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https://www.readbyqxmd.com/read/28500210/first-line-medications-for-alcohol-use-disorders-among-public-drug-plan-beneficiaries-in-ontario
#1
Sheryl Spithoff, Suzanne Turner, Tara Gomes, Diana Martins, Samantha Singh
OBJECTIVE: To examine use of first-line alcohol use disorder (AUD) medications (naltrexone and acamprosate) among public drug plan beneficiaries in the year following an AUD diagnosis. DESIGN: Retrospective population-based cohort study. SETTING: Ontario. PARTICIPANTS: Individuals eligible for public drug plan benefits who had an AUD diagnosis at a hospital visit between April 1, 2011, and March 31, 2012. MAIN OUTCOME MEASURES: Number of AUD medications dispensed to public drug plan beneficiaries who had a recent hospital visit with an AUD diagnosis, and number of prescriptions dispensed per person...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28476269/barriers-to-and-facilitators-of-pharmacotherapy-for-alcohol-use-disorder-in-va-residential-treatment-programs
#2
Andrea K Finlay, Laura S Ellerbe, Jessie J Wong, Christine Timko, Anna D Rubinsky, Shalini Gupta, Thomas R Bowe, Jennifer L Burden, Alex H S Harris
Among US military veterans, alcohol use disorder (AUD) is prevalent and in severe cases patients need intensive AUD treatment beyond outpatient care. The Department of Veterans Affairs (VA) delivers intensive, highly structured addiction and psychosocial treatment through residential programs. Despite the evidence supporting pharmacotherapy among the effective treatments for AUD, receipt of these medications (e.g., naltrexone, acamprosate) among patients in residential treatment programs varies widely. In order to better understand this variation, the current study examined barriers and facilitators to use of pharmacotherapy for AUD among patients in VA residential treatment programs...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28413623/glutamate-plasticity-woven-through-the-progression-to-alcohol-use-disorder-a-multi-circuit-perspective
#3
REVIEW
Lara Hwa, Joyce Besheer, Thomas Kash
Glutamate signaling in the brain is one of the most studied targets in the alcohol research field. Here, we report the current understanding of how the excitatory neurotransmitter glutamate, its receptors, and its transporters are involved in low, episodic, and heavy alcohol use. Specific animal behavior protocols can be used to assess these different drinking levels, including two-bottle choice, operant self-administration, drinking in the dark, the alcohol deprivation effect, intermittent access to alcohol, and chronic intermittent ethanol vapor inhalation...
2017: F1000Research
https://www.readbyqxmd.com/read/28406579/disparities-in-pharmacotherapy-for-alcohol-use-disorder-in-the-context-of-universal-healthcare-a-swedish-register-study
#4
Katherine J Karriker-Jaffe, Jianguang Ji, Jan Sundquist, Kenneth S Kendler, Kristina Sundquist
BACKGROUND AND AIM: Pharmacotherapy can be an important part of the continuum of care for alcohol use disorder (AUD). The Swedish universal healthcare system emphasizes provision of care to marginalized groups. The primary aim was to test associations of neighbourhood deprivation and disadvantaged social status with receipt of AUD pharmacotherapy in this context. DESIGN: Data from linked population registers were used to follow an open cohort over 7 years. SETTING: Sweden...
April 12, 2017: Addiction
https://www.readbyqxmd.com/read/28319159/drug-therapy-for-alcohol-dependence-in-primary-care-in-the-uk-a-clinical-practice-research-datalink-study
#5
Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P van Staa, Munir Pirmohamed
AIM: To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care. DESIGN: Open cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Database. PARTICIPANTS: 39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013. MAIN OUTCOME MEASURE: Use of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence...
2017: PloS One
https://www.readbyqxmd.com/read/28301219/management-of-comorbid-bipolar-disorder-and-substance-use-disorders
#6
Ihsan M Salloum, Edson Sherwood Brown
BACKGROUND: The comorbidity of substance use disorders (SUDs) in bipolar disorder is among the highest in psychiatric disorders. Evidence-based controlled psychosocial or pharmacological interventions trials, which may guide treatment decisions, have not been systematically reviewed. OBJECTIVE: To present a narrative review of the public health and clinical significance of this condition, including diagnostic and treatment implications, and to evaluate controlled trials conducted to date...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28240173/personalized-medicine-of-alcohol-addiction-pharmacogenomics-and-beyond
#7
Vangelis George Manolopoulos, Georgia Ragia
Alcohol addiction or alcoholism is the most severe form of problem drinking. A variety of treatment methods for alcoholism are currently available that combine medications, behavioral treatment and peer support. The drugs that are currently approved by the U.S. Food and Drug Administration (FDA) for treatment of alcohol dependence are disulfiram, naltrexone and acamprosate. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that different factors, both psychosocial and economic, as well as genetic variation, are significant contributors to interindividual variation both of clinical presentation of alcohol problems and response to a given treatment...
