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High dose opioid agonist therapy for patients with opioid use disorder: a case series exploring this patient-centered approach. 针对阿片类药物使用障碍患者的大剂量阿片类药物激动剂疗法:探索这种以患者为中心的方法的系列病例。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-09-02 DOI: 10.1080/10550887.2024.2383804
Priya Nigam, Jennifer Marx, Omolara Olasimbo, Vikranth Induru, Ho-Man Yeung

Objectives: Management of opioid withdrawal in the inpatient setting can vary widely depending on the patient, the physician, and the institution. Although buprenorphine and methadone are first-line therapy for withdrawal management, some patients experience barriers to those medications. In this case series, we explore high dose opioid agonist therapy (HDOAT) as a novel and effective option to bridge to recovery in this particular setting.

Methods: This retrospective case series includes- five patients with opioid use disorder (OUD) who were treated with HDOAT while hospitalized and reports on their outcomes.

Results: All five patients completed lifesaving medical therapy, engaged with community health workers for resources, and successfully transitioned to medications for opioid use disorder (MOUD). More importantly, none of the patients had patient directed discharges (PDDs). Furthermore, there were no inpatient drug uses or overdoses requiring naloxone administration, even with very high doses of oxycodone. None of the five patients were readmitted within thirty days.

Conclusions: Although more rigorous research is needed, HDOAT may be a viable strategy for OUD when patients continued to decline buprenorphine or methadone on admission. This case series demonstrated the successful use of this strategy toward preventing PDDs, promoting treatment completion, and allowing substance recovery and rehabilitation, in patients who elected to defer MOUD on arrival.

目的:住院患者的阿片类药物戒断管理因患者、医生和机构的不同而有很大差异。虽然丁丙诺啡和美沙酮是戒断治疗的一线疗法,但有些患者在使用这些药物时会遇到障碍。在本病例系列中,我们探讨了大剂量阿片类激动剂疗法(HDOAT),将其作为在这种特殊情况下实现康复的一种新颖而有效的选择:这组回顾性病例包括五名在住院期间接受 HDOAT 治疗的阿片类药物使用障碍(OUD)患者,并报告了他们的治疗结果:结果:所有五名患者都完成了挽救生命的医疗治疗,与社区卫生工作者接触以获得资源,并成功过渡到阿片类药物使用障碍 (MOUD) 的药物治疗。更重要的是,所有患者都没有在患者指导下出院(PDD)。此外,即使使用了非常大剂量的羟考酮,也没有出现需要使用纳洛酮的住院用药或过量用药情况。五名患者均未在三十天内再次入院:尽管还需要进行更严格的研究,但如果患者在入院时继续拒绝使用丁丙诺啡或美沙酮,那么 HDOAT 可能是治疗 OUD 的一种可行策略。本系列病例表明,对于在入院时选择推迟 MOUD 的患者,这一策略可以成功预防 PDD,促进治疗的完成,并允许药物的恢复和康复。
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引用次数: 0
Inpatient initiation of long-acting injectable buprenorphine at a community hospital: A retrospective case series. 一家社区医院的住院病人开始使用长效注射用丁丙诺啡:回顾性病例系列。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-09-01 DOI: 10.1080/10550887.2024.2391145
Clarissa O'Conor, Shai Farhi, Ethan Cowan, Ruchi Fitzgerald

Objectives: Determine if long-acting injectable buprenorphine (LAIB) can be successfully and safely administered in the hospital with minimal sublingual buprenorphine lead-in and potentially improve follow-up engagement in care.

Methods: We performed a retrospective case series of 46 patients who received LAIB while hospitalized at a safety-net community hospital. We abstracted demographic information, details about substance use disorder treatment history, in-hospital buprenorphine initiation methods and follow-up data from inpatient and outpatient electronic medical records.

