokinetics and Bioequivalence Evaluation of a New Oxycodone Tamper-Resistant Tablet Administered with an Opioid Antagonist in Patients with Chronic Pain. Clin Drug Investig 2019; 40:139-148. [PMID: 31679120 DOI: 10.1007/s40261-019-00870-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Oxycodone tamper resistant (OTR) is a new extended-release abuse-deterrent formulation providing improvements in the tamper resistant characteristics. This study aimed to investigate the pharmacokinetic properties of the new OTR tablets and evaluate the bioequivalence of oxycodone from OTR and the original extended release (ER) formulation tablets administered with an opioid antagonist in patients with chronic pain. METHODS In this open-label, randomized, cross-over study, the enrolled patients were randomised to receive a single dose of 40 mg OTR or 40 mg OXYCONTIN® (OXY) tablet administered with naltrexone blockade under fasting conditions. Serial blood samples for pharmacokinetic analysis were collected. Plasma oxycodone was quantified by a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. Tolerability was evaluated by monitoring adverse events, physical examinations, 12-lead ECG and laboratory tests. RESULTS A total of 38 patients were enrolled and 33 subjects completed the study. After a single dose of 40 mg tablets, pharmacokinetic results of the new OTR tablet were found to be similar to those of original extended-release oxycodone tablet. OTR 40 mg was bioequivalent to OXY 40 mg and was well tolerated in patients with chronic pain. CONCLUSIONS The new OTR formulation could provide a new choice in the treatment of chronic pain and reduce the potential for oxycodone abuse. Chictr.org identifier: ChiCTR1800017253.
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Affiliation(s)
- Zhu Luo
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Jia Miao
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Shiqing Shu
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Ying Wang
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xiaohong Zhu
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Chao Hu
- GCP Center/Institute of Drug Clinical Trials, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yali Shen
- Department of Abdominal Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
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Farquharson S, Brouillette C, Smith W, Shende C. A Surface-Enhanced Raman Spectral Library of Important Drugs Associated With Point-of-Care and Field Applications. Front Chem 2019; 7:706. [PMID: 31709234 PMCID: PMC6823623 DOI: 10.3389/fchem.2019.00706] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/08/2019] [Indexed: 12/03/2022] Open
Abstract
During the past decade, the ability of surface-enhanced Raman spectroscopy (SERS) to measure extremely low concentrations, such as mg/L and below, and the availability of hand-held Raman spectrometers, has led to a significant growth in the number and variety of applications of SERS to real-world problems. Most of these applications involve the measurement of drugs, such as quantifying medication in patients, identifying illicit drugs in impaired drivers, and more recently, identifying drugs used as weapons. Similar to Raman spectroscopy, most of the point-of-care and field applications involve the identification of the drug to determine the course of action. However, unlike Raman spectroscopy, spectral libraries are not readily available to perform the necessary identification. In a large part, this is due to the uniqueness of the commercially available SERS substrates, each of which can produce different spectra for the same drug. In an effort to overcome this limitation, we have measured numerous drugs using the most common, and readily available SERS material and hand-held Raman analyzers, specifically gold colloids and analyzers using 785 nm laser excitation. Here we present the spectra of some 39 drugs of current interest, such as buprenorphine, delta-9 tetrahydrocannabinol, and fentanyl, which we hope will aid in the development of current and future SERS drug analysis applications.
