4.3 Million Americans Working Full Time Had an Anxiety Disorder in the Past Year Substance Abuse and Mental Health Administration This report has two elements of interest to the addiction field: 1) as background, the report describes the single most common rationale that those with substance use disorders give for their use of substances, anxiety (4.3 million adult U.S. workers); 2) it showcases SAMHSA’s Illness Management and Recovery Evidence-Based Practice toolkit, with embedded link, a program of multiple documents and an orientation PowerPoint that describes a participatory approach to management of chronic mental illness. While most obviously intended for those with chronic mental illness other than substance use disorders (SUD), the toolkit certainly has applicability to those with serious mental illness (SMI) comorbidity. The adaptation to those with SUD alone may require more imagination, but is conceptually valid.
Editor’s Comments William Haning, MD, FASAM, DFAPA The federally-supported study involving medication assisted treatment (MAT) cited below [“Only 25 Percent of Treatment Facilities Offer Medications for Alcohol Use Disorder: Study”] provides an opportunity to discuss the evolution of treatment facilities in this country. William L.White’s Slaying the Dragon, Chestnut Health 1998 (out of print) remains the authoritative history of treatment practices in the U.S. Taken in conjunction with works by Roy Porter (deceased) describing medical care institutions in England, it becomes evident that most of the standards
of residential care have arisen in the lay community...
Mobile Phone Use Patterns and Preferences in Safety Net Office-Based Buprenorphine Patients Journal of Addiction Medicine (free ASAM member resource) Mobile phone and text messaging use patterns and preferences among this sample of office-based buprenorphine participants highlight the potential of adopting patient-centered mobile phone-based interventions in this treatment setting. While this survey is valuable for establishing the utility of text messaging as an adjunct to patient care, it raises questions concerning the level of security of patient documents using this technology. It may consequently demonstrate an unintended consequence of the HIPAA, and invites an examination of safeguards.
RAND Releases Report on State Insights on Marijuana Legalization Rand Corporation Vermont commissioned the 218 page report, “Considering Marijuana Legalization: Insights for Vermont and Other Jurisdictions,” to learn about the various consequences of legalizing marijuana. The report does not provide an opinion on legalization, but rather provides a factual basis to discuss the effects of various changes to state marijuana laws. The report provides an overview of marijuana policy generally, marijuana policy in Vermont, consequences of marijuana use on health and the criminal justice system, taxation and regulatory schemes, and much more. Using lessons from other states, the report provides insight into how states have dealt with the complexities of marijuana policies.
Announcement of Requirements and Registration for the Opioid Overdose Prevention Challenge Substance Abuse and Mental Health Services Administration Briefly, this is a contest to develop an app, with three prizes, $5K, $7.5K, and $10K, cash. The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued a challenge to help prevent opioid overdose and support recovery through innovative, software-based solutions that help people know the signs of opioid use, understand what to do if a family member or friend overdoses on heroin or opioid pain medications, and support treatment for opioid addiction and recovery.
Alcohol-Related Risk of Suicidal Ideation, Suicide Attempt, and Completed Suicide: A Meta-Analysis Plos One There is sufficient evidence that alcohol use disorder (AUD) significantly increases the risk of suicidal ideation, suicide attempt, and completed suicide. Therefore, AUD can be considered an important predictor of suicide and a major source of premature death. This study has value in population-protection public health planning.
More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations Annals of Family Medicine This article buttresses the concept of the single-POC provider, popular elsewhere. Comprehensiveness is lauded as 1 of the 5 core virtues of primary care, but its relationship with outcomes is unclear. We measured associations between variations in comprehensiveness of practice among family physicians and healthcare utilization and costs for their Medicare beneficiaries.
Maine Bill Aims to Make Abuse-Deterrent Painkillers More Affordable National Public Radio The problem of opiate addiction in Maine is one that state Rep. Barry Hobbins knows something about. "One of my family members has been struggling with this dreaded addiction of opiates for six years," he says. So when pharmaceutical company Pfizer — which makes opioids that have abuse-deterrent properties — asked Hobbins to sponsor a bill that would require insurance companies to cover these more expensive drugs at the same level as other opioids, he agreed. Concern is warranted, whether the legislation will have the desired effect.
Only 25 Percent of Treatment Facilities Offer Medications for Alcohol Use Disorder: Study Partnership for Drug-Free Kids Only 25 percent of all substance abuse treatment facilities offer at least one medication to treat alcohol use disorders (AUD), a new study finds. Although four drugs have been approved by the Food and Drug Administration for this purpose, many patients lack access to evidence-based treatments that can potentially benefit them, the researchers say. Researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA) analyzed national data from a 2012 census of more than 14,000 U.S. substance abuse treatment facilities to see how many facilities offered AUD medication. They looked at facilities that offered inpatient, residential or outpatient care, or a combination.
Chronic Stress Induces Anxiety via an Amygdalar Intracellular Cascade that Impairs Endocannabinoid Signaling Neuron Collapse of endocannabinoid (eCB) signaling in the amygdala contributes to stress-induced anxiety, but the mechanisms of this effect remain unclear. eCB production is tied to the function of the glutamate receptor mGluR5, itself dependent on tyrosine phosphorylation. Herein, the authors identify a novel pathway linking eCB regulation of anxiety through phosphorylation of mGluR5. Mice lacking LMO4, an endogenous inhibitor of the tyrosine phosphatase PTP1B, display reduced mGluR5 phosphorylation, eCB signaling, and profound anxiety that is reversed by genetic or pharmacological suppression of amygdalar PTP1B.
What is Recovery? ASAM Magazine There has not been a way of measuring the concept of recovery. This changed with the November publication of the results of the NIH-funded "What Is Recovery?" study in the Journal of Studies on Alcohol and Drugs. The study provides an empirically-derived definition of recovery based on how it is experienced by those who actually live it. Readers are encouraged to go to the full text of the article that served as the basis for this piece, with its complete demographic data regarding the sample and account of methods.
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