Treating Opioid Dependence: Pain Medicine Physiology of Tolerance and Addiction

James, Dominika Lipowska; Jowza, Maryam

doi:10.1097/grf.0000000000000422

Cited by 9 publications

(4 citation statements)

References 30 publications

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“…In the field of OUDs, a review (Kakko et al, 2019) highlights the benefits of nonpharmacological approaches, such as CBT and MBIs, as supplementary treatments to opioid agonist therapies (Garland et al, 2019; James and Jowza, 2019). Despite the positive impact of these treatments on craving, many OUD patients continue to suffer from negative affect and dysphoria, as stated elsewhere.…”

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders

et al. 2021

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Substance use disorders (SUDs) are characterized by a recurrent and maladaptive use of drugs and/or alcohol. Cognitive behavioral therapies (CBTs) comprise different types of interventions: traditional CBT and the more recent "third wave" behavior therapies, such as acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and schema therapy (ST). We searched English-language articles published between 2014 and present. This review includes randomized controlled trials (RCTs), quasi-RCTs, pilot studies, and reviews of CBTs for SUDs available on PubMed. Results seem to indicate that CBT and MBCT are effective interventions for SUDs; however, the studies showed a high degree of heterogeneity, so no exhaustive conclusions could be outlined at this time. ACT and DBT in SUD management are limited to few studies and results are therefore inconclusive.

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Section: Resultsmentioning

confidence: 99%

The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders

et al. 2021

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“…Commonly used opioids for the management of neuropathic pain include tramadol, oxycodone, and morphine . Although opioids are efficient in pain management, long-term use can greatly decrease the quality of life with severe side effects and tolerance, which makes patients hesitant to use them despite the pain . Some doctors prescribe polytherapy by prescribing other drugs in combination with opioids such as TCA’s to increase the effectiveness and minimize tolerance, but the experimental and clinical evidence in support of polytherapy is scant.…”

Section: Limitations Of Conventional Treatmentsmentioning

confidence: 99%

Scope and Applications of Nanomedicines for the Management of Neuropathic Pain

et al. 2020

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Neuropathic pain, resulting from the dysfunction of the peripheral and central nervous system, occurs in a variety of pathological conditions including trauma, diabetes, cancer, HIV, surgery, multiple sclerosis, ischemic attack, alcoholism, spinal cord damage, and many others. Despite the availability of various treatment strategies, the percentage of patients achieving adequate pain relief remains low. The clinical failure of most effective drugs is often not due to a lack of drug efficacy but due to the dose-limiting central nervous system (CNS) toxicity of the drugs that preclude dose escalation. There is a need for cross-disciplinary collaborations to meet these challenges. In this regard, the integration of nanotechnology with neuroscience is one of the most important fields. In recent years, promising preclinical research has been reported in this field. This review highlights the current challenges associated with conventional neuropathic pain treatments, the scope for nanomaterials in delivering drugs across the blood−brain barrier, and the state and prospects of nanomaterials for the management of neuropathic pain.

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“…Pharmacological and non-pharmacological interventions such as psychological counseling and group meeting are used for opioid dependency treatment ( 7 ). According to the American Psychiatric Association (APA) guideline for pharmacological opioid dependency management; treatment commonly is initiated with acute detoxification and then is continued by long-term opioid replacement therapy ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…There are several types of long-term pharmacological therapies such as agonists, partial agonists, and antagonists of opioid receptors, like treatment with methadone, buprenorphine, and naltrexone, respectively. Also, combined therapies like buprenorphine/naloxone can be used ( 7 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

The effects of naltrexone on retention in treatment and being opioid-free in opioid-dependent people: A systematic review and meta-analysis

et al. 2022

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BackgroundOpioid dependency is a chronic relapsing disorder for which different therapeutically interventions have been developed. Naltrexone is a non-selective opioid antagonist that can be utilized for maintenance therapy in opioid dependency. In this systematic review, we aimed to evaluate the effects of naltrexone on retention in treatment and being opioid-free.MethodsWe systematically searched PubMed and EMBASE databases up to February 5, 2022, using the following keywords: “Naltrexone,” “Substance abuse,” “Drug abuse,” “Opiate-related disorder,” and “Opioid dependence.” Studies that included opiate-dependent individuals who were treated with naltrexone and assessed retention in treatment or being opioid-free were included. Two authors independently used the Cochrane risk-of-bias tool for quality assessment. A random effect model in Comprehensive Meta-Analysis software was used for the conduction of the meta-analysis. We performed subgroup analysis to evaluate the effects of naltrexone types on outcomes.ResultsEighteen studies, including 2,280 participants met our inclusion criteria. The duration of treatment ranged from 21 days to 24 months. The retention in treatment with naltrexone was 63% higher than controls (odds ratio (OR): 1.64 [95% confidence interval (CI), 0.78–3.44]. The OR for being opioid-free was 1.63 (95% CI, 0.57–4.72). Injectable naltrexone was significantly effective on retention in treatment (OR 1.86; 95% CI, 1.17–2.98).ConclusionsWe found that naltrexone could be useful for retention in treatment and being opioid-free, however, the findings were not significant. Further high-quality and large-scale observational studies are recommended.

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Treating Opioid Dependence: Pain Medicine Physiology of Tolerance and Addiction

Cited by 9 publications

References 30 publications

The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders

The Effectiveness of Cognitive Behavioral Therapy Techniques for the Treatment of Substance Use Disorders

Scope and Applications of Nanomedicines for the Management of Neuropathic Pain

The effects of naltrexone on retention in treatment and being opioid-free in opioid-dependent people: A systematic review and meta-analysis

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