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https://www.readbyqxmd.com/read/28733097/injectable-naltrexone-oral-naltrexone-and-buprenorphine-utilization-and-discontinuation-among-individuals-treated-for-opioid-use-disorder-in-a-united-states-commercially-insured-population
#1
Jake R Morgan, Bruce R Schackman, Jared A Leff, Benjamin P Linas, Alexander Y Walley
We investigated prescribing patterns for five opioid use disorder (OUD) medications: 1) injectable naltrexone, 2) oral naltrexone, 3) sublingual or oralmucosal buprenorphine/naloxone, 4) sublingual buprenorphine, and 5) transdermal buprenorphine in a nationally representative claims-based database (Truven Health MarketScan®) of commercially insured individuals in the United States. We calculated the prevalence of OUD in the database for each year from 2010 to 2014 and the proportion of diagnosed patient months on OUD medication...
July 3, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28731336/triple-reuptake-inhibitors-as-potential-therapeutics-for-depression-and-other-disorders-design-paradigm-and-developmental-challenges
#2
Murugaiah A M Subbaiah
Although first-line antidepressants offer therapeutic benefit, about 35% of depressed patients are not adequately treated, creating a large unmet medical need. These medicines mostly enhance the synaptic levels of serotonin and/or norepinephrine. Evidence from preclinical and clinical studies implicate dopamine hypofunction in the pathophysiology of depression. Triple reuptake inhibitors (TRIs), which elevate dopamine in addition to serotonin and norepinephrine, may demonstrate greater efficacy, with the reversal of anhedonia and improved tolerability...
July 21, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28730160/epigenetic-interactions-between-alcohol-and-cannabinergic-effects-focus-on-histone-modification-and-dna-methylation
#3
Tiyash Parira, Alejandra Laverde, Marisela Agudelo
Epigenetic studies have led to a more profound understanding of the mechanisms involved in chronic conditions. In the case of alcohol addiction, according to the National Institute on Alcohol Abuse and Alcoholism, 16 million adults suffer from Alcohol Use Disorders (AUDs). Even though therapeutic interventions like behavioral therapy and medications to prevent relapse are currently available, no robust cure exists, which stems from the lack of understanding the mechanisms of action of alcohol and the lack of development of precision medicine approaches to treat AUDs...
April 2017: Journal of Alcoholism and Drug Dependence
https://www.readbyqxmd.com/read/28726549/homeless-veterans-experiences-with-substance-use-recovery-and-treatment-through-photo-elicitation
#4
Samuel F Sestito, Keri L Rodriguez, Shaddy K Saba, James W Conley, Michael A Mitchell, Adam J Gordon
BACKGROUND: Homeless Veterans often have addictions and comorbidities that complicate utilization of longitudinal healthcare services, such as primary care. An understanding of experiences of Veterans enrolled in a Homeless Patient Aligned Care Team (H-PACT) may improve addiction treatment engagement in these settings. We aimed to describe H-PACT Veterans' experiences with substance use (SU), substance use recovery (SUR), and substance use treatment (SUT). METHODS: Homeless Veterans were recruited from a Veteran primary care medical home clinic between September 2014 and March 2015...
July 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28725284/addiction-and-moralization-the-role-of-the-underlying-model-of-addiction
#5
Lily E Frank, Saskia K Nagel
Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a 'de-moralized' discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction...
2017: Neuroethics
https://www.readbyqxmd.com/read/28725282/addiction-and-the-brain-development-not-disease
#6
Marc Lewis
I review the brain disease model of addiction promoted by medical, scientific, and clinical authorities in the US and elsewhere. I then show that the disease model is flawed because brain changes in addiction are similar to those generally observed when recurrent, highly motivated goal seeking results in the development of deep habits, Pavlovian learning, and prefrontal disengagement. This analysis relies on concepts of self-organization, neuroplasticity, personality development, and delay discounting. It also highlights neural and behavioral parallels between substance addictions, behavioral addictions, normative compulsive behaviors, and falling in love...
