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Journal of Addiction Medicine

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https://www.readbyqxmd.com/read/28614161/multiple-cerebral-infarcts-in-a-young-patient-associated-with-marijuana-use
#1
Leila Costa Volpon, Camila Lacerda Muniz de Melo Sousa, Silvia Keiko Kavaguti Moreira, Sara Reis Teixeira, Ana Paula de Carvalho Panzeri Carlotti
: Cerebrovascular events associated with marijuana use have been reported previously. This association is plausible, but not well-established yet. A 14-year-old girl, long-term heavy cannabis user, presented with generalized tonic-clonic seizures and decreased level of consciousness a few hours after smoking cannabis. Brain magnetic resonance imaging showed multiple areas of acute, subacute and chronic ischemic lesions in the left frontal lobe, basal ganglia, and corpus callosum. History of other illicit drug use and other known causes of stroke were ruled out...
June 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28590393/addiction-research-training-programs-four-case-studies-and-recommendations-for-evaluation
#2
Aimee N C Campbell, Sudie E Back, Jamie S Ostroff, Denise A Hien, Marc N Gourevitch, Christine E Sheffer, Kathleen T Brady, Kathleen Hanley, Sewit Bereket, Sarah Book
: The presence of structured addiction research training programs helps to ensure that the scientific workforce includes well-trained, diverse scientists necessary to reduce the negative impact of alcohol, drug, and tobacco use disorders. Although the field has made significant progress in the development of standards for clinical training in addiction medicine, there remains significant room for improvement in the training of addiction researchers, and also opportunities to synergize across addiction research training programs...
June 5, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28590392/pilot-studies-examining-feasibility-of-substance-use-disorder-screening-and-treatment-linkage-at-urban-sexually-transmitted-disease-clinics
#3
Jan Gryczynski, Courtney D Nordeck, Shannon Gwin Mitchell, Kathleen R Page, Luke L Johnsen, Kevin E O'Grady, Robert P Schwartz
BACKGROUND: Sexually transmitted disease (STD) clinics provide critical public health services for screening and treatment of sexually transmitted infections throughout the United States. These settings serve high-risk populations, often on a walk-in basis, and may be promising venues for integrating substance use disorder (SUD) services. METHODS: We report findings from 2 pilot studies conducted at Baltimore City Health Department's STD clinics. The screening study characterized rates of SUDs among STD clinic patients...
June 5, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28590391/misuse-of-novel-synthetic-opioids-a-deadly-new-trend
#4
Matthew P Prekupec, Peter A Mansky, Michael H Baumann
: Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription medications. During 2015 alone, there were 9580 deaths from synthetic opioids other than methadone. Most of these fatalities were associated with IMF rather than diverted pharmaceutical fentanyl...
June 5, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28574864/methadone-management-of-withdrawal-associated-with-loperamide-related-opioid-use-disorder
#5
Raphael J Leo, Muhammad A Ghazi, Kelly S Jaziri
: Loperamide hydrochloride is an over-the-counter anti-diarrheal agent, acting via mu-opioid receptor agonist effects in the intestinal myenteric plexus. Although preclinical investigations suggested that abuse liability associated with loperamide use is low, there are increasing numbers of cases reported to the US Food and Drug Administration, of abuse, dependence, and withdrawal associated with loperamide use. A case of a patient with opioid use disorder, that is, in the form of protracted loperamide excess use, requiring management of withdrawal with methadone is presented...
June 1, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28574863/mephentermine-dependence-in-a-young-athlete-case-report-with-review-of-literature
#6
Swarndeep Singh, Ankit Gupta, Siddharth Sarkar
: Mephentermine is structurally related to amphetamines and is banned for its use as a performance-enhancing drug in competitive sports. Limited literature is available on management of mephentermine dependence. Here, we describe a case of mephentermine dependence followed by review of literature and a discussion about its management. A 20-year-old professional wrestler presented with high-dose intravenous mephentermine use, and rapid development of dependence, in the absence of any comorbid substance use or psychiatric disorder...
