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https://www.readbyqxmd.com/read/28921780/factors-associated-with-attrition-in-substance-using-patients-enrolled-in-an-intensive-outpatient-program
#1
James Mckowen, Nicholas Carrellas, Courtney Zulauf, Emin Nalan Ward, Ronna Fried, Timothy Wilens
BACKGROUND AND OBJECTIVES: Data suggest individuals with substance use disorders (SUD) have high rates of attrition from treatment and exhibit impairments on measures of executive functioning (EF). The primary aim of this pilot study was to investigate if EF is associated with attrition from a 1 month intensive outpatient program (IOP) for SUD, and examine the feasibility of implementing the project. METHODS: Baseline neurocognitive functioning was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the self-reported Behavior Rating Inventory of Executive Functioning (BRIEF-A) questionnaire...
September 18, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28858148/alcohol-or-drug-use-and-trauma-recidivism
#2
COMPARATIVE STUDY
Sergio Cordovilla-Guardia, Raquel Vilar-López, Pablo Lardelli-Claret, Francisco Guerrero-López, Enrique Fernández-Mondéjar
BACKGROUND: Alcohol, illicit drugs, and psychotropic medications are well-known causes of traumatic events. However, the association of each type of substance with trauma recidivism remains unclear. OBJECTIVES: The purpose of this study was to quantify the strength of associations between the type of substance detected in patients admitted for traumatic injury and trauma recidivism, defined as a documented history of past trauma. METHODS: The presence of alcohol and drugs (cannabis, cocaine, amphetamines, methamphetamines, benzodiazepines, opiates, methadone, barbiturates, and tricyclic antidepressants) was analyzed in 1,156 patients between 16 and 70 years old, hospitalized in a trauma hospital between November 2011 and March 2015...
September 2017: Nursing Research
https://www.readbyqxmd.com/read/28844770/preoperative-chronic-opioid-users-in-total-knee-arthroplasty-which-patients-persistently-abuse-opiates-following-surgery
#3
Kelvin Y Kim, Afshin A Anoushiravani, Kevin K Chen, Mackenzie Roof, William J Long, Ran Schwarzkopf
BACKGROUND: Chronic opioid users pose a unique challenge for orthopedic surgeons, as they often report suboptimal outcomes following total knee arthroplasty (TKA). We aim at identifying risk factors associated with patients who were preoperative chronic opioid users and continued to use 6 months following TKA. METHODS: All preoperative chronic opioid users among 338 consecutive TKA cases performed at our institution between February and June 2016 were identified and divided into 2 cohorts: patients who (1) persistently used opioids and (2) discontinued use by the 6-month time point following surgery...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28841113/pharmacoepigenomics-of-opiates-and-methadone-maintenance-treatment-current-data-and-perspectives
#4
Cynthia Marie-Claire, Clément Jourdaine, Jean-Pierre Lépine, Frank Bellivier, Vanessa Bloch, Florence Vorspan
Current treatments of opioid addiction include primarily maintenance medications such as methadone. Chronic exposure to opiate and/or long-lasting maintenance treatment induce modulations of gene expression in brain and peripheral tissues. There is increasing evidence that epigenetic modifications underlie these modulations. This review summarizes published results on opioid-induced epigenetic changes in animal models and in patients. The epigenetic modifications observed with other drugs of abuse often used by opiate abusers are also outlined...
September 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28838318/anesthetic-management-during-adenotonsillectomy-for-twins-with-congenital-insensitivity-to-pain-with-anhidrosis-two-case-reports
#5
Cong Wang, Xianwei Zhang, Shanna Guo, Jiaoli Sun, Ningbo Li
BACKGROUND: Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder characterized by hyperpyrexia, anhidrosis, pain insensitivity, self-inflicted injuries, and intellectual disability. The anesthetic management of these patients is challenging owing to the high risk of perioperative complications resulting from their autonomic dysfunction, such as hyperthermia, hypotension, and bradycardia, which result from autonomic nervous system dysfunction. CASE PRESENTATION: Two 3-year-old Han Chinese identical male twins (weighing 13...
