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NEWS
Mentally Ill Face High Risk for Homicide (CME/CE)
www.medpagetoday.com - 3/5/13
AAP Outlines Fetal Damage with Drug Abuse (CME/CE)
www.medpagetoday.com - 2/24/13
Can't Pin Kid's Substance Abuse on Mom's Smoking (CME/CE)
www.medpagetoday.com - 11/4/12
 
PATIENT RESOURCES
Depression: MedlinePlus
www.nlm.nih.gov - 3/20/13
Women's Health: MedlinePlus
www.nlm.nih.gov - 3/18/13
Seniors' Health: MedlinePlus
www.nlm.nih.gov - 3/15/13
 
CLINICAL TRIALS
Middle School to High School Transition Project: Depression and Substance Abuse Prevention
www.clinicaltrials.gov -
Middle School to High School Transition Project: Depression and Substance Abuse Prevention.
Substance Abuse Self-Help Group Referral: Outcomes and Services Use
www.clinicaltrials.gov -
Substance Abuse Self-Help Group Referral: Outcomes and Services Use. This study has been completed.
Study Comparing Two Types of Psychotherapy for Treating Depression and Substance Abuse
www.clinicaltrials.gov -
Study Comparing Two Types of Psychotherapy for Treating Depression and Substance Abuse.
 
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Substance Abuse
 
LATEST FEATURES
September 6, 2011
Substance Use Disorders in Patients With Anxiety Disorders
In this article, we attempt to leverage state-of-the-art research findings to provide empirically informed perspectives and practices related to these issues. More »
September 6, 2011
Anxiety Disorders With Comorbid Substance Abuse
Anxiety disorders occur in 18% to 28% of the US general population during any 12-month period. In anxiety disorder, there is a 33% to 45% 12-month prevalence rate for a comorbid substance use disorder (SUD). More »
August 16, 2011
Is It Possible to Stop Smoking During Substance Abuse Treatment?
What is your experience with patients who may decide to quit multiple substances simultaneously? Is it overambitious? More »
July 11, 2011
Substance Abuse Quiz
Which tool is helpful in screening for sexual addiction? Is the symptom severity in women treated for substance abuse generally equivalent to that of... More »
June 8, 2011
Novel Therapies for Cognitive Dysfunction Secondary to Substance Abuse
Advances in the fields of neuropsychological assessment and neuroimaging have enormously expanded our knowledge about the profile and severity of cognitive deficits in patients with substance use disorders. More »
May 24, 2011
Self-medication for Anxiety Increases Risk for Substance Use Disorders
Patients with anxiety disorders who self-medicate with alcohol or drugs may be increasing their risk for... More »
January 20, 2011
The Link Between Substance Abuse, Violence, and Suicide
Emerging research suggests that some individuals with particular types of substance use and abuse may be more likely to engage in suicidal behaviors. For example, those who use opiates, cocaine, or sedatives may have a noticeably higher risk of suicide than those who use other drugs. More »
January 10, 2011
Does Research Support “Craving” as a Core Symptom of Substance Use Disorders in DSM-5?
Recently, the Substance Use Disorder Work group of the DSM-5 announced the inclusion of “craving” in the diagnostic criteria for all substance use disorders despite its lack of empirical support from the very analyses conducted by that Workgroup. In addition, no detailed literature review supports... More »
September 24, 2010
Substance Abuse Quiz
Are a history of complicated pneumonia and possible obstructive sleep apnea part of the DSM-IV exclusionary... More »
August 13, 2010
Substance Abuse and HIV: Treatment Challenges
Substance abuse, especially injection drug abuse, is often associated with chronic infectious diseases, including HIV infection, hepatitis B, hepatitis C, and tuberculosis. Delivery of effective treatment for these chronic conditions can be very challenging in patients who continue to abuse... More »
Showing 11 - 20 of 77 results.
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JOURNAL SCAN
Major depression in pregnancy and post partum associated with anxiety disorders and substance use
ebn.bmj.com - 9/20/12
Implications for practice and research

  • Women are vulnerable to depression and anxiety during pregnancy and post partum, yet only one in four seek help.

  • Clinical management of mothers experiencing depression should assess for substance abuse, unmet needs and psychiatric co-morbidities.

  • Population-based studies can determine prevalence but cause and effect is best shown through intervention-based randomised controlled trials.

