A recent study in The Lancet appears to conclude that Vivitrol (extended release naltrexone) and Suboxone (buprenorphine/naloxone) are equally effective treatments for patients with opioid use disorders (Lee JD et al, The Lancet 2018;391(10118):309–318)—at least this is how the study has generally been reported.

Gabapentin (Neurontin) is a “novel anticonvulsant” and is FDA indicated for partial seizures and post-herpetic neuralgia. But the drug has long been heavily marketed to psychiatrists to treat a range of conditions from bipolar disorder to anxiety to alcohol withdrawal

As clinicians, we’re more interested in preventing excessive drinking than curing hangovers. But it’s always nice to have some helpful advice for patients, which we found in a recently published literature review of clinical trials of hangover treatments.

A challenging barrier for patients with opi­oid use disorders is the discomfort that can occur during the “induction phase” of their treatment, which is the period between discontinuation of opioids and initiation of medication-assisted therapy (MAT).

In this article, I’ll start by briefly outlining what the research tells us about the risks of substance use to the fetus. The more informed you are about these risks, the more persuasive and helpful you can be to patients. I’ll then move on to discussing how, as an OB/GYN, I approach the evaluation and treatment of these patients, emphasizing issues of interest to clinicians.

Typically, the most frequent problem that I’m referred is the pregnant patient who’s dependent on opioids. And this could be either someone who’s using illicit drugs, such as heroin, or is prescribed prescription opioids.

Mindfulness is a growing trend in mental health treatment, but it often requires hours of practice to become proficient. What if you could provide your patients with an introductory mindfulness lesson in less than 15 minutes and see meaningful reductions in their risky drinking?

Detox (also known as “medically supervised withdrawal”) refers to treatment to help patients withdraw from substances that cause physical dependence, such as alcohol, sedative-hypnotics, and opioids. But detox is far more than a several-day process of ridding the body of an addictive substance. It should be considered an important component in the overall care and treatment of addiction.

Currently in the US, cannabis has evolved into an issue of individual freedom, leading to full legalization in some states on the presumption that the substance isn’t addictive. Unfortunately, cannabis use disorder is indeed a problem for many patients, Kevin Hill, MD, tells us. In fact, says Dr. Hill, one of the greatest challenges you’ll encounter while treating patients is convincing them that cannabis use disorder is a real thing. Here are some treatment strategies.