Results: In total, 46 hospitalized patients received LAIB during the study period. The majority of our patients were older Black adults with Medicaid who self-reported intranasal heroin use. A low-dose buprenorphine initiation protocol was used most commonly, either in sublingual or intravenous form, with only two cases of precipitated withdrawal occurring during the buprenorphine initiation process and no cases of precipitated withdrawal after the administration of LAIB. 87% (40) of the patients received LAIB after receiving either sublingual or IV buprenorphine for fewer than the recommended seven days. Of the 46 hospitalized patients who received LAIB, 23 (50%) attended a follow-up addiction medicine appointment within 30 days of discharge.

Conclusions: Hospital administration of LAIB could play an important role in retention in care after hospital discharge.

目标:确定长效注射用丁丙诺啡(LAIB)能否在医院内成功、安全地使用,同时尽量减少舌下含服丁丙诺啡的时间,并可能改善后续治疗的参与度:我们对在一家安全网社区医院住院期间接受 LAIB 治疗的 46 名患者进行了回顾性病例系列研究。我们从住院和门诊电子病历中摘录了人口统计学信息、药物使用障碍治疗史详情、院内丁丙诺啡启动方法和随访数据:在研究期间,共有 46 名住院患者接受了 LAIB 治疗。大部分患者都是拥有医疗补助计划的黑人老年人,他们自述曾吸食海洛因。最常用的是低剂量丁丙诺啡起始方案,采用舌下含服或静脉注射的形式,在丁丙诺啡起始过程中仅有两例出现骤停,而在服用LAIB后没有出现骤停。87%的患者(40人)在接受丁丙诺啡舌下或静脉注射不足建议的7天后接受了LAIB。在接受LAIB治疗的46名住院患者中,有23人(50%)在出院后30天内接受了成瘾医学随访:结论:LAIB的医院用药在出院后的留院治疗中发挥着重要作用。
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引用次数: 0
Implications of xylazine exposure in pregnancy: a narrative review. 妊娠期接触甲苯噻嗪的影响:叙述性综述。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-08-21 DOI: 10.1080/10550887.2024.2391156
Ilana Hull, Raagini Jawa, Margaret Shang, Corey Davis, Cambria King, Gary McMurtrie, Elizabeth Krans

The rise in pregnancy-related overdose deaths has been driven by the use of high-potency illicitly-manufactured synthetic opioids including fentanyl. Xylazine, a veterinary sedative, is increasingly noted as a common adulterant in the United States illicit opioid supply. Exposure to the xylazine-fentanyl combination has been associated with severe harms including sedation, necrotic wounds, and symptoms of xylazine withdrawal. Due to limited data that directly addresses the risks of xylazine exposure during human pregnancy, we conducted a narrative review to summarize the available evidence about the clinical implications of xylazine exposure in pregnancy drawing from evidence from animal models, the general adult population, and the authors' clinical experiences. Because xylazine exposure presents unique risks to pregnant persons, management of xylazine exposure and related clinical sequelae in pregnant persons warrants nuanced clinical management. Further, additional research is critically needed to develop best practice guidelines related to the management of co-occurring xylazine-opioid exposure during pregnancy including harm reduction strategies to reduce exposure risk during pregnancy.

包括芬太尼在内的高浓度非法制造的合成类阿片的使用推动了与妊娠相关的过量用药致死率的上升。赛拉嗪是一种兽用镇静剂,越来越多地成为美国非法阿片类药物供应中常见的掺杂物。接触赛拉嗪-芬太尼混合物会造成严重危害,包括镇静、伤口坏死和赛拉嗪戒断症状。由于直接涉及人类妊娠期间接触异丙嗪的风险的数据有限,我们进行了一次叙述性综述,从动物模型、普通成年人群和作者的临床经验中总结了有关妊娠期间接触异丙嗪的临床影响的现有证据。由于接触异丙嗪会给孕妇带来独特的风险,因此需要对孕妇接触异丙嗪及相关临床后遗症进行细致入微的临床管理。此外,还亟需开展更多研究,以制定最佳实践指南,用于管理妊娠期并发的异丙嗪-阿片类药物暴露,包括减少伤害的策略,以降低妊娠期的暴露风险。
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引用次数: 0
Impulsivity and self-harm behavior in patients with synthetic cannabinoids dependence. 合成大麻素依赖患者的冲动和自残行为。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-31 DOI: 10.1080/10550887.2024.2375462
Hani Hamed Dessoki, Zainab Mostafa Mohammed, Marwa S Ismael, Hasnaa Osama, Hisham Salah

Background: Synthetic cannabinoids (SCs) dependence is increasingly prevalent among young individuals globally, with limited understanding of their potential detrimental effects. Therefore, we conducted this comparative study to assess impulsivity and non-suicidal self-harm behavior in patients with SCs dependence.

