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  1. Article: Changes in Psychological Outcomes after Cessation of Full Mu Agonist Long-Term Opioid Therapy for Chronic Pain.

    Silva, Marcelina Jasmine / Coffee, Zhanette / Yu, Chong Ho Alex / Hu, Joshua

    Journal of clinical medicine

    2023  Volume 12, Issue 4

    Abstract: Improved understanding of psychological features associated with full mu agonist long-term opioid therapy (LTOT) cessation may offer advantages for clinicians. This preliminary study presents changes in psychological outcomes in patients with chronic, ... ...

    Abstract Improved understanding of psychological features associated with full mu agonist long-term opioid therapy (LTOT) cessation may offer advantages for clinicians. This preliminary study presents changes in psychological outcomes in patients with chronic, non-cancer pain (CNCP) after LTOT cessation via a 10-week multidisciplinary program which included treatment with buprenorphine. Paired
    Language English
    Publishing date 2023-02-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12041354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Microinduction to Buprenorphine from Methadone for Chronic Pain: Outpatient Protocol with Case Examples.

    Jasmine Silva, Marcelina / Coffee, Zhanette / Goza, Jessica / Rumrill, Kelly

    Journal of pain & palliative care pharmacotherapy

    2022  Volume 36, Issue 1, Page(s) 40–48

    Abstract: The negative sequelae of full mu agonist chronic opioid analgesic therapy (COAT) are numerous and well documented. One safer alternative to COAT use in chronic, non-cancer pain (CNCP) is a transition to buprenorphine. However, transitioning patients from ...

    Abstract The negative sequelae of full mu agonist chronic opioid analgesic therapy (COAT) are numerous and well documented. One safer alternative to COAT use in chronic, non-cancer pain (CNCP) is a transition to buprenorphine. However, transitioning patients from methadone COAT regimens can be challenging due to the pharmacodynamics of buprenorphine, as well as to the limited commercial formulations of buprenorphine available, and their restrictive instructions for use. Presented here are clinical cases transitioned to buprenorphine from methadone via a novel microinduction protocol during enrollment in an outpatient, group, integrative, multidisciplinary program. The protocol was successful to promote satisfactory and sustained COAT cessation for patients with CNCP and is arguably safer than current conventional practices.
    MeSH term(s) Analgesics, Opioid/therapeutic use ; Buprenorphine/pharmacology ; Buprenorphine/therapeutic use ; Chronic Pain/drug therapy ; Humans ; Methadone ; Opioid-Related Disorders/drug therapy ; Outpatients
    Chemical Substances Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ) ; Methadone (UC6VBE7V1Z)
    Language English
    Publishing date 2022-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2078852-6
    ISSN 1536-0539 ; 1536-0288
    ISSN (online) 1536-0539
    ISSN 1536-0288
    DOI 10.1080/15360288.2022.2049422
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2463: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Prolonged cessation of chronic opioid analgesic therapy: a multidisciplinary intervention.

    Silva, Marcelina Jasmine / Coffee, Zhanette H / Yu, Chong Ho

    The American journal of managed care

    2022  Volume 28, Issue 2, Page(s) 60–65

    Abstract: Objectives: To contribute to the literature of best-practice approaches to promote full mu agonist chronic opioid analgesic therapy (COAT) cessation in a population with chronic, noncancer pain by describing initial and extended follow-up outcomes from ... ...

