Pain Management in the Individual with Serious Illness and Comorbid Substance Use Disorder

2016 ◽  
Vol 51 (3) ◽  
pp. 433-447 ◽  
Author(s):  
Anne F. Walsh ◽  
Kathleen Broglio
Keyword(s):  
Substance Use ◽  
Pain Management ◽  
Substance Use Disorder ◽  
Serious Illness ◽  
The Individual

ADHD and substance misuse

2018 ◽  
Author(s):  
Timothy Wilens ◽  
Nicholas Carrellas ◽  
Joseph Biederman
Keyword(s):  
Substance Use ◽  
Cigarette Smoking ◽  
Substance Use Disorder ◽  
Extended Release ◽  
Substance Misuse ◽  
Genetic Factors ◽  
Elevated Risk ◽  
Adhd Treatment ◽  
Stimulant Medications ◽  
The Individual

There has been great interest in the overlap between ADHD and substance use disorder (SUD). ADHD is a common neurobehavioural disorder of childhood that places the individual at elevated risk for later SUD. Studies have shown that 25–40% of adults and adolescents with SUD have ADHD. Although the exact link between the two disorders is still unclear, it appears their connection is complex, and involves the interplay between various biological, behavioural, and genetic factors. Early pharmacotherapy of ADHD does not increase SUD, and, in fact, appears to reduce cigarette smoking and SUD. In individuals with ADHD and SUD, stabilization of SUD is recommended initially, with consideration of adjunct non-stimulant and extended release stimulant medications. More research on the mechanisms of overlap between the disorders, preventative effects of early ADHD treatment on SUD, and concurrent treatments for ADHD and SUD are necessary.

scholarly journals A randomized trial of a pain management intervention for adults receiving substance use disorder treatment

Addiction ◽  
2016 ◽  
Vol 111 (8) ◽  
pp. 1385-1393 ◽  
Author(s):  
Mark A. Ilgen ◽  
Amy S. B. Bohnert ◽  
Stephen Chermack ◽  
Carly Conran ◽  
Mary Jannausch ◽  
...  
Keyword(s):  
Substance Use ◽  
Pain Management ◽  
Randomized Trial ◽  
Substance Use Disorder ◽  
Substance Use Disorder Treatment ◽  
Management Intervention ◽  
Disorder Treatment

Needs of Spouses of Patients with Substance Use Disorder: A Qualitative Study

2021 ◽  
Author(s):  
Shiva Soraya ◽  
Mandana Haghshenas ◽  
Hamid Reza Ahmadkhaniha ◽  
Somayeh Azarnik ◽  
Hossein MansourKiaei ◽  
...  
Keyword(s):  
Substance Use ◽  
Qualitative Study ◽  
Social Services ◽  
Substance Use Disorder ◽  
Substance Dependence ◽  
Wide Spectrum ◽  
Family Members ◽  
Purposeful Sampling ◽  
The Individual ◽  
Initial Interviews

Background: The skill of adjusting and regulating the needs and adaptation are the most fundamental abilities of family members. Since substance use related disorders create serious health threats and cost burdens for family, it is important to investigate the needs of spouses of these patients. Regarding the wide spectrum of needs based on previous researches, the psychiatric needs were the focus in this study. By evaluating the needs, the executives of social services can better determine the basic needs of patients and their family members. Methods: This is a qualitative study applying a content analysis approach. Based on the objectives of this research, purposeful sampling was done and continued until information saturation. In total, 16 spouses of patients using substance were interviewed. Initial interviews began with guiding questions and the probing questions were applied in the following interviews. Participants’ emotions were coded and codes with similar concepts were placed together in one category and subcategories were created. Results: After conducting 16 in-depth interviews, 38 initial codes were obtained and categorized into 6 key concepts (Neglecting the reciprocal roles and rights, lack of responsibility, lack of motivation, psychiatric changes due to substance use, feelings of insecurity, and defective communication). Conclusion: The present study paves the way in better understanding of the needs of the spouses of patients with substance use disorder, and enables the specialists in this area to adjust the treatment according to each individual patient and evaluate emerging patient related issues and challenges as well. Substance dependence, in addition to making problems for the individual and the society, leads to unsatisfied needs of close family members and acquaintances. In other words, treatment will be more effective if each patient is recognized individually, the family is educated, and family-level interventions are provided.

