The Experts below are selected from a list of 82836 Experts worldwide ranked by ideXlab platform
Puja Seth - One of the best experts on this subject based on the ideXlab platform.
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Fentanyl law enforcement submissions and increases in synthetic opioid involved overdose deaths 27 states 2013 2014
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew R Gladden, Pedro Martínez, Puja SethAbstract:In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured Fentanyl (IMF) as a threat to public health and safety (1,2). IMF is unlawfully produced Fentanyl, obtained through illicit drug markets, includes Fentanyl analogs, and is commonly mixed with or sold as heroin (1,3,4). Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of Fentanyl and Fentanyl-precursor chemicals by criminal organizations (3). Fentanyl is a synthetic opioid 50-100 times more potent than morphine (2).* Multiple states have reported increases in Fentanyl-involved overdose (poisoning) deaths (Fentanyl deaths) (2). This report examined the number of drug products obtained by law enforcement that tested positive for Fentanyl (Fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include Fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). Fentanyl deaths are not reported separately in national data. Analyses also were conducted on data from 27 states(†) with consistent death certificate reporting of the drugs involved in overdoses. Nationally, the number of Fentanyl submissions and synthetic opioid deaths increased by 426% and 79%, respectively, during 2013-2014; among the 27 analyzed states, Fentanyl submission increases were strongly correlated with increases in synthetic opioid deaths. Changes in Fentanyl submissions and synthetic opioid deaths were not correlated with changes in Fentanyl prescribing rates, and increases in Fentanyl submissions and synthetic opioid deaths were primarily concentrated in eight states (high-burden states). Reports from six of the eight high-burden states indicated that Fentanyl-involved overdose deaths were primarily driving increases in synthetic opioid deaths. Increases in synthetic opioid deaths among high-burden states disproportionately involved persons aged 15-44 years and males, a pattern consistent with previously documented IMF-involved deaths (5). These findings, combined with the approximate doubling in Fentanyl submissions during 2014-2015 (from 5,343 to 13,882) (6), underscore the urgent need for a collaborative public health and law enforcement response. Language: en
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Fentanyl law enforcement submissions and increases in synthetic opioid involved overdose deaths 27 states 2013 2014
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew R Gladden, Pedro Martínez, Puja SethAbstract:In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured Fentanyl (IMF) as a threat to public health and safety (1,2). IMF is unlawfully produced Fentanyl, obtained through illicit drug markets, includes Fentanyl analogs, and is commonly mixed with or sold as heroin (1,3,4). Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of Fentanyl and Fentanyl-precursor chemicals by criminal organizations (3). Fentanyl is a synthetic opioid 50-100 times more potent than morphine (2).* Multiple states have reported increases in Fentanyl-involved overdose (poisoning) deaths (Fentanyl deaths) (2). This report examined the number of drug products obtained by law enforcement that tested positive for Fentanyl (Fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include Fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). Fentanyl deaths are not reported separately in national data. Analyses also were conducted on data from 27 states(†) with consistent death certificate reporting of the drugs involved in overdoses. Nationally, the number of Fentanyl submissions and synthetic opioid deaths increased by 426% and 79%, respectively, during 2013-2014; among the 27 analyzed states, Fentanyl submission increases were strongly correlated with increases in synthetic opioid deaths. Changes in Fentanyl submissions and synthetic opioid deaths were not correlated with changes in Fentanyl prescribing rates, and increases in Fentanyl submissions and synthetic opioid deaths were primarily concentrated in eight states (high-burden states). Reports from six of the eight high-burden states indicated that Fentanyl-involved overdose deaths were primarily driving increases in synthetic opioid deaths. Increases in synthetic opioid deaths among high-burden states disproportionately involved persons aged 15-44 years and males, a pattern consistent with previously documented IMF-involved deaths (5). These findings, combined with the approximate doubling in Fentanyl submissions during 2014-2015 (from 5,343 to 13,882) (6), underscore the urgent need for a collaborative public health and law enforcement response.
