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https://www.readbyqxmd.com/read/28339890/pennsylvania-state-core-competencies-for-education-on-opioids-and-addiction
#1
Michael A Ashburn, Rachel L Levine
Objective.:  The objective of this project was to develop core competencies for education on opioids and addiction to be used in all Pennsylvania medical schools. Methods.:  The Pennsylvania Physician General created a task force that was responsible for the creation of the core competencies. A literature review was completed, and a survey of graduating medical students was conducted. The task force then developed, reviewed, and approved the core competencies...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28306416/the-addiction-benefits-scorecard-a-framework-to-promote-health-insurer-accountability-and-support-consumer-engagement
#2
Itai Danovitch, David Kan
Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans...
March 17, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#3
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
March 15, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28264758/merging-outpatient-addiction-and-opioid-maintenance-programs-during-a-disaster-lessons-from-hurricane-sandy
#4
Vishal K Gupta, Helena Hansen, Sonia Mendoza, Xinlin Linda Chen, Ronnie G Swift
OBJECTIVE: After Hurricane Sandy flooded Bellevue Hospital in New York City, its opiate maintenance patients were displaced and Bellevue's outpatient program was temporarily merged with the program at Metropolitan Hospital for continuation of care. The merger forced Metropolitan to accommodate a program twice as large as its own and required special staff coordination and adjustments in clinical care. METHODS: Physicians, clinicians, and administrators from both institutions participated in interviews regarding the merger...
March 7, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28252511/nurse-practitioner-prescriptive-authority-for-buprenorphine-from-data-2000-to-cara-2016
#5
Katherine S Fornili, Susanne A Fogger
The aim of this Policy Watch column is to provide an update on a much anticipated legislation, enacted in 2016, which enabled office-based opioid treatment (OBOT) with buprenorphine prescribing for the treatment of opioid addiction by nurse practitioners (as well as physician assistants). First, an overview of the Drug Addiction Treatment Act of 2000, which only permitted OBOT prescribing by physicians, will be described. It will be followed by a summary of the Recovery Enhancement for Addiction Treatment Act of 2015-2016...
January 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28251524/pain-management-of-patients-with-substance-abuse-in-the-ambulatory-setting
#6
REVIEW
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Richard Zhu, Roberta Hines
PURPOSE OF REVIEW: Abuse of illicit substances and prescription opioids is a growing problem that presents challenges for pain management in the inpatient and outpatient setting. With future patient care models shifting toward shorter hospital stays and more same-day surgeries, it is crucial that clinicians learn to manage this patient population and strike a balance between the overtreatment of pain that can subsequently worsen tolerance and addiction, and the undertreatment of pain that can lead to pseudoaddiction...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28242537/primary-healthcare-based-integrated-care-with-opioid-agonist-treatment-first-experience-from-ukraine
#7
Olga Morozova, Sergey Dvoriak, Iryna Pykalo, Frederick L Altice
BACKGROUND: Ukraine's HIV epidemic is concentrated among people who inject drugs (PWID), however, coverage with opioid agonist therapies (OATs) available mostly at specialty addiction clinics is extremely low. OAT integrated into primary healthcare clinics (PHCs) provides an opportunity for integrating comprehensive healthcare services and scaling up OAT. METHODS: A pilot study of PHC-based integrated care for drug users conducted in two Ukrainian cities between 2014 and 2016 included three sub-studies: 1) cross-sectional treatment site preference assessment among current OAT patients (N=755); 2) observational cohort of 107 PWID who continued the standard of care versus transition of stabilized and newly enrolled PWID into PHC-based integrated care; and 3) pre/post analysis of attitudes toward PWID and HIV patients by PHC staff (N=26)...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#8
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226334/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-2
#9
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Donald E Jones, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent in the United States and worldwide. The consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. The risk for misuse of prescribed opioids is much higher in patients with chronic pain, especially those with concurrent substance use and /or mental health disorders. Several reasons can account for the occurrence of opioid abuse and misuse, including self-medication, use for reward, compulsive use related to addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226333/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-1
#10
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent both in this country and worldwide. Consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self-medication, use for reward, compulsive use because of addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28219963/overdose-risk-in-young-children-of-women-prescribed-opioids
#11
Yaron Finkelstein, Erin M Macdonald, Alejandro Gonzalez, Marco L A Sivilotti, Muhammad M Mamdani, David N Juurlink
BACKGROUND AND OBJECTIVE: Over the past 20 years, the prescribing of opioids has increased dramatically in North America, with parallel increases in opioid addiction, overdose, and associated deaths. We examined whether young children of women prescribed opioids were at increased risk of opioid overdose. METHODS: We conducted a population-based, nested case control study in Ontario, Canada, between 2002 and 2015. We identified children aged ≤10 years, whose mothers received publicly funded prescriptions for an opioid or a nonsteroidal antiinflammatory drug (comparator analgesic) in the preceding year...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28209683/evaluation-of-6-remote-first-nations-community-based-buprenorphine-programs-in-northwestern-ontario-retrospective-study
#12
Solomon Mamakwa, Meldon Kahan, Dinah Kanate, Mike Kirlew, David Folk, Sharon Cirone, Sara Rea, Pierre Parsons, Craig Edwards, Janet Gordon, Fiona Main, Len Kelly
OBJECTIVE: To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. DESIGN: Retrospective cohort study. SETTING: Six First Nations communities in northwestern Ontario. PARTICIPANTS: A total of 526 First Nations participants in opioid-dependence treatment programs...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28114925/two-birds-with-one-stone-experiences-of-combining-clinical-and-research-training-in-addiction-medicine
#13
J Klimas, R McNeil, K Ahamad, A Mead, L Rieb, W Cullen, E Wood, W Small
BACKGROUND: Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. METHODS: We interviewed physicians from the St...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28091758/-deaths-from-propofol-abuse-survey-of-institutes-of-forensic-medicine-in-germany-austria-and-switzerland
#14
C Maier, J Iwunna, M Tsokos, F Mußhoff
Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28069861/the-fine-line-between-doctoring-and-dealing
#15
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
#16
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
#17
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...
February 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27979642/severe-carisoprodol-withdrawal-after-a-14-year-addiction-and-acute-overdose
#18
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
#19
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
#20
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
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