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Physician addiction

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https://www.readbyqxmd.com/read/28069861/the-fine-line-between-doctoring-and-dealing
#1
Pooja Lagisetty
To treat a patient with addiction, a physician must overcome feelings of frustration and betrayal.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28051841/a-review-of-a-national-training-initiative-to-increase-provider-use-of-mat-to-address-the-opioid-epidemic
#2
REVIEW
Frances R Levin, Adam Bisaga, Maria A Sullivan, Arthur Robin Williams, Kathryn Cates-Wessel
BACKGROUND AND OBJECTIVES: The Providers' Clinical Support System for Medication Assisted Treatment (PCSS-MAT) initiative focuses on training and mentoring health professionals in the treatment of opioid use disorders (OUD) using pharmacological strategies. Led by the American Academy of Addiction Psychiatry (AAAP), PCSS-MAT is a consortium representing four of the five national professional organizations authorized by DATA 2,000-AAAP, American Osteopathic Academy of Addiction Medicine, American Psychiatric Association, and American Society of Addiction Medicine...
December 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/28017304/e-cigarettes-what-a-practicing-cardiologist-needs-to-know
#3
EDITORIAL
Joshua Liberman, Samuel Wann
Cardiologists and other physicians caring for patients who either smoke tobacco or are potential or active users of E-cigarettes have many questions about this increasingly popular method for delivering nicotine to the brain: (1) What are E-cigarettes? (2) What harm do E-cigarettes pose to users and bystanders? (3) Can E-cigarettes help tobacco smokers quit? (4) Are E-cigarettes a gateway to tobacco smoking, addicting new users, particularly the young, to nicotine? and (5) Should E-cigarettes be tolerated, or even favored over tobacco, as a less harmful substitute for those unable to stop smoking tobacco? This editorial summarizes evidence and expert opinion, preparing the physician for informed discussion of this controversial subject with their patients and colleagues...
November 19, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27979642/severe-carisoprodol-withdrawal-after-a-14-year-addiction-and-acute-overdose
#4
Kathy T Vo, Howard Horng, Craig G Smollin, Neal L Benowitz
BACKGROUND: Carisoprodol, a centrally acting muscle relaxant with a high abuse potential, has barbiturate-like properties at the GABA-A receptor, leading to central nervous system depression and desired effects. Its tolerance and dependence has been previously demonstrated in an animal model, and withdrawal has been described in several recent case reports. Many cases can be effectively managed with a short course of benzodiazepines or antipsychotic agents. However, abrupt cessation in a patient with a history of long-term and high-dose carisoprodol abuse may result in symptoms that are more difficult for providers to treat...
December 12, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27973746/maintenance-of-certification-how-performance-in-practice-changes-improve-tobacco-cessation-in-addiction-psychiatrists-practice
#5
James H Ford, Karen A Oliver, Miriam Giles, Kathryn Cates-Wessel, Dean Krahn, Frances R Levin
BACKGROUND AND OBJECTIVES: In 2000, the American Board of Medical Specialties implemented the Maintenance of Certification (MOC), a structured process to help physicians identify and implement a quality improvement project to improve patient care. This study reports on findings from an MOC Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry (AAAP). METHOD: A 3-phase process was utilized to recruit AAAP members to participate in the study...
January 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/27936489/follow-up-of-alcohol-consumption-after-liver-transplantation-interest-of-an-addiction-team
#6
Hélène Donnadieu-Rigole, Laetitia Olive, Bertrand Nalpas, Audrey Winter, José Ursic-Bedoya, Stéphanie Faure, Georges-Philippe Pageaux, Pascal Perney
BACKGROUND: Alcohol relapses after liver transplantation (LT) constitute a critical issue. Because there is no widely accepted definition of LT, its prevalence varies from 7 to 95% across studies. Only a severe relapse, the frequency of which is estimated to be 11 to 26%, decreases life expectancy after 5 years of LT and requires specific care. To improve the early identification of alcohol consumption among transplanted patients, liver transplant teams may be helped by input from an addiction team...