M. A. Millar - One of the best experts on this subject based on the ideXlab platform.
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Patient-controlled epidural Fentanyl following spinal Fentanyl at Caesarean section.
Anaesthesia, 2002Co-Authors: D. W. Cooper, Paul Mowbray, E Garcia, M. A. MillarAbstract:Spinal Fentanyl can improve analgesia during Caesarean section. However, there is evidence that, following its relatively short-lived analgesic effect, there is a more prolonged spinal opioid tolerance effect. The effectiveness of postoperative epidural Fentanyl analgesia may therefore be reduced following the use of spinal Fentanyl at operation. This randomised, double-blind study was designed to assess whether patient-controlled epidural Fentanyl could produce effective analgesia following 25 microg of spinal Fentanyl at operation. Patients undergoing elective Caesarean section received spinal bupivacaine combined with either Fentanyl 25 microg (Fentanyl group; n = 18) or normal saline (saline group; n = 18). Patient-controlled epidural Fentanyl was used for postoperative analgesia. The Fentanyl group used a mean of 23.4 (SD 14.5) microg x h(-1) of Fentanyl, compared with 27.0 (10.8) microg x h(-1) for the saline group (p =0.41). Using a 0-100 mm visual analogue score for pain, the maximum pain score recorded at rest for the Fentanyl group was median 24 [IQR 15-35] mm, compared with 15 [13-45] mm for the saline group (p = 0.41). The maximum pain score recorded on coughing for the Fentanyl group was 29 [24-46] mm, compared with 27 [19-47] mm for the saline group (p = 0.44). Nine of the Fentanyl group rated postoperative analgesia as excellent and nine as good, compared with 10 of the saline group who rated it as excellent and eight as good (p = 0.74). Epidural Fentanyl can produce effective analgesia following the use of 25 microg spinal Fentanyl at Caesarean section.
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Patient‐controlled epidural Fentanyl following spinal Fentanyl at Caesarean section
Anaesthesia, 2002Co-Authors: D. W. Cooper, Paul Mowbray, E Garcia, M. A. MillarAbstract:Summary Spinal Fentanyl can improve analgesia during Caesarean section. However, there is evidence that, following its relatively short-lived analgesic effect, there is a more prolonged spinal opioid tolerance effect. The effectiveness of postoperative epidural Fentanyl analgesia may therefore be reduced following the use of spinal Fentanyl at operation. This randomised, double-blind study was designed␣to assess whether patient-controlled epidural Fentanyl could produce effective analgesia following 25 µg of spinal Fentanyl at operation. Patients undergoing elective Caesarean section received spinal bupivacaine combined with either Fentanyl 25 µg (Fentanyl group; n = 18) or␣normal saline (saline group; n = 18). Patient-controlled epidural Fentanyl was used for postoperative analgesia. The Fentanyl group used a mean of 23.4 (SD 14.5) µg.h−1 of Fentanyl, compared with 27.0 (10.8) µg.h−1 for the saline group (p = 0.41). Using a 0–100 mm visual analogue score for pain, the maximum pain score recorded at rest for the Fentanyl group was median 24 [IQR 15–35] mm, compared with 15 [13–45] mm for the saline group (p = 0.41). The maximum pain score recorded on coughing for the Fentanyl group was 29 [24–46] mm, compared with 27 [19–47] mm for the saline group (p = 0.44). Nine of the Fentanyl group rated postoperative analgesia as excellent and nine as good, compared with 10 of the saline group who rated it as excellent and eight as good (p = 0.74). Epidural Fentanyl can produce effective analgesia following the use of 25 µg spinal Fentanyl at Caesarean section.
Matthew R Gladden - One of the best experts on this subject based on the ideXlab platform.