    Abstract Objectives: To contribute to the literature of best-practice approaches to promote full mu agonist chronic opioid analgesic therapy (COAT) cessation in a population with chronic, noncancer pain by describing initial and extended follow-up outcomes from a limited group program that utilized a standardized, multidisciplinary curriculum containing robust complementary care access in a private practice setting.
    Study design: A retrospective review of data from electronic health records and the California Prescription Drug Monitoring Program for program participants between October 2017 and December 2019.
    Methods: Daily oral morphine milligram equivalent (MME) dose use upon entry, at program graduation, at 6 months post graduation, and at extended follow-up of 7 to 24 months post graduation were compared and reported for program participants.
    Results: A total of 109 program participants with incoming daily COAT use amounts as high as 600 MME (median, 60 MME; 25% quartile, 36.5 MME; 75% quartile, 90 MME; interquartile range, 53.5 MME) had a successful COAT cessation rate of 90% at program graduation, which was maintained at 6 months and extended follow-up at 95% and 97%, respectively.
    Conclusions: This pilot study contributes to the literature by documenting a successful and potentially generalizable strategy to promote COAT cessation, and by providing unusually lengthy follow-up for postintervention COAT cessation monitoring.
    MeSH term(s) Analgesics, Opioid/therapeutic use ; Chronic Pain/drug therapy ; Drug Prescriptions ; Humans ; Pilot Projects ; Practice Patterns, Physicians' ; Prescription Drug Monitoring Programs ; Retrospective Studies
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-02-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2035781-3
    ISSN 1936-2692 ; 1088-0224 ; 1096-1860
    ISSN (online) 1936-2692
    ISSN 1088-0224 ; 1096-1860
    DOI 10.37765/ajmc.2022.88785
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5353: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MG 86: Show issues

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  4. Article ; Online: The escalation of the opioid epidemic due to COVID-19 and resulting lessons about treatment alternatives.

    Silva, Marcelina Jasmine / Kelly, Zakary

    The American journal of managed care

    2020  Volume 26, Issue 7, Page(s) e202–e204

    Abstract: Factors worsening the opioid epidemic during the coronavirus disease 2019 (COVID-19) pandemic provide valuable insight for strategy change where we have historically suffered great loss, bodily and financially. ...

    Abstract Factors worsening the opioid epidemic during the coronavirus disease 2019 (COVID-19) pandemic provide valuable insight for strategy change where we have historically suffered great loss, bodily and financially.
    MeSH term(s) Analgesics, Opioid/adverse effects ; COVID-19 ; Comorbidity ; Coronavirus Infections/epidemiology ; Drug Overdose/epidemiology ; Health Services Accessibility/statistics & numerical data ; Health Status Disparities ; Humans ; Opioid Epidemic/prevention & control ; Opioid Epidemic/statistics & numerical data ; Opioid-Related Disorders/epidemiology ; Pandemics ; Pneumonia, Viral/epidemiology ; United States/epidemiology
    Chemical Substances Analgesics, Opioid
    Keywords covid19
    Language English
    Publishing date 2020-07-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2035781-3
    ISSN 1936-2692 ; 1088-0224 ; 1096-1860
    ISSN (online) 1936-2692
    ISSN 1088-0224 ; 1096-1860
    DOI 10.37765/ajmc.2020.43386
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5353: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MG 86: Show issues

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  5. Article: The escalation of the opioid epidemic due to COVID-19 and resulting lessons about treatment alternatives

    Silva, Marcelina Jasmine / Kelly, Zakary

    Am J Manag Care

    Abstract: Factors worsening the opioid epidemic during the coronavirus disease 2019 (COVID-19) pandemic provide valuable insight for strategy change where we have historically suffered great loss, bodily and financially. ...

    Abstract Factors worsening the opioid epidemic during the coronavirus disease 2019 (COVID-19) pandemic provide valuable insight for strategy change where we have historically suffered great loss, bodily and financially.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #652038
    Database COVID19

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  6. Article ; Online: Anxiety and Fear Avoidance Beliefs and Behavior May Be Significant Risk Factors for Chronic Opioid Analgesic Therapy Reliance for Patients with Chronic Pain-Results from a Preliminary Study.

    Silva, Marcelina Jasmine / Coffee, Zhanette / Yu, Chong Ho / Martel, Marc O

    Pain medicine (Malden, Mass.)

    2021  Volume 22, Issue 9, Page(s) 2106–2116

    Abstract: Objective: To describe differences between patients with chronic, non-cancer pain (CNCP) who were successfully able to cease full mu agonist chronic opioid analgesic therapy (COAT), and those who exhibited refractory COAT reliance, among those who ... ...