June 1, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28514235/ondansetron-does-not-reduce-withdrawal-in-patients-with-physical-dependence-on-chronic-opioid-therapy
#7
Larry F Chu, John Sun, Anna Clemenson, Matthew J Erlendson, Tom Rico, Erika Cornell, Hannah Obasi, Zahra N Sayyid, Ellen M Encisco, Jeff Yu, Jamison G Gamble, Ian Carroll, J David Clark
OBJECTIVES: Individuals taking opioids for an extended period of time may become physically dependent, and will therefore experience opioid withdrawal should they stop taking the medication. Previous work in animal and human models has shown that the serotonin (5-HT3) receptor may be implicated in opioid withdrawal. In this study, we investigated if ondansetron, a 5-HT3-receptor antagonist, could reduce the symptoms of opioid withdrawal after chronic opioid exposure in humans. METHODS: In this double-blinded, randomized, crossover study, 33 chronic back pain patients (N = 33) were titrated onto sustained-release oral morphine for 30 days...
May 16, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28514234/associations-between-physical-pain-pain-management-and-frequency-of-nonmedical-prescription-opioid-use-among-young-adults-a-sex-specific-analysis
#8
Tristan I Evans, Elliott J Liebling, Traci C Green, Scott E Hadland, Melissa A Clark, Brandon D L Marshall
OBJECTIVES: We sought to determine sex-specific associations between experiences of physical pain, pain management, and frequency of nonmedical prescription opioid (NMPO) use among young adults. METHODS: Among participants enrolled in the Rhode Island Young Adult Prescription Drug Study, we identified associations between physical pain in the past 6 months, pain history, pain management, polysubstance use, and weekly NMPO use. In sex-specific models, independent correlates of weekly NMPO use were identified via modified stepwise Poisson regression...
May 16, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28441274/-meth-mouth-an-interdisciplinary-review-of-a-dental-and-psychiatric-condition
#9
Cornel N Stanciu, Magdalena Glass, Brian C Muzyka, Oliver M Glass
OBJECTIVE: Chronic methamphetamine (MA) users experience many dental problems, a condition characterized as "meth mouth." These devastating effects on dentition is the main reason why many seek professional help. Here, we discuss the effects of MA on oral health and advocate for improved collaboration between dentists and mental health providers. We also introduce a dental evaluation tool with the goal of improving the quality of care for this often-marginalized patient population. METHODS: A Medline literature search (1985-2016) was conducted with keywords "meth mouth," "methamphetamine AND oral health"; "methamphetamine AND dental"; "methamphetamine AND dentist...
April 24, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28441272/treating-smoking-in-adults-with-co-occurring-acute-psychiatric-and-addictive-disorders
#10
Smita Das, Norval J Hickman, Judith J Prochaska
OBJECTIVES: Tobacco use is undertreated in individuals with psychiatric and substance use disorders (SUDs), with concerns that quitting smoking may compromise recovery. We evaluated outcomes of a tobacco intervention among psychiatric patients with co-occurring SUDs. METHODS: Data from 2 randomized tobacco treatment trials conducted in inpatient psychiatry were combined; analyses focused on the subsample with co-occurring SUDs (n = 216). Usual care provided brief advice to quit and nicotine replacement therapy during the smoke-free hospitalization...
April 24, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28426439/high-mortality-among-patients-with-opioid-use-disorder-in-a-large-healthcare-system
#11
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
OBJECTIVES: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system. METHODS: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014...
April 20, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28379862/vermont-hub-and-spoke-model-of-care-for-opioid-use-disorder-development-implementation-and-impact
#12
John R Brooklyn, Stacey C Sigmon
BACKGROUND: Opioid use disorders (OUDs) are reaching epidemic proportions in the United States, and many geographic areas struggle with a persistent shortage in availability of opioid agonist treatment. Over the past 5 years, Vermont addiction medicine physicians and public health leaders have responded to these challenges by developing an integrated hub-and-spoke opioid treatment network. METHODS: In the present report, we review the development, implementation, and impact of this novel hub-and-spoke model for expanding OUD treatment in Vermont...
April 4, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28375881/institutional-substance-use-disorder-intervention-improves-general-internist-preparedness-attitudes-and-clinical-practice
#13
Sarah E Wakeman, Genevieve Pham Kanter, Karen Donelan
OBJECTIVE: To assess the impact of hospital substance use disorder (SUD) initiative, which, beginning in October 2014, implemented an inpatient addiction consult team, a postdischarge addiction clinic, recovery coaches, and SUD treatment within primary care on general internists' attitudes, clinical practice, and preparedness to care for SUD. METHODS: Pre and postintervention survey of general internal medicine physicians at Massachusetts General Hospital, in Boston, Massachusetts, in September 2014 (n = 290) and 2015 (n = 296) was conducted...
