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Addiction medicine

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
Darakhshan Jabeen Haleem, Shazia Nawaz
: Morphine and other opioids are amongst most effective prescription medications for the treatment of pain. Addiction and hyperalgesia associated with their long-term use, limits the clinical utility of these drugs. In view of a role of somatodendritic serotonin-1A receptors in addiction and analgesic effects of morphine, the present study concerns effects of co-use of buspirone, a partial agonist at serotonin-1A receptor, on reinforcing, hyperalgesic and motor effects of morphine in rats...
October 11, 2016: Journal of Pain: Official Journal of the American Pain Society
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
Maria Claudia Rodríguez, Perla Villamor, Tatiana Castillo
INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction...
November 2016: International Journal of Pediatric Otorhinolaryngology
John F Kelly
BACKGROUND: Alcoholics Anonymous (AA) is a world-wide recovery mutual-help organization that continues to arouse controversy. In large part, concerns persist because of AA's ostensibly quasi-religious/spiritual orientation and emphasis. In 1990 the United States' Institute of Medicine called for more studies on AA's effectiveness and its mechanisms of behavior change (MOBC) stimulating a flurry of federally funded research. This paper reviews the religious/spiritual origins of AA and its program and contrasts its theory with findings from this latest research...
October 8, 2016: Addiction
John McGonigle, Anna Murphy, Louise M Paterson, Laurence J Reed, Liam Nestor, Jonathan Nash, Rebecca Elliott, Karen D Ersche, Remy Sa Flechais, Rexford Newbould, Csaba Orban, Dana G Smith, Eleanor M Taylor, Adam D Waldman, Trevor W Robbins, Jf William Deakin, David J Nutt, Anne R Lingford-Hughes, John Suckling
OBJECTIVES: We aimed to set up a robust multi-centre clinical fMRI and neuropsychological platform to investigate the neuropharmacology of brain processes relevant to addiction - reward, impulsivity and emotional reactivity. Here we provide an overview of the fMRI battery, carried out across three centres, characterizing neuronal response to the tasks, along with exploring inter-centre differences in healthy participants. EXPERIMENTAL DESIGN: Three fMRI tasks were used: monetary incentive delay to probe reward sensitivity, go/no-go to probe impulsivity and an evocative images task to probe emotional reactivity...
October 4, 2016: Journal of Psychopharmacology
Pablo Barrio, Antoni Gual
ISSUES: Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. APPROACH: A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years) with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients' own goals, and empowering...
2016: Patient Preference and Adherence
Toshihide Nishimura, Haruhiko Nakamura
Molecular therapies targeting lung cancers with mutated epidermal growth factor receptor (EGFR) by EGFR-tyrosin kinase inhibitors (EGFR-TKIs), gefitinib and erlotinib, changed the treatment system of lung cancer. It was revealed that drug efficacy differs by race (e.g., Caucasians vs. Asians) due to oncogenic driver mutations specific to each race, exemplified by gefitinib / erlotinib. The molecular target drugs for lung cancer with anaplastic lymphoma kinase (ALK) gene translocation (the fusion gene, EML4-ALK) was approved, and those targeting lung cancers addicted ROS1, RET, and HER2 have been under development...
2016: Advances in Experimental Medicine and Biology
Amélie Bremare, Nicolas Girardon, Mélanie Margot
Within the framework of cooperation between the physical medicine and rehabilitation (PMR) department and psychiatry department in our establishment with care and education, we have created in 2006 a unit with both somatic and psychic care, allowing management of preadolescents and adolescents suffering from complex somatoform disorder with pain in full-time hospitalization. They have chronic pain associated with motor exclusion of a limb, which have for consequence a participation restriction on scholar and extra-scholar activities with a larger impact than it should be...
September 2016: Annals of Physical and Rehabilitation Medicine
Mayurbhai R Patel, Stephen D Kozuch, Christopher N Cultrara, Reeta Yadav, Suiying Huang, Uri Samuni, John Koren, Gabriela Chiosis, David Sabatino
The emerging field of RNA nanotechnology has been used to design well-programmed, self-assembled nanostructures for applications in chemistry, biology, and medicine. At the forefront of its utility in cancer is the unrestricted ability to self-assemble multiple siRNAs within a single nanostructure formulation for the RNAi screening of a wide range of oncogenes while potentiating the gene therapy of malignant tumors. In our RNAi nanotechnology approach, V- and Y-shape RNA templates were designed and constructed for the self-assembly of discrete, higher-ordered siRNA nanostructures targeting the oncogenic glucose regulated chaperones...
October 3, 2016: Nano Letters
Tri Le, David E Gerber
The advent of precision medicine in non-small cell lung cancer has remarkably altered the direction of research and improved clinical outcomes. The identification of molecular subsets with differential response to targeted therapies began with the identification of epidermal growth factor receptor mutated tumors in subsets of non-small cell lung cancer (NSCLC). Emboldened by unprecedented response rates to kinase inhibitors seen in that subset, the oncologic community searched for other molecular subsets featuring oncogene addiction...
