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Addiction medicine

About: Addiction medicine is a research topic. Over the lifetime, 1070 publications have been published within this topic receiving 23685 citations.


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Journal ArticleDOI
TL;DR: The aim of this study is to review the operation of a specialist adolescent drug and alcohol consultation liaison service in a tertiary paediatric hospital.
Abstract: AIM: The aim of this study is to review the operation of a specialist adolescent drug and alcohol consultation liaison service in a tertiary paediatric hospital. METHOD: A retrospective review of patient records was conducted to identify patient characteristics and assess service utilisation. RESULTS: Two hundred adolescents were referred over 4 years. Most presented during mid-adolescence (14-16 years). Alcohol, cannabis and nicotine were the most frequently reported substances, and almost half of referrals involved polysubstance use. Mental health diagnoses and behavioural problems were commonly reported. Almost two-thirds (63.5%) attended an appointment for drug and alcohol assessment and intervention (n = 92) or were referred to appropriate services (n = 35). Adolescents more likely to engage and attend an appointment with the specialist adolescent addiction medicine service included those with amphetamine use, polysubstance use, chronic illness, any mental health diagnosis and mood disorder. Indigenous Australians and those with a history of aggression were more difficult to engage. CONCLUSIONS: Adolescents present to paediatric health settings with drug- and alcohol-related issues, including associated harms. These comprise, but are not limited to, physical and sexual assault, family conflict, mood and behavioural concerns (including psychosis), and forensic issues. Early intervention aims to reduce long-term risks such as dependence in adulthood. Specialist adolescent drug and alcohol services may assist in identifying and engaging these high-risk and often complex young people in developmentally appropriate treatment. Language: en

8 citations

Journal ArticleDOI
TL;DR: In this paper, three factors are important to consider when integrating measurement-based care for opioid use disorders into primary care: integration with other behavioral health and substance use disorders care, the availability of a brief, valid measure that is responsive to change, and implementation in a manner that fosters accurate reporting.
Abstract: Three factors are important to consider when integrating measurement-based care for opioid use disorders into primary care: integration with other behavioral health and substance use disorders care, the availability of a brief, valid measure that is responsive to change, and implementation in a manner that fosters accurate reporting.

8 citations

Journal ArticleDOI
TL;DR: Kleinman et al. as discussed by the authors proposed to use methadone in an acute care setting for the treatment of opioid use disorder (OUD) among hospital inpatients, which can relieve patient suffering and distress and enable patients to remain in the hospital for medically necessary care.
Abstract: Ideas and OpinionsFebruary 2022Treating Opioid Withdrawal in the Hospital: A Role for Short-Acting OpioidsRobert A. Kleinman, MD and Sarah E. Wakeman, MDRobert A. Kleinman, MDCentre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (R.A.K.)Search for more papers by this author and Sarah E. Wakeman, MDDivision of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts (S.E.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-3968 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Controlled Substances Act and associated regulations prohibit U.S. clinicians from prescribing opioids, except buprenorphine, as treatment for opioid use disorder (OUD). Besides creating barriers to OUD treatment, this framework has constrained strategies for treating opioid withdrawal symptoms (OWS). Short-acting opioids are not recommended in U.S. guidelines for OWS management, and patients who receive treatment of OWS are typically provided with buprenorphine, methadone, or nonopioid medications (1).The treatment of OWS among hospital inpatients has 3 principal clinical objectives: 1) relieve patient suffering and distress; 2) enable patients to remain in the hospital for medically necessary care; and 3) facilitate ...References1. American Society of Addiction Medicine. ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update. ASAM; 2020. Google Scholar2. Liebschutz JM, Crooks D, Herman D, et al. Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial. JAMA Intern Med. 2014;174:1369-76. [PMID: 25090173] doi:10.1001/jamainternmed.2014.2556 CrossrefMedlineGoogle Scholar3. Ti L, Ti L. Leaving the hospital against medical advice among people who use illicit drugs: a systematic review. Am J Public Health. 2015;105:e53-9. [PMID: 26469651] doi:10.2105/AJPH.2015.302885 CrossrefMedlineGoogle Scholar4. Simon R, Snow R, Wakeman S. Understanding why patients with substance use disorders leave the hospital against medical advice: a qualitative study. Subst Abus. 2020;41:519-525. [PMID: 31638862] doi:10.1080/08897077.2019.1671942 CrossrefMedlineGoogle Scholar5. Antoine D, Huhn AS, Strain EC, et al. Method for successfully inducting individuals who use illicit fentanyl onto buprenorphine/naloxone. Am J Addict. 2021;30:83-87. [PMID: 32572978] doi:10.1111/ajad.13069 CrossrefMedlineGoogle Scholar6. Hemmons P, Bach P, Colizza K, et al. Initiation and rapid titration of methadone in an acute care setting for the treatment of opioid use disorder: a case report. J Addict Med. 2019;13:408-411. [PMID: 30741835] doi:10.1097/ADM.0000000000000507 CrossrefMedlineGoogle Scholar7. Center for Drug Evaluation and Research. Multi-Discipline Review. U.S. Food and Drug Administration; 2018. Accessed at www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211527Orig1s000MultidisclipineR.pdf on 24 May 2021. Google Scholar8. Ahmed S, Bhivandkar S, Lonergan BB, et al. Microinduction of buprenorphine/naloxone: a review of the literature. Am J Addict. 2021;30:305-315. [PMID: 33378137] doi:10.1111/ajad.13135 CrossrefMedlineGoogle Scholar9. Hydromorphone hydrochloride injection USP. Prescribing information. Sandoz Canada; 2019. Accessed at https://pdf.hres.ca/dpd_pm/00050892.PDF on 24 May 2021. Google Scholar10. Grewal HK, Ti L, Hayashi K, et al. Illicit drug use in acute care settings. Drug Alcohol Rev. 2015;34:499-502. [PMID: 25944526] doi:10.1111/dar.12270 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (R.A.K.)Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts (S.E.W.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-3968.Corresponding Author: Robert A. Kleinman, MD, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4, Canada; e-mail, robert.[email protected]ca.Author Contributions: Conception and design: R.A. Kleinman, S.E. Wakeman.Drafting of the article: R.A. Kleinman, S.E. Wakeman.Critical revision for important intellectual content: R.A. Kleinman, S.E. Wakeman.Final approval of the article: R.A. Kleinman, S.E. Wakeman.Administrative, technical, or logistic support: R.A. Kleinman.This article was published at Annals.org on 23 November 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics February 2022Volume 175, Issue 2Page: 283-284KeywordsDrugsHospital medicineInpatientsOpioid addictionOpioid use disorderOpioidsOutpatient clinicsOutpatientsPatientsSafety ePublished: 23 November 2021 Issue Published: February 2022 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

8 citations

Journal ArticleDOI
TL;DR: The potential impact of recent legislation when fully implemented to end the real and perceived segregation of addiction and substance abuse disorders from mainstream healthcare and insurance reimbursement is discussed.

8 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
202324
202251
202175
202065
201946
201827