Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review Journal of the American Medical Association Use of marijuana in FDA-approved formulations for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence. The issue of which of the constituent cannabinoids are responsible for the therapeutic effect is not addressed in this article. Six trials that included 325 patients examined chronic pain, 6 trials that included 396 patients investigated neuropathic pain, and 12 trials that included 1600 patients focused on multiple sclerosis. Several of these trials had positive results, suggesting that marijuana or cannabinoids may be efficacious for these indications.
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FROM JOURNAL OF ADDICTION MEDICINE
Co-Occurrence of Substance-Related and Other Mental Health Disorders Among Adolescent Cannabis Users Journal of Addiction Medicine (free ASAM member resource) The results of this study confirms that cannabis use carries the risk of dependence and also carries with it significant risk of comorbidities, both with respect to other substance use disorders and other psychiatric illness. The degree of risk is not addressed; all subjects were recruited from a population with presumed substance use disorders.
Management Strategies to Reduce Psychiatric Readmissions Agency for Healthcare Research and Quality In this 139 page report, the first 53 pages narratively review the efficacy of psychiatric readmission reduction interventions. The authors of this technical brief aimed to describe and compare four core management strategies to reduce psychiatric readmissions—length of stay for inpatient care, transition support services (i.e., care provided as the individual moves to outpatient care), short-term alternatives to psychiatric rehospitalization (i.e., short-term outpatient care provided in place of psychiatric rehospitalization for those not at significant risk of harm to self or others), and long-term approaches for reducing psychiatric rehospitalization—for patients at high risk of psychiatric readmission. The importance of this to the addiction community arises from the overwhelming effect that SUDs have on readmission
risk.
National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment American Journal of Public Health This convincing data analysis is intended to drive policy review and change. The authors generated national and state rates of past-year opioid abuse or dependence, maximum potential buprenorphine treatment capacity, number of patients receiving methadone from opioid treatment programs (OTPs), and the percentage of OTPs operating at 80% capacity or more using Substance Abuse and Mental Health Services Administration data.
Recommendations for Prevention of Weight Gain and Use of Behavioral and Pharmacological Interventions to Manage Overweight and Obesity in Adults in Primary Care Canadian Task Force on Preventative Health Care This is an update of 1999 guidelines. It employs a weighted, structured assessment of existing data. It is not clear from the guidelines that pharmacological management has a significant place in either prevention or in long-term management of obesity. Routine use of medication was not recommended. These clinical guidelines aim to provide evidence-based recommendations for structured interventions aimed at preventing weight gain in adults of normal weight and to provide recommendations for behavioral and pharmacologic interventions for weight loss to manage overweight and obesity in adults, including those at risk of type 2 diabetes.
Time to Restore Body Weight in Adults and Adolescents Receiving Cognitive Behavior Therapy for Anorexia Nervosa Journal of Eating Disorders 95 subjects, 61 completers demonstrated a more rapid response to CBT among adolescents than adults in normalizing weight. Anorexia nervosa is considered one of the most difficult psychiatric disorders to treat. Patients are often reluctant to accept treatment and among those who start a large subgroup has a poor outcome. Anorexia nervosa is also difficult to study because it is relatively rare, associated with medical risks, and may require a lengthy duration of treatment.
Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-Analysis Annals of Internal Medicine Because psychological approaches are likely to produce sustained benefits without the risk for tolerance or adverse effects associated with pharmacologic approaches, cognitive behavioral therapy for insomnia (CBT-i) is now commonly recommended as first-line treatment for chronic insomnia.
Sleep-Wake Disturbances After Traumatic Brain Injury The Lancet Neurology Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia.
Brain Inflammation Links Chronic Pain with Depression Medical News Today For the first time, scientists have discovered that brain inflammation caused by chronic nerve pain can affect signaling in the regions of the brain associated with mood and motivation. This discovery suggests there is a mechanism that connects chronic pain with symptoms of depression and anxiety that many patients experience.
ASAM Comments on Medicaid Parity Rule ASAM ASAM praised the proposed rule’s application of parity protections to all Medicaid managed care beneficiaries, whether or not they receive behavioral health services through a “carve out” arrangement, and requested further clarity on the definition of “long term care” and the rule’s treatment of medication coverage.
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