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https://www.readbyqxmd.com/read/29141653/test-of-a-workforce-development-intervention-to-expand-opioid-use-disorder-treatment-pharmacotherapy-prescribers-protocol-for-a-cluster-randomized-trial
#1
Todd Molfenter, Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden
BACKGROUND: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations' efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications...
November 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29133499/caring-for-the-tribe-from-addiction-to-zen
#2
David Loxterkamp
The culture of medicine is rapidly changing. The majority of primary care physicians are now employed, and the decisions that govern us are made farther and farther from the point of care. Our sense of well-being is threatened less by the demands of clinical practice than it is by the emptiness of our job: we have forgotten who we are working for, or working with, or why we are working at all. The solution lies in creating the kind of practice environment that we advocate for in each of our patients' lives.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29130600/opioid-dependence-and-pregnancy-in-early-twentieth-century-america
#3
Nathan Tauger
BACKGROUND AND AIMS: Research on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of "crack babies," turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today...
November 11, 2017: Addiction
https://www.readbyqxmd.com/read/29127758/-physical-activity-the-holy-grail-of-modern-medicine
#4
Vladimír Tuka, Martina Daňková, Karel Riegel, Martin Matoulek
Movement is the basic attribute of life. It is not surprising that the return to regular physical activity is a very effective and cheap means of preventing and treating most non-cummunicable diseases. Therefore, every physician should be able to prescribe a suitable physical activity. The minimum amount of physical activity with proven effects in primary prevention of chronic diseases is relatively low: 150 minutes of moderate physical activity or 75 minutes of high intensity exercise per week or a combination of the two...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#5
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29091359/-opioid-dependence-treatment-in-general-practice
#6
Gaëtan Conti, Laurianne Mer, Ghazi Kardous, Olivier Pasche
Opioid dependence causes numerous comorbidities primary care physicians have often to deal with. We currently have alternative substitution treatments available in Switzerland for opioid dependent patients, all of whom are known to be effective in treating and preventing the consequences of this addiction. Some of the known medications have a narrow therapeutic range that may hinder the prescription. This article attempts to offer the primary care physician tools and knowledge, based on the most recent recommendations, in order to optimize the management of opioid dependent patients...
November 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29056980/youth-mental-health-family-practice-and-knowledge-translation-video-games-about-psychosis-family-physicians-perspectives
#7
Manuela Ferrari, Archie Suzanne
OBJECTIVE: Family practitioners face many challenges providing mental healthcare to youth. Digital technology may offer solutions, but the products often need to be adapted for primary care. This study reports on family physicians' perspectives on the relevance and feasibility of a digital knowledge translation (KT) tool, a set of video games, designed to raise awareness about psychosis, marijuana use, and facilitate access to mental health services among youth. METHOD: As part of an integrated knowledge translation project, five family physicians from a family health team participated in a focus group...
2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#8
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#9
REVIEW
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29025818/mental-health-and-addictions-capacity-building-for-community-health-centres-in-ontario
#10
Akwatu Khenti, Fiona C Thomas, Sirad Mohamoud, Pablo Diaz, Oriana Vaccarino, Kate Dunbar, Jaime C Sapag
PROBLEM ADDRESSED: In recent years, there has been increased recognition in Canada of the need to strengthen mental health services in primary health care (PHC). Collaborative models, including partnerships between PHC and specialized mental health care providers, have emerged as effective ways for improving access to mental health care and strengthening clinical capacity. Primary health care physicians and other health professionals are well positioned to facilitate the early detection of mental disorders and provide appropriate treatment and follow-up care, helping to tackle stigma toward mental health problems in the process...
October 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29024121/the-need-to-exercise-caution-in-accepting-addiction-as-a-reason-for-performing-euthanasia
#11
Wayne Hall, Malcolm Parker
The recent practice in Belgium and the Netherlands of accepting addiction as a reason for performing euthanasia raises important issues for the field of addiction and the practice of euthanasia. In this paper we outline some of these issues. We also argue that physicians making decisions about whether to accept requests for euthanasia from people with an allegedly untreatable addiction should consider two issues carefully. They should ensure that: (1) the person has the capacity to give free and informed consent to undergo euthanasia; and (2) their request is the outcome of a deliberative process in which all reasonable treatment options and harm reduction measures have been offered to and considered by the person...
