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Micro-costing analysis of harm reduction services in office-based addiction treatment. (PubMed, Drug Alcohol Depend) - "We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity."

HEOR • Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Infectious Disease • Psychiatry

Mechanistic insights into opioid-induced pulmonary edema: receptor specificity and sodium transport. (PubMed, Ir J Med Sci) - "Opioid-induced AFC impairment involves receptor-specific alterations in alveolar fluid regulation, with the DOR playing a dominant inhibitory role, suggesting its involvement in the development of pulmonary edema."

Journal • Acute Respiratory Distress Syndrome • Addiction (Opioid and Alcohol) • Anesthesia • Cardiovascular • Pain • Respiratory Diseases

The role of central versus peripheral opioid receptors in fentanyl-induced brain hypoxia. (PubMed, J Neurophysiol) - "These findings suggest that naloxone-methiodide is not a strictly peripheral antagonist. At moderate to high doses, naloxone-methiodide's ability to reverse fentanyl-induced hypoxia may be at least partly mediated by the drug's action on central opioid receptors."

Journal • CNS Disorders • Depression • Psychiatry

Recreational use of nitrous oxide resulting in severe B12 deficiency, pancytopenia and hemolytic anemia (ASH 2025) - "Case description We present a case of a 24-year-old female with a past medical history of iron deficiency anemia,substance-use disorder including fentaNYL abuse and recreational nitrous oxide presented to theemergency department with shortness of breath, weakness, fatigue, and recurrent fevers, chills, myalgia,and lightheadedness...Patient started on vancomycin andcefepime for septic shock...For manypatients, stopping recreational nitrous oxide and supplementing vitamin B12 is sufficient to improvepancytopenia, but prolonged deficiency of vitamin B12 can lead to permanent axonal damage. This casehighlights the importance of recognizing vitamin B12 deficiency in recreational nitrous oxide users, andpreventing hematological and long-term neurological complications."

Anemia • CNS Disorders • Eosinophilia • Hematological Disorders • Human Immunodeficiency Virus • Infectious Disease • Influenza • Musculoskeletal Pain • Neutropenia • Pneumonia • Respiratory Diseases • Respiratory Syncytial Virus Infections • Septic Shock • Thrombocytopenia

Fentanyl test strip use and homelessness among people who use drugs in Rhode Island. (PubMed, Int J Drug Policy) - "We found that housing status was not independently and longitudinally associated with FTS use; however, people who used crystal methamphetamine were more than twice as likely to have used FTS in the past month. Future research exploring how differential housing situations may affect uptake of harm reduction services is needed to prevent fentanyl overdose."

Journal

Prevalence and Patterns of Off-Label Transmucosal Immediate-Release Fentanyl Use in French General Practice: A Mixed-Methods Study Based on a Voluntary Online Survey. (PubMed, Pain Ther) - "This study confirms widespread off-label TIRF use in well-defined clinical situations. While many GPs report positive outcomes, important concerns remain, including limited training, difficulty with dose titration, and the risk of use disorder. Targeted education and clearer prescribing guidelines could help ensure a safer and more appropriate use of TIRF in GPs practice."

Journal • Otorhinolaryngology • Pain • Rheumatology

Dosing and Safety of Methadone Initiation in the Setting of Fentanyl: A Systematic Review. (PubMed, J Addict Med) - "The current observational literature is limited, with some support for accelerated methadone initiation in inpatient and outpatient settings for appropriately selected patients exposed to fentanyl."

Journal • Addiction (Opioid and Alcohol) • Anesthesia • Substance Abuse

Incidence and Risk Factors of Orthostatic Hypotension and Postural Tachycardia Following Sedated Colonoscopy: A Prospective Observational Study. (PubMed, Diagnostics (Basel)) - " This prospective observational study included 76 adult patients (ASA I-III) who underwent colonoscopy with fentanyl-propofol sedation between August and November 2024...Younger age and female sex were identified as independent risk factors for OI symptoms, suggesting a possible role of autonomic variability. Routine post-procedure monitoring and assisted mobilization before discharge may improve patient safety and recovery outcomes."

Journal • Observational data • Anesthesia • Cardiovascular • Hypotension

Individual differences in behavioral effects of xylazine and opioid-xylazine mixtures in male rats. (PubMed, Psychopharmacology (Berl)) - "Individual differences were observed in multiple behavioral measures following xylazine administration and may recapitulate the divisiveness of xylazine reported in people who use drugs."