February 23, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28220511/review-article-pharmacotherapy-for-alcohol-dependence-the-why-the-what-and-the-wherefore
#8
REVIEW
E T Goh, M Y Morgan
BACKGROUND: The development of alcohol dependence is associated with significant morbidity and mortality. For the majority of affected people the most appropriate goal, in terms of drinking behaviour, is abstinence from alcohol. Psychosocial intervention is the mainstay of the treatment but adjuvant pharmacotherapy is also available and its use recommended. AIM: To provide an updated analysis of current and potential pharmacotherapeutic options for the management of alcohol dependence...
February 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28132696/socioeconomic-and-geographic-disparities-in-access-to-pharmacotherapy-for-alcohol-dependence
#9
Kirsten C Morley, Warren Logge, Sallie-Anne Pearson, Andrew Baillie, Paul S Haber
A higher rate of alcohol-attributable morbidity and mortality exists in remote and socioeconomically disadvantaged regions of Australia. This study aimed to explore the dispensing pattern of pharmacotherapy for alcohol dependence across these groups. A retrospective cohort study of patients (aged 15-84) dispensed acamprosate or naltrexone (July 2009-June 2013) was conducted. Observed dispensing rates were obtained for 541 local government areas (LGA) of Australia. Expected dispensing was based on national rates and age standardized to each LGA...
March 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28093021/altering-ethanol-pharmacokinetics-to-treat-alcohol-use-disorder-can-you-teach-an-old-dog-new-tricks
#10
Carolina L Haass-Koffler, Fatemeh Akhlaghi, Robert M Swift, Lorenzo Leggio
Disulfiram was the first pharmacotherapy approved to treat alcohol use disorder in the 1950s. Disulfiram alters ethanol pharmacokinetics and causes uncomfortable reactions (e.g. headache, tachycardia, nausea, flushing and hypotension) when alcohol is consumed. Subsequently, a better understanding of the neurobiological pathways involved in alcohol use disorder led to the development of other medications (e.g. naltrexone and acamprosate). These neurobiological-based medications act on alcohol use disorder-related phenotypes including craving, stress, and/or withdrawal...
January 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28064151/supervised-disulfiram-s-superior-effectiveness-in-alcoholism-treatment-ethical-methodological-and-psychological-aspects
#11
Colin Brewer, Emmanuel Streel, Marilyn Skinner
Disulfiram (DSF) causes the ALDH-mediated deterrence of alcohol consumption. We review recent meta-analyses showing the superior effectiveness of supervised disulfiram (SD) in alcoholism treatment compared with oral naltrexone or acamprosate (ACP). The success of SD is also consistent with the almost complete absence of alcoholism in Japanese homozygotes for 'inefficient' ALDH. However, SD is an underused treatment and some clinicians have ethical objections to DSF. We examine these objections and argue that they are based on a misunderstanding of how DSF works...
March 9, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/27984008/treatment-of-alcohol-use-disorder-in-patients-with-alcoholic-liver-disease
#12
REVIEW
Lorenzo Leggio, Mary R Lee
Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral, and/or pharmacologic treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In addition to medications approved by the US Food and Drug Administration for alcohol use disorder (disulfiram, naltrexone, and acamprosate), recent efforts to identify potential new treatments have yielded promising candidate pharmacotherapies...
February 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27895598/pharmacotherapy-for-alcohol-use-disorders-physicians-perceptions-and-practices
#13
Caridad Ponce Martinez, Priyanka Vakkalanka, Nassima Ait-Daoud
BACKGROUND AND OBJECTIVES: Alcohol use disorders (AUDs) are an important cause of morbidity and mortality. Despite the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommendations that medications be considered for patients with alcohol dependence, the mainstay of treatment has been counseling. We designed a survey to assess the treatment practices of psychiatrists and family medicine (FM) physicians in an effort to identify barriers to the use of pharmacotherapy and develop strategies to increase physician knowledge and utilization of these medications...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27890540/association-of-plasma-calcium-concentrations-with-alcohol-craving-new-data-on-potential-pathways
#14
Rilana Schuster, Anne Koopmann, Martin Grosshans, Iris Reinhard, Rainer Spanagel, Falk Kiefer
Recently, calcium was suggested to be the active moiety of acamprosate. We examined plasma calcium concentrations in association with severity of alcohol dependence and its interaction with regulating pathways and alcohol craving in alcohol-dependent patients. 47 inpatient alcohol-dependent patients undergoing detoxification treatment underwent laboratory testing, including calcium, sodium, liver enzymes as well as serum concentrations of calcitonin, parathyroid hormone and vitamin D. The psychometric dimension of craving was analyzed with the Obsessive Compulsive Drinking Scale (OCDS)...