October 10, 2017: Addiction
https://www.readbyqxmd.com/read/29016917/cannabis-for-the-treatment-of-chronic-pain-in-the-era-of-an-opioid-epidemic-a-symposium-based-review-of-sociomedical-science
#12
Dermot P Maher, Daniel B Carr, Kevin Hill, Brian McGeeney, Valerie Weed, William C Jackson, David J DiBenedetto, Edward M Moriarty, Ronald J Kulich
Objective: This manuscript reviews medical literature published pertaining to the management of chronic pain with medical marijuana therapy (MMJ), with an emphasis on the social, medical, and legal aspects of therapy. Design: Narrative review of peer-reviewed literature. Methods: The 3rd Symposium on Controlled Substances and Their Alternatives for the Treatment of Pain was held in Boston on February 27, 2016, with a focus on MMJ for the treatment of chronic pain...
July 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28990210/the-impact-of-practice-guidelines-on-opioid-utilization-for-injured-workers
#13
Christine Buttorff, Antonio J Trujillo, Renan Castillo, Andres I Vecino-Ortiz, Gerard F Anderson
BACKGROUND: Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury. OBJECTIVE: This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol. RESEARCH DESIGN: This study uses a differences-in-differences study design with a propensity-score-matched control group...
October 9, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28988103/opioid-tapering-in-patients-with-prescription-opioid-use-disorder-a-retrospective-study
#14
Kehua Zhou, Peng Jia, Swati Bhargava, Yong Zhang, Taslima Reza, Yuan Bo Peng, Gary G Wang
BACKGROUND AND AIMS: Opioid use disorder (OUD) refers to a maladaptive pattern of opioid use leading to clinically significant impairment or distress. OUD causes, and vice versa, misuses and abuse of opioid medications. Clinicians face daily challenges to treat patients with prescription opioid use disorder. An evidence-based management for people who are already addicted to opioids has been identified as the national priority in the US; however, options are limited in clinical practices...
October 4, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28966991/illustrating-and-analyzing-the-processes-of-multi-institutional-collaboration-lessons-learnt-at-howard-university-hospital
#15
Mansoor Malik, Suneeta Kumari, Partam Manalai, Maria Hipolito
Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training...
May 2017: Internal Medicine Review (Washington, D.C.: Online)
https://www.readbyqxmd.com/read/28953743/managing-opioid-addiction-risk-in-plastic-surgery-during-the-perioperative-period
#16
REVIEW
Daniel Demsey, Nicholas J Carr, Hance Clarke, Sharon Vipler
Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28947415/prescribing-of-electronic-activity-monitors-in-cardiometabolic-diseases-qualitative-interview-based-study
#17
Alice Bellicha, Sandrine Macé, Jean-Michel Oppert
BACKGROUND: The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited...
September 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28944090/rapid-identification-of-buprenorphine-in-patient-saliva
#18
Stuart Farquharson, Kathryn Dana, Chetan Shende, Zachary Gladding, Jenelle Newcomb, Jessica Dascher, Ismene L Petrakis, Albert J Arias
Buprenorphine is becoming the medication of choice to help patients withdraw from opioid addiction. However, treatment is compromised by the inability of physicians to assess patient usage during scheduled examinations. Here we describe the development of a point-of-care (POC) analyzer that can rapidly measure both illicit and treatment drugs in patient saliva, ideally in the physician's office, and with a degree of accuracy similar to chromatography. The analyzer employs a relatively simple supported liquid extraction to isolate the drugs from the saliva and surface-enhanced Raman spectroscopy (SERS) to detect the drugs...
June 2017: Journal of Analytical & Bioanalytical Techniques
https://www.readbyqxmd.com/read/28938502/-alarming-pregabalin-abuse-in-munich-prevalence-patterns-of-use-and-complications
#19
Nicolas Zellner, Florian Eyer, Tobias Zellner
Background Pregabalin is used e. g. for the treatment of neuropathic pain and anxiety disorder. Recently, its potential for abuse and addiction has become apparent. Methods From 2008 - 2015, we searched our database for the term "Pregabalin", including all patients treated in our department and all calls to the Poison Information Centre (PIC) Munich.From October 2013 to September 2014, all patients were included in a cohort study who either were admitted with a drug intoxication or who presented themselves for a course of detoxification (except ethanol)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28932964/treatment-strategies-for-the-opioid-dependent-patient
#20
REVIEW
Shweta Teckchandani, Meredith Barad
PURPOSE OF REVIEW: This review is intended to help the headache physician think through and plan for management issues concerning the use of opioids. We ask the headache physician to consider if there are instances where prescribing or continuing prescriptions of opiates is plausible, and if so, how can the physician proceed as safely as possible. Our goal is to start a conversation regarding the inevitable encounter with a patient on opiates or requesting opiates. RECENT FINDINGS: The use of opiates in our society has reached a crisis in staggering death and addiction rates...
September 20, 2017: Current Pain and Headache Reports
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