Substance Abuse

May 15, 2004 Issue
Routine Screening for Depression, Alcohol Problems, and Domestic Violence [Point-of-Care Guides]

During routine office visits, primary care physicians are expected to efficiently and effectively screen their patients for common, important conditions. Routine screening for depression is recommended by the U.S. Preventive Services Task Force (USPSTF) as long as systems are in place to ensure accu...

Nov 15, 2003 Issue
Common Problems in Patients Recovering from Chemical Dependency [Article]

Chemical dependency is a common, chronic disease that affects up to 25 percent of patients seen in primary care practices. The treatment goal for patients recovering from chemical dependency should be to avoid relapse. This requires physicians to have an open, nonjudgmental attitude and specific exp...

Sep 1, 2003 Issue
Recognition and Prevention of Inhalant Abuse [Article]

Inhalant abuse is a prevalent and often overlooked form of substance abuse in adolescents. Survey results consistently show that nearly 20 percent of children in middle school and high school have experimented with inhaled substances. The method of delivery is inhalation of a solvent from its contai...

Jun 15, 2001 Issue
Methadone Therapy for Opioid Dependence [Article]

The 1999 Federal regulations extend the treatment options of methadone-maintained opioid-dependent patients from specialized clinics to office-based opioid therapy (OBOT). OBOT allows primary care physicians to coordinate methadone therapy in this group with ongoing medical care. This patient group ...

Dec 1, 2000 Issue
Gamma-Hydroxybutyrate (GHB): A Newer Drug of Abuse [Article]

Gamma-hydroxybutyrate (GHB) is an illicitly marketed substance that has recently gained popularity among body builders and party attendees as a drug of abuse. GHB is a depressant that acts on the central nervous system. It is purported as a strength enhancer, euphoriant and aphrodisiac and is one of...

May 1, 2000 Issue
An Approach to Drug Abuse, Intoxication and Withdrawal [Article]

The symptomatic effects of drug abuse are a result of alterations in the functioning of the following neurotransmitters or their receptors: acetylcholine, dopamine, gamma-aminobutyric acid, norepinephrine, opioids and serotonin. Anticholinergic drugs antagonize acetylcholine receptors. Dissociative ...

Apr 15, 2000 Issue
Addiction: Part II. Identification and Management of the Drug-Seeking Patient [Article]

The medications most often implicated in prescription drug abuse are opioid analgesics, sedative-hypnotics and stimulants. Patients with acute or chronic pain, anxiety disorders and attention-deficit disorder are at increased risk of addiction comorbidity. It is important to ask patients about their...

Apr 1, 2000 Issue
Addiction: Part I. Benzodiazepines-Side Effects, Abuse Risk and Alternatives [Article]

Benzodiazepines are widely prescribed for a variety of conditions, particularly anxiety and insomnia. They are relatively safe and, with overdose, rarely result in death. However, used chronically, benzodiazepines can be addicting. These agents are often taken in combination with other drugs of abus...

Dec 01, 1999 Issue
Marijuana: Medical Implications [Article]

Over 50 percent of people will use marijuana sometime in their life. While intoxication lasts two to three hours, the active ingredient in marijuana, delta-9-tetrahydro-cannabinol, can accumulate in fatty tissues, including the brain and testes. Adverse effects from marijuana use include decreased c...

Dec 01, 1999 Issue
Is My Colleague Overprescribing Narcotics? [Curbside Consultation]

Physicians regularly face the ethical dilemma of determining whether the prescribing habits of a colleague are appropriate, and must then decide how to deal with that person. Such situations can engender hostility and resentment among colleagues and are rarely easily handled.

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