Subjects and method: We conducted this comparative, case-control study in the outpatient clinics of (Beni-suef University Hospital). We recruited 30 patients with SCs dependence and the 30 healthy subjects as a control group. Psychometric scales, including Addiction Severity Index (ASI), Barratt Impulsivity Scale-11 (BIS-11), Deliberate Self-harm Inventory-Short Version (DSHI), SCID I, SCID II, and drug urine screen, were applied to compare the two study arms.

Results: DSHI-s scores were significantly higher between the two study arms (3.23 ± 4.97 vs. 0.0 ± 0.0, p < 0.001, for cases and controls, respectively). Similarly, the mean ± SD score of the BIS scale was significantly higher in cases 68.13 ± 9.75 compared to the control group (45.67 ± 5.12) with a statistically significant difference (p < 0.001). Using the regression analysis, we observed a significant positive linkage between age, duration of substance use, DSHI-s, and the Barratt scale.

Conclusion: Patients with synthetic cannabis addiction exhibited more impulsivity and self-harm behaviors compared to healthy controls. The adverse effects of substance use disorder escalated, notably in individuals classified as having severe addiction based on the Addiction Severity Index. Age and length of substance use were found to be potential factors influencing the level of impulsivity and self-harm actions.

背景:合成大麻素(SCs)依赖症在全球年轻人中越来越普遍,但人们对其潜在的有害影响了解有限。因此,我们进行了这项比较研究,以评估合成大麻素依赖患者的冲动性和非自杀性自残行为:我们在 Beni-suef 大学医院门诊部进行了这项病例对照比较研究。我们招募了 30 名 SCs 依赖症患者和 30 名健康受试者作为对照组。我们采用了心理测量量表,包括成瘾严重程度指数(ASI)、巴拉特冲动量表-11(BIS-11)、蓄意自残量表-简版(DSHI)、SCID I、SCID II 和毒品尿检,对两组研究对象进行了比较:结果:两个研究组的 DSHI-s 得分明显更高(3.23 ± 4.97 vs. 0.0 ± 0.0,p p 结论:合成大麻成瘾患者的 DSHI-s 得分明显高于合成大麻成瘾患者:与健康对照组相比,合成大麻成瘾患者表现出更多的冲动和自残行为。根据成瘾严重程度指数,药物使用障碍的不良影响会加剧,尤其是被归类为严重成瘾的患者。研究发现,年龄和使用药物的时间长短是影响冲动程度和自残行为的潜在因素。
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引用次数: 0
Associations between ENDS and cigarette use, and compromised immunity in US adults: Findings from the 2021-2022 NHIS. 美国成年人使用 ENDS 和吸烟与免疫力下降之间的关系:2021-2022 年国家健康调查(NHIS)结果。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-26 DOI: 10.1080/10550887.2024.2380116
Seyedeh Yasaman Alemohammad, Amirmohammad Khalaji, Olatokunbo Osibogun, Rime Jebai, Wei Li, Ateeqa Ijaz, Miranda Gehris, Ghader Dargahi Abbasabad, Kenneth Ward, Zoran Bursac, Ziyad Ben Taleb, Mohammad Ebrahimi Kalan

Background: Tobacco use presents increased risks for individuals with weakened immune systems (WIS). We investigated the association between cigarette and electronic nicotine delivery systems (ENDS or e-cigarettes) use and WIS in US adults using data from the 2021-2022 National Health Interview Survey.

Methods: Data from 57,133 adults were analyzed, focusing on WIS prevalence due to health conditions, prescriptions, or both. Cigarette and ENDS use were categorized as never, former, or current. Weighted multivariable regression models adjusted for demographics and other health conditions to assess associations between tobacco use and WIS.

