The Yale journal of biology and medicine
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Smoking rates in people with serious mental illness (SMI) are disproportionately high compared to the general population. It is a leading contributor to the early mortality in this population. Smoking cessation rates are low in this group, though patients are motivated to quit. ⋯ Of these, 30 (38.5 percent) were found to either quit (16/78) or reduce (14/78) smoking. Varenicline appeared to be particularly effective. Review of the literature and results of this study suggest that smoking cessation pharmacotherapies are effective for SMI patients and should be offered to those who smoke.
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The opioid overdose epidemic is a major threat to the public's health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose.
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This paper discusses the evolution of U. S. policy responses to calls to allow patients to use cannabis for medical purposes. It first summarizes the research evidence on the safety and efficacy of cannabinoids for various medical uses. ⋯ S. states have allowed patients to use cannabis for medical purposes. These include allowing access for research trials only, allowing medical necessity as a defense against prosecution, and allowing commercial medical dispensaries to provide cannabis to approved patients. It argues that liberal definitions of indications for medical cannabis use and the commercialization of medical cannabis supply in California have produced the de facto legalization of recreational cannabis use.
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Review Multicenter Study
Non-Medical Prescription Opioid Use and Prescription Opioid Use Disorder: A Review.
Over the past few decades, there has been a rise in the non-medical use of prescription opioids, which has now reached epidemic proportions in the United States. In some cases, this non-medical use progresses to prescription opioid use disorder, heroin use, injection, and inhalation drug use, all of which may have further devastating consequences. The purpose of this review article is to discuss the epidemiology of the non-medical use of prescription opioids; discuss the potential progression to subsequent prescription opioid use disorder; review the state and national efforts in development to address addiction and diversion in the United States; discuss treatment options; and, lastly, to evaluate the impact of the related stigma to the development of opioid use disorder. Many unanswered questions remain, and we will explore future possibilities in how the medical community can play a role in curbing this epidemic.