September 13, 2016: Seminars in Cancer Biology
Alena Ondrejkovicova, Gabriel Petrovics, Katarína Svitkova, Bibiana Bajtekova, Ondrej Bangha
Acupuncture is one of the branches of Chinese Traditional Medicine dating back almost 5 000 years. The expansion of China's trade and business relations with other Asian countries brought about the spreading of acupuncture in 7th Century. Nowadays, acupuncture is an interdisciplinary clinical field of Medicine dealing with treatment, diagnostics and prevention of mainly functional disorders, algic, allergic and addictive conditions of various etiology, localization and intensity. It draws from the millennia of experience of Oriental Medicine as well as contemporary knowledge of morphology, physiology and neurophysiology...
July 16, 2016: Neuro Endocrinology Letters
Farah Younes, Ghinwa Halawi, Hicham Jabbour, Nada El Osta, Latife Karam, Aline Hajj, Lydia Rabbaa Khabbaz
BACKGROUND AND AIMS: Internet addiction (IA) could be a major concern in university medical students aiming to develop into health professionals. The implications of this addiction as well as its association with sleep, mood disorders and self-esteem can hinder their studies, impact their long-term career goals and have wide and detrimental consequences for society as a whole. The objectives of this study were to: 1) Assess potential IA in university medical students, as well as factors associated with it; 2) Assess the relationships between potential IA, insomnia, depression, anxiety, stress and self-esteem...
2016: PloS One
Bonnie J Bereznicki, Millicent P Chapman, Luke R E Bereznicki
OBJECTIVE: To investigate actual and perceived disease control in Australians with asthma, and identify factors associated with overestimation of asthma control. METHODS: This was a cross-sectional study of Australian adults with asthma, who were recruited via Facebook to complete an online survey. The survey included basic demographic questions, and validated tools assessing asthma knowledge, medication adherence, medicine beliefs, illness perception and asthma control...
September 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Muhammad A Parvaz, Scott J Moeller, Rita Z Goldstein
Importance: A common trigger for relapse in drug addiction is the experience of craving via exposure to cues previously associated with drug use. Preclinical studies have consistently demonstrated incubation of cue-induced drug-seeking during the initial phase of abstinence, followed by a decline over time. In humans, the incubation effect has been shown for alcohol, nicotine, and methamphetamine addictions, but not for heroin or cocaine addiction. Understanding the trajectory of cue-induced craving during abstinence in humans is of importance for addiction medicine...
September 7, 2016: JAMA Psychiatry
(no author information available yet)
This final rule modifies the TRICARE regulation to reduce administrative barriers to access to mental health benefit coverage and to improve access to substance use disorder (SUD) treatment for TRICARE beneficiaries, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and governing laws. This rule seeks to eliminate unnecessary quantitative and non-quantitative treatment limitations on SUD and mental health benefit coverage and align beneficiary cost-sharing for mental health and SUD benefits with those applicable to medical/surgical benefits, expand covered mental health and SUD treatment under TRICARE to include coverage of intensive outpatient programs and treatment of opioid use disorder and to streamline the requirements for mental health and SUD institutional providers to become TRICARE authorized providers, and to develop TRICARE reimbursement methodologies for newly recognized mental health and SUD intensive outpatient programs and opioid treatment programs...
September 2, 2016: Federal Register
Daniel Vardeh, Richard J Mannion, Clifford J Woolf
UNLABELLED: The past few decades have witnessed a huge leap forward in our understanding of the mechanistic underpinnings of pain, in normal states where it helps protect from injury, and also in pathological states where pain evolves from a symptom reflecting tissue injury to become the disease itself. However, despite these scientific advances, chronic pain remains extremely challenging to manage clinically. Although the number of potential treatment targets has grown substantially and a strong case has been made for a mechanism-based and individualized approach to pain therapy, arguably clinicians are not much more advanced now than 20 years ago, in their capacity to either diagnose or effectively treat their patients...
September 2016: Journal of Pain: Official Journal of the American Pain Society
Amélie Daveluy, Elisabeth Frauger, Hélène Peyrière, Christophe Moracchini, Françoise Haramburu, Joëlle Micallef
Addiction to illicit substances or medicines is influenced by cultural, religious, ethnic factors as well as local availability. The purpose of this study was to evaluate the profile of drug users and characteristics of the psychoactive substances used in French overseas territories, using data from the OPPIDUM survey. OPPIDUM is an annual, nationwide, multicentric, cross-sectional study based on specialized care centres that included subjects presenting a drug addiction or under opiate maintenance treatment...
September 1, 2016: Fundamental & Clinical Pharmacology
Andrea G Barthwell, Jonathan M Young, Michael C Barnes, Shruti R Kulkarni
According to the Substance Abuse and Mental Health Services Administration, 2.4 million individuals have an opioid use disorder (OUD). Yet, nearly 80 percent of them-more than 1.9 million people-do not receive treatment. Medication-assisted treatment (MAT), specifically with buprenorphine, has proven to be effective in treating patients with OUDs while also reducing costs to the healthcare system, criminal justice system, and workforce. Despite its effectiveness, barriers to MAT continue to exist. Consequently, many individuals must wait months, if not years, to receive treatment...
July 2016: Journal of Opioid Management
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
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