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Physician addiction

Gordon D Ko, Sara L Bober, Sean Mindra, Jason M Moreau
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis...
2016: Journal of Pain Research
Karen E van den Hondel, Anne Linde Saaltink, Peter Paul M Bender
BACKGROUND: Forensic physicians are responsible for first-line medical care of detainees (individuals held in custody) in the police station. The Dutch police law contains a 'duty of care', which gives the police responsibility for the apparent mentally ill and/or confused people they encounter during their work. The police can ask a forensic physician to do a primary psychiatric assessment of any apparent mentally ill detainee. The forensic physician determines if the apparent mentally ill behavior of the detainee is due to a somatic illness, or has a psychiatric cause for which the detainee needs admission to a psychiatric hospital...
October 11, 2016: Journal of Forensic and Legal Medicine
Disa Dahlman, Åsa Palm, Christina Sunesdotter, Katja Troberg, Camilla Wallin
Low-threshold primary care for patients in opiate maintenance therapy. A pilot project in Malmö, Sweden, integrates primary care and OMT  This report illustrates how integration of primary care and opiate maintenance therapy (OMT) may improve OMT patients health and minimize obstacles for care seeking. OMT patients have poor health. Around 80 % have hepatitis C, a majority smoke tobacco, and socio-economic status is generally low. However, somatic health is often under-prioritized in this group. To improve OMT patients physical health', two OMT clinics and one primary care center in Malmö, Sweden, started a pilot project in 2014...
October 14, 2016: Läkartidningen
Charlotte Griffioen, Eva G Willems, Sanne M Kouwenhoven, Monique A A Caljouw, Wilco P Achterberg
BACKGROUND: Insufficient pain management in vulnerable older persons living in long-term care facilities is common, and opiophobia might contribute to this. As opiophobia and its related factors have not been investigated in long-term care, this study evaluates the degree of knowledge of opioids among elderly-care physicians (ECPs) and ECP trainees, as well as their attitudes and other factors possibly influencing the clinical use of opioids in these facilities. METHODS: A questionnaire was designed and distributed among ECPs and ECP trainees by email, regional symposia, and all three university training faculties for elderly-care medicine in the Netherlands...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Kai-Hsiang Kang, Li-Fen Kuo, I-Chen Cheng, Chih-Shiuh Chang, Wen-Ing Tsay
BACKGROUND/PURPOSE: According to WHO guideline, the consumption of opioids is an important sign of national progress in cancer pain relief. However, precise data on the consumption of opioid analgesics consumption in Taiwan has not been published. We investigate opioid analgesic consumption in Taiwan between 2002 and 2014 compare the results with those in other countries to see what we could learn about other methods of pain management. To find out the different patterns between Taiwan and other country, improves the quality of pain management...
October 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Eric Egnot, Kim Jordan, John O Elliott
BACKGROUND: Use of the electronic cigarette for nicotine delivery has increased dramatically in recent years. Information continues to emerge on its role as a smoking cessation aid, but little is known about resident physician use of the device in clinical practice. METHODS: In 2015, an electronic survey was administered to resident physicians in one healthcare system in Columbus, Ohio. The survey included questions about personal smoking exposure, knowledge, beliefs, attitudes about electronic cigarettes and early adoption of electronic cigarettes with patients...
October 3, 2016: Postgraduate Medical Journal
Marie-Louise Mares, David H Gustafson, Joseph E Glass, Andrew Quanbeck, Helene McDowell, Fiona McTavish, Amy K Atwood, Lisa A Marsch, Chantelle Thomas, Dhavan Shah, Randall Brown, Andrew Isham, Mary Jane Nealon, Victoria Ward
BACKGROUND: Millions of Americans need but don't receive treatment for substance use, and evidence suggests that addiction-focused interventions on smart phones could support their recovery. There is little research on implementation of addiction-related interventions in primary care, particularly in Federally Qualified Health Centers (FQHCs) that provide primary care to underserved populations. We used mixed methods to examine three FQHCs' implementation of Seva, a smart-phone app that offers patients online support/discussion, health-tracking, and tools for coping with cravings, and offers clinicians information about patients' health tracking and relapses...
