Journal of addictive diseases
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Many patients receiving sustained-action narcotics during therapy for heroin addiction have symptoms of fatigue, depression, diminished libido, and impaired sexual function. They are rarely, however, evaluated for narcotic-induced hypogonadism, or treated with sex-hormone replacement. ⋯ We have documented improved quality of life during sex-hormone replacement therapy in patients with narcotic-induced hypogonadism, most of whom were receiving their narcotics for control of chronic pain. These studies suggest that similar hormone replacement therapy may assist patients receiving narcotics for treatment of heroin addiction.
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Of 1320 patients who were hospitalized for injuries, a total of 315 were known to be intoxicated with alcohol at the time of trauma. A retrospective chart review was performed to determine which biopsychosocial markers correlated with increasing severity of alcohol use disorders in a sample of 184 (58.4%) of these 315 patients. Markers associated with increased severity were: an increased mean corpuscular volume (MCV; p = 0.007), previous legal problems (p = 0.023), previous alcohol rehabilitation (p < 0.001), previous attendance at self-help meetings (p < 0.001), admitting to having an alcohol problem (p < 0.001), and a willingness to change drinking behavior (p < 0.001). Routine toxicology screening tests, simple questions about previous alcohol or drug abuse treatment, and direct questions about the patient's own perception of the severity of disease and readiness to change drinking behavior can identify many victims of major trauma who could potentially benefit from a referral for alcohol rehabilitation.