Results: Among US adults, 4.3% had prescription-related WIS, 4.6% had health condition-related WIS, and 7% had WIS due to either reason. Adjusted results from multivariable regression models indicated that adults with WIS due to health conditions were more likely to be current (AOR = 1.21, 95%CI: 1.05-1.40) and former (AOR = 1.25, 95%CI: 1.11-1.39) cigarette smokers compared to counterparts without WIS. Adults with WIS due to prescriptions were more likely to be former cigarette smokers (AOR = 1.19, 95%CI: 1.06-1.34). Those with WIS for any reason were more likely to be current (AOR = 1.19, 95%CI: 1.05-1.35) and former (AOR = 1.24, 95%CI: 1.13-1.36) cigarette smokers. Adults with WIS due to health conditions (AOR = 1.23, 95%CI: 1.06-1.41) or any reasons (AOR = 1.19, 95%CI:1.05-1.34) were more likely to be former ENDS users compared to those without WIS.

Conclusions: In this nationally representative study, we found a notable link between cigarette and ENDS use with WIS, particularly among those with health condition-related or prescription-related WIS, underscoring the importance of addressing tobacco use in this vulnerable population.

背景:吸烟会增加免疫力低下者(WIS)的风险。我们利用 2021-2022 年全国健康访谈调查(National Health Interview Survey)的数据,研究了美国成年人使用香烟和电子尼古丁输送系统(ENDS 或电子烟)与 WIS 之间的关系:对 57,133 名成年人的数据进行了分析,重点关注因健康状况、处方或两者导致的 WIS 患病率。香烟和 ENDS 的使用分为从未使用、曾经使用和目前使用。加权多变量回归模型对人口统计学和其他健康状况进行了调整,以评估烟草使用与WIS之间的关联:结果:在美国成年人中,4.3%的人的WIS与处方有关,4.6%的人的WIS与健康状况有关,7%的人的WIS与其中任何一个原因有关。多变量回归模型的调整结果表明,与没有 WIS 的成年人相比,因健康状况而有 WIS 的成年人更有可能现在吸烟(AOR = 1.21,95%CI:1.05-1.40)和曾经吸烟(AOR = 1.25,95%CI:1.11-1.39)。因处方而患有 WIS 的成年人更有可能曾经吸烟(AOR = 1.19,95%CI:1.06-1.34)。因任何原因而患有 WIS 的人更有可能是当前吸烟者(AOR = 1.19,95%CI:1.05-1.35)和曾经吸烟者(AOR = 1.24,95%CI:1.13-1.36)。因健康状况(AOR = 1.23,95%CI:1.06-1.41)或任何原因(AOR = 1.19,95%CI:1.05-1.34)而使用 WIS 的成年人与未使用 WIS 的成年人相比,更有可能曾经使用过 ENDS:在这项具有全国代表性的研究中,我们发现卷烟和ENDS的使用与WIS之间存在明显的联系,尤其是在那些与健康状况相关或与处方相关的WIS人群中,这强调了解决这一弱势群体烟草使用问题的重要性。
{"title":"Associations between ENDS and cigarette use, and compromised immunity in US adults: Findings from the 2021-2022 NHIS.","authors":"Seyedeh Yasaman Alemohammad, Amirmohammad Khalaji, Olatokunbo Osibogun, Rime Jebai, Wei Li, Ateeqa Ijaz, Miranda Gehris, Ghader Dargahi Abbasabad, Kenneth Ward, Zoran Bursac, Ziyad Ben Taleb, Mohammad Ebrahimi Kalan","doi":"10.1080/10550887.2024.2380116","DOIUrl":"10.1080/10550887.2024.2380116","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use presents increased risks for individuals with weakened immune systems (WIS). We investigated the association between cigarette and electronic nicotine delivery systems (ENDS or e-cigarettes) use and WIS in US adults using data from the 2021-2022 National Health Interview Survey.</p><p><strong>Methods: </strong>Data from 57,133 adults were analyzed, focusing on WIS prevalence due to health conditions, prescriptions, or both. Cigarette and ENDS use were categorized as never, former, or current. Weighted multivariable regression models adjusted for demographics and other health conditions to assess associations between tobacco use and WIS.</p><p><strong>Results: </strong>Among US adults, 4.3% had prescription-related WIS, 4.6% had health condition-related WIS, and 7% had WIS due to either reason. Adjusted results from multivariable regression models indicated that adults with WIS due to health conditions were more likely to be current (AOR = 1.21, 95%CI: 1.05-1.40) and former (AOR = 1.25, 95%CI: 1.11-1.39) cigarette smokers compared to counterparts without WIS. Adults with WIS due to prescriptions were more likely to be former cigarette smokers (AOR = 1.19, 95%CI: 1.06-1.34). Those with WIS for any reason were more likely to be current (AOR = 1.19, 95%CI: 1.05-1.35) and former (AOR = 1.24, 95%CI: 1.13-1.36) cigarette smokers. Adults with WIS due to health conditions (AOR = 1.23, 95%CI: 1.06-1.41) or any reasons (AOR = 1.19, 95%CI:1.05-1.34) were more likely to be former ENDS users compared to those without WIS.</p><p><strong>Conclusions: </strong>In this nationally representative study, we found a notable link between cigarette and ENDS use with WIS, particularly among those with health condition-related or prescription-related WIS, underscoring the importance of addressing tobacco use in this vulnerable population.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction. 更正。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-15 DOI: 10.1080/10550887.2024.2366699
{"title":"Correction.","authors":"","doi":"10.1080/10550887.2024.2366699","DOIUrl":"10.1080/10550887.2024.2366699","url":null,"abstract":"","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cannabidiol (CBD) and hemp oil use in veterans using a VA Pain Clinic: a cross-sectional survey study. 使用退伍军人疼痛诊所的退伍军人使用大麻二酚 (CBD) 和麻油的情况:横断面调查研究。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-07 DOI: 10.1080/10550887.2024.2355365
Carisa Voightman, Ciciley Littlewolf, Regan Helbling, Kimberly D P Hammer, Anna Montgomery, Scott Turner

Background: Many United States veterans utilize prescription opioids to treat chronic pain symptoms and are subsequently at risk for opioid and alcohol misuse. As more states legalized the use of cannabis for medical use, increasing numbers of people are using cannabis pharmacotherapy for pain. The veterans Health Administration (VHA) Directive 1315, July 28, 2023 prohibits any medical staff on recommending, making referral to, and complete forms for a state approved program. Also, a veterans medical center does not provide marijuana to veterans. State laws do not change the status of CBD under federal law. CBD is illegal in the federal system.

Objectives: Our aim was to investigate the prevalence of cannabidiol product usage in Veterans and the association with changes in self-reported pain.

Methods: We conducted a cross-sectional descriptive survey offering questionnaires to patients greater than 18 years of age receiving care at the Fargo Veteran Health Administration medical center Pain Clinic (2101 Elm St N, Fargo ND, 58102).

Results: A total of 218 veterans participated of which 81.2% were male and 52.3% were in the age range of 60-80 years. Twenty-one participants reported cannabidiol usage (9.6%), with 52.4% using to treat pain symptoms. Average pain scores pre-usage of 6.37 were reduced to 4.05 post-usage indicating a statistically significant reduction in pain (p < 0.001).

Conclusion: Our study broadened the baseline knowledge of cannabidiol use in the Veteran population. Limitations include results being self-reported and the inability to verify cannabinoid constituents.