    • Financial reinforcers for improving medication adherence: findings from a meta-analysis.
    pubmed.gov - 9/1/12
    Increasingly, financial reinforcement interventions based on behavioral economic principles are being applied in health care settings, and this study examined the use of financial reinforcers for enhancing adherence to medications.|Electronic databases and bibliographies of relevant references were searched, and a meta-analysis of identified trials was conducted. The variability in effect size and the impact of potential moderators (study design, duration of intervention, magnitude of reinforcement, and frequency of reinforcement) on effect size were examined.|Fifteen randomized studies and 6 nonrandomized studies examined the efficacy of financial reinforcement interventions for medication adherence. Financial reinforcers were applied for adherence to medications for tuberculosis, substance abuse, human immunodeficiency virus, hepatitis, schizophrenia, and stroke prevention. Reinforcement interventions significantly improved adherence relative to control conditions with an overall
    Health-care service utilization in substance abusers receiving contingency management and standard care treatments.
    pubmed.gov - 8/1/12
    To determine the impact of standard care and contingency management treatments on the utilization of general health-care services by substance abusers. PARTICIPANTS, DESIGN AND MEASUREMENTS: This secondary analysis pooled 1028 treatment-seeking substance abusers from five randomized clinical trials that compared the effects of standard care (SC, n=362) to standard care plus contingency management (CM, n=666). In each trial, subjects in the CM condition showed significantly greater reductions in substance use than their SC counterparts. For each subject, utilization of 15 general health-care services was measured 1 year prior to treatment intake and up to 9 months following treatment intake. Post-intake utilization data were pro-rated to be comparable to the 1-year pre-intake data. Paired t-tests evaluated changes in service utilization pre- and post-intake, and difference-in-differences regression models were used to estimate the impact of CM, compared to SC, on
    BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP.
    pubmed.gov - 7/1/12
    The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short- and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people.
    HIV risk among men who have sex with men who have experienced childhood sexual abuse: systematic review and meta-analysis.
    pubmed.gov - 6/1/12
    Previous research has indicated a high prevalence of childhood sexual abuse (CSA) among men who have sex with men (MSM) in the United States, and has suggested that CSA history is a risk factor for HIV infection in MSM. We conducted a systematic review to identify, synthesize, meta-analyze, and critique the current state of relevant literature. Systematic review methodology was utilized to identify 12 studies that compared MSM with a history of CSA to MSM without a history of CSA on HIV risk indicators including HIV serostatus, sexually transmitted infections (STIs), sexual behaviors, and illicit drug use. Overall, 27.3% (n = 4,263) of the MSM in all included studies (n = 15,622) reported a CSA history. Across the studies that used probabilistic sampling (n = 8,240), the estimated prevalence of CSA was 21.8% (n = 1,800). Meta-analysis indicated that MSM with CSA history were more likely to be HIV positive [odds ratio (OR) = 1.54; 95% confidence interval (CI) = 1.22-1.95)] and to
     