August 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28828225/quantifying-absolute-glutamate-concentrations-in-nucleus-accumbens-of-prescription-opioid-addicts-by-using-1-h-mrs
#6
Xi-Long Liu, Long Li, Jian-Neng Li, Ji-Hua Tang, Jia-Hui Rong, Bo Liu, Ze-Xuan Hu
INTRODUCTION: The diagnosis of psychoactive substance use disorders has been based primarily on descriptive, symptomatic checklist criteria. In opioid addiction, there are no objective biological indicators specific enough to guide diagnosis, monitor disease status, and evaluate efficacy of therapeutic interventions. Proton magnetic resonance spectroscopy ((1)H MRS) of the brain has potential to identify and quantify biomarkers for the diagnosis of opioid dependence. The purpose of this study was to detect the absolute glutamate concentration in the nucleus accumbens (NAc) of patients with prescription opioid dependence using (1)H MRS, and to analyze its clinical associations...
August 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#7
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28802938/impulse-control-and-related-disorders-in-parkinson-s-disease
#8
Daniel Weintraub, Daniel O Claassen
Impulse control disorders (ICDs), such as compulsive gambling, buying, sexual, and eating behaviors, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness. Related behaviors include punding (stereotyped, repetitive, purposeless behaviors), dopamine dysregulation syndrome (DDS) (compulsive medication overuse), and hobbyism (e.g., compulsive internet use, artistic endeavors, and writing). These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28795846/a-novel-non-opioid-protocol-for-medically-supervised-opioid-withdrawal-and-transition-to-antagonist-treatment
#9
Gregory Rudolf, Jim Walsh, Abigail Plawman, Paul Gianutsos, William Alto, Lloyd Mancl, Vania Rudolf
BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin...
August 10, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28776146/a-focused-addiction-curriculum-and-its-impact-on-student-knowledge-attitudes-and-confidence-in-the-treatment-of-patients-with-substance-use
#10
Robert J Feeley, David T Moore, Kirsten Wilkins, Brian Fuehrlein
BACKGROUND: Assessment of attitudes towards addiction in medical students has largely gone unexplored. This study examines the impact of a supplemental substance use disorder curriculum in the psychiatry clerkship on medical student attitudes towards addiction. METHODS: The curriculum was only administered to students at one clerkship site. Subsequently, medical students were surveyed across all sites regarding their attitudes towards addiction. RESULTS: The survey response rate was 37...
August 3, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28758767/posttraumatic-stress-disorder-in-opioid-agonist-therapy-a-review
#11
Anthony H Ecker, Natalie Hundt
OBJECTIVE: Posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) co-occur at high rates, and this co-occurrence is associated with a range of problems related to mental and physical health. OUD is commonly treated with opioid agonist therapies (OAT), which have been shown to be effective for reducing opiate use and related negative health consequences. Given the high comorbidity of PTSD and OUD, many individuals in OAT have PTSD and continue to experience symptoms of both disorders despite OAT treatment...
July 31, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28701128/high-rates-of-general-practice-attendance-by-former-prisoners-a-prospective-cohort-study
#12
Megan Carroll, Matthew J Spittal, Anna R Kemp-Casey, Nicholas G Lennox, David B Preen, Georgina Sutherland, Stuart A Kinner
OBJECTIVES: To determine the rates at which people recently released from prison attend general practitioners, and to describe service users and their encounters. DESIGN, PARTICIPANTS AND SETTING: Prospective cohort study of 1190 prisoners in Queensland, interviewed up to 6 weeks before expected release from custody (August 2008 - July 2010); their responses were linked prospectively with Medicare and Pharmaceutical Benefits Scheme data for the 2 years after their release...
July 17, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#13
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
September 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28690665/use-of-integrative-medicine-in-the-united-states-military-health-system
#14
REVIEW
Cathaleen Madsen, Megan Vaughan, Tracey Pérez Koehlmoos
Integrative medicine (IM) is a model of care which uses both conventional and nonconventional therapies in a "whole person" approach to achieve optimum mental, physical, emotional, spiritual, and environmental health, and is increasingly popular among patients and providers seeking to relieve chronic or multifactorial conditions. The US Department of Defense (DoD) shows particular interest in and usage of IM for managing chronic conditions including the signature "polytrauma triad" of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) among its beneficiaries in the Military Health System (MHS)...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28673522/very-early-disengagement-and-subsequent-re-engagement-in-primary-care-office-based-opioid-treatment-obot-with-buprenorphine
#15
David Hui, Zoe M Weinstein, Debbie M Cheng, Emily Quinn, Hyunjoong Kim, Colleen Labelle, Jeffrey H Samet
INTRODUCTION: Patients with opioid use disorder often require multiple treatment attempts before achieving stable recovery. Rates of disengagement from buprenorphine are highest in the first month of treatment and termination of buprenorphine therapy results in return to use rates as high as 90%. To better characterize these at-risk patients, this study aims to describe: 1) the frequency and characteristics of patients with very early disengagement (≤1month) from Office Based Opioid Treatment (OBOT) with buprenorphine and 2) the frequency and characteristics of patients who re-engage in care at this same OBOT clinic within 2years, among the subset of very early disengagers...