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Fentanyl law enforcement submissions and increases in synthetic opioid involved overdose deaths 27 states 2013 2014
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew R Gladden, Pedro Martínez, Puja SethAbstract:In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured Fentanyl (IMF) as a threat to public health and safety (1,2). IMF is unlawfully produced Fentanyl, obtained through illicit drug markets, includes Fentanyl analogs, and is commonly mixed with or sold as heroin (1,3,4). Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of Fentanyl and Fentanyl-precursor chemicals by criminal organizations (3). Fentanyl is a synthetic opioid 50-100 times more potent than morphine (2).* Multiple states have reported increases in Fentanyl-involved overdose (poisoning) deaths (Fentanyl deaths) (2). This report examined the number of drug products obtained by law enforcement that tested positive for Fentanyl (Fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include Fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). Fentanyl deaths are not reported separately in national data. Analyses also were conducted on data from 27 states(†) with consistent death certificate reporting of the drugs involved in overdoses. Nationally, the number of Fentanyl submissions and synthetic opioid deaths increased by 426% and 79%, respectively, during 2013-2014; among the 27 analyzed states, Fentanyl submission increases were strongly correlated with increases in synthetic opioid deaths. Changes in Fentanyl submissions and synthetic opioid deaths were not correlated with changes in Fentanyl prescribing rates, and increases in Fentanyl submissions and synthetic opioid deaths were primarily concentrated in eight states (high-burden states). Reports from six of the eight high-burden states indicated that Fentanyl-involved overdose deaths were primarily driving increases in synthetic opioid deaths. Increases in synthetic opioid deaths among high-burden states disproportionately involved persons aged 15-44 years and males, a pattern consistent with previously documented IMF-involved deaths (5). These findings, combined with the approximate doubling in Fentanyl submissions during 2014-2015 (from 5,343 to 13,882) (6), underscore the urgent need for a collaborative public health and law enforcement response. Language: en
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Fentanyl law enforcement submissions and increases in synthetic opioid involved overdose deaths 27 states 2013 2014
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew R Gladden, Pedro Martínez, Puja SethAbstract:In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured Fentanyl (IMF) as a threat to public health and safety (1,2). IMF is unlawfully produced Fentanyl, obtained through illicit drug markets, includes Fentanyl analogs, and is commonly mixed with or sold as heroin (1,3,4). Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of Fentanyl and Fentanyl-precursor chemicals by criminal organizations (3). Fentanyl is a synthetic opioid 50-100 times more potent than morphine (2).* Multiple states have reported increases in Fentanyl-involved overdose (poisoning) deaths (Fentanyl deaths) (2). This report examined the number of drug products obtained by law enforcement that tested positive for Fentanyl (Fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include Fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). Fentanyl deaths are not reported separately in national data. Analyses also were conducted on data from 27 states(†) with consistent death certificate reporting of the drugs involved in overdoses. Nationally, the number of Fentanyl submissions and synthetic opioid deaths increased by 426% and 79%, respectively, during 2013-2014; among the 27 analyzed states, Fentanyl submission increases were strongly correlated with increases in synthetic opioid deaths. Changes in Fentanyl submissions and synthetic opioid deaths were not correlated with changes in Fentanyl prescribing rates, and increases in Fentanyl submissions and synthetic opioid deaths were primarily concentrated in eight states (high-burden states). Reports from six of the eight high-burden states indicated that Fentanyl-involved overdose deaths were primarily driving increases in synthetic opioid deaths. Increases in synthetic opioid deaths among high-burden states disproportionately involved persons aged 15-44 years and males, a pattern consistent with previously documented IMF-involved deaths (5). These findings, combined with the approximate doubling in Fentanyl submissions during 2014-2015 (from 5,343 to 13,882) (6), underscore the urgent need for a collaborative public health and law enforcement response.
D. W. Cooper - One of the best experts on this subject based on the ideXlab platform.
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Patient-controlled epidural Fentanyl following spinal Fentanyl at Caesarean section.
