Articles related to ADDICTION/SUBSTANCE ABUSE

The combined analysis showed that therapist-led CBT, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related obsessions and compulsions. Lisdexamfetamine and topiramate reduced weight. SGAs reduced symptoms of depression.

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.

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.

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.

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.

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.