Drug and alcohol dependence
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Drug Alcohol Depend · Sep 2009
Measurement of opioid problems among chronic pain patients in a general medical population.
Chronic opioid therapy for non-malignant pain has greatly expanded, increasing the urgency of identifying those experiencing problems related to prescribed opioids. The Prescription Drug Use Questionnaire (PDUQ), which shares substantial content with subsequently developed instruments, was developed within a pain clinic setting designed to identify problematic opioid use. The utility of the PDUQ and its relationship with the DSM-IV approach needs to be established for patients being treated in general medical settings. ⋯ In this study of chronic pain patients on opioids in a general medical population, the PDUQ performed differently than in previously described pain clinic populations. CIDI DSM-IV items were distinct from a reduced set of PDUQ items, suggesting the need to reconsider approaches to the measurement of opioid problems for these patients. The four factors identified deserve further study, as they may signal the need for distinct interventions to improve the care of patients prescribed chronic opioid therapy for pain.
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Drug Alcohol Depend · Sep 2009
Opioid use behaviors, mental health and pain--development of a typology of chronic pain patients.
The intersection of pain, addiction and mental health has not been adequately described. We describe the roles of these three conditions in a chronic pain patient population using opioid analgesics. Aims were to improve our understanding of this population as well as to explore ways of identifying different types of patients. ⋯ We describe three distinct types of patient classes as well as data elements that could help identify the two atypical types. Further research is needed to confirm these findings and determine the utility of this approach in other clinical settings.
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Drug Alcohol Depend · Aug 2009
Randomized Controlled TrialComparison of subjective, pharmacokinetic, and physiological effects of marijuana smoked as joints and blunts.
Recent increases in marijuana smoking among the young adult population have been accompanied by the popularization of smoking marijuana as blunts instead of as joints. Blunts consist of marijuana wrapped in tobacco leaves, whereas joints consist of marijuana wrapped in cigarette paper. To date, the effects of marijuana smoked as joints and blunts have not been systematically compared. ⋯ Joints produced greater increases in plasma THC and subjective ratings of marijuana intoxication, strength, and quality compared to blunts, and these effects were more pronounced in women compared to men. However, blunts produced equivalent increases in heart rate and higher carbon monoxide levels than joints, despite producing lower levels of plasma THC. These findings demonstrate that smoking marijuana in a tobacco leaf may increase the risks of marijuana use by enhancing carbon monoxide exposure and increasing heart rate compared to joints.
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Drug Alcohol Depend · Jul 2009
Pathways between nonmedical opioid use/dependence and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
While nonmedical use of opioids and psychiatric disorders are prevalent in the population, little is known about the temporal ordering between nonmedical opioid use and dependence and psychiatric disorders. ⋯ Our findings support a general vulnerability to nonmedical opioid use and major psychopathologies, as well as evidence for a 'self-medication' model for dependence resulting from nonmedical opioid use with bipolar disorder and generalized anxiety disorder.
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Drug Alcohol Depend · Jul 2009
Multicenter StudyWomen who abuse prescription opioids: findings from the Addiction Severity Index-Multimedia Version Connect prescription opioid database.
Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. ⋯ Gender-specific factors should be taken into account in efforts to screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted.