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The New England Journal of Medicine
In this cohort study of insurance data over an 18-year period covering more than 15,000 pregnancies that involved methadone or buprenoprine use, buprenorphine in pregnancy was associated with a lower risk of adverse neonatal outcomes versus methadone use. However, the risk of adverse maternal outcomes was similar.
Internal Medicine December 6th 2022
MedPage Today
By 2018, gabapentin and opioids were prescribed in an overlapping manner in 7.6% of prescriptions. Prescribers are likely responding to restrictions on opioid prescribing put in place during the opioid epidemic. Increased co-prescribing was most frequently done under the direction of a pain specialist. Still, the effectiveness of the concurrent prescribing of opioids and gabapentin is uncertain and potentially dangerous because of an association with all-cause and drug-related hospitalizations.
MDLinx
Many drugs of abuse increase orexin production in both animal and human brains. Blocking the orexin system reverses addiction in animals. Orexin levels normally cycle in a circadian rhythm, with additional activation when under stress. Opioids, cocaine, alcohol, and other substances activate the cells that produce orexin, but don’t deactivate them. They stay on constantly, producing high levels of orexin that drive the desire for another hit. Anti-orexin insomnia medications might be of benefit in treating addiction.
Internal Medicine November 29th 2022
Clinical Advisor
This overview and discussion highlights the learnings gleaned during practice in a ketamine service unit. Discussion points include treatment considerations for the two entities, switching from IV to intranasal, and a collection of pearls.
Psychiatry November 8th 2022
CMEZone.com
Part 1—Pain Management Fundamentals Following completion of this activity (1.0 AMA PRA Category 1 Credit™, 1.0 AANP credit, 1.0 ACPE credit, 1.0 ANCC credit), the participant should be able to: Explain the importance of comprehensive pain education Outline the fundamental concepts of pain management, such as pain definitions and pain mechanisms. Examine patients who are in pain, including identifying risk factors for substance abuse and addiction. Discuss the various pain-management approaches, including nonpharmacologic and pharmacologic (non-opioid and opioid analgesic) therapies.
Clinical Pharmacology October 27th 2022
Northwestern Medicine
Prior research has revealed a potential link between damage to specific parts of the brain and repetitive addictive behaviors. In this report, with findings published in Nature Medicine, the investigators found that lesions that disrupted smoking and alcohol addiction behaviors occurred in many different brain locations and were characterized by a specific pattern of brain connectivity.
Neurology October 25th 2022