September 29, 2016: BMC Medical Informatics and Decision Making
Julia M Geynisman-Tan, Jolyn S Taylor, Terri Edersheim, Debra Taubel
Trafficking of women and children for sexual exploitation is the fastest growing criminal enterprise in the world. This is a public health crisis and, as physicians who have direct contact with victims, we have a unique opportunity to intervene. The authors developed a specialty clinic for survivors of sex trafficking in 2013 at an academic medical center in New York City. Twenty of the 24 women seen in the Survivor Clinic saw a physician while being trafficked. Sex trafficking violates basic human rights, including the rights to bodily integrity, dignity, health and freedom from violence and torture...
September 21, 2016: American Journal of Obstetrics and Gynecology
Zakari A Suleiman, Kolawole W Wahab, Israel K Kolawole
OBJECTIVE: Although opioid analgesics are effective in the treatment of moderate to severe acute, cancer and chronic non-malignant pains, they are under-prescribed in Nigeria. The objective of this study was to assess the prescription pattern of opioids among physicians in a north central State, Nigeria.. DESIGN: This was a descriptive cross sectional study. SETTING: The study was conducted at the International Association for the Study of Pain (IASP)-sponsored workshops on pain and palliative care at the University of Ilorin Teaching Hospital, Ilorin, Nigeria...
June 2016: Ghana Medical Journal
Jonatan Wistrand
In recent decades studies based on questionnaires and interviews have concluded that when doctors become ill they face significant barriers to seeking help. Several reasons have been proposed, primarily the notion that doctors' work environment predisposes them to an inappropriate help-seeking behaviour. In this article, the idea of the ill physician as a paradox in a medical drama is examined. Through a text-interpretive and comparative approach to historical illness narratives written by doctors suffering from one specific diagnosis, namely opioid addiction, the complex set of considerations guiding their behaviour as patients are to some extent revealed...
September 1, 2016: Medical Humanities
Lucy Macfarlane, Glynn Owens, Borja Del Pozo Cruz
Objectives There remains limited consensus regarding the definition and conceptual basis of exercise addiction. An understanding of the factors motivating maintenance of addictive exercise behavior is important for appropriately targeting intervention. The aims of this study were twofold: first, to establish consensus on features of an exercise addiction using Delphi methodology and second, to identify whether these features are congruous with a conceptual model of exercise addiction adapted from the Work Craving Model...
September 2016: Journal of Behavioral Addictions
Sandra Castillo-Guzman, Omar González-Santiago, Ismael A Delgado-Leal, Gerardo E Lozano-Luévano, Misael J Reyes-Rodríguez, César V Elizondo-Solis, Teresa A Nava-Obregón, Dionicio Palacios-Ríos
Background. Medications are not exempt from adverse drug reactions (ADR) and how the physician perceives the risk of prescription drugs could influence their availability to report ADR and their prescription behavior. Methods. We assess the perception of risk and the perception of ADR associated with COX2-Inbitors, paracetamol, NSAIDs, and morphine in medical students and residents of northeast of Mexico. Results. The analgesic with the highest risk perception in both group of students was morphine, while the drug with the least risk perceived was paracetamol...
2016: PeerJ
Kathryn Graham, Joyce Cheng, Sharon Bernards, Samantha Wells, Jürgen Rehm, Paul Kurdyak
OBJECTIVE: To measure service use and costs associated with health care for patients with mental health (MH) and substance use/addiction (SA) problems. METHODS: A 5-year cross-sectional study (2007-2012) of administrative health care data was conducted (average annual sample size = 123,235 adults aged >18 years who had a valid Ontario health care number and used at least 1 service during the year; 55% female). We assessed average annual use of primary care, emergency departments and hospitals, and overall health care costs for patients identified as having MH only, SA only, co-occurring MH and SA problems (MH+SA), and no MH and/or SA (MH/SA) problems...