Journal • Preclinical • CNS Disorders • Depression • Psychiatry

Integration of safer smoking equipment in U.S. syringe services programs: Qualitative insights from program staff. (PubMed, Int J Drug Policy) - "Implementation of safer smoking equipment represents a critical evolution in harm reduction programming that may engage underserved communities in the range of evidence-based prevention services offered by SSPs. Flexible funding and supportive implementation climates are needed to support SSPs in providing this impactful service."

Journal • Infectious Disease • Novel Coronavirus Disease

Anesthetic induction drugs during tracheal intubation in critically ill patients: a systematic review. (PubMed, J Anesth) - "This review found limited evidence on the hemodynamic effects of anesthetic agents other than etomidate during tracheal intubation in critically ill patients. Standardized definitions and high-quality research are needed to better characterize post-induction hypotension and determine the safest anesthetic combinations."

Intubation • Journal • Anesthesia • Endocrine Disorders • Hypotension • Nephrology • Renal Disease

Perioperative Multimodal General Anesthesia Focusing on Specific Central Nervous System Targets Does Not Reduce Postoperative Interleukin-6 and Neurofilament Light Levels in Patients Undergoing Cardiac Surgeries: A Randomized Controlled Trial. (PubMed, J Cardiothorac Vasc Anesth) - "MMGA did not reduce postoperative IL-6 or NFL levels, nor did it improve neurocognitive outcomes, compared with standard of care. The higher burst suppression in the MMGA group underscores the need for structured EEG education among cardiac anesthesiologists. Future studies should explore other EEG metrics and multimodal strategies for perioperative brain protection."

Journal • Anesthesia • Cardiovascular • CNS Disorders • Cognitive Disorders • Pain • IL6 • NEFL

Chasing the New Dragon: Toxic Spongiform Leukoencephalopathy With Chronic Fentanyl Inhalation. (PubMed, Neurology) - No abstract available

Journal • CNS Disorders

Comparison of oliceridine and fentanyl intraoperative analgesia on postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy: study protocol for a randomized, double-blind, controlled trial. (PubMed, Trials) - P=N/A | "We hypothesize that oliceridine may offer effective analgesia and a lower incidence of PONV than fentanyl in intraoperative pain management for this high-risk group. The findings may provide valuable insights into optimizing perioperative pain management strategies and enhancing patient recovery."

Clinical • Journal • Anesthesia • Pain

Comparative efficacy and safety of dexmedetomidine and midazolam for conscious sedation in blind nasotracheal intubation: a randomized controlled trial. (PubMed, Front Med (Lausanne)) - "Sixty patients undergoing oral and maxillofacial surgery were randomly divided into the dexmedetomidine (DEX) group (1.0 μg/kg, 15 min of infusion + pethidine 1.0 mg/kg) and the midazolam (MID) group (0.02 mg/kg + pethidine 1.0 mg/kg)...The intraoperative fentanyl dosage, end-tidal carbon dioxide partial pressure (PETCO2) were recorded, and postoperative numerical rating scale (NRS) score, satisfaction and adverse reaction incidence were evaluated...The dosage of sufentanil, the postoperative NRS score, and adverse reactions (nausea, vomiting, respiratory depression) were reduced in the DEX group (p  0.05). Dexmedetomidine used for blind nasotracheal intubation for oral and maxillofacial surgery can provide comprehensive anesthesia effects, significantly reduce the stress response of tracheal intubation and the dosage of intraoperative opioids, while maintaining good hemodynamic stability."

Intubation • Journal • Anesthesia • CNS Disorders • Depression • Otorhinolaryngology • Psychiatry

Thoracic Ultrasound-Guided Regional Nerve Blockade for Pain Management Following Open Heart Surgery in Children: A Systematic Review and Network Meta-analysis of Analgesic Efficacy and Impact on Postoperative Opioid Requirements. (PubMed, Pediatr Cardiol) - "Compared to no intervention, parasternal blocks particularly DPB and SPB were associated with a significant reduction in both intraoperative and 24-h postoperative fentanyl consumption...In contrast, blocks such as ESPB, PVB, and MICB showed limited benefit for median sternotomy pain. Given the substantial heterogeneity in the current evidence, the routine use of these techniques should be guided by institutional experience and individualized patient factors."

