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Physician addiction

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https://www.readbyqxmd.com/read/29351141/an-exploration-of-emergency-physicians-attitudes-toward-patients-with-substance-use-disorder
#1
Cecelia Kathleen Mendiola, Giorgio Galetto, Michael Fingerhood
OBJECTIVES: Much is known about some healthcare professionals' attitudes toward patients with substance use disorders, but few studies have specifically looked at emergency department (ED) physicians. Individuals with substance use disorders are more likely to be people who chronically, frequently use the ED, and thus ED physicians are in a unique position to provide early identification and intervention for people struggling with addiction. The purpose of this study was to understand ED physicians' attitudes toward patients with substance use disorder with the aim of decreasing stigma and improving the care of ED patients with substance use disorder...
January 18, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29344053/an-overview-of-exposure-to-ethanol-containing-substances-and-ethanol-intoxication-in-children-based-on-three-illustrated-cases
#2
REVIEW
Kam Lun Hon, Alexander Kc Leung, Eddie Cheung, Bryan Lee, Michelle Mc Tsang, Alcy R Torres
Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. In all cases, a focused history is the key to prompt diagnosis and timely management. Physicians should be aware of this potential poison in children presented with acute confusional or encephalopathic state...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29331646/progress-in-the-management-of-advanced-thoracic-malignancies-in-2017
#3
REVIEW
Roberto Ferrara, Laura Mezquita, Benjamin Besse
The treatment paradigm of non-small cell lung cancer (NSCLC) underwent a major revolution during the course of 2017. Immune checkpoint inhibitors (ICIs) brought remarkable improvements in response and overall survival (OS) both in unselected pretreated patients and in untreated patients with PD-L1 expression ≥50%. Furthermore, compelling preliminary results were reported for new combinations of anti-PD-1/PD-L1 agents with chemotherapy or anti-CTLA4 inhibitors. The success of the ICIs appeared to extend to patients with small cell lung cancer (SCLC), mesothelioma or thymic tumors...
January 10, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#4
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29324253/a-qualitative-study-comparing-physician-reported-barriers-to-treating-addiction-using-buprenorphine-and-extended-release-naltrexone-in-u-s-office-based-practices
#5
Barbara Andraka-Christou, Matthew J Capone
AIM: Our aim was to compare physician-reported barriers to sublingual buprenorphine (BUP) and extended-release naltrexone (XR-NLT) prescribing in U.S. office-based practices, and to identify potential policies for minimizing these barriers. Only one previous qualitative study has examined physician-reported barriers to prescribing XR-NLT and no qualitative study has compared physician-reported barriers between the two medications. METHODS: Researchers conducted individual semi-structured and in-depth interviews with 20 licensed physicians in four U...
January 8, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29317849/is-medical-treatment-of-alcohol-withdrawal-syndrome-a-stag-hunt-challenges-and-opportunities-in-managing-risk-and-uncertainty-in-addiction-cessation
#6
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/29303096/-insomnia-in-hospital
#7
J M J Stoffels, A Thijs
- Every night in hospitals physicians on night shift are confronted with insomnia among their patients and have to make a decision on prescribing sleeping medication.- The extent to which insomnia is disadvantageous to hospital patients and its effects on clinical outcomes have not been well investigated.- A recent systematic review concluded that it is not known if treatment of insomnia with medication, such as melatonin or benzodiazepines, has a beneficial or a disadvantageous effect on clinical outcomes...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29302220/a-brief-review-of-the-genetics-and-pharmacogenetics-of-opioid-use-disorders
#8
Wade Berrettini
Increased physician prescribing of opioids to treat chronic nonprogressive pain has been accompanied by an increase in opioid addiction. Twin studies of opioid addiction are consistent with an inherited component of risk, approximately 50%. Several genome-wide association study (GWAS) reports indicate that genetic risk for opioid addiction is conveyed by many alleles of small effect (odds ratios <1.5). These reports have detected alleles in potassium-ion-channel genes (KCNC1 and KCNG2) and in a glutamate receptor auxiliary protein (CNIH3)...
September 2017: Dialogues in Clinical Neuroscience
https://www.readbyqxmd.com/read/29288475/cancer-pain-management-at-oncology-units-comparing-knowledge-attitudes-and-perceived-barriers-between-physicians-and-nurses
#9
Muhammad Darawad, Malek Khalel Alnajar, Maysoon S Abdalrahim, Aqel Mohammad El-Aqoul
Pain is a major symptom that causes suffering among patients diagnosed with cancer. Identifying physicians' and nurses' knowledge, attitudes, and their perceived barriers of cancer pain management is considered an essential step in improving cancer pain relief. The purposes of this study are to compare physicians' and nurses' knowledge and attitudes toward cancer pain management (CPM) and describe their perceived barriers to CPM at oncology units. A descriptive cross-sectional design was utilized to obtain data through self-report questionnaire...