    MEDLINE
    Adolescent substance misuse: neurobiology and evidence-based interventions.
    pubmed.gov - 1/1/13
    This chapter reviews empirical research on risk-factors for adolescent onset of substance use and misuse, with a particular focus on a recent body of literature aimed at understanding the link between early onset substance use, neuropsychological impairment and future addiction risk. The evidence suggests a causal pathway with some studies showing that adolescents might be more sensitive to the neurotoxic effects of substances, which contributes to their heightened addiction vulnerability. While questions remain pertaining to the extent to which cognitive precursors to early onset substance use account for these impairments, the evidence from a few studies suggests that early substance misuse produces some cognitive or emotional processing impairment beyond these premorbid deficits. The possible interaction between premorbid deficits and the effects of substance use on cognitive development might also explain why early onset substance use so rapidly spirals into substance abuse and
    Individuality and contextual influences on drug dependence: a 15-year Prospective longitudinal study of adolescents from Harlem.
    pubmed.gov - 12/24/12
    In this 15-year longitudinal study the authors investigated individual and contextual factors that predispose adolescents from a disadvantaged urban area to drug dependence in adulthood. Adolescents were recruited from schools serving East Harlem in New York City. Of the 838 participants followed to adulthood, 59% were women, 55% were African American, and 45% were Puerto Rican. Self-report data were obtained on externalizing and internalizing problems, substance use, and contextual influences across adolescence and young adulthood. Drug dependence was assessed in adulthood. Multivariate logistic regressions of drug dependence were performed on the whole sample and separately by gender. Each of the domains was associated with adult drug dependence. Although mean gender differences were found, most associations of risk factors with drug dependence did not vary significantly by gender. Treating externalizing and internalizing problems, reducing substance use, and providing coping skills
    Multimorbidity patterns in HIV-infected patients: the role of obesity in chronic disease clustering.
    pubmed.gov - 12/14/12
    Increases in multimorbidity and obesity have been noted in HIV-infected populations in the current treatment era. Patterns of multimorbid disease clustering and the impact of obesity on multimorbidity are understudied in this population.|We examined obesity and multimorbidity patterns among 1844 HIV-infected patients in the UAB 1917 Clinic. Exploratory factor analysis was used to identify the underlying factor structure responsible for clustering. Patterns among the resulting morbidity factors by body mass index (BMI) category were explored. Multivariable logistic regression models were fit to identify predictors of multimorbidity cluster patterns.|The prevalence of multimorbidity was 65% (1205/1844). Prevalence increased with progressive BMI categories from underweight (64%) to obese (79%). Three multimorbidity clusters were identified: "metabolic," including hypertension, gout, diabetes mellitus, and chronic kidney disease (range, 0.41-0.84; P < 0.001); "Behavioral," including mood
    A review of community-based participatory research in child health.
    pubmed.gov - 12/11/12
    To review published studies that use an authentic community-based participatory research (CBPR) approach in child health to highlight the benefits, barriers, and scope of this approach with pediatric populations.|Studies using CBPR in child health were identified using PubMed, Scopus, and Web of Science through MeSH heading and keyword searches. Keywords included "community-based participatory research" and "child," "youth," and "adolescent." Literature reviews and community-placed articles were excluded.|A total of 34 CBPR studies focused on child health were identified and analyzed for this review. The most common child health issue in these studies was obesity/diabetes. Other child health topics included health needs assessments, reproductive health, female health, HIV treatment, physical activity, mental health, maternal/child health, substance abuse, asthma, and youth with disabilities/special healthcare needs. IMPLICATIONS/CONCLUSION: CBPR offers a unique approach for
    The prevalence of employed nurses identified or enrolled in substance use monitoring programs.
    pubmed.gov - 12/10/12
    For over 100 years, nurses' particular work conditions have been anecdotally associated with increases in substance abuse. Reasons include job-related stress and easy access to medications. Current research has suggested that prevalence of nurses with substance use problems is actually similar to, if not less than, that seen in the general population. However, given nurses' proximity to critical patient care, the potential threat to public health, as well as the current shortage of practitioners and problems related to retention, the lack of research on the effectiveness of the two existing treatment protocols (disciplinary and alternative-to-discipline [ATD]) is a pressing issue of concern to the nursing profession.|The aims of this study were to estimate the 1-year prevalence of employed nurses requiring an intervention for substance use problems in the United States and the 1-year prevalence of nurses enrolled in substance abuse monitoring programs and to compare the sum total of
     
    PRACTICE GUIDELINES
    Guide to Clinical Preventive Services, 2010-2011: Section 2 (continued)
    www.ahrq.gov - 8/31/10
    Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
    National Guideline Clearinghouse | Substance Abuse and Mental Health Services Administration (U.S.) (SAMHSA)
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    National Guideline Clearinghouse | Guidelines by Topic: Substance Abuse, Intravenous
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    National Guideline Clearinghouse | Guidelines by Topic: Substance Abuse Detection
    www.guidelines.gov -
    NGC is the National Guideline Clearinghouse.
    National Guideline Clearinghouse | Guidelines for breastfeeding and the drug-dependent woman.
    www.guidelines.gov -
    Guidelines for breastfeeding and the drug-dependent woman.



     
    FROM PHYSICIANS PRACTICE
    Five Steps to Improving Patient Access
    Judy Capko,  May 21, 2013
    Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
    Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
    Marion K. Jenkins,  May 21, 2013
    Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
    Finding Physician Work-Life Balance in the Small Moments
    Jennifer Frank, MD,  May 21, 2013
    At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
    Three Areas to Reduce Costs at Your Medical Practice
    Greg Mertz,  May 19, 2013
    By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
    Dos and Don’ts for Starting a Physician Blog
    Michael Woo-Ming, MD,  May 18, 2013
    Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
     

     
     
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