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Journal of Addiction Medicine

Steven L Proctor, Autumn Birch, Philip L Herschman
OBJECTIVES: Medication treatment with methadone or buprenorphine has shown demonstrated effectiveness for opioid dependence; while premature discharge is associated with adverse outcomes. Specific reasons for premature discharge generally fall into 2 broad categories (ie, patient- and program-initiated). Previous studies have typically failed to distinguish between different types of discharge reasons among patients who leave treatment early. This study sought to determine whether type of medication was associated with differential discharge reasons among medication treatment patients who were prematurely discharged...
September 7, 2018: Journal of Addiction Medicine
Anne C Fernandez, Christopher Bush, Erin E Bonar, Frederic C Blow, Maureen A Walton, Amy S B Bohnert
PURPOSE: Overdose from alcohol and/or drugs kills tens of thousands of Americans annually, with a large number of deaths attributed to opioid pain medications. Addiction treatment patients are known to be at high risk for overdose; however, the relationship between pain and overdose history within this group is understudied, especially in relation to alcohol overdoses. In the present study, we evaluated whether nonfatal overdose history was more likely among addiction treatment patients with pain, and examined the characteristics of overdoses among those with and without pain...
August 29, 2018: Journal of Addiction Medicine
Sharon S Allen
No abstract text is available yet for this article.
August 17, 2018: Journal of Addiction Medicine
Robert S Howe
No abstract text is available yet for this article.
August 17, 2018: Journal of Addiction Medicine
Hussam Jefee-Bahloul, Lantie Jorandby, Albert J Arias
: Topiramate is an anticonvulsant medication with increasingly strong evidence, supporting its use for treating alcohol use disorder (AUD) based on clinical trials. These clinical cases summarize the initiation and titration of topiramate in AUD treatment. The core issues of patient selection, consideration of comorbid psychiatric and medical conditions, side-effect profile, safety and effectiveness are reviewed. Addiction physicians should take a leading role in using topiramate to treat AUDs, working with patients to balance the benefits of topiramate with the risk...
August 9, 2018: Journal of Addiction Medicine
Ajay Manhapra, Anirban Chakraborty, Albert J Arias
: Topiramate is a non-benzodiazepine anticonvulsant medication with multi-faceted pharmacologic action. It has emerged as an efficacious pharmacotherapeutic option for the treatment of addiction, especially alcohol use disorder (AUD). We present a broad narrative review of the putative mechanism of action and clinical utility of topiramate with regard to AUD and other substance use disorders. Collective evidence suggests topiramate is an effective treatment option in AUD, with notable efficacy in reducing harmful drinking patterns in AUD...
August 9, 2018: Journal of Addiction Medicine
Jon E Grant, Sarah A Redden, Katherine Lust, Samuel R Chamberlain
BACKGROUND: This study sought to examine the occurrence of the nonmedical use of prescription stimulants (amphetamines and methylphenidate) in a university sample and their associated physical and mental health correlates, including potential relationships with risky sexual practices. METHODS: A 156-item anonymous online survey was distributed via e-mail to a sample of 9449 university students. Current use of alcohol and drugs, psychological and physical status, and academic performance were assessed, along with questionnaire-based measures of impulsivity and compulsivity...
August 7, 2018: Journal of Addiction Medicine
Cindy Parks Thomas
: Medication treatment of opioid use disorder (OUD) is recognized as an effective evidence-based treatment. It has been underused, in part due to challenges in recruiting and retaining a provider workforce that is able to prescribe and manage patients treated with OUD medications. A national goal should be: anyone with an OUD must have adequate access to a range of medications for treatment and support, provided in high-quality settings, and all programs receiving public or private funding should be so equipped...
August 7, 2018: Journal of Addiction Medicine
Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Jee-Seon Kim, Elizabeth Collier, Sanford Starr, Lynn M Madden, Eric Haram, Todd Molfenter
OBJECTIVES: Effective pharmacological treatments for opioid use disorder (OUD) continue to be underutilized, particularly within specialty substance use disorder (SUD) treatment organizations. Few studies have examined whether specific practices to recruit prescribers, financial needs, and human resource needs facilitate or impede the implementation of pharmacotherapy. METHODS: Surveys were completed by administrators from 160 treatment programs in Florida, Ohio, and Wisconsin...
August 7, 2018: Journal of Addiction Medicine
Shannon Gwin Mitchell, Jan Gryczynski, Robert P Schwartz
: This commentary puts the recent findings by Carroll et al into historical perspective, noting both the long-held problem of medication diversion when pharmacotherapy access is limited, and the ways in which medication diversion concerns and regulations help create those treatment access barriers. Recent efforts to bridge the treatment gap, including increases in Federal funding through the 21st Century Cures Act and expanding the buprenorphine patient cap and scope of eligible providers under the Comprehensive Addiction Recovery Act (CARA) will likely help; however, important structural barriers remain...
August 7, 2018: Journal of Addiction Medicine
Jennifer J Carroll, Josiah D Rich, Traci C Green
OBJECTIVES: Buprenorphine/naloxone, an evidence-based treatment for opioid use disorder, is sometimes diverted for non-medical use. In Rhode Island, the prevalence of opioid use and, more recently, of fentanyl in the illicit drug supply is driving overdose fatalities, which increases the need for treatment and raises questions about the changing role of diverted medication in shaping overdose risk. METHODS: This study considered data from 2 Rhode Island based studies (conducted in 2009 and 2016, respectively) of people who use illicit or diverted prescription opioids and their patterns of buprenorphine/naloxone diversion...