背景:许多美国退伍军人使用处方阿片类药物治疗慢性疼痛症状,并因此面临滥用阿片类药物和酒精的风险。随着越来越多的州将大麻的医疗用途合法化,越来越多的人开始使用大麻药物治疗疼痛。退伍军人健康管理局(VHA)2023 年 7 月 28 日发布的第 1315 号指令禁止任何医务人员推荐、转诊和填写州批准项目的表格。此外,退伍军人医疗中心不向退伍军人提供大麻。州法律不会改变 CBD 在联邦法律中的地位。在联邦系统中,CBD 是非法的:我们的目的是调查退伍军人使用大麻二酚产品的普遍程度以及与自述疼痛变化的关联:我们进行了一项横断面描述性调查,向在法戈退伍军人健康管理局医疗中心疼痛诊所(2101 Elm St N, Fargo ND, 58102)接受治疗的 18 岁以上患者发放问卷:共有 218 名退伍军人参加了此次调查,其中 81.2% 为男性,52.3% 年龄在 60-80 岁之间。21 名参与者报告使用大麻二酚(9.6%),其中 52.4% 用于治疗疼痛症状。使用前的平均疼痛评分为 6.37 分,使用后降至 4.05 分,表明疼痛在统计学上有显著减轻(p 结论:我们的研究拓宽了人们对大麻二酚的基本认识:我们的研究拓宽了退伍军人使用大麻二酚的基础知识。不足之处包括研究结果为自我报告,且无法验证大麻素成分。
{"title":"Cannabidiol (CBD) and hemp oil use in veterans using a VA Pain Clinic: a cross-sectional survey study.","authors":"Carisa Voightman, Ciciley Littlewolf, Regan Helbling, Kimberly D P Hammer, Anna Montgomery, Scott Turner","doi":"10.1080/10550887.2024.2355365","DOIUrl":"https://doi.org/10.1080/10550887.2024.2355365","url":null,"abstract":"<p><strong>Background: </strong>Many United States veterans utilize prescription opioids to treat chronic pain symptoms and are subsequently at risk for opioid and alcohol misuse. As more states legalized the use of cannabis for medical use, increasing numbers of people are using cannabis pharmacotherapy for pain. The veterans Health Administration (VHA) Directive 1315, July 28, 2023 prohibits any medical staff on recommending, making referral to, and complete forms for a state approved program. Also, a veterans medical center does not provide marijuana to veterans. State laws do not change the status of CBD under federal law. CBD is illegal in the federal system.</p><p><strong>Objectives: </strong>Our aim was to investigate the prevalence of cannabidiol product usage in Veterans and the association with changes in self-reported pain.</p><p><strong>Methods: </strong>We conducted a cross-sectional descriptive survey offering questionnaires to patients greater than 18 years of age receiving care at the Fargo Veteran Health Administration medical center Pain Clinic (2101 Elm St N, Fargo ND, 58102).</p><p><strong>Results: </strong>A total of 218 veterans participated of which 81.2% were male and 52.3% were in the age range of 60-80 years. Twenty-one participants reported cannabidiol usage (9.6%), with 52.4% using to treat pain symptoms. Average pain scores pre-usage of 6.37 were reduced to 4.05 post-usage indicating a statistically significant reduction in pain (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our study broadened the baseline knowledge of cannabidiol use in the Veteran population. Limitations include results being self-reported and the inability to verify cannabinoid constituents.</p>","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"1-4"},"PeriodicalIF":1.6,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical detoxification of bromazolam using diazepam: a case report. 使用地西泮对溴唑仑进行临床解毒:病例报告。
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-05 DOI: 10.1080/10550887.2024.2365006
Daan Buitenhuis, David P Herdes, Sebastiaan O Verboeket

An increasing number of new psychoactive substances (NPS), such as designer benzodiazepines, are becoming available on the recreational drug market. These are new unregistered substances and thereby an attempt to evade legislation. Often there is very limited clinical information available regarding these NPS, which could result in undesirable clinical outcomes in the management of intoxications, dependencies and withdrawals following NPS use. In this case report we describe a 23-year-old woman, who was admitted to our residential addiction care facility for the detoxification of the designer benzodiazepine bromazolam. Her daily use of 6 mg bromazolam was converted to 20 mg diazepam. Although we expected a higher dose would have been needed, 20 mg was sufficient and was tapered without complications. This case report demonstrates the safe conversion of 6 mg of bromazolam to 20 mg of diazepam by combining the use of fixed-dose and symptom-triggered-dose regimens. More clinical data is necessary to formulate advisory management for the detoxification of bromazolam and other designer benzodiazepines.

