Those who are challenged by dependency on prescription drugs or suffer drug addictions have few options available to them for recovery, such as psychotherapy and physiotherapy. Here we present a new ...approach with clinical examples involving stimulant addiction or overdose of hypnotic drugs that were received BIOCERAMIC Resonance, which was developed based on concept of 12 meridian channels of traditional Chinese medicine, and has successful withdrawal or dose reduction benefits. We describe the whole process and the clinical outcome. And by help of our previous publication on functional MRI, we discuss the possible brain locations response to BIOCERAMIC Resonance that may be corresponding to the beneficial effects of relief of depression, sleep deprivation and other mental symptoms that associate with substance abuse and withdrawal effects. We suggest this could be potentially widely application on substances abuse.
Studying anxiety in neurogenetic syndromes may inform the intersection of biological and developmental risks, facilitating effective and targeted interventions. We longitudinally examined stranger ...fear in infants and toddlers with fragile X syndrome (FXS; n = 46) and typical controls (n = 33), as well as associations between observed stranger fear and rating scales of anxiety, withdrawal and autism features within FXS. Results indicated atypical facial fear in FXS, although facial fear did not index anxiety, autistic symptoms or social withdrawal. Instead, lower withdrawal was associated with decreased distress vocalizations across age, and higher autistic symptoms were associated with lower intensity escape behaviors. Early stranger fear in FXS reflects both typical and atypical dimensions and may help index emergence of social anxiety in this population.
Opioid use disorder (OUD) and its consequences are a major public health concern. The partial agonist buprenorphine is a safe and effective treatment for OUD, but concerns about abuse, misuse, and ...diversion of buprenorphine have been raised. This narrative review examined the rates and motives for use of illicit buprenorphine in the United States. Findings from the 17 included studies suggest the majority of study participants using illicit buprenorphine do so for reasons related to misuse (to manage opioid withdrawal symptoms or achieve or maintain abstinence from other opioids). A smaller percentage of study respondents reported using buprenorphine for reasons related to abuse (to get high). There appears to be a gap between need for buprenorphine and access to adequate treatment. Attenuation of policy-related barriers and adoption of appropriate buprenorphine use by the treatment community are critical tools in the continued effort to reduce the burdens associated with OUD.
•Most who use illicit buprenorphine do so for reasons related to misuse (eg, manage withdrawal or maintain abstinence from other opioids).•A much smaller percentage of study most respondents reported using illicit buprenorphine for reasons related to abuse (to get high).•There appears to be a gap between need for buprenorphine and access to adequate treatment.
This article concerns the interplay between government policy and practice and refugee children's welfare as these issues have been brought to the fore in public debate and controversy in the recent ...past in Sweden. Framed by the tension between immigration law and human rights conventions such as the UN Convention on the Rights of the Child (CRC), incidences of ill-health and suffering among asylum-seeking children have both spurred public concerns over their vulnerability and welfare and questioned the authenticity and legitimacy of their claims. The images reflect the ambiguous constructions of refugee children and their families either as victims or as untrustworthy 'others'. The article addresses the ways in which the focus on children resonates particularly in the Swedish context, related both to a long-standing concern with children's wellbeing and to a Swedish self-image as international model for children's rights. The issues manifested in the Swedish context form part of a wider problematic: suffering and vulnerability are expressions of, but also a potential resource in, an extremely harsh situation of severely limited options; they also have something to say about the risks of 'humanitarianism' and the changing terms of asylum in Europe today.
In the United States, the Food and Drug Administration (FDA) has initiated a public dialogue about reducing the nicotine content of cigarettes. A reduced-nicotine standard could increase withdrawal ...symptoms among current smokers. We examined the impact of switching smokers to cigarettes that varied in nicotine content on withdrawal symptoms over 6 weeks. A secondary analysis (N = 839) of a 10-site, double-blind clinical trial of nontreatment-seeking smokers was completed. Participants were instructed to smoke study cigarettes, containing 0.4 to 15.8 mg of nicotine/g of tobacco, for 6 weeks and were then abstinent overnight. Using latent growth curves, trajectories of individual withdrawal symptoms were compared between the reduced nicotine content (RNC) conditions and a normal nicotine content (NNC) condition. Path analyses compared symptoms after overnight abstinence. Relative to NNC cigarettes, participants smoking RNC cigarettes had increased anger/irritability/frustration and increased appetite/weight gain during the initial weeks, but the symptoms resolved by Week 6. Individuals who were biochemically verified as adherent with using only the 0.4 mg/g cigarettes had higher sadness levels (Cohen's d = .40) at Week 6 compared with the NNC condition, although symptoms were mild. After a post-Week 6 overnight abstinence challenge, some RNC conditions relative to NNC condition exhibited reduced withdrawal. Individuals who were biochemically confirmed as adherent to the lowest nicotine condition experienced only mild and transient symptom elevations. Thus, a reduced-nicotine standard for cigarettes produced a relatively mild and temporary increase in withdrawal among nontreatment-seeking smokers (ClinicalTrials.gov No. NCT01681875).
Public Health Significance
We found no evidence in nontreatment-seeking smokers that lowering the nicotine content in cigarettes to a less addictive level would result in severe or protracted nicotine withdrawal.
Background:
There is a significant discourse in the literature that opines that people who use illicit opiates are unable to provide informed consent due to withdrawal symptoms and cognitive ...impairment as a result of opiate use.
Aims:
This paper discusses the issues related to informed consent for this population.
