Addiction - Articles - Page 9 | CARLAT PUBLISHING

Note From the Editor-in-Chief

October 1, 2018

Bachaar Arnaout, MD Editor-in-Chief

Addiction spares no age group, but it often goes undetected in older adults age 65 or older, and its treatment poses age-specific challenges.

Alcohol Use Disorder Meds in Older Adults

October 1, 2018

Rehan Aziz, MD, FAPA

Rehan Aziz, MD, FAPA Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

How should we employ pharmacotherapies for alcohol use disorder (AUD) in older adult patients? There are three FDA-approved medications (acamprosate, disulfiram, and naltrexone) and two other commonly used off-label agents (gabapentin and topiramate).

Substance Use Disorder in Older Adults

October 1, 2018

David Oslin, MD

David Oslin, MD Professor of Psychiatry, Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania Medical Center Dr. Oslin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

As we age, we are more vulnerable to a lot of things—the same amount of alcohol or the same amount of any of these substances is going to cause more impairment in an older person vs a younger one. As an example, our stability and gait can worsen as we get older, so any substance that affects gait or balance will have a larger effect.

Low-Risk Drinking Limits: What Should We Tell Older Adult Patients?

October 1, 2018

Thomas Jordan, MD, MPH

Thomas Jordan, MD, MPH Contributing writer to the Carlat newsletters Dr. Jordan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

How much can our older patients safely drink? And what does “safe” or “low-risk” drinking actually mean? The National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is the branch of the NIH that focuses on problems related to alcohol, has released guidelines for low-risk drinking limits in older patients.

Opioids Not Superior to Other Medicines for Some Chronic Pain

October 1, 2018

Rehan Aziz, MD

Rehan Aziz, MD Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Rising rates of opioid overdose deaths have sounded alarm bells over opioid prescribing practices for chronic pain. Unfortunately, and despite the absence of quality data on their risks vs benefits, long-term opioid management has remained a common approach to managing chronic musculoskeletal pain.

Sleep Apnea in Patients With Substance Use Disorders: A Primer

August 23, 2018

Rehan Aziz, MD

Rehan Aziz, MD Associate Professor of Psychiatry and Neurology, Rutgers University—Robert Wood Johnson Medical School Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

There are three types of sleep apnea: obstructive sleep apnea (OSA), central sleep apnea, and mixed. Of these, OSA is by far the most common, and that’s what we’ll focus on in this article. OSA is caused by excessive relaxation of the throat during sleep, which in some people causes enough obstruction to impede the flow of air.

Treating Insomnia With Addiction

August 23, 2018

Eric Hermes, MD

Eric Hermes, MD Assistant Professor, Department of Psychiatry, Yale School of Medicine, New Haven, CT Dr. Hermes has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

With substance use disorders (SUDs) that are comorbid with chronic insomnia, what would you say are some of the main treatment challenges?

Non-Addictive, Pharmacological Options for Sleep

August 23, 2018

Daniel Carlat, MD

Daniel Carlat, MD Publisher, The Carlat Addiction Treatment Report Dr. Carlat has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

In this month’s interview with Dr. Eric Hermes, we learned about his approach to treating insomnia in patients with substance use disorders, with a focus on cognitive behavioral therapy. In this article, we’ll look at some non-addictive pharmacological options.

Adolescents With ADHD and Substance Use Disorders: A Primer

July 1, 2018

Candace Good, MD

Candace Good, MD Child and adolescent psychiatrist, SunPointe Health, State College, PA Dr. Good has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

You are evaluating a 16-year-old boy referred for mandated substance use treatment by his high school, where he was found drinking alcohol and smoking cannabis with a friend in the restroom.

Talking to Parents and Adolescent Patients About Substance Use

July 1, 2018

Joanna Quigley, MD

Joanna Quigley, MD Associate medical director for Child and Adolescent Ambulatory Services, University of Michigan, Ann Arbor, MI Dr. Quigley has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Since they already often seem two steps ahead of us, with adolescents it can be really helpful to use direct routes. Be very specific in your questions. For example, don’t just ask, “Do you smoke?” Ask, “Are you using any nicotine products? What are you using in your vape?”