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https://www.readbyqxmd.com/read/28724151/assessment-of-addiction-medicine-training-in-family-medicine-residency-programs-a-cera-study
#1
Sebastian Tong, Roy Sabo, Rebecca Aycock, Ramakrishna Prasad, Rebecca Etz, Anton Kuzel, Alex Krist
BACKGROUND AND OBJECTIVES: Substance use disorder (SUD) is a widespread problem but physicians may feel inadequately prepared to provide addiction care. We sought to assess current addiction medicine curricula in US family medicine residencies (FMRs) and evaluate barriers to improving or implementing addiction medicine curricula. METHODS: Questions regarding addiction medicine training were added to the December 2015 Council of Academic Family Medicine Educational Research Alliance (CERA) survey to US FMR program directors to evaluate each FMR's curriculum, potential workforce production, perceived barriers to improving or implementing curricula and faculty training in addiction medicine...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28723248/reducing-opioid-misuse-among-adolescents-through-physician-education
#2
Nonie S Arora, Kayla M Marcotte, John A Hopper
Increased prescribing of opioids has been associated with an epidemic of nonmedical prescription opioid use in the United States; adolescents and young adults are particularly vulnerable to opioid misuse. The role of physicians as healthcare providers, educators, and confidants for their adolescent patients equips them to intervene in adolescent opioid misuse. We advocate for improving the education of physicians and residents regarding opioid use and misuse among adolescents. To achieve this, we can require residency education that includes opioid misuse and appropriate prescribing, widely disseminate existing resources on management of pain and opioid misuse, and develop pain management and addiction mentorship programs...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28721525/-epidemic-or-peripheral-phenomenon-a%C3%A2-medical-history-of-the-cocaine-wave-in-the-weimar-republic
#3
Hannes Walter
An empirical investigation refutes the popular conception that excessive drug usage was a widespread social phenomenon in the Weimar Republic. Although physicians warned the public and politicians of a "cocaine wave" that threatened the public health, there is no evidence that indicates a significant increase of cocaine use during the twenties. The decisive cause for this moral panic was caused instead by the disease pattern of "Cocainism". The addiction carried the imprint of an infectious disease and would destroy the body, the will, and the civic life of its victims...
July 18, 2017: NTM
https://www.readbyqxmd.com/read/28694276/denial-the-greatest-barrier-to-the-opioid-epidemic
#4
Nicole Gastala
"Why can't you be like my old doctor?" This essay explores my experiences as a new family physician in a rural town endemic with liberal opioid prescribing practices and opioid addiction. I detail my inner turmoil while overcoming resistance to change, the influence of these experiences on my professional growth, and my decision to offer medication-assisted treatment.
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28663601/a-mixed-method-analysis-of-reports-on-100-cases-of-improper-prescribing-of-controlled-substances
#5
James M DuBois, John T Chibnall, Emily E Anderson, Michelle Eggers, Kari Baldwin, Meghan Vasher
Improper prescribing of controlled substances contributes to opioid addictions and deaths by overdose. Studies conducted to-date have largely lacked a theoretical framework and ignored the interaction of individual with environmental factors. We conducted a mixed-method analysis of published reports on 100 cases that occurred in the United States. An average of 17 reports (e.g., from medical boards) per case were coded for 38 dichotomous variables describing the physician, setting, patients, and investigation...
October 2016: Journal of Drug Issues
https://www.readbyqxmd.com/read/28661867/electronic-cigarettes-and-adolescents
#6
Karen Arane, Ran D Goldman
Question I see in my office an increased number of adolescents who use electronic cigarettes (e-cigarettes). Should I encourage adolescents to choose e-cigarettes over regular cigarettes if they decide to smoke? Are e-cigarettes less harmful and a potential smoking cessation method for adolescents? Answer While e-cigarettes do not have carcinogenic tobacco, most contain nicotine, which not only leads to addiction, but can also impair brain development and cognitive function in youth. Recent studies have also shown that adolescents who use e-cigarettes are more likely to begin smoking tobacco cigarettes...
November 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28642642/access-to-and-payment-for-office-based-buprenorphine-treatment-in-ohio
#7
Theodore V Parran, Joseph Z Muller, Elina Chernyak, Chris Adelman, Christina M Delos Reyes, Douglas Rowland, Mykola Kolganov
IMPORTANCE: Office-based opiate agonist therapy has dramatically expanded access to medication-assisted treatment over the past decade but has also led to increased buprenorphine diversion. OBJECTIVE: Our study sought to characterize physicians who participate in office-based therapy (OBT) to assess patient access to OBT in Ohio 10 years after its introduction. DESIGN/SETTING/PARTICIPANTS: Cross-sectional telephone survey of Drug Addiction Treatment Act-waivered physicians in Ohio listed by the Center for Substance Abuse Treatment (CSAT)...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/28629236/advances-in-new-psychoactive-substances-identification-the-u-r-i-to-n-consortium
#8
Elisabetta Bertol, Fabio Vaiano, Francesco Mari, Maria Grazia Di Milia, Silvia Bua, Claudiu T Supuran, Fabrizio Carta
Identification of new psychoactive substances (NPS) in biological and non-biological samples represents a hard challenge for forensic toxicologists. Their great chemical variety and the speed with which new NPS are synthesised and spread make stringent the need of advanced tools for their detection based on multidisciplinary approaches. For this reason, in August 2016, the "Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction" (U.R.I.To.N.) was founded by the Forensic Toxicology Division of the University of Florence...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28571505/buprenorphine-implants-in-medical-treatment-of-opioid-addiction
#9
Steven Chavoustie, Michael Frost, Ole Snyder, Joel Owen, Mona Darwish, Ryan Dammerman, Victoria Sanjurjo
Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations...