November 24, 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27755217/anterior-cingulate-glutamate-is-reduced-by-acamprosate-treatment-in-patients-with-alcohol-dependence
#15
Mark A Frye, David J Hinton, Victor M Karpyak, Joanna M Biernacka, Lee J Gunderson, Scott E Feeder, Doo-Sup Choi, John D Port
Although the precise drug mechanism of action of acamprosate remains unclear, its antidipsotropic effect is mediated in part through glutamatergic neurotransmission. We evaluated the effect of 4 weeks of acamprosate treatment in a cohort of 13 subjects with alcohol dependence (confirmed by a structured interview, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) on proton magnetic resonance spectroscopy glutamate levels in the midline anterior cingulate cortex (MACC). We compared levels of metabolites with a group of 16 healthy controls...
December 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27729866/methanolic-extract-of-morinda-citrifolia-l-noni-unripe-fruit-attenuates-ethanol-induced-conditioned-place-preferences-in-mice
#16
Yasmin Khan, Vijayapandi Pandy
Phytotherapy is an emerging field successfully utilized to treat various chronic diseases including alcohol dependence. In the present study, we examined the effect of the standardized methanolic extract of Morinda citrifolia Linn. unripe fruit (MMC), on compulsive ethanol-seeking behavior using the mouse conditioned place preference (CPP) test. CPP was established by injections of ethanol (2 g/kg, i.p.) in a 12-day conditioning schedule in mice. The effect of MMC and the reference drug, acamprosate (ACAM), on the reinforcing properties of ethanol in mice was studied by the oral administration of MMC (1, 3, and 5 g/kg) and ACAM (300 mg/kg) 60 min prior to the final CPP test postconditioning...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27692188/a-naturalistic-evaluation-of-extended-release-naltrexone-in-clinical-practice-in-missouri
#17
Paul Crits-Christoph, Hannah M Markell, Mary Beth Connolly Gibbons, Robert Gallop, Christie Lundy, Mark Stringer, David R Gastfriend
The purpose of this study was to compare the naturalistic outcomes of individuals with alcohol or opioid use problems who were treated with extended-release naltrexone (XR-NTX) to those treated with psychosocial treatment only and also to those treated with other medication-assisted therapies in Missouri during 2010 to 2011. We analyzed intake and discharge data collected as part of SAMHSA's Treatment Episode Data Set assessments. Patients who received XR-NTX during their treatment episode were compared, for those reporting alcohol (but not opioids) as their problem (N=21,137), to those who received oral naltrexone, acamprosate, and psychosocial treatment only, and for those who reported opioids as a problem (N=8996), to those receiving oral naltrexone, buprenorphine/naloxone, and psychosocial treatment only...
November 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27633982/multifaceted-academic-detailing-program-to-increase-pharmacotherapy-for-alcohol-use-disorder-interrupted-time-series-evaluation-of-effectiveness
#18
Alex H S Harris, Thomas Bowe, Hildi Hagedorn, Andrea Nevedal, Andrea K Finlay, Risha Gidwani, Craig Rosen, Chad Kay, Melissa Christopher
BACKGROUND: Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. METHODS: An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate...
September 15, 2016: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/27534440/discussing-prevalence-impacts-and-treatment-of-substance-use-disorders-in-athletes
#19
Felipe Gil, Arthur Guerra de Andrade, João Maurício Castaldelli-Maia
The consumption of alcohol, tobacco, and other drugs has become a concern in high-performance athletes. Professional athletes are more exposed to drugs than the general population. Although some drugs are unquestionably detrimental to performance, several studies have nevertheless shown evidence of increased consumption of these substances within this sub-population. This review aimed to elucidate alcohol, tobacco, cocaine, cannabis, and opioid use among high-performance athletes, discussing the prevalence of substance use, its impacts, and alternatives to treatment in this special population...
August 18, 2016: International Review of Psychiatry
https://www.readbyqxmd.com/read/27484692/are-alcohol-anti-relapsing-and-alcohol-withdrawal-drugs-useful-in-cannabinoid-users
#20
Patrycja Kleczkowska, Irena Smaga, Małgorzata Filip, Magdalena Bujalska-Zadrozny
Cannabinoids are still classified as illegal psychoactive drugs despite their broad and increasingly acknowledged therapeutic potential. These substances are most famous for their wide recreational use, particularly among young adults to either alter the state of consciousness, intensify pleasure induced by other psychoactive substances or as an alternative to the previously abused drugs. It is important to emphasize that cannabinoids are often taken together with a variety of medications intended for the treatment of alcohol use disorder (AUD) or alcohol withdrawal syndrome (AWS)...
November 2016: Neurotoxicity Research
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