2017: Neuroethics
https://www.readbyqxmd.com/read/28723415/pharmacology-of-human-trace-amine-associated-receptors-therapeutic-opportunities-and-challenges
#7
REVIEW
Mark D Berry, Raul R Gainetdinov, Marius C Hoener, Mohammed Shahid
The discovery in 2001 of a G protein-coupled receptor family, subsequently termed trace amine-associated receptors (TAAR), triggered a resurgence of interest in so-called trace amines. Initial optimism quickly faded, however, as the TAAR family presented a series of challenges preventing the use of standard medicinal chemistry and pharmacology technologies. Consequently the development of basic tools for probing TAAR and translating findings from model systems to humans has been problematic. Despite these challenges the last 5 years have seen considerable advances, in particular with respect to TAAR1, which appears to function as an endogenous rheostat, maintaining central neurotransmission within defined physiological limits, in part through receptor heterodimerization yielding biased signaling outputs...
July 16, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28721822/opioid-antagonists-for-pharmacological-treatment-of-gambling-disorder-are-they-relevant
#8
Caroline Victorri-Vigneau, Andrew Spiers, Pascal Caillet, Mélanie Bruneau, Gaëlle Challet-Bouju, Marie Grall-Bronnec
Background To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective This study aims to evaluate the relevance of opioid antagonists for treating GD. Method A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed...
July 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28721525/-epidemic-or-peripheral-phenomenon-a%C3%A2-medical-history-of-the-cocaine-wave-in-the-weimar-republic
#9
Hannes Walter
An empirical investigation refutes the popular conception that excessive drug usage was a widespread social phenomenon in the Weimar Republic. Although physicians warned the public and politicians of a "cocaine wave" that threatened the public health, there is no evidence that indicates a significant increase of cocaine use during the twenties. The decisive cause for this moral panic was caused instead by the disease pattern of "Cocainism". The addiction carried the imprint of an infectious disease and would destroy the body, the will, and the civic life of its victims...
July 18, 2017: NTM
https://www.readbyqxmd.com/read/28720620/in-this-issue-opiates-tobacco-social-determinants-of-health-social-accountability-for-non-profit-hospitals-more-on-pcmh-and-clinical-topics
#10
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue contains several articles about the factors contributing to the complex and deadly interplay between social determinants of health, pain, mental illness, and addictive substances such as opioids and tobacco. One article clearly is a call to action: more than half of opioid prescriptions in the United States are given to patients with mental health problems. Two articles report work on the next steps for social determinants of health in health care settings. Social accountability based on community health needs assessments required of community hospitals should lead to the creation of more family medicine residency positions...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720013/the-5-ht1b-serotonin-receptor-regulates-methylphenidate-induced-gene-expression-in-the-striatum-differential-effects-on-immediate-early-genes
#11
David Alter, Joel A Beverley, Ronak Patel, Carlos A Bolaños-Guzmán, Heinz Steiner
Drug combinations that include a psychostimulant such as methylphenidate (Ritalin) and a selective serotonin reuptake inhibitor such as fluoxetine are indicated in several medical conditions. Co-exposure to these drugs also occurs with "cognitive enhancer" use by individuals treated with selective serotonin reuptake inhibitors. Methylphenidate, a dopamine reuptake inhibitor, by itself produces some addiction-related gene regulation in the striatum. We have demonstrated that co-administration of selective serotonin reuptake inhibitors potentiates these methylphenidate-induced molecular effects, thus producing a more "cocaine-like" profile...
July 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28718723/core-addiction-medicine-competencies-for-doctors-an-international-consultation-on-training
#12
Astri Parawita Ayu, Nady El-Guebaly, Arnt Schellekens, Cor De Jong, Gabrielle Welle-Strand, William Small, Evan Wood, Walter Cullen, Jan Klimas
BACKGROUND: Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education...
July 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28716656/atomoxetine-in-abstinent-cocaine-users-cognitive-subjective-and-cardiovascular-effects
#13
Elise E DeVito, Aryeh I Herman, Noah S Konkus, Huiping Zhang, Mehmet Sofuoglu
No pharmacotherapies are approved for the treatment of cocaine use disorders (CUD). Behavioral treatments for CUD are efficacious for some individuals, but recovery rates from CUD remain low. Cognitive impairments in CUD have been linked with poorer clinical outcomes. Cognitive enhancing pharmacotherapies have been proposed as promising treatments for CUD. Atomoxetine, a norepinephrine transporter inhibitor, shows potential as a treatment for CUD based on its efficacy as a cognitive enhancer in other clinical populations and impact on addictive processes in preclinical and human laboratory studies...