Anaesthesia, 2002Co-Authors: D. W. Cooper, Paul Mowbray, E Garcia, M. A. MillarAbstract:Spinal Fentanyl can improve analgesia during Caesarean section. However, there is evidence that, following its relatively short-lived analgesic effect, there is a more prolonged spinal opioid tolerance effect. The effectiveness of postoperative epidural Fentanyl analgesia may therefore be reduced following the use of spinal Fentanyl at operation. This randomised, double-blind study was designed to assess whether patient-controlled epidural Fentanyl could produce effective analgesia following 25 microg of spinal Fentanyl at operation. Patients undergoing elective Caesarean section received spinal bupivacaine combined with either Fentanyl 25 microg (Fentanyl group; n = 18) or normal saline (saline group; n = 18). Patient-controlled epidural Fentanyl was used for postoperative analgesia. The Fentanyl group used a mean of 23.4 (SD 14.5) microg x h(-1) of Fentanyl, compared with 27.0 (10.8) microg x h(-1) for the saline group (p =0.41). Using a 0-100 mm visual analogue score for pain, the maximum pain score recorded at rest for the Fentanyl group was median 24 [IQR 15-35] mm, compared with 15 [13-45] mm for the saline group (p = 0.41). The maximum pain score recorded on coughing for the Fentanyl group was 29 [24-46] mm, compared with 27 [19-47] mm for the saline group (p = 0.44). Nine of the Fentanyl group rated postoperative analgesia as excellent and nine as good, compared with 10 of the saline group who rated it as excellent and eight as good (p = 0.74). Epidural Fentanyl can produce effective analgesia following the use of 25 microg spinal Fentanyl at Caesarean section.
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Patient‐controlled epidural Fentanyl following spinal Fentanyl at Caesarean section
Anaesthesia, 2002Co-Authors: D. W. Cooper, Paul Mowbray, E Garcia, M. A. MillarAbstract:Summary Spinal Fentanyl can improve analgesia during Caesarean section. However, there is evidence that, following its relatively short-lived analgesic effect, there is a more prolonged spinal opioid tolerance effect. The effectiveness of postoperative epidural Fentanyl analgesia may therefore be reduced following the use of spinal Fentanyl at operation. This randomised, double-blind study was designed␣to assess whether patient-controlled epidural Fentanyl could produce effective analgesia following 25 µg of spinal Fentanyl at operation. Patients undergoing elective Caesarean section received spinal bupivacaine combined with either Fentanyl 25 µg (Fentanyl group; n = 18) or␣normal saline (saline group; n = 18). Patient-controlled epidural Fentanyl was used for postoperative analgesia. The Fentanyl group used a mean of 23.4 (SD 14.5) µg.h−1 of Fentanyl, compared with 27.0 (10.8) µg.h−1 for the saline group (p = 0.41). Using a 0–100 mm visual analogue score for pain, the maximum pain score recorded at rest for the Fentanyl group was median 24 [IQR 15–35] mm, compared with 15 [13–45] mm for the saline group (p = 0.41). The maximum pain score recorded on coughing for the Fentanyl group was 29 [24–46] mm, compared with 27 [19–47] mm for the saline group (p = 0.44). Nine of the Fentanyl group rated postoperative analgesia as excellent and nine as good, compared with 10 of the saline group who rated it as excellent and eight as good (p = 0.74). Epidural Fentanyl can produce effective analgesia following the use of 25 µg spinal Fentanyl at Caesarean section.
Matthew L. Banks - One of the best experts on this subject based on the ideXlab platform.