Clinical • Journal • Retrospective data • Review • Anesthesia • Cardiovascular • Pain • Pediatrics

Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. (PubMed, Prehosp Emerg Care) - "Each crew completed three high-fidelity simulations (infant seizure, infant cardiac arrest and child burn) requiring two doses of midazolam, epinephrine, or fentanyl. Immediate causes of error involve incorrect weight, administering air, and improper dilution, which tools like the MI-MEDIC dosing reference aid do not address. Further research is needed to develop comprehensive strategies addressing the active errors identified in our study."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Infectious Disease • Pediatrics

Pathways to 7-day Extended-release Buprenorphine (CAM2038) Administration in Emergency Department and Hospitalized Patients. (PubMed, J Addict Med) - "CAM2038 administration, including for the initiation of therapeutic buprenorphine, seems to be feasible and well-tolerated in inpatient and emergency department settings, with low rates of precipitated withdrawal and patient-directed discharge. The use of short-acting opioids for initial withdrawal management may contribute to successful outcomes. These findings support CAM2038 as a valuable option for treating opioid use disorder in the emergency department and hospital settings, particularly among patients who use fentanyl."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry • Substance Abuse

Practice-Change Pathway to Reduce Procedural Distress During Intussusception Reduction-A Quality Improvement Initiative. (PubMed, Pediatr Emerg Care) - "This QI initiative improved rates of analgesic and anxiolytic provision to reduce distress in patients undergoing intussusception reduction, without adverse outcomes. This project highlights the effectiveness of structured interventions in optimizing pediatric procedural pain management and potentially serves as a model for spread to other pediatric emergency departments."

Journal • Anesthesia • Gastrointestinal Disorder • Pain • Pediatrics

Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats. (PubMed, Drug Alcohol Depend) - "These results demonstrate that opioid withdrawal increases motivation for opioid use while reducing motivation for stimulants, particularly at higher costs. Understanding these dynamics is crucial for developing effective polysubstance treatments addressing both opioid dependence and stimulant co-use."

Journal • Preclinical • Addiction (Opioid and Alcohol)

Development and application of automatic magnetic solid phase extraction assisted High-resolution mass spectrometry for sensitive and rapid determination of 26 fentanyl and metabolites in urine samples. (PubMed, J Chromatogr A) - "The method was successfully applied to the detection and quantification of fentanyl and its major metabolite norfentanyl in authentic urine samples. These results demonstrate the potential of this method for the reliable detection of fentanyl analogues in forensic and clinical toxicology."

Journal

The Analgesic Effects of Ultrasound-guided Recto-intercostal Fascial Plane Block in Laparoscopic Hiatus Hernia Repair: A Randomized Double-Blind Controlled Study. (PubMed, Anaesth Crit Care Pain Med) - P=N/A | "The RIFPB reduced the intraoperative nociception and the 24-h postoperative opioid consumption after LHHR. Also, it delayed the need for rescue morphine; reduced pain scores, PONV incidence, and increased patient satisfaction after surgery."

Clinical • Journal • Anesthesia • Gastroenterology • Pain

Transdermal Drug Delivery Systems: A Comprehensive Review of Mechanisms, Technologies, and Clinical Applications. (PubMed, Pharm Res) - "Future directions in TDDS research focus on integrating nanotechnology, AI-driven optimization, wearable sensors, and closed-loop smart systems. These integrations aim to achieve greater precision, personalization, and efficiency in transdermal drug delivery, providing valuable insights for future research and translational development."

Journal • Review • Cardiovascular • CNS Disorders • Nicotine Addiction • Pain

High-Throughput Screening Using the Self-Controlled Tree-Based Scan Statistic to Identify Medications Associated With Hospitalization for Severe Acute Liver Injury. (PubMed, Pharmacoepidemiol Drug Saf) - "High-throughput screening using tree-based scan statistics detected potentially hepatotoxic drugs for investigation in future pharmacoepidemiology studies."

Journal • CNS Disorders • Gastroenterology • Hepatology • Liver Failure • Pain

Analgesic Effect of Rectus Sheath Block Versus Local Infiltration Analgesia in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial. (PubMed, Obes Surg) - "Pre-incisional RSB demonstrated an intraoperative opioid-sparing effect and superior early postoperative analgesia compared with LIA, supporting its role as a component of multimodal analgesia for LSG."

Journal • Anesthesia • Gastrointestinal Disorder • Genetic Disorders • Obesity • Pain