Addiction medicine

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

Physician blame and vulnerability: novel predictors of physician willingness to work with patients who misuse opioids.

Abstract: Successfully combating the opioid crisis requires patients who misuse opioids to have access to affirming and effective health care. However, there is a shortage of physicians who are willing to work with these patients. We investigated novel predictors of what might be contributing to physicians’ unwillingness to engage with this patient population to better identify and direct interventions to improve physician attitudes. 333 physicians who were board certified in the state of Ohio completed a survey about their willingness to work with patients who misuse opioids. The hypothesized relationships between the proposed predictors and willingness to work with this patient population were tested using multivariate regression, supplemented with qualitative analysis of open-text responses to questions about the causes of addiction. Perceptions of personal invulnerability to opioid misuse and addiction, opioid misuse and addiction controllability, and health care provider blame for the opioid crisis were negatively associated with physician willingness to work with patients who misuse opioids after controlling for known predictors of physician bias toward patients with substance use disorders. Physicians working in family and internal medicine, addiction medicine, and emergency medicine were also more willing to work with this patient population. Distancing oneself and health care professionals from opioid misuse and placing blame on those who misuse are negatively associated with treatment willingness. Interventions to improve physician willingness to work with patients who misuse opioids can target these beliefs as a way to improve physician attitudes and provide patients with needed health care resources.

The hospital treatment of alcoholism and drug addiction

Abstract: Inpatient treatment of alcoholism is an option indicated by certain clinical criteria. The American Society of Addiction Medicine suggests four levels of care, and six assessment dimensions determine which level of care is indicated. An addiction medicine physician can consult with the primary care physician to recommend appropriate placement in difficult cases. Abstinence is a primary goal of treatment; for without abstinence, no other recovery will be possible. The remaining goals of recovery are detoxification, medical evaluation, stabilization of life-threatening emotional issues, education, identification of barriers to recovery, readjustment of behavior toward recovery, and orientation and membership in a self-help group. Successful family contributions can make the difference between success or failure of treatment goals; the role the family plays in recovery is discussed. Treatment for family members is important; the physical, emotional, and spiritual effects on family members can be just as profound on them as they are on the alcoholic. Continuing care maintains the link between the patient and the professional recovery community after discharge and is appropriate for all patients. Extended care allows for structured support of sobriety and often further progress through psychosocial issues identified during the initial treatment phase (i.e., abuse, molestation, unresolved grief). Extended care is indicated for patients requiring further structured assistance in early recovery. A large variety of treatment options are available once the decision has been made to hospitalize the patient.

A Pilot Study of a Telemedicine-based Substance Use Disorder Evaluation to Enhance Access to Treatment Following Near-Fatal Opioid Overdose.

Abstract: The opioid epidemic is a growing public health emergency in the United States, with deaths from opioid overdose having increased five-fold since 1999. Emergency departments (EDs) are the primary sites of medical care after near-fatal opioid overdose but are poorly equipped to provide adequate substance use treatment planning prior to discharge. In many underserved locales, limited access to clinicians trained in addiction medicine and behavioral health exacerbates this disparity. In an effort to improve post-overdose care in the ED, we developed a telemedicine protocol to facilitate timely access to substance use disorder evaluations. In this paper, we describe the conception and refinement of the telemedicine program, our experience with the first 20 participants, and potential implications of the platform on health disparities for individuals with opioid use disorder.

Pandemics and Mental Health: an Unfortunate Alliance.

Abstract: Mental health issues not only affect the person but society as a whole. This is especially apparent during times of pandemics or other social unrest situations as currently seen during the COVID-19 crisis. It can manifest itself as violence (towards or from the mentally ill person), increased substance use, increased overcrowding of our prisons, tackling with comorbid medical conditions which have worsened due to lack of initial attention (a particularly big problem among the mentally ill), increased strain on tax payers, and overall affecting the quality of everyone's life. Furthermore, mental health maladies can cause increase work absenteeism and poor work performance and decreased economic productivity. The stigma associated with mental health also leads to poor funding form policy makers, as there is a lack of forceful advocacy in dealing with these issues. The World Health Organization (WHO) estimates that the loss of productivity due to mental health disability accounts to close to 5% of the gross national product of the European Union (WHO 2019). One of the most crucial causes of lack of mental screening, recognition, and treatment is the limited availability of mental health trained providers. The physician assistant profession is in a unique role to fill this niche as they have been trained as generalists who specialize only when getting trained in their specific field during their employment. Additionally, the fact that PAs do have lateral mobility does lend this profession to meet the needs of society, especially in the psychiatric fields, in a prompt and competent manner. The need for physician assistants (PAs) in psychiatry and addiction medicine is a nationwide trend resulting in existing and emerging shortages of psychiatric and addiction medicine providers. They can provide relatively inexpensive, easily accessible, and good quality care to their clients.