越来越多的新型精神活性物质(NPS),如特制苯并二氮杂卓,开始在娱乐性毒品市场上出现。这些都是未注册的新物质,因此试图逃避立法。有关这些 NPS 的临床信息往往非常有限,这可能会导致在处理使用 NPS 后的中毒、依赖性和戒断时出现不理想的临床结果。在本病例报告中,我们描述了一名 23 岁的女性,她因使用特制的苯二氮卓溴唑仑而被送入我们的住院戒毒护理机构戒毒。她每天服用的 6 毫克溴唑仑被转换为 20 毫克地西泮。尽管我们预计需要更大的剂量,但 20 毫克的剂量已经足够,并且在没有并发症的情况下逐渐减量。本病例报告表明,通过结合使用固定剂量和症状触发剂量方案,可以安全地将 6 毫克溴唑仑转换为 20 毫克地西泮。有必要获得更多临床数据,以便为溴唑仑和其他苯二氮卓类药物的戒毒制定咨询管理办法。
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引用次数: 0
Years of life lost due to unintentional drug overdose relative to the leading underlying causes of death in the United States: a comparative analysis of excess mortality 2017-2019. 美国因无意药物过量而损失的生命年数与主要基本死因的比较:2017-2019 年超额死亡率比较分析。
IF 2.3 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-01 Epub Date: 2023-03-06 DOI: 10.1080/10550887.2023.2173929
Stephanie Garcia, Julie Teater, Candice Trimble, Parker Entrup, Orman E Hall, O Trent Hall

The present study aims to compare Years of Life Lost for unintentional drug overdose and the leading underlying causes of death in the United States annually from 2017 to 2019. Years of Life Lost provide valuable context to incident deaths when comparing the relative mortality burden of underlying causes of death. Prior research has shown unintentional drug overdose was the third leading cause of Years of Life Lost in the state of Ohio in 2017. However, this finding has yet to be replicated at the national level in the US. Death statistics for 2017-2019 were accessed via CDC WONDER. Years of Life Lost were calculated for unintentional drug overdose and each of the top five causes of incident deaths in the US during the study period. Unintentional drug overdose caused nearly seven million Years of Life Lost in the US during the three-year period of study and was the fourth leading cause of Years of Life Lost after cancer, heart disease and other accidents. Incidence alone provides an incomplete picture of the effect of unintentional drug overdose on overall mortality burden in the US. Years of Life Lost give critical context to the overdose crisis, underscoring unintentional drug overdose as a leading cause of premature mortality.

本研究旨在比较美国从 2017 年到 2019 年每年因无意药物过量和主要基本死因而损失的生命年数。在比较基本死因的相对死亡负担时,"生命损失年数 "为意外死亡提供了宝贵的背景资料。先前的研究表明,在 2017 年俄亥俄州,无意药物过量是导致生命损失年数的第三大原因。然而,这一发现尚未在美国全国范围内得到复制。2017-2019 年的死亡统计数据通过疾病预防控制中心 WONDER 获取。在研究期间,针对无意药物过量和美国五大事故死亡原因中的每一种,都计算了生命损失年数。在为期三年的研究期间,意外用药过量在美国造成了近 700 万年的生命损失,是继癌症、心脏病和其他事故之后造成生命损失的第四大原因。仅凭发病率并不能全面反映意外用药过量对美国总体死亡负担的影响。生命损失年数 "为药物过量危机提供了重要的背景资料,强调了无意药物过量是导致过早死亡的主要原因。
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引用次数: 0
President's message. 主席致辞
IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI: 10.1080/10550887.2024.2358265
Jon Lepley
{"title":"President's message.","authors":"Jon Lepley","doi":"10.1080/10550887.2024.2358265","DOIUrl":"10.1080/10550887.2024.2358265","url":null,"abstract":"","PeriodicalId":47493,"journal":{"name":"Journal of Addictive Diseases","volume":" ","pages":"167-169"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Addictive Diseases
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