scholarly journals Lateral Preoptic Area Neurons Signal Cocaine Self-Administration Behaviors

2021 ◽  
Author(s):  
Kevin R Coffey ◽  
Vaishnavi Venkat ◽  
Mark West ◽  
David Barker
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Preoptic Area ◽  
Operant Response ◽  
Discrete Elements ◽  
Self Administration ◽  
Drug Seeking ◽  
The Face ◽  
Highly Correlated ◽  
The Individual

The lateral preoptic area is implicated in numerous aspects of substance use disorder. In particular, the lateral preoptic area is highly sensitive to the pharmacological properties of psychomotor stimulants, and its activity promotes drug-seeking in the face of punishment and reinstatement during abstinence. Despite the lateral preoptic areas complicity in substance use disorder, how precisely lateral preoptic area neurons encode the individual components of drug self-administration has not been ascertained. To bridge this gap, we examined how the firing of single lateral preoptic area neurons correlates with three discrete elements of cocaine self-administration: 1) drug-seeking (pre-response), 2) drug-taking (response), and 3) receipt of the cocaine infusion. A significant subset of lateral preoptic area neurons responded to each component with a mix of increases and decreases in firing-rate. A majority of these neurons encoded the operant response with increases in spiking, though responses during the drug-seeking, taking, and reciept windows were highly correlated.

Pain Management in the Patient with Substance Use Disorder

2018 ◽  
Author(s):  
Thomas Hickey ◽  
Jessica Feinleib
Keyword(s):  
Substance Use ◽  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Respiratory Depression ◽  
Substance Use Disorder ◽  
Multimodal Analgesia ◽  
Surgical Patient ◽  
Acute Postoperative Pain ◽  
Aggressive Communication

Managing pain in the patient with substance use disorder can be challenging. This chapter describes those challenges and provides strategies to address them. Specifically it discusses the prevalence and specific considerations for commonly abused substances, the need for aggressive communication among perioperative clinicians, and a strategy to decrease acute postoperative pain and associated complications using opioid-sparing, multimodal analgesia. It includes a discussion of the concept of equianalgesic opioid doses and management of opioid-related side effects including respiratory depression, with regard to buprenorphine, naltrexone, and methadone. Specific consideration is given to the surgical patient treated with buprenorphine, and a defined clinical plan is outlined.

scholarly journals Evaluation of American Indian Health Service Training in Pain Management and Opioid Substance Use Disorder

2016 ◽  
Vol 106 (8) ◽  
pp. 1427-1429 ◽  
Author(s):  
Joanna G. Katzman ◽  
Chris Fore ◽  
Snehal Bhatt ◽  
Nina Greenberg ◽  
Julie Griffin Salvador ◽  
...  
Keyword(s):  
Substance Use ◽  
Pain Management ◽  
Health Service ◽  
American Indian ◽  
Substance Use Disorder ◽  
Indian Health Service ◽  
Indian Health ◽  
Service Training ◽  
American Indian Health

Regulatory Pathways to Promote Treatment for Substance Use Disorder or Other Under-Treated Conditions Using Risk Adjustment

2018 ◽  
Vol 46 (4) ◽  
pp. 935-939
Author(s):  
Matthew J.B. Lawrence
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Risk Adjustment ◽  
Legal Analysis ◽  
Regulatory Pathways ◽  
Administrative Process ◽  
Part C ◽  
Federal Laws ◽  
The Individual ◽  
Almost All

This commentary provides a legal analysis of the extent to which changes proposed by scholars to promote care for substance use disorder or other under-treated illnesses through risk adjustment could be implemented administratively, without legislation, in federal risk adjustment systems: Medicare's privatized component, Medicare's pharmaceutical component, and the individual and small group market. As the article explains, federal laws governing risk adjustment provide broad discretion to regulators and can reasonably be interpreted to permit (or in the case of Part C even compel) full and final implementation through the administrative process of almost all of the changes that scholars have proposed.

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