August 7, 2018: Journal of Addiction Medicine
Lorra Garey, Brooke Y Kauffman, Kara F Manning, Samar A Taha, Norman B Schmidt, Clayton Neighbors, Michael J Zvolensky
: Smoking is the leading cause of preventable death in the United States. Efforts have been made to develop effective, integrated smoking-cessation treatments for individuals with greater difficulty quitting, including individuals with elevated anxiety sensitivity (AS). Despite initial evidence for the efficacy of these treatments, little is understood about pretreatment predictors of early treatment milestones, including treatment initiation and response. Positive affectivity (PA) and negative affectivity (NA) are unique mood traits that may be related to early treatment milestones...
July 31, 2018: Journal of Addiction Medicine
Ayodeji Okusanya, Xiaofan Li
: Opioid use disorder and its associated mortality have become national epidemic problems. Different measures and regulations have been implemented to curb this trend, including stricter opioid prescribing practice. With the decreased access to prescription opioids, individuals with opioid use disorder have explored alternatives including loperamide, a peripheral opioid mu-receptor agonist. There are reports of increased loperamide misuse, dependence, and mortality rate in the past few years from poison control centers, medical examiners' offices, and clinical settings...
July 31, 2018: Journal of Addiction Medicine
Bhavita Kumari, Syeda Kanwal Aslam, Sidra Zaheer, Syed Omair Adil, Kashif Shafique
OBJECTIVE: To determine the levels of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) among exclusive groups of waterpipe (WP) smokers, cigarette smokers, and nonsmokers. METHODS: This cross-sectional study was conducted among adults, apparently healthy individuals, aged between 18 and 40 years of either gender. NLR and PLR as measures of systemic inflammation were studied in association with individuals' sociodemographic, health, and tobacco use related characteristics...
July 30, 2018: Journal of Addiction Medicine
Michael Frost, Raymond Bobb
: A long-acting buprenorphine subdermal implant, Probuphine, was approved by the Food and Drug Administration (FDA) in May 2016, for the maintenance treatment of patients with opioid-use disorder. Long-acting implants offer the potential benefits of improved medication adherence, consistent daily dosing, and reduced risk of medication diversion. Sets of 4 implants are typically inserted for a period of 6 months and then removed. Similar technology has been successfully utilized in implantable formulations of birth control medications; however, there is currently little clinical experience involving buprenorphine implants that have remained in the body for extended periods of time...
July 26, 2018: Journal of Addiction Medicine
Erika Litvin Bloom, Michael V Burke, Chris Kotsen, Adam O Goldstein, Carol Ripley-Moffitt, Michael B Steinberg, Mary Dailey, Laura E Hunt, Matthew P Bars
OBJECTIVES: The US Affordable Care Act (ACA) now requires almost all health insurance plans to cover tobacco use treatment (TUT), but TUT remains underutilized. METHODS: We conducted an anonymous online survey of US TUT providers in 2016 regarding their billing practices. RESULTS: Participants (n = 131) provided services primarily in medical and behavioral health settings and were from a variety of professions. Most provided intensive individual (>15 minutes per session) and/or group counseling...
July 23, 2018: Journal of Addiction Medicine
Azin Khazaeli, Jason M Jerry, Mohsen Vazirian
: In this article, we describe a middle-aged woman with a history of addiction to opioid medications who eventually became dependent on kratom. Her kratom-related withdrawal symptoms responded to a trial of buprenorphine-naloxone. Subsequently, she was maintained on this medication.
July 4, 2018: Journal of Addiction Medicine
Cora von Hammerstein, Ruben Miranda, Henri-Jean Aubin, Lucia Romo, Yasser Khazaal, Amine Benyamina, Amandine Luquiens
: Despite the major health consequences of problem gambling, such as suicide, over-indebtedness, delinquency, or family problems, there is currently no approved drug available for the treatment of problem gambling. The efficacy of cognitive behavioral therapies (CBTs) has been demonstrated repeatedly. However, some people seem resistant to conventional CBT alone. We present the case of a 59-year-old woman with a gambling disorder, who relapsed, despite a CBT-based intervention, and who then received a combined therapy aiming to enhance self-control: a mindfulness-based therapy and cognitive training targeting inhibition...
July 2, 2018: Journal of Addiction Medicine
Duc Anh Ngo, Nassima Ait-Daoud, Saumitra Rege, Christopher Ding, Lauren Gallion, Christopher Holstege
No abstract text is available yet for this article.
June 28, 2018: Journal of Addiction Medicine
Anupriya Gogne, Shannon Erisman
: Psychotic symptoms may emerge in up to 40% of people who misuse stimulants, with physiological changes in the perinatal period potentially contributing to the development of psychosis. In this report, we discuss the case of a woman presenting with stimulant misuse, psychosis, and obsessive compulsive disorder-like symptoms in the postpartum period. We describe the patient's symptoms at presentation, differential diagnoses, treatment course, and related challenges.
June 26, 2018: Journal of Addiction Medicine
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