Substance Abuse

Jan 1, 2016 Issue
Skin Ulcers of Unknown Etiology [Photo Quiz]

A woman with a long history of cocaine use presented to the emergency department with leg ulcers and ecchymoses on her ears.

Jul 1, 2015 Issue
Nicotine Replacement Therapy for Smoking Cessation [Medicine by the Numbers]

Studies show that 1 in 15 patients successfully quit smoking and 1 in 94 patients experienced chest pain or palpitations. Want to know more?

Jun 15, 2015 Issue
Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children [Putting Prevention into Practice]

J.P. is a 16-year-old white female nonsmoker who presents for a sports clearance physical. She is in good overall health, excels academically, and plays water polo at school. During the patient history, she mentions that she and three friends were suspended from school for drinking cough syrup after a water polo tournament.

Mar 1, 2015 Issue
Primary Care Behavioral Interventions to Reduce Illicit Drug and Nonmedical Pharmaceutical Use in Children and Adolescents: Recommendation Statement [U.S. Preventive Services Task Force]

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral interventions to prevent or reduce illicit drug or nonmedical pharmaceutical use in children and adolescents. This recommendation applies to children and adoles...

Feb 1, 2015 Issue
Buprenorphine Maintenance vs. Methadone Maintenance or Placebo for Opioid Use Disorder [Cochrane for Clinicians]

At dosages greater than 2 mg per day, buprenorphine maintains treatment retention better than placebo. When flexible dosing (doses adjusted based on patient symptoms) is used, the effectiveness of buprenorphine is comparable to that of methadone in suppressing opioid use.

Jul 15, 2013 Issue
A Primary Care Approach to Substance Misuse [Article]

Substance misuse is common among patients in primary care settings. Although it has a substantial health impact, physicians report low levels of preparedness to identify and assist patients with substance use disorders. An effective approach to office-based treatment includes a coherent framework fo...

Jul 1, 2013 Issue
Uncommon Adverse Effects of Commonly Abused Illicit Drugs [Editorials]

Illicit drug use should be considered in the differential diagnosis of many clinical presentations, because the list of known deleterious effects is growing. There are an increasing number of case reports involving uncommon adverse effects of commonly abused illicit drugs.

Sep 15, 2012 Issue
Opioid Dependence [Clinical Evidence Handbook]

What are the effects of drug treatments for stabilization (maintenance), withdrawal, and relapse prevention in persons with opioid dependence?

Oct 1, 2011 Issue
Abuse of Over-the-Counter Medications Among Teenagers and Young Adults [Editorials]

In recent years, recognition of over-the-counter (OTC) medication abuse by patients—especially teenagers and young adults—has increased.1 Abuse is defined as the use of a drug to experience psychoactive effects instead of for its medical indication. OTC medications are easily abused because they are...

Mar 1, 2010 Issue
Urine Drug Screening: A Valuable Office Procedure [Article]

Urine drug screening can enhance workplace safety, monitor medication compliance, and detect drug abuse. Ordering and interpreting these tests requires an understanding of testing modalities, detection times for specific drugs, and common explanations for false-positive and false-negative results. E...

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