Addiction medicine

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

Exploring the opportunities of Proposition 36.

Abstract: This article must be considered a work-in-progress. The California Society of Addiction Medicine seeks to briefly enumerate some guiding principles for initial consideration. It is the Society's hope that the issues presented here can promote further discussion and planning in collaboration with our colleagues in the criminal justice system, the community of California treatment providers, and other social service agencies, and in future consultations with experts at the National Institutes of Health and other relevant research and treatment agencies in California, Washington, and elsewhere.

Qualitative Assessment of Clerkship Students' Perspectives of the Topics of Pain and Addiction in their Preclinical Curriculum.

Abstract: A majority of physicians feel poorly trained in the treatment of chronic pain and addiction. As such, it is critical that medical students receive appropriate education in both pain management and addiction. The purpose of this study was to assess the pre-clinical curriculum in pain medicine and addiction from the perspective of students after they had completed their pre-clinical training and to assess what they perceived as the strengths and weaknesses of their training. The authors conducted focused interviews among clinical medical students who had completed at least 6 months of clerkships. The interviews targeted the students’ retrospective opinions about the pre-clinical curriculum and their preparedness for clinical encounters with either pain or addiction-related issues during their rotations. Coders thematically analyzed the de-identified interview transcripts, with consensus reached through discussion and code modification. Themes that emerged through the focused interviews included: fragmented curricular structure (and insufficient time) for pain and addiction medicine, not enough specific treatment strategies for pain or addiction, especially for complex clinical scenarios, and lack of a trained work-force to provide guidance in the management of pain and addiction. This study demonstrated the feasibility of gathering student perspectives to inform changes to improve the pre-clinical curriculum in pain and addiction medicine. Students identified multiple areas for improvement at the pre-clerkship level, which have informed updates to the curriculum. More research is needed to determine if curricular changes based on student feedback lead to improved learning outcomes.

[Health care needs of cocaine users in Hungary: results of a qualitative study].

Abstract: INTRODUCTION: There have not been any substantive collection of data on cocaine users in Hungary although there were numerous indications that a cocaine problem may exist. AIM: In the frame of the project entitled "Support Needs for Cocaine and Crack Users in Europe" the aim of the authors was to identify the qualitative characteristics of Hungarian cocaine users. STUDY GROUP AND METHODS: In addition to a quantitative study of 210 cocaine users, we selected nine subjects by random sampling and conducted problem-oriented depth interviews with them. Three of the subjects belonged in the party group (weekend use, social integration), three in the scene group (part of the marginal drug-using subculture) and three in the therapy group (undergoing treatment for drug use at the time of the study). The main thread of the interview covered the following main aspects: 1. Drug-using behaviour--reduction, termination or continuation of use; 2. Use of support services; 3. Experiences with addiction medicine services; 4. Support needs. RESULTS: The interviews decide to give up cocaine use when they perceive the disproportionately high costs of cocaine use on the basis of simple cost-benefit calculation. Apart from the existential costs, the main costs include sleep disorder, psychological and psychiatric symptoms and problems (depression, sensitivity, paranoid state, panic, anxiety, sexual disorders, etc.), symptoms reminiscent of serious cardiac disorders (chest pain) and interpersonal problems. They were able to reach professional help by chance, through friends. Cocaine users do not favour state health services, they are mistrustful of the handling of data. For this reason they prefer private doctors. They seek medical help not for detoxification but rather to prevent a relapse, generally for problems arising after withdrawal. Psychological help dominates in the assistance given. Heroin-dependent cocaine users seek help from the staff in the place where methadone treatment is given. Much depends in the management of abstinence on the degree of involvement in the subculture, emotional support, the attitude to work, the extent of disorders arising after withdrawal, and the quality of the personal relationship formed with the doctor. Most cocaine users require complex multi-disciplinary treatment. CONCLUSION: Cocaine use can be characterised along the dimensions of work, self-image, conspiracy, openness, criminality, basic drug, the negative or positive reinforcing function of cocaine: Dr. Jekyll and Mr. Hyde type, Carmen type, Pinocchio type. The Dr. Jekyll and Mr. Hyde type is characterised by a double life, the Carmen type is the prototype of the sovereign female placing the emphasis on sexuality, the Pinocchio type is a trouble-making, criminal risk-seeker. While some of those within the Dr. Jekyll and Mr. Hyde type are open to help and others do not seek help, the Carmen type is open and the Pinocchio type closed to help unless their legal interests require the opposite.

L'alcoologie de liaison. Proposition de repères cliniques

Abstract: In France, the development of care for persons suffering from substance use disorders has a hospital side, whose liaison activity is one of the legs. Developed on the model of liaison psychiatry, alcohol liaison medicine is one of the first terms of the development of addiction medicine at the hospital. If many organizational references can be found to develop a liaison and care team in addiction medicine (ELSA), clinical markers are scarce to help caregivers to develop an atypical care relationship, according to the conditions of brevity or uniqueness of the meeting, and the need to establish a link and quickly undo it and pass on to other professionals. We suggest to approach in ten points the essential structural elements for a clinical activity in alcohol liaison medicine, considering successively the requirements for: talking about alcohol with someone who asks for nothing, daring to speak about alcohol and other substances, responding to emergencies, coping with pressures and constraints of care, working with repetition and failure, screening and taking in account the addictive disorders, avoiding the trap of causality, intervening in a limited time, waiving to measure the effects of his/her interventions, and finally working with all the care providers.