Substance Abuse

Jan 01, 2022 Issue
Harm Reduction for Patients With Substance Use Disorders [Curbside Consultation]

Patients engaged in high-risk activities are often ambivalent about changing their behavior. Harm reduction is an approach that focuses on limiting harm and improving quality of life for patients who persist with high-risk behaviors; the foundations of harm reduction are pragmatism and compassion. T...

Dec 01, 2021 Issue
Cannabis Essentials: Tools for Clinical Practice [Article]

Cannabis use in the United States is increasing annually in people of all ages. This increase is fueled by state-level legalization, decreased risk perception, and increased social acceptability. Cannabis and its active components, cannabinoids, have been studied for medical uses and marketed in man...

Sep 01, 2021 Issue
Neonatal Abstinence Syndrome: A Call for Mother-Infant Dyad Treatment Approach [Editorials]

Neonatal abstinence syndrome (NAS) is a constellation of symptoms observed in newborns exposed to opioids during pregnancy. The incidence of NAS has steadily increased during the past decade as more infants have been born to mothers with opioid use disorder (OUD). Pregnancy and the postpartum period...

Mar 1, 2021 Issue
Caring for the Physician Affected by Substance Use Disorder [Curbside Consultation]

A 34-year-old physician, H.M., is an established patient in my practice. H.M. presents for a follow-up visit after finishing inpatient treatment for opioid use disorder.

Feb 15, 2021 Issue
Performance-Enhancing Drug Use in Recreational Athletes [Editorials]

Family physicians may be surprised to learn the number of their patients who use performance-enhancing drugs, either deliberately to improve athletic performance or unknowingly through contaminated dietary supplements.

Jan 15, 2021 Issue
Screening for Unhealthy Drug Use: Recommendation Statement [U.S. Preventive Services Task Force]

The USPSTF recommends screening by asking questions about unhealthy drug use in adults age 18 years or older. Screening should be implemented when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred.

Jan 15, 2021 Issue
Evidence Lacking to Support Universal Unhealthy Drug Use Screening [Editorials]

To address the growing problem of unhealthy drug use, the U.S. Preventive Services Task Force (USPSTF) recently updated its recommendations on screening for unhealthy drug use in adults and adolescents. For the first time, the USPSTF recommends screening adults 18 years and older by asking about unhealthy drug use.

Oct 15, 2020 Issue
Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults [Putting Prevention into Practice]

M.P. is a 14-year-old patient who comes to your office for a well-child visit. After taking a history and conducting a physical examination, you conclude that the patient is doing well. M.P. eats a healthy diet at home and is part of a local soccer league.

Oct 15, 2020 Issue
Primary Care–Based Interventions to Prevent Illicit Drug Use: Recommendation Statement [U.S. Preventive Services Task Force]

The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults

Jul 1, 2020 Issue
Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder Treatment [Graham Center Policy One-Pagers]

Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family physicians.

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