January 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27933002/gender-differences-in-demographic-and-clinical-features-of-physicians-admitted-to-a-program-for-medical-professionals-with-mental-disorders
#7
María Dolores Braquehais, Pilar Arrizabalaga, Pilar Lusilla, Sergi Valero, Miquel Jordi Bel, Eugeni Bruguera, Leo Sher, Miquel Casas
OBJECTIVE: To examine the demographic and clinical differences between men and women admitted to a Physicians' Health Programme (PHP). METHOD: Retrospective chart review of 778 medical records of physicians admitted to the Barcelona PHP from February 1, 1998 until December 31, 2015. RESULTS: Women admitted to the Barcelona PHP were younger than men, were more likely to be self-referred and to be admitted for a non-addictive mental disorder...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27928716/the-physician-at-risk-disruptive-behaviour-burnout-addiction-and-suicide
#8
EDITORIAL
Hilary P Grocott, Gregory L Bryson
No abstract text is available yet for this article.
February 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27928715/the-impaired-anesthesiologist-what-you-should-know-about-substance-abuse
#9
Stefan T Samuelson, Ethan O Bryson
PURPOSE: Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. PRINCIPAL FINDINGS: Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life...
February 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27926654/neonatal-abstinence-syndrome-and-ethical-approaches-to-the-identification-of-pregnant-women-who-use-drugs
#10
Mishka Terplan, Howard Minkoff
The United States is experiencing an epidemic of opioid use, addiction, and neonatal abstinence syndrome. Consequentially, a great deal of public, and public health, attention has turned toward the timely recognition of pregnant women who use drugs. We explore the clinical efficacy and ethical acceptability of different methods of identification-contrasting drug testing (using biologic samples such as urine) with screening (using an instrument or questionnaire) under both universal and selective approaches within the current legal and social landscape, which is fraught with potential adverse consequences for both the woman and her child...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27891385/when-pulmonary-function-test-is-available-should-we-wait-for-the-copd-symptoms-to-develop
#11
REVIEW
Varshil Mehta, Nimit Desai, Smit Patel
Adolescent smokers are more likely to be addicted to nicotine and develop a chronic habit. Chronic smoking has a direct impact on quality of life and life expectancy. Repeated environmental exposure and smoke inhalation can be deleterious to health. In order to evaluate the core functioning of the lungs, Pulmonary Function Tests (PFTs) are conducted. This panel of tests should be advised for all patients complaining of shortness of breath. Since clinical features resulting from chronic smoking tend to appear late in the course of the disease, PFTs are immensely useful for early identification of abnormalities in asymptomatic adult smokers...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27876616/the-starting-treatment-for-ethanol-in-primary-care-trials-step-trials-protocol-for-three-parallel-multi-site-stepped-care-effectiveness-studies-for-unhealthy-alcohol-use-in-hiv-positive-patients
#12
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
January 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27871198/-it-is-easier-for-me-to-shoot-up-stigma-abandonment-and-why-hiv-positive-drug-users-in-russia-fail-to-link-to-hiv-care
#13
Tetiana Kiriazova, Karsten Lunze, Anita Raj, Natalia Bushara, Elena Blokhina, Evgeny Krupitsky, Carly Bridden, Dmitry Lioznov, Jeffrey H Samet, Allen L Gifford
Many HIV-positive people who inject drugs (PWID) globally are not receiving HIV care. This represents a major challenge among key populations to end the global HIV epidemic. This qualitative study explored the process and associated barriers of linking HIV-positive PWID who are in addiction treatment to HIV care in St. Petersburg, Russia. We conducted three focus groups and seven semi-structured interviews with participants in the LINC ("Linking Infectious and Narcology Care") project at addiction and HIV hospitals in St...