    Abstract Objective: To describe differences between patients with chronic, non-cancer pain (CNCP) who were successfully able to cease full mu agonist chronic opioid analgesic therapy (COAT), and those who exhibited refractory COAT reliance, among those who participated in a multidisciplinary program designed for COAT cessation.
    Design: A retrospective review of electronic medical records (EMR) data was organized for preliminary analysis.
    Setting: A multicenter private practice specializing in CNCP, which received patient referrals from the surrounding geographical area of primary and specialty care offices in Northern California.
    Subjects: Data from 109 patients with CNCP who participated in a multidisciplinary program to cease COAT between the dates of October 2017 to December 2019 were examined.
    Methods: EMR data, pre-COAT cessation, of oral morphine milligram equivalence (MME) and validated questionnaire responses assessing anxiety and fear-based beliefs and behavior, as well as opioid misuse, were extracted and compared between those who successfully ceased COAT and those who did not.
    Results: Patients who were unsuccessful at COAT cessation reported significantly higher Fear Avoidance Beliefs Questionnaire (FAB) scores. No significant differences were found based on incoming MME amounts, Current Opioid Misuse Measure (COMM) or Tampa Scale of Kinesiophobia (TSK) scores. Pain Catastrophizing Scale (PCS) scores showed a split pattern with unclear significance.
    Conclusions: Results suggest that fear avoidance beliefs and behavior, as measured by the FAB, play a significant role in refractory COAT reliance for patients with CNCP.
    MeSH term(s) Analgesics, Opioid/therapeutic use ; Anxiety ; Chronic Pain/drug therapy ; Fear ; Humans ; Retrospective Studies ; Risk Factors
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2021-03-23
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2015903-1
    ISSN 1526-4637 ; 1526-2375
    ISSN (online) 1526-4637
    ISSN 1526-2375
    DOI 10.1093/pm/pnab069
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6119: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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  7. Article ; Online: Continuous Perioperative Sublingual Buprenorphine.

    Silva, Marcelina Jasmine / Rubinstein, Andrea

    Journal of pain & palliative care pharmacotherapy

    2016  Volume 30, Issue 4, Page(s) 289–293

    Abstract: Buprenorphine, a semisynthetic thebaine derivative, is a unique opioid, as it has activity at multiple receptors, including mu (partial agonist), kappa (antagonist), OLR-1 (agonist), and delta (antagonist). Because buprenorphine's pharmacology is ... ...

    Abstract Buprenorphine, a semisynthetic thebaine derivative, is a unique opioid, as it has activity at multiple receptors, including mu (partial agonist), kappa (antagonist), OLR-1 (agonist), and delta (antagonist). Because buprenorphine's pharmacology is relatively complex, misconceptions about its actions are common. Most other opioids act solely or predominately as full mu receptor agonists. Common practice at many institutions calls for the cessation of regular buprenorphine use 48-72 hours prior to surgery. This practice is based on three foundational theories that have come from scant data about the properties of buprenorphine: (1) that buprenorphine is only a partial mu agonist and therefore is not a potent analgesic; (2) because buprenorphine has a ceiling effect on respiratory depression, it also has a ceiling effect on analgesia; and (3) that buprenorphine acts as a "blockade" to the analgesic effects of other opiates when coadministered due to its strong binding affinity. However, several recent studies have called this practice into question. At our institution, we continue buprenorphine perioperatively, whenever possible, in order to provide superior pain control, discourage potentially problematic use and the more dangerous side effects of full mu agonist opiates, and avoid putting recovery at risk for those with opiate dependency issues. We present a unique case comparing two different outcomes for the same surgical course performed at two different times on the same chronic pain patient. These differences may be attributable to the variable of buprenorphine being present for one perioperative course and not the other. Pain control was easier to achieve, and functional recovery was greater when buprenorphine was maintained throughout the perioperative period when compared with using a full mu agonist opioid for chronic pain preoperatively. This is an outcome that much of the literature heretofore suggests would be unlikely. We review some aspects of buprenorphine's unique pharmacology that may explain why remaining on buprenorphine perioperatively may be preferable, which contradicts many practice guidelines.
    Language English
    Publishing date 2016-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2078852-6
    ISSN 1536-0539 ; 1536-0288
    ISSN (online) 1536-0539
    ISSN 1536-0288
    DOI 10.1080/15360288.2016.1231734
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2463: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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