August 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28659987/the-potential-role-of-naltrexone-in-borderline-personality-disorder
#16
Azadeh Moghaddas, Mehrnoush Dianatkhah, Saba Ghaffari, Padideh Ghaeli
Objective: Management of borderline personality disorder (BPD) is a difficult challenge due to the complex features of this disorder. This article reviews the use of naltrexone in the treatment of BPD. Method: Published articles and clinical trials were searched in Google Scholar, MedLine, ELSEVIER, and Cochrane database of systematic reviews abstracts in English language between 1990 and 2017. Results: Naltrexone (NTX), a nonspecific competitive opiate antagonist, has been noted to be helpful in controlling self-injurious behavior (SIB) and dissociative symptoms in patients with BPD...
April 2017: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/28655025/effect-of-buprenorphine-weekly-depot-cam2038-and-hydromorphone-blockade-in-individuals-with-opioid-use-disorder-a-randomized-clinical-trial
#17
Sharon L Walsh, Sandra D Comer, Michelle R Lofwall, Bradley Vince, Naama Levy-Cooperman, Debra Kelsh, Marion A Coe, Jermaine D Jones, Paul A Nuzzo, Fredrik Tiberg, Behshad Sheldon, Sonnie Kim
Importance: Buprenorphine is an efficacious, widely used treatment for opioid use disorder (OUD). Daily oral transmucosal formulations can be associated with misuse, diversion, and nonadherence; these limitations may be obviated by a sustained release formulation. Objective: To evaluate the ability of a novel, weekly, subcutaneous buprenorphine depot formulation, CAM2038, to block euphorigenic opioid effects and suppress opioid withdrawal in non-treatment-seeking individuals with OUD...
September 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28631421/impact-of-synthetic-cannabinoids-on-the-duration-of-opioid-related-withdrawal-and-craving-among-patients-of-addiction-clinics-in-kazakhstan-a-prospective-case-control-study
#18
Mariya Prilutskaya, Francesco Saverio Bersani, Ornella Corazza, Sergey Molchanov
OBJECTIVE: The aim of the study was to prospectively assess whether regular use of synthetic cannabinoids (SCs) affects the duration of opioid-related withdrawal and craving symptoms in patients undergoing drug detoxification treatments. METHODS: Patients (n = 193) with opioid use disorder, among which 47 patients are regularly using SCs, underwent integrated drug detoxification therapies. The Clinical Opiate Withdrawal Scale and a specific visual analogue scale were used to assess opioid withdrawal and craving symptoms over time...
May 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28630256/the-small-gtpase-rac1-contributes-to-extinction-of-aversive-memories-of-drug-withdrawal-by-facilitating-gabaa-receptor-endocytosis-in-the-vmpfc
#19
Weisheng Wang, Yun-Yue Ju, Qi-Xin Zhou, Jian-Xin Tang, Meng Li, Lei Zhang, Shuo Kang, Zhong-Guo Chen, Yu-Jun Wang, Hui Ji, Yu-Qiang Ding, Lin Xu, Jing-Gen Liu
Extinction of aversive memories has been a major concern in neuropsychiatric disorders, such as anxiety disorders and drug addiction. However, the mechanisms underlying extinction of aversive memories are not fully understood. Here, we report that extinction of conditioned place aversion (CPA) to naloxone-precipitated opiate withdrawal in male rats activates Rho GTPase Rac1 in the ventromedial prefrontal cortex (vmPFC) in a BDNF-dependent manner, which determines GABAA receptor (GABAAR) endocytosis via triggering synaptic translocation of activity-regulated cytoskeleton-associated protein (Arc) through facilitating actin polymerization...
July 26, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28598698/beyond-serotonin-newer-antidepressants-in-the-future
#20
Gopalkumar Rakesh, Chi-Un Pae, Prakash S Masand
There are numerous antidepressants for the treatment of major depressive disorder (MDD) on the market. However, inadequate treatment response, therapeutic lag between drug administration and the onset of clinical improvement, and safety/tolerability issues with the use of contemporary antidepressants have accelerated the search for newer antidepressants with novel mechanisms of action. Areas covered: The authors review novel antidepressants with rapid efficacy for diverse MDD symptoms and have fewer adverse effects (AEs)...
June 19, 2017: Expert Review of Neurotherapeutics
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