November 22, 2016: AIDS Care
https://www.readbyqxmd.com/read/27842786/toxicology-in-addiction-medicine
#14
REVIEW
Daniel A Schwarz, M P George, Martin H Bluth
Toxicology testing in addiction medicine varies across the spectrum, yet remains a powerful tool in monitoring addictive patients. There are many reference laboratories offering toxicology testing, and physicians should have some understanding of laboratory, methodology, testing portfolio, and customer support structure to aid them in selecting the best toxicology laboratory for their patients. Consultation with a clinical pathologist/toxicologist in conjunction with the consideration of monitoring large numbers of illicit and psychoactive drugs in the addictive patient may provide important clinical information for their treatment...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27837404/the-biology-of-addiction
#15
Brent MacNicol
In this narrative review, the neurobiological mechanisms underlying substance abuse and addiction are discussed with a particular emphasis on the mechanisms that promote ongoing use and relapse. Addiction is estimated to affect 10-15% or more of the adult population, including physicians. Genetic predisposition, psychological and environmental risk factors, the timing of exposure to the substance, the type of substance used, and the frequency of use influence the individual's susceptibility to addiction. Abused substances act on the brain's reward system, a neural circuit that produces pleasurable feelings in response to stimuli that promote survival, thereby modifying future behavior to seek out similar stimuli...
November 11, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27832755/experience-of-the-use-of-ketamine-to-manage-opioid-withdrawal-in-an-addicted-woman-a-case-report
#16
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27813656/filler-migration-to-the-forehead-due-to-multiple-filler-injections-in-a-patient-addicted-to-cosmetic-fillers
#17
Chia-Hua Lin, Chien-Ping Chiang, Bai-Yao Wu, Hong-Wei Gao
Filler migration is a potential complication following the injection of multiple fillers. With the increasing popularity of multiple filler injections, migrated granulomas should be an essential differential diagnosis for newly growing facial lumps. It is important for all physicians to be aware that complication induced by dermal fillers can occur in locations other than the planned injected sites. We described a case of filler migration to the forehead due to not only two fillers injections, as the patient was addicted to cosmetic fillers...
November 4, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/27803891/a-qualitative-study-of-the-relationship-between-methamphetamine-abuse-and-sexual-dysfunction-in-male-substance-abusers
#18
Behrouz Dolatshahi, Ali Farhoudian, Mozhgan Falahatdoost, Mahmoud Tavakoli, Ebrahim Rezaie Dogahe
BACKGROUND: Increased prevalent use of methamphetamine is a global public challenge. Information on drug use can be helpful in preventing high-risk behavior related to drug abuse. OBJECTIVES: This study aims to investigate the sexual function changes related to methamphetamine use in the male clients of public and private addiction treatment centers. PATIENTS AND METHODS: In this qualitative study, 45 men (35 methamphetamine users, 5 family members of the users, and 5 psychiatrists or physicians who were famous for treating or researching addiction) are involved...
September 2016: International Journal of High Risk Behaviors & Addiction
https://www.readbyqxmd.com/read/27797649/state-of-training-clinical-services-and-research-on-dual-disorders-across-france-india-israel-and-spain
#19
Yatan Pal Singh Balhara, Shaul Lev-Ran, José Martínez-Raga, Amine Benyamina, Shalini Singh, Lisa Blecha, Nestor Szerman
OBJECTIVE: This article overviews training, clinical services, and research on dual disorders across four countries: France, India, Israel, and Spain. METHODS: The current dual disorders systems in each of the four countries were reviewed, with a focus on strengths and limitations of each. RESULTS: In France, psychiatric care occurs within the public health care system and involves little training of medical graduates for managing dual disorders...
July 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27785104/smoking-alcohol-and-substance-use-and-rates-of-quitting-during-pregnancy-is-it-hard-to-quit
#20
Ahmet Bulent Yazici, Hilal Uslu Yuvaci, Esra Yazici, Ebru Halimoglu Caliskan, Arif Serhan Cevrioglu, Atila Erol
BACKGROUND: Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. AIM: The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy...
2016: International Journal of Women's Health
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