August 19, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Mickael Vourc'h, Fanny Feuillet, Pierre-Joachim Mahe, Véronique Sebille, Karim Asehnoune
BACKGROUND: Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment...
August 19, 2016: Trials
Karen H Antman, Harris A Berman, Terence R Flotte, Jeffrey Flier, Dennis M Dimitri, Monica Bharel
Drug overdose has become the leading cause of injury death in the United States. More than half of those deaths involve prescription drugs, specifically opioids. A key component of addressing this national epidemic is improving prescriber practices.A review of the curricula at the four medical schools in Massachusetts revealed that, although they taught components of addiction medicine, no uniform standard existed to ensure that all students were taught prevention and management strategies for prescription drug misuse...
August 16, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Cornelis A J De Jong, Christine Goodair, Ilana Crome, Darius Jokubonis, Nady El-Guebaly, Geert Dom, Arnt Schellekens, Barbara Broers, Emilis Subata, Gabrielle Katrine Welle-Strand, Lonneke Luycks, Michel Wolters, Tamara Schoof
This perspective article focuses on the need for training and education for undergraduate medical students on substance-related disorders, and describes initiatives undertaken in the United Kingdom (UK), Netherlands, United States (US), and Norway to develop the skills, knowledge, and attitudes needed by future doctors to treat patients adequately. In addition, we stress that in postgraduate training, further steps should be taken to develop Addiction Medicine as a specialized and transverse medical domain...
March 2016: Yale Journal of Biology and Medicine
Declan T Barry, Tera Fazzino, Emily Necrason, Joel Ginn, Lynn E Fiellin, David A Fiellin, Brent A Moore
OBJECTIVE: We set out to examine physicians' perceptions of the provision of ancillary services for opioid dependent patients receiving buprenorphine. METHODS: An e-mail invitation describing the study was sent out by the American Society of Addiction Medicine to its membership (approximately 3700 physicians) and other entities (for a total of approximately 7000 e-mail addresses). E-mail recipients were invited to participate in a research study funded by the National Institutes on Drug Abuse involving completion of an online survey; 346 physicians completed the survey...
September 2016: Journal of Addiction Medicine
Kulnaree Hanpatchaiyakul, Henrik Eriksson, Jureerat Kijsomporn, Gunnel Östlund
BACKGROUND: Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. OBJECTIVE: The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts' suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment...
2016: Global Health Action
Sonia Mendoza, Allyssa S Rivera-Cabrero, Helena Hansen
Growing nonmedical prescription opioid analgesic use among suburban and rural Whites has changed the public's perception of the nature of opioid addiction, and of appropriate interventions. Opioid addiction has been recast as a biological disorder in which patients are victims of their neurotransmitters and opioid prescribers are irresponsible purveyors of dangerous substances requiring controls. This framing has led to a different set of policy responses than the "War on Drugs" that has focused on heroin trade in poor urban communities; in response to prescription opioid addiction, prescription drug monitoring programs and tamper-resistant opioid formulations have arisen as primary interventions in place of law enforcement...
August 2016: Transcultural Psychiatry
Fanny Pélissier, Isabelle Claudet, Peggy Gandia-Mailly, Amine Benyamina, Nicolas Franchitto
BACKGROUND: Chronic cannabis users may experience cyclical episodes of nausea and vomiting and learned behavior of hot bathing. This clinical condition, known as cannabis hyperemesis syndrome, was first reported in 2004. OBJECTIVE: Our aim was to promote early recognition of this syndrome in emergency departments (EDs) and to increase referral to addiction specialists. METHODS: Cannabis abusers were admitted to the ED for vomiting or abdominal pain from June 1, 2014 to January 1, 2015 and diagnosed with cannabis hyperemesis syndrome by a specialized addiction team...
July 30, 2016: Journal of Emergency Medicine
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