December 29, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29277147/factors-that-promote-and-hinder-medication-adherence-from-the-perspective-of-inmates-in-a-provincial-remand-center-a-mixed-methods-study
#10
Lauren Cuthbertson, Karolina Kowalewski, Jennifer Edge, Keith Courtney
Effective medication delivery to inmates within correctional facilities is essential for managing symptoms, preventing relapse, slowing disease progression, and enabling recovery. Despite its importance, medication adherence in correctional facilities is poor. This mixed methods study explores the factors that affect medication adherence from the perspective of 20 inmates at a provincial remand center in Alberta, Canada. Themes describing factors that promote or hinder medication adherence emerged: patient-related factors (addiction, social support, insight into disease, and purpose of medications), health care provider-related factors (health care provider attributes and trust in physicians), and correctional setting factors...
January 1, 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/29248905/primary-addictive-substances-used-among-patients-treated-in-a-hospital-based-addiction-medicine-service
#11
Daniel Feingold, Shaul Lev-Ran
INTRODUCTION: This study sought to explore the differences in primary addictive substances used among individuals referred to an ambulatory hospital-based addiction service in Israel according to sex, age and source of referral. METHOD: Data were drawn from all referral forms received during a two-year period (N=140). Categories of primary addictive substances included alcohol, drugs (cannabis, synthetic cannabinoids, illicit stimulants and heroin) and medications (prescription opioids, prescription stimulants and benzodiazepines)...
2017: Israel Journal of Psychiatry and related Sciences
https://www.readbyqxmd.com/read/29228821/public-expenditures-for-mental-health-services-in-canadian-provinces
#12
Jian Wang, Philip Jacobs, Arto Ohinmaa, Anne Dezetter, Alain Lesage
OBJECTIVE: The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. METHODS: This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29223914/cannabis-use-disorder-and-male-sex-predict-medical-cannabis-card-status-in-a-sample-of-high-risk-adolescents
#13
Janet Kim, Marilyn E Coors, Susan E Young, Kristen M Raymond, Christian J Hopfer, Tamara L Wall, Robin P Corley, Sandra A Brown, Joseph T Sakai
OBJECTIVE: To examine if a substance use disorder (SUD), especially cannabis use disorder in adolescence, predicts future medical cannabis card status among high-risk youth. METHODS: Data collection occurred in Denver and San Diego. We recruited adolescents, with or at high risk for SUD and conduct problems (hereafter probands) and their siblings (n=654). Baseline (Wave 1) assessments took place between 1999 and 2008, and follow-up (Wave 2) took place between 2010 and 2013...
December 2, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29204977/managing-concerning-behaviors-in-patients-prescribed-opioids-for-chronic-pain-a-delphi-study
#14
Jessica S Merlin, Sarah R Young, Joanna L Starrels, Soraya Azari, E Jennifer Edelman, Jamie Pomeranz, Payel Roy, Shalini Saini, William C Becker, Jane M Liebschutz
BACKGROUND: Current guideline-recommended monitoring of patients prescribed long-term opioid therapy (LTOT) for chronic pain will likely result in increased identification of behaviors of concern for misuse and addiction, but there is a dearth of empiric evidence about how these behaviors should be managed. OBJECTIVE: To establish expert consensus about treatment approaches for common and challenging concerning behaviors that arise among patients on LTOT. DESIGN: We used a Delphi approach, which allows for generation of consensus...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29185250/management-of-hepatitis-c-in-decentralised-versus-centralised-drug-substitution-programmes-and-minimally-invasive-point-of-care-tests-to-close-gaps-in-the-hcv-cascade
#15
Andrea Bregenzer, Anna Conen, Jürg Knuchel, Andrée Friedl, Franz Eigenmann, Martin Näf, Peter Ackle, Martin Roth, Christoph Andreas Fux
BACKGROUND: In Switzerland, intravenous drug use accounts for the majority of hepatitis C virus (HCV) infections. Early HCV treatment prevents further transmissions and reduces morbidity and mortality due to decompensated liver cirrhosis and hepatocellular carcinoma. Nevertheless, patients in drug substitution programmes are often insufficiently screened and treated. AIM: The aim was to compare the current state of HCV management in centralised and decentralised drug substitution programmes of the canton Aargau...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29177439/attitudes-beliefs-practices-and-concerns-among-clinicians-prescribing-opioids-in-a-large-academic-institution
#16
Jon O Ebbert, Lindsey M Philpot, Casey M Clements, Jenna K Lovely, Wayne T Nicholson, Sarah M Jenkins, Tim J Lamer, Halena M Gazelka
Objectives: Opioid treatment of chronic noncancer pain (CNCP) adds complexity and uncertainty to patient interactions. We sought to assess clinician attitudes, beliefs, practice styles, and concerns around opioid prescribing following the release of the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain. Methods: E-mailed electronic survey to clinicians at a large academic medical institution. Results: A total of 961 clinicians responded to the survey (response rate = 40%), 720 of whom prescribed opioids and were not in training...
June 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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
#17
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
#18
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
#19
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
#20
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
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