April 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28368906/tobacco-use-disorder-among-patients-with-smoking-related-chronic-medical-disease-association-with-comorbid-substance-use-disorders
#14
Ajay Manhapra, Robert Rosenheck
INTRODUCTION: Very little is known of the behavioral vulnerabilities of patients diagnosed with smoking-related chronic medical illness who continue to smoke, potentially worsening morbidity and mortality risks. This study explores the association of tobacco use disorder (TUD) among those with smoking-related chronic medical illnesses with other substance use disorders (SUDs) and risk factors. METHODS: Among veterans with smoking-related chronic medical illnesses identified from the National Veterans Health Administration administrative records from fiscal year 2012, we compared the characteristics of those with a diagnosis of TUD (International Classification of Diseases, 9th edition code 305...
March 31, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28368905/when-knowledge-and-experience-do-not-help-a-study-of-nonfatal-drug-overdoses
#15
Jake M Najman, Fairlie McIlwraith, Robert Kemp, Andrew Smirnov
: With recent increases in overdose deaths in Australia, there is renewed interest in understanding the factors that contribute to overdose. We examine the experiences of persons who report a nonfatal drug overdose. Fifty people who inject drugs (PWID) and who had accidently overdosed in the past 12 months were recruited and interviewed at 1 of 4 Needle and Syringe Program sites during September and October 2013.Participants were typically male, middle-aged, with long injecting histories. Half of the participants reported mainly injecting pharmaceutical opioids...
March 31, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28557962/response-to-urine-drug-testing-in-a-family-residency-practice
#16
Michael G McDonell, Imara I West, Richard K Ries, Dennis M Donovan, Kristin Bumgardner, Chris Dunn, David C Atkins, Peter Roy-Byrne, Charles Maynard
No abstract text is available yet for this article.
May 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28557961/urine-drug-testing-in-a-family-medicine-residency-practice
#17
Hunter E Woodall, Natawadee Young, Amanda Davis, Mary Beth Wright
No abstract text is available yet for this article.
May 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28557960/accuracy-of-diagnosis-and-international-classification-of-diseases-tenth-revision-coding-for-alcohol-dependence-alcohol-withdrawal-and-alcohol-withdrawal-delirium-among-inpatients-at-a-university-hospital
#18
Wandee Wansrisuthon, Woraphat Ratta-Apha, Lakkhana Thongchot, Pornjira Pariwatcharakul
No abstract text is available yet for this article.
May 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28557959/how-to-deliver-a-more-persuasive-message-regarding-addiction-as-a-medical-disorder
#19
Keith Humphreys
: Many members of our field are frustrated that the public does not see addiction as a legitimate medical disorder which should be compassionately addressed as a health problem rather than a criminal justice problem. Although some attribute the disconnect to the public's lack of scientific knowledge or attachment to outdated moral views regarding substance use, this commentary suggests that the problem may well be our own messaging. We would be more persuasive if we acknowledged that addiction is different from most medical disorders because of its high negative externalities, and that this understandably makes the public more scared of and angry about addiction than they are about conditions like asthma, type II diabetes, and hypertension...
May 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28557958/appropriate-use-of-drug-testing-in-clinical-addiction-medicine
#20
Margaret Jarvis, Jessica Williams, Matthew Hurford, Dawn Lindsay, Piper Lincoln, Leila Giles, Peter Luongo, Taleen Safarian
: Biological drug testing is a tool that provides information about an individual's recent substance use. Like any tool, its value depends on using it correctly; that is, on selecting the right test for the right person at the right time. This document is intended to clarify appropriate clinical use of drug testing in addiction medicine and aid providers in their decisions about drug testing for the identification, diagnosis, treatment, and recovery of patients with, or at risk for, addiction. The RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) process for combining scientific evidence with the collective judgment of experts was used to identify appropriate clinical practices and highlight areas where research is needed...
May 2017: Journal of Addiction Medicine
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