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Conjugate vaccine produces long-lasting attenuation of Fentanyl vs. food choice and blocks expression of opioid withdrawal-induced increases in Fentanyl choice in rats
Neuropsychopharmacology, 2019Co-Authors: E. Andrew Townsend, Steven Blake, Kaycee E. Faunce, Candy S. Hwang, Yoshihiro Natori, Bin Zhou, Paul T. Bremer, Kim D. Janda, Matthew L. BanksAbstract:The current opioid crisis remains a significant public health issue and there is a critical need for biomedical research to develop effective and easily deployable candidate treatments. One emerging treatment strategy for opioid use disorder includes immunopharmacotherapies or opioid-targeted vaccines. The present study determined the effectiveness of a Fentanyl-tetanus toxoid conjugate vaccine to alter Fentanyl self-administration using a Fentanyl-vs.-food choice procedure in male and female rats under three experimental conditions. For comparison, continuous 7-day naltrexone (0.01–0.1 mg/kg/h) and 7-day clonidine (3.2–10 μg/kg/h) treatment effects were also determined on Fentanyl-vs.-food choice. Male and female rats responded for concurrently available 18% diluted Ensure® (liquid food) and Fentanyl (0–10 μg/kg/infusion) infusions during daily sessions. Under baseline and saline treatment conditions, Fentanyl maintained a dose-dependent increase in Fentanyl-vs.-food choice. First, Fentanyl vaccine administration significantly blunted Fentanyl reinforcement and increased food reinforcement for 15 weeks in non-opioid dependent rats. Second, surmountability experiments by increasing the unit Fentanyl dose available during the self-administration session 10-fold empirically determined that the Fentanyl vaccine produced an approximate 22-fold potency shift in Fentanyl-vs.-food choice that was as effective as the clinically approved treatment naltrexone. Clonidine treatment significantly increased Fentanyl-vs.-food choice. Lastly, Fentanyl vaccine administration prevented the expression of withdrawal-associated increases in Fentanyl-vs.-food choice following introduction of extended 12 h Fentanyl access sessions. Overall, these results support the potential and further consideration of immunopharmacotherapies as candidate treatments to address the current opioid crisis.
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Conjugate vaccine produces long-lasting attenuation of Fentanyl vs. food choice and blocks expression of opioid withdrawal-induced increases in Fentanyl choice in rats
Neuropsychopharmacology, 2019Co-Authors: E. Andrew Townsend, Steven Blake, Kaycee E. Faunce, Candy S. Hwang, Yoshihiro Natori, Bin Zhou, Paul T. Bremer, Kim D. Janda, Matthew L. BanksAbstract:The current opioid crisis remains a significant public health issue and there is a critical need for biomedical research to develop effective and easily deployable candidate treatments. One emerging treatment strategy for opioid use disorder includes immunopharmacotherapies or opioid-targeted vaccines. The present study determined the effectiveness of a Fentanyl-tetanus toxoid conjugate vaccine to alter Fentanyl self-administration using a Fentanyl-vs.-food choice procedure in male and female rats under three experimental conditions. For comparison, continuous 7-day naltrexone (0.01–0.1 mg/kg/h) and 7-day clonidine (3.2–10 μg/kg/h) treatment effects were also determined on Fentanyl-vs.-food choice. Male and female rats responded for concurrently available 18% diluted Ensure® (liquid food) and Fentanyl (0–10 μg/kg/infusion) infusions during daily sessions. Under baseline and saline treatment conditions, Fentanyl maintained a dose-dependent increase in Fentanyl-vs.-food choice. First, Fentanyl vaccine administration significantly blunted Fentanyl reinforcement and increased food reinforcement for 15 weeks in non-opioid dependent rats. Second, surmountability experiments by increasing the unit Fentanyl dose available during the self-administration session 10-fold empirically determined that the Fentanyl vaccine produced an approximate 22-fold potency shift in Fentanyl-vs.-food choice that was as effective as the clinically approved treatment naltrexone. Clonidine treatment significantly increased Fentanyl-vs.-food choice. Lastly, Fentanyl vaccine administration prevented the expression of withdrawal-associated increases in Fentanyl-vs.-food choice following introduction of extended 12 h Fentanyl access sessions. Overall, these results support the potential and further consideration of immunopharmacotherapies as candidate treatments to address the current opioid crisis.