PubMed Update June 2013

13 new papers this month, from drug development to naloxone programming, epidemiology to practice management, toxicology to supply side drug control.

1) Illicit drug overdose - Prevalence and acute management.

Li W, Gunja N.

Aust Fam Physician. 2013 Jul;42(7):481-5.

Comment: Unable to access.  Appears to be a general review of managing illicit drug toxicities.

2) Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.

Leece PN, Hopkins S, Marshall C, Orkin A, Gassanov MA, Shahin RM.

Can J Public Health. 2013 Apr 18;104(3):e200-4.

Comment: Unable to access. There have been several papers describing the initial experience of naloxone programs and this is a welcome addition to that literature.

3) Vital signs: overdoses of prescription opioid pain relievers and other drugs among women - United States, 1999-2010.

Centers for Disease Control and Prevention (CDC).

MMWR Morb Mortal Wkly Rep. 2013 Jul 5;62(26):537-42.

Comment: A review of drug overdose mortality data among women, demonstrating that women have been particularly affected by the recent epidemic.

4) Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal in Russian cities.

Coffin PO, Sullivan SD.

J Med Econ. 2013 Jun 19. [Epub ahead of print]

Comments: An adaptation of the model developed for the United States, taking into account structural differences, epidemiologic data, and costs in Russia. Because of limitations in emergency medical services in Russia, the high rate at which overdoses are witnessed, and the very low costs of naloxone, this intervention is likely to be even more cost-effective in Russia than it appears to be in the United States.

5) Use of Naloxone for Clonidine Intoxication in the Pediatric Age Group: Case Report and Review of the Literature.

Ahmad SA, Scolnik D, Snehal V, Glatstein M.

Am J Ther. 2013 Jun 18. [Epub ahead of print]

Comment: I was curious as to why one would use naloxone in this circumstance – and no surprise it did not work.

6) Brief overdose education can significantly increase accurate recognition of opioid overdose among heroin users.

Jones JD, Roux P, Stancliff S, Matthews W, Comer SD.

Int J Drug Policy. 2013 Jun 14. doi:pii: S0955-3959(13)00080-7.

Comment: Brief training on overdose prevention works.

7) Efforts to Reduce Overdose Deaths.

Sherman SG, Han J, Welsh C, Chaulk P, Serio-Chapman C.

Am J Public Health. 2013 Jun 13. [Epub ahead of print]

Schwartz et al. Respond.

Schwartz RP, Gryczynski J, O'Grady KE, Sharfstein JM, Warren G, Olsen YK, Mitchell SG, Jaffe JH.

Am J Public Health. 2013 Jun 13. [Epub ahead of print]

Comment: An intriguing dialogue about the Baltimore paper on opioid agonist treatment and overdose. That’s all I’ll say.

8) Methadone-induced toxic brain damage.

Corré J, Pillot J, Hilbert G.

Case Rep Radiol. 2013;2013:602981. doi: 10.1155/2013/602981. Epub 2013 May 22.

Comment: Cerebellar and basal ganglia damage from methadone overdose.

9) The feasibility of pharmacy-based naloxone distribution interventions: a qualitative study with injection drug users and pharmacy staff in Rhode Island.

Zaller ND, Yokell MA, Green TC, Gaggin J, Case P.

Subst Use Misuse. 2013 Jun;48(8):590-9. doi: 10.3109/10826084.2013.793355. Epub 2013 Jun 10.

Comment: Unable to access. Interviews with 21 drug injectors and 21 pharmacy staff. Overall there was good acceptance of the concept, although some misinformation about naloxone, some concerns about drug user and pharmacy staff interactions, and some concerns about cost.

10) Supply-side response to declining heroin purity: fentanyl overdose episode in New Jersey.

Hempstead K, Yildirim EO.

Health Econ. 2013 Jun 6. doi: 10.1002/hec.2937. [Epub ahead of print]

Comment: Fascinating.

11) EMS Runs for Suspected Opioid Overdose: Implications for Surveillance and Prevention.

Knowlton A, Weir BW, Hazzard F, Olsen Y, McWilliams J, Fields J, Gaasch W.

Prehosp Emerg Care. 2013 Jul-Sep;17(3):317-29. doi: 10.3109/10903127.2013.792888.

Comments: Unable to access, so I’m unclear on details from this paper.

12) A Response to the Opioid Overdose Epidemic: Naloxone Nasal Spray.

Wermeling DP.

Drug Deliv Transl Res. 2013 Feb 1;3(1):63-74.

Comments: Unable to access. A review of the rationale for nasal delivery of naloxone.

13) Sublingual Buprenorphine for Chronic Pain: A Survey of Clinician Prescribing Practices.

Rosen K, Gutierrez A, Haller D, Potter JS.

Clin J Pain. 2013 May 30. [Epub ahead of print]

Comments: The use of buprenorphine for chronic pain is an exciting idea whose time has come.