July 14, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28715290/trainees-knowledge-attitudes-and-practices-towards-caring-for-the-substance-exposed-mother-infant-dyad
#14
Davida M Schiff, Barry Zuckerman, Elisha M Wachman, Megan Bair-Merritt
BACKGROUND: As rates of substance use disorder during pregnancy rise, pediatric trainees are increasingly caring for infants with neonatal abstinence syndrome (NAS). This study evaluated the knowledge, attitudes, and practices of trainees caring for substance-exposed newborns and their families, comparing differences by level and type of training, and personal experience with addiction or trauma. METHODS: A cross-sectional survey of medical students, pediatric, medicine/pediatrics and family medicine residents in 2015-2106...
July 17, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28713441/analysis-of-raw-biofluids-by-mass-spectrometry-using-microfluidic-diffusion-based-separation
#15
Joshua Heinemann, Brigit Noon, Daniel Willems, Katherine Budeski, Brian Bothner
Elucidation and monitoring of biomarkers continues to expand because of their medical value and potential to reduce healthcare costs. For example, biomarkers are used extensively to track physiology associated with drug addiction, disease progression, aging, and industrial processes. While longitudinal analyses are of great value from a biological or healthcare perspective, the cost associated with replicate analyses is preventing the expansion of frequent routine testing. Frequent testing could deepen our understanding of disease emergence and aid adoption of personalized healthcare...
January 21, 2017: Analytical Methods: Advancing Methods and Applications
https://www.readbyqxmd.com/read/28707583/cannabis-an-overview-of-its-adverse-acute-and-chronic-effects-and-their-implications
#16
Talitha C Ford, Amie C Hayley, Luke A Downey, Andrew C Parrott
In many communities, cannabis is perceived as a low-risk drug, leading to political lobbying to decriminalise its use. However, acute and chronic cannabis use has been shown to be harmful to several aspects of psychological and physical health, such as mood states, psychiatric outcomes, neurocognition, driving and general health. Furthermore, cannabis is highly addictive, and the adverse effects of withdrawal can lead to regular use. These in turn have adverse implications for public safety and health expenditure...
July 12, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28704148/-i-was-not-sick-and-i-didn-t-need-to-recover-methadone-maintenance-treatment-mmt-as-a-refuge-from-criminalization
#17
David Frank
BACKGROUND: Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences, or meet the needs of people who use drugs (PWUD), many of whom who use the program as a pragmatic means of reducing harms associated with criminalization...
July 13, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28703074/serum-ionic-dysequilibria-in-clinical-opioid-dependence-cross-sectional-and-longitudinal-studies
#18
A S Reece, A Norman, G K Hulse
INTRODUCTION: Despite an increasing awareness that the activity of excitable membranes is determined by the underlying ionic gradients across them, and their importance in drug dependency, we were not able to identify any reports of comparing the electrolyte composition of opioid-dependent and non-addicted controls. METHODS: Linear regression was used to compare clinical pathology blood results taken from 2699 opioid-dependent patients (ODP) and 5307 medical control (MC) patients on a total of 21,734 occasions for the period 1995-2015...
August 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28697909/women-and-the-opioid-crisis-historical-context-and-public-health-solutions
#19
REVIEW
Mishka Terplan
Driven by a legitimate but overly opioid-focused response to pain, the United States is currently experiencing an opioid crisis, a crisis with parallels to the first opioid epidemic at the turn of the 20th century. Women, particularly white reproductive-age women, are increasingly the face of the opioid crisis. Given the penetration of opioid misuse and addiction across all income and insurance strata, any provider who cares for women needs to be prepared to assess and evaluate opioid use, misuse, and addiction...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28694276/denial-the-greatest-barrier-to-the-opioid-epidemic
#20
Nicole Gastala
"Why can't you be like my old doctor?" This essay explores my experiences as a new family physician in a rural town endemic with liberal opioid prescribing practices and opioid addiction. I detail my inner turmoil while overcoming resistance to change, the influence of these experiences on my professional growth, and my decision to offer medication-assisted treatment.
July 2017: Annals of Family Medicine
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