Ethical considerations:
Ethical approval was obtained from both the local REB and the university. Written informed consent was obtained from all participants.
Method:
This was a qualitative interpretive descriptive study. 22 participants were interviewed, including 18 nurses, 2 social workers and 2 clinic support workers. The findings were analyzed using thematic analysis, which is a way of systematically reducing the complexity of the information to arrive at generalized explanations.
Results:
The staff at the clinic were overwhelming clear in their judgment that people who use opiates can and should be able to participate in research and that their drug use is not a barrier to informed consent.
Conclusions:
It is important to involve people who use opiates in research. Protectionist concerns about this population may be overstated. Such concerns do not promote the interests of research participants. People who use heroin need to be able to tell their story.
Despite considerable progress in reducing cigarette smoking prevalence and enhancing smoking cessation treatments, most smokers who attempt to quit relapse. The current randomized clinical trial ...evaluated the efficacy of an adjunctive behavioral smoking cessation treatment based on learning theory. Adult daily smokers were randomly assigned to standard treatment (N = 47) with nicotine patch and individual counseling or to standard treatment plus a “practice quitting” program involving seven sessions of escalating prescribed abstinence periods (N = 46) prior to a target stop smoking date. Practice quitting was designed to extinguish smoking in response to withdrawal symptoms. Retention in treatment was excellent and the treatment manipulation increased the interval between cigarettes across practice quitting sessions on average by 400%. The primary endpoint, seven-day point-prevalence abstinence four weeks post-quit, was not significantly affected by practice quitting (31.9% in the standard treatment condition, 37.0% in the practice quitting condition). Practice quitting increased latency to a first lapse among those who quit smoking for at least one day and prevented progression from a first lapse to relapse (smoking daily for a week) relative to standard treatment, however. Practice quitting is a promising adjunctive treatment in need of refinement to enhance adherence and efficacy.
Display omitted
•Acceptance of a practice quitting smoking-cessation intervention was excellent.•Practicing quitting smoking results in improved abstinence duration during cessation.•Practice quitting had a modest non-significant effect on point-prevalence abstinence.•Practice quitting delayed first smoking lapses and progression to relapse.
The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is commonly used in hospitals to titrate medications for alcohol withdrawal syndrome (AWS), but may be difficult to apply to ...intensive care unit (ICU) patients who are too sick or otherwise unable to communicate.
To evaluate the frequency of CIWA-Ar monitoring among ICU patients with AWS and variation in CIWA-Ar monitoring across patient demographic and clinical characteristics.
The study included all adults admitted to an ICU in 2017 after treatment for AWS in the Emergency Department of an academic hospital that standardly uses the CIWA-Ar to assess AWS severity and response to treatment. Demographic and clinical data, including Richmond Agitation-Sedation Scale (RASS) assessments (an alternative measure of agitation/sedation), were obtained via chart review. Associations between patient characteristics and CIWA-Ar monitoring were tested using logistic regression.
After treatment for AWS, only 56% (n = 54/97) of ICU patients were evaluated using the CIWA-Ar; 94% of patients had a documented RASS assessment (n = 91/97). Patients were significantly less likely to receive CIWA-Ar monitoring if they were intubated or identified as Black.
CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. These hypothesis-generating findings raise questions about the utility of the CIWA-Ar in ICU settings. Future studies should assess alternative measures for titrating AWS medications in the ICU that do not require verbal responses from patients and further explore the association of race with AWS monitoring.
Quitting smoking unassisted Smith, Andrea L; Chapman, Simon
JAMA : the journal of the American Medical Association,
01/2014, Letnik:
311, Številka:
2
Journal Article
Recenzirano
The need to focus research on the smokers who gave up smoking unassisted is discussed. The key lessons that can be learnt from these individuals in order to encourage others to give up smoking are ...highlighted.
Introduction: Alcohol dependence is well known for its harmful effects and is considered as the ‘gate way’ drug of abuse across the globe. There has been a progressive increase in its abuse with a ...serious impact on health contributing to high morbidity and mortality. Aim: To evaluate the extent and pattern of alcohol consumption, reasons for and factors influencing its consumption. Materials and Methods: This was a cross-sectional study conducted in a tertiary Hospital. All in-patients admitted in psychiatry ward with diagnosis of alcohol dependence were included for the study. A pilot study was done to assess the feasibility of Case Record Form (CRF). Data collected from all alcohol dependent in-patients in psychiatry ward for a year on socio-demographic profile, patterns and types of alcohol use, the age at onset and duration of consumption/dependence along with treatment details was evaluated for in-patients reporting at a tertiary care hospital. Results: In this cross-sectional study, 102 subjects were assessed, among them 35.30% from upper lower and middle socioeconomic category and 24.50% skilled worker group. The mean age of study population was 41.17±9.80 years with 81% in the productive age group. The mean age at onset of regular alcohol consumption was 24 years in 68.62% and 18 years in 27.45% of hospital admissions. The average number of years for first hospital admission after initiation of regular alcohol consumption was 19.92 years. The number of patients who consumed spirits was 96% and those consumed more than 3 units/day was 73.6%. The hospital admissions for alcohol related illnesses were 58.80% and those reported to seek medical help on their own was 52.9%. Conclusion: The findings indicate that alcohol dependence is common among adolescents and young adults who are the in the productive age group. The upper lower and middle socioeconomic groups are at higher risk of dependence. There is a need for stringent policies, programs, early identification, treatment and preventive measures using age specific, feasible and efficient interventional tools to achieve ‘harm reduction’ due to alcohol dependence.
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