June 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28562310/mental-health-services-utilization-and-expenditures-among-children-enrolled-in-employer-sponsored-health-plans
#10
Angela Wangari Walter, Yiyang Yuan, Howard J Cabral
BACKGROUND AND OBJECTIVES: Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. METHODS: Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28554597/why-aren-t-physicians-prescribing-more-buprenorphine
#11
Andrew S Huhn, Kelly E Dunn
BACKGROUND & OBJECTIVE: Buprenorphine is an underutilized pharmacotherapy that can play a key role in combating the opioid epidemic. Individuals with opioid use disorder (OUD) often struggle to find physicians that prescribe buprenorphine. Many physicians do not have the waiver to prescribe buprenorphine, and a large proportion of physicians that are waivered do not prescribe to capacity. This study aimed to quantitatively understand why physicians do not utilize buprenorphine for the treatment of OUD more frequently...
July 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28543648/making-the-choices-necessary-to-make-a-difference-the-responsibility-of-national-bioethics-commissions
#12
Christine Grady
In this essay, I offer some reflections on how the topics were identified and approached by the Presidential Commission for the Study of Bioethical Issues, on which I had the honor to serve, in the hope that the reflections may be useful to future national bioethics commissions. In the executive order that established the bioethics commission, President Obama explicitly recognized the ethical imperative to responsibly pursue science, innovation, and advances in biomedical research and health care, and the importance of national attention to these issues...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28486877/effects-of-the-mental-health-parity-and-addictions-equality-act-on-depression-treatment-choice-in-primary-care-facilities
#13
Daniel M Goldberg, Hsien-Chang Lin
Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians' choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007-2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients...
January 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28459476/an-osteopathic-approach-to-chronic-pain-management
#14
John A Jerome
Chronic pain reduces quality of life and productivity, costing billions in health care dollars and lost revenue. Physicians routinely prescribe opioids, which has led to opioid addiction and overdose. The US surgeon general recommends nonpharmacologic treatment for patients with chronic pain. A paradigm shift is necessary for patients to partner with physicians to take control of their own health. This article outlines the cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies that osteopathic physicians can integrate in their treatment of patients with chronic pain...
May 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#15
Peter S Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction, and lack of efficacy...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28394437/access-to-treatment-for-opioid-use-disorders-medical-student-preparation
#16
Elinore F McCance-Katz, Paul George, Nicole Alexander Scott, Richard Dollase, Allan R Tunkel, James McDonald
The current opioid epidemic requires new approaches to increasing access to treatment for patients with opioid use disorders and to improve availability of medication assisted treatment. We propose a model where medical students complete the necessary training to be eligible for the waiver to prescribe opioid medications to treat these disorders by the time of medical school graduation. This plan would increase the number of Drug Abuse Treatment Act of 2000 (DATA 2000) waivered physicians who could gain additional experience in treating substance use disorders during residency and provide the access to clinical care needed for individuals suffering with opioid use disorder...
June 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28379862/vermont-hub-and-spoke-model-of-care-for-opioid-use-disorder-development-implementation-and-impact
#17
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/28376444/discussing-opioid-risks-with-patients-to-reduce-misuse-and-abuse-evidence-from-2-surveys
#18
Joachim O Hero, Caitlin McMurtry, John Benson, Robert Blendon
We used 2 population-representative surveys to evaluate the recommendation from recent clinical guidelines for prescribing opioid analgesics that physicians discuss the risk of long-term use disorders with patients. In nationally representative data we observed a 60% lower rate, after adjustment for covariates, in a self-reported saving of pills among respondents who say they talked with their physicians about the risks of prescription painkiller addiction (67% lower rate without adjustment). These findings suggest patient education efforts, as currently practiced in the United States, may have positive behavioral consequences that could lower the risks of prescription painkiller abuse...
November 2016: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376226/urinary-concentrations-of-topically-administered-pain-medications
#19
Michele A Glinn, Andrew J Lickteig, Luke Weber, Sherri Recer, Matthew Salske, Audrey Harvey, Brian Rappold, Julie Stensland, Patrick Bell
A common treatment for chronic pain is prescription of analgesics, but their long-term use entails risk of morbidity, addiction and misuse. One way to reduce the risk of abuse is prescribing of analgesics in a topical form. Physicians are urged to perform urine drug testing to ensure that patients are compliant with their medication regimens. However, there is little data on the efficiency of transdermal delivery for many analgesic drugs, and no data on expected urine drug levels. This study includes data from over 29,000 specimens tested for gabapentin, ketamine, cyclobenzaprine or amitriptyline used orally or topically...
March 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28375881/institutional-substance-use-disorder-intervention-improves-general-internist-preparedness-attitudes-and-clinical-practice
#20
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
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