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addiction management

Prabha S Chandra, Lakshmi Shiva, Madhuri H Nanjundaswamy
PURPOSE OF REVIEW: India has experienced rapid urbanization in the last few decades. This review focuses on recent research related to the effects of urbanization on mental health with a specific focus on various population groups in urban India. RECENT FINDINGS: With a specific focus on recent research undertaken amongst special populations such as youth, women and the elderly, the findings demonstrate increasing rates of substance use and technology addiction among youth; high self-harm rates in various groups such as adolescents and women; the effects of violence and abuse on the mental health of women; psychological distress among the elderly in modern urban India...
March 9, 2018: Current Opinion in Psychiatry
Jenna L Butner, Curtis Bone, Caridad C Ponce Martinez, Grace Kwon, Mark Beitel, Lynn M Madden, Madeline H Bono, Anthony Eller, Declan T Barry
BACKGROUND: Despite high rates of chronic pain among their patients, opioid agonist treatment (OAT) counselors report an absence of training to manage chronic pain. METHODS: A multidisciplinary team developed a tailored training for counselors to screen and address chronic pain via a brief psychosocial intervention, and implemented it with 52 addiction counselors. Data on knowledge (9 true-false items) as well as attitudes, interest, and perceived ability (scored on 5-point Likert-type scales) were collected from counselors before (pre-test), after (post-test) training, and after 6 months (follow-up)...
March 9, 2018: Substance Abuse
Georgia Smith, Hannah Farrimond
Amid fears about the medicalisation of old age, the high prevalence of sleeping medication use in older cohorts is a significant public health concern. Long-term use is associated with a plethora of negative effects, such as cognitive impairment and risk of addiction. However, little is known about the lived experience of older adults using sleeping medication longer term. Episodic interviews lasting approximately 90 minutes were conducted with 15 independently living adults, aged 65-88 years, who were using sedative-hypnotic or tricyclic sleeping medication for more than 11 years on average...
March 1, 2018: Health (London)
Lello Tesema, Jeffrey Marshall, Rachel Hathaway, Christina Pham, Camille Clarke, Genevieve Bergeron, James Yeh, Michael Soliman, Danny McCormick
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs provision of OBOT and addiction medicine training. METHODS: We conducted a survey of residency program directors (RPD) at all U.S. residency programs in internal medicine, family medicine and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPD's beliefs about OBOT and potential barriers to providing OBOT training...
March 7, 2018: Substance Abuse
Ashish Joshi, Sushil Falodia, Naveen Kumar, R L Solanki
Strictures of the small intestine have been attributed many causes of Crohn's disease, nonsteroidal anti-inflammatory drugs, neoplastic, post-surgical, and corrosive ingestion. Opium as a cause of small intestine strictures has not been described. Six cases of opium addicts diagnosed with small intestine strictures were selected after excluding the possible etiology of strictures. Investigations like upper gastrointestinal endoscopy, colonoscopy (in patients with small intestinal obstruction), barium meal follow-through, and histopathology of strictures were done in all patients...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Ana Marques, Franck Durif, Pierre-Olivier Fernagut
Impulse control disorders (ICD) are frequent side effects of dopamine replacement therapy (DRT) used in Parkinson's disease (PD) with devastating consequences on the patients and caregivers. ICD are behavioural addictions including compulsive gambling, shopping, sexual behaviour, and binge eating that are mainly associated with dopamine D2/D3 agonists. Their management is a real clinical challenge due to the lack of therapeutic alternative. Clinical studies have identified demographic and clinical risk factors for ICD such as younger age at disease onset, male gender, prior history of depression or substance abuse, REM sleep behaviour disorders and higher rate of dyskinesia...
March 7, 2018: Journal of Neural Transmission
Caitlin V Bucher, A J Day, Maria Carvalho
Since the number of prescriptions for opioid medications have continued to rise, there have been questions about the safety of using opioids in pain management. Traditionally, opioid analgesics were reserved for a few select conditions, such as terminal illness and surgery, but currently opioids have been readily prescribed for multiple conditions. The objective of this manuscript is to clarify the current state of opioid use and to discuss alternative transdermal analgesic therapies in pain management. Transdermal compounded medications are patient-specific and customizable to include different types of drugs, in various dosage strengths, that are to be delivered simultaneously in one application...
January 2018: Journal of Opioid Management
Gina C Dobbs, Susanne A Fogger
In the wake of epidemic of opioid overdoses in the United States, patients who are receiving treatment for chronic pain with opioid have come under increasing scrutiny. The Centers for Disease Control and Prevention issued a guideline for managing chronic pain in 2016, which makes recommendations for opioids based on current evidence. This review will highlight key components of the guideline including differentiating addiction from dependence to assist nurses to better inform patient care in managing chronic pain...
January 2018: Journal of Addictions Nursing
Laura M Anderson, Thomas P Chacko
Binge eating disorder, food addiction, and dysregulated overeating are common among people with severe obesity and prevalent among bariatric surgery populations. These problematic eating habits share commonalities with other addictions. Effective, holistic self-management is needed to promote long-term weight loss and psychosocial adjustment among patients who are severely obese who undergo surgery, especially those with clinically remarkable levels of binge eating, food addiction, or dysregulated overeating...
January 2018: Journal of Addictions Nursing
Jenna Goesling, Lewei A Lin, Daniel J Clauw
PURPOSE OF REVIEW: Chronic pain impacts millions of people in the USA. At the heart of the problem of chronic pain remains the complex psychosocial aspects associated with living with chronic pain. Given the overlap between chronic pain and mental health, a promising treatment approach is to improve how we integrate psychiatry into pain management. RECENT FINDINGS: Treatment of chronic pain and comorbid mental health issues requires a multidisciplinary approach...
March 5, 2018: Current Psychiatry Reports
Sara Faccidomo, Katarina S Swaim, Briana L Saunders, Taruni S Santanam, Seth M Taylor, Michelle Kim, Grant T Reid, Vallari R Eastman, Clyde W Hodge
RATIONALE: There is a clear need for discovery of effective medications to treat behavioral pathologies associated with alcohol addiction, such as chronic drinking. OBJECTIVE: The goal of this preclinical study was to assess effects of chronic alcohol drinking on the nucleus accumbens (NAcb) proteome to identify and validate novel targets for medications development. MATERIALS AND METHODS: Two-dimensional difference in-gel electrophoresis (2D-DIGE) with matrix-assisted laser desorption ionization tandem time-of-flight (MALDI-TOF/TOF) was used to assess effects of chronic voluntary home-cage (24-h access) alcohol drinking on the NAcb proteome of C57BL/6J mice...
March 3, 2018: Psychopharmacology
Athena K Petrides, Stacy E F Melanson, Michalis Kantartjis, Rachel D Le, Christiana A Demetriou, James G Flood
BACKGROUND: Oral fluid (OF) has become an increasingly popular matrix to assess compliance in pain management and addiction settings as it reduces the likelihood of adulteration. However, drug concentrations and windows of detection are not as well studied in OF as in urine (UR). We compared the clinical utility and analytical performance of OF and UR as matrices for detecting common benzodiazepines and opioids. METHODS: OF and UR concentrations of 5 benzodiazepines and 7 opioids were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 263 paired OF and UR specimens...
February 27, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Diane M Flynn, Linda H Eaton, Honor McQuinn, Ashley Alden, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation...
December 2017: Contemporary Clinical Trials Communications
Hui Han, Jing Ying Zhang, Yih-Ing Hser, Di Liang, Xu Li, Shan Shan Wang, Jiang Du, Min Zhao
BACKGROUND: Mobile health technologies have been found to improve the self-management of chronic diseases. However, there is limited research regarding their feasibility in supporting recovery from substance use disorders (SUDs) in China. OBJECTIVE: The objective of this study was to examine the feasibility of a mobile phone-based ecological momentary assessment (EMA) app by testing the concordance of drug use assessed by the EMA, urine testing, and a life experience timeline (LET) assessment...
February 27, 2018: JMIR MHealth and UHealth
M R Hoyt, U Shah, J Cooley, M Temple
OBJECTIVES: Management of labor analgesia and post-cesarean delivery pain is challenging in the patient taking buprenorphine as opioid addiction maintenance therapy. We observed whether substituting clonidine for fentanyl in an epidural solution would provide adequate analgesia for labor and after cesarean delivery. METHODS: We substituted our standard 2 µg/mL fentanyl in 0.0625% bupivacaine epidural solution with 2 µg/mL clonidine in 0.0625% bupivacaine, or 1...
January 31, 2018: International Journal of Obstetric Anesthesia
Andrew H Rogers, Jafar Bakhshaie, Hantin Lam, Kirsten J Langdon, Joseph W Ditre, Michael J Zvolensky
Pain problems are of significant public health concern, and with opioid-related problems and death due to overdose at an all-time high, there is significant public health importance to identify risk factors that link instances of pain to opioid misuse among persons with pain whether or not they have been prescribed opioids for pain management. Severe pain and pain-related problems have been associated with increased risk for opioid misuse, and recent research indicates that pain-related anxiety (worry about the negative consequences of pain) may contribute to a more debilitating pain experience...
February 26, 2018: Cognitive Behaviour Therapy
C S Andreassen, S Pallesen, T Torsheim, Z Demetrovics, M D Griffiths
BACKGROUND: Research into problematic tanning (or 'tanning addiction') has markedly increased over the past few years. Although several excessive tanning instruments exist, most of these are psychometrically poor, not theoretically anchored, and have mainly been used on small samples. OBJECTIVE: Against this background, a new tanning addiction scale was developed based on a specific theoretical approach utilising core addiction criteria. METHODS: A scale comprising seven items (i...
February 25, 2018: British Journal of Dermatology
Lauren Folgosa Cooley, Sandra B Barker
The use of canine-assisted therapy (CAT) in healthcare is expanding and the purpose of this review is to highlight its potential use in the surgical patient. While CAT literature to date has detailed widespread benefits in blood pressure control and improving pain, anxiety, and stress, little research has been performed specifically in surgical patients who may benefit significantly from CAT interventions. Critical points highlighted herein are as follows: (1) Hypertension is common and significantly increases morbidity and mortality associated with elective surgery...
February 24, 2018: Alternative Therapies in Health and Medicine
Sabrina Rossi, Giovanna Finocchiaro, Silvia Marchetti, Luca Toschi, Armando Santoro
Despite efforts, brain metastases (BM) remain a critical issue in the management of patients affected by non-small-cell lung cancer (NSCLC). To date, radiotherapy is still considered the gold standard treatment; on the other hand, systemic chemotherapeutical agents are not so often an effective therapy for BM, whereas targeted agents in oncogene-addicted disease have shown a good activity also on BM. Anti-programmed death-1/programmed death ligand-1 agents represent a new valid therapeutic strategy for NSCLC as well as for several tumor types, but their efficacy on patients with BM is still unclear mainly due to the strict selection criteria adopted in clinical trials...
April 2018: Immunotherapy
Vijay Kata, Matthew B Novitch, Mark R Jones, Best O Anyama, Erik M Helander, Alan D Kaye
PURPOSE OF REVIEW: The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. RECENT FINDINGS: There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties...
February 19, 2018: Current Opinion in Supportive and Palliative Care
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