Articles related to ADDICTION MEDICINE

A 37-year-old man presented with persistent swelling, limited range of motion, and loss of hand dexterity in both hands. He had a history of IV drug use, including opiates and methamphetamine. The examination showed diffuse swelling without joint inflammation. Lab tests were normal, and imaging revealed soft-tissue swelling. The diagnosis was puffy hand syndrome, a common complication of IV drug use. Treatment options are mainly symptomatic, including discontinuation of IV drug use and the use of low-stretch bandages and compression gloves. Puffy hand syndrome, often unrecognized by general practitioners, should be considered in patients with swelling and limited hand function who have a history of IV drug use. The syndrome involves progressive fibrosis of subcutaneous tissues due to repeated injection-induced vascular and dermal sclerosis. Diagnosis is based on clinical presentation, history, and evaluation ruling out other conditions. Treatment focuses on symptomatic relief and cessation of IV drug use.

NEW YORK CITY | THE GLASSHOUSE CHELSEASATURDAY, JUNE 24, 2023 In a comprehensive in-person setting, psychiatrists will get current, clinically relevant, and practice-based updates. This full-day conference will feature interesting presentations conducted by renowned thought leaders in schizophrenia, postpartum depression, major depressive disorder, ADHD, and addiction. Each session will include a patient perspective to ensure professionals obtain practical, real-world understanding.

Implementing trauma-informed care (TIC) in dental clinics can greatly improve the patient experience and health outcomes. When patients have been exposed to adverse childhood experiences (ACEs), it increases their risk of long-term health issues. By acknowledging these experiences, we can engage patients better and avoid re-traumatizing them. ACEs are closely linked to poor dental health, with higher rates of tooth loss and the need for restorations. Surprisingly, TIC is not routinely taught in undergraduate education. TIC involves understanding trauma signs, integrating knowledge into the dental practice, and focusing on safety, trust, support, collaboration, empowerment, and cultural considerations. To implement TIC, create a soothing environment, validate patient concerns, give them control, explain procedures, and obtain consent. Pre-screening for trauma history and training staff to recognize and de-escalate re-traumatization are crucial. Dental professionals can promote a culture of awareness, understanding, and action by prioritizing empathy, understanding patient beliefs, and providing compassionate care. It’s important to assume all patients may have experienced adverse events and apply trauma-informed care as standard practice. By doing so, we improve our patients’ oral health-related quality of life.

This 15-year multicohort survey of legal and illicit drug use among teens found that middle schools and high schools with higher levels of prescription stimulant therapy for ADHD tended to have the highest rates of prescription stimulant misuse. Other discovered associations included more parents with higher levels of education, non-Northeastern location, and more non-Hispanic White students.

The study authors highlight that buprenorphine can be safely started in an emergency department without triggering withdrawal, even among individuals who use stronger opioids like fentanyl. They note, “this study provides further evidence that all emergency department physicians can and should be using buprenorphine to help individuals take the first steps into treatment and toward recovery.”

Originally published in JAMA Psychiatry, a broad-based study shows nearly 7% of OUD patients are adding buprenorphine to urine sample to fake treatment adherence. Buprenorphine spiking suggests to the physician that the treatment plan is not working—especially in patients continuing illicit drug use.