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8
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Nasseef MT, Singh JP, Ehrlich AT, McNicholas M, Park DW, Ma W, Kulkarni P, Kieffer BL, Darcq E. Oxycodone-Mediated Activation of the Mu Opioid Receptor Reduces Whole Brain Functional Connectivity in Mice. ACS Pharmacol Transl Sci 2019; 2:264-274. [PMID: 32259060 DOI: 10.1021/acsptsci.9b00021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/17/2022]
Abstract
Oxycodone is a potent medicinal opioid analgesic to treat pain. It is also addictive and a main cause for the current opioid crisis. At present, the impact of oxycodone on coordinated brain network activities, and contribution of the mu opioid receptor (MOR) to these effects, is unknown. We used pharmacological magnetic resonance imaging in mice to characterize MOR-mediated oxycodone effects on whole-brain functional connectivity (FC). Control (CTL) and MOR knockout (KO) animals were imaged under dexmedetomidine in a 7Tesla scanner. Acquisition was performed continuously before and after 2 mg/kg oxycodone administration (analgesic in CTL mice). Independent component analysis (data-driven) produced a correlation matrix, showing widespread oxycodone-induced reduction of FC across 71 components. Isocortex, nucleus accumbens (NAc), pontine reticular nucleus, and periacqueducal gray (PAG) components showed the highest number of significant changes. Seed-to-voxel FC analysis (hypothesis-driven) was then focused on PAG and NAc considered key pain and reward centers. The two seeds showed reduced FC with 8 and 22 Allen Brain Atlas-based regions, respectively, in CTL but not KO mice. Further seed-to-seed quantification showed highest FC modifications of both PAG and NAc seeds with hypothalamic and amygdalar areas, as well as between them, revealing the strongest impact across reward and aversion/pain centers of the brain. In conclusion, we demonstrate that oxycodone reduces brain communication in a MOR-dependent manner, and establish a preliminary whole-brain FC signature of oxycodone. This proof-of-principle study provides a unique platform and reference data set to test other MOR opioid agonists and perhaps discover new mechanisms and FC biomarkers predicting safer analgesics.
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Affiliation(s)
- Md Taufiq Nasseef
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Jai Puneet Singh
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Aliza T Ehrlich
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Michael McNicholas
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Da Woon Park
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Weiya Ma
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Praveen Kulkarni
- Center for Translational Neuro-Imaging, Northeastern University, Boston, Massachusetts 02115, United States
| | - Brigitte L Kieffer
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
| | - Emmanuel Darcq
- Douglas Hospital Research Center, Department of Psychiatry, School of Medicine, McGill University, Montreal, Quebec H4H 1R3, Canada
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Garcia MM, Goicoechea C, Avellanal M, Traseira S, Martín MI, Sánchez-Robles EM. Comparison of the antinociceptive profiles of morphine and oxycodone in two models of inflammatory and osteoarthritic pain in rat. Eur J Pharmacol 2019; 854:109-118. [PMID: 30978319 DOI: 10.1016/j.ejphar.2019.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 01/19/2023]
Abstract
Oxycodone and morphine are two opioid drugs commonly used for the treatment of moderate to severe pain. However, their use in the management of noncancer pain remains a controversial issue and, in this respect, the evidence on their effectiveness and safety, particularly in osteoarthritis, is being questioned. In order to analyse their analgesic profile, two different pain models in rats were used: the formalin-induced inflammatory pain and the monosodium iodoacetate (MIA)-induced knee osteoarthritic pain. Drugs were administered systemically (i.p.) and their antinociceptive effect and potency were assessed. In the formalin test, both morphine and oxycodone produced a dose-dependent antinociceptive effect, but oxycodone outdid morphine in terms of effectiveness and potency (nearly two times) in the early (acute nociceptive) as in the late phase (inflammatory). In the osteoarthritis model, both drugs reduced movement-evoked pain (knee-bend test), mechanical allodynia (von Frey test) and heat hyperalgesia (Plantar test). Pretreatment with naloxone and naloxone methiodide reduced morphine and oxycodone effects. Peripheral mu-opioid receptors play a crucial role in the antinociceptive effect of both drugs on movement-evoked pain and heat hyperalgesia, but not on tactile allodynia. The main finding of our study is that oxycodone has a better antinociceptive profile in the inflammatory and osteoarthritic pain, being more effective than morphine at 14 days post-MIA injection (phase with neuropathic pain); it overcame the morphine effect by improving the movement-induced pain, tactile allodynia and heat hyperalgesia. Therefore, oxycodone could be an interesting option to treat patients suffering from knee osteoarthritis when opioids are required.
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Affiliation(s)
- Miguel M Garcia
- Área de Farmacología y Nutrición - Unidad Asociada I+D+i Al Instituto de Química Médica (CSIC), Grupo de Excelencia Investigadora URJC-Banco de Santander-Grupo Multidisciplinar de Investigación y Tratamiento Del Dolor (i+Dol), Dpto. Ciencias Básicas de La Salud, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Avda. Atenas, S/n. 28922 Alcorcón, Madrid, Spain
| | - Carlos Goicoechea
- Área de Farmacología y Nutrición - Unidad Asociada I+D+i Al Instituto de Química Médica (CSIC), Grupo de Excelencia Investigadora URJC-Banco de Santander-Grupo Multidisciplinar de Investigación y Tratamiento Del Dolor (i+Dol), Dpto. Ciencias Básicas de La Salud, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Avda. Atenas, S/n. 28922 Alcorcón, Madrid, Spain
| | - Martín Avellanal
- Unidad Del Dolor, Hospital Universitario La Moraleja, Avda. de Francisco Pi y Margall, 81, 28050, Madrid, Spain
| | - Susana Traseira
- Departamento Médico, Mundipharma Pharmaceuticals, S.L. C/ Bahía de Pollensa 11, 28042, Madrid, Spain
| | - Ma Isabel Martín
- Área de Farmacología y Nutrición - Unidad Asociada I+D+i Al Instituto de Química Médica (CSIC), Grupo de Excelencia Investigadora URJC-Banco de Santander-Grupo Multidisciplinar de Investigación y Tratamiento Del Dolor (i+Dol), Dpto. Ciencias Básicas de La Salud, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Avda. Atenas, S/n. 28922 Alcorcón, Madrid, Spain
| | - Eva Ma Sánchez-Robles
- Área de Farmacología y Nutrición - Unidad Asociada I+D+i Al Instituto de Química Médica (CSIC), Grupo de Excelencia Investigadora URJC-Banco de Santander-Grupo Multidisciplinar de Investigación y Tratamiento Del Dolor (i+Dol), Dpto. Ciencias Básicas de La Salud, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Avda. Atenas, S/n. 28922 Alcorcón, Madrid, Spain.
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Jones MR, Viswanath O, Peck J, Kaye AD, Gill JS, Simopoulos TT. A Brief History of the Opioid Epidemic and Strategies for Pain Medicine. Pain Ther 2018; 7:13-21. [PMID: 29691801 PMCID: PMC5993682 DOI: 10.1007/s40122-018-0097-6] [Citation(s) in RCA: 208] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Indexed: 12/30/2022] Open
Abstract
The opioid epidemic has resulted from myriad causes and will not be solved by any simple solution. Consequent to a staggering increase in opioid-related deaths in the USA, various governmental inputs and stakeholder strategies have been proposed and implemented with varying success. This article summarizes the history of opioid use and explores the causes for the present day epidemic. Recent trends in opioid-related data demonstrate an almost fourfold increase in overdose deaths from 1999 to 2008. Tragically, opioids claimed over 64,000 lives just last year. Some solutions have undergone legislation, including the limitation of numbers of opioids postsurgery, as well as growing national prevalence of enhanced recovery after surgery protocols which focus on reduced postoperative opioid consumption and shortened hospital stays. Stricter prescribing practices and prescription monitoring programs have been instituted in the recent past. Improvement in abuse deterrent strategies which is a major focus of the Food and Drug Administration (FDA) for all opioid preparations will likely play an important role by increasing the safety of these medications. Future potential strategies such as additional legislative policies, public awareness, and physician education are also detailed in this review.
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Affiliation(s)
- Mark R Jones
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Omar Viswanath
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jacquelin Peck
- Johns Hopkins Medical Center, All Children's Hospital, St. Petersburg, FL, USA
| | - Alan D Kaye
- Louisiana State University Health Science Center, New Orleans, LA, USA
| | - Jatinder